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GAAM Vol.

II
Revised January 1992

Appendex 18

REIMBURSEMENT EXPENSES RECEIPT
Date __________________

No. _____________________

Received from ______________________________________________

GAAM Vol. II
Revised January 1992

Appendex 18

REIMBURSEMENT EXPENSES RECEIPT
Date __________________

No. _____________________

Received from ______________________________________________

(Name)

(Name)

_____________________________________________________ the amount

_____________________________________________________ the amount

of _____________________________________________ (Php____________)

of _____________________________________________ (Php____________)

in payment for ___________________________________________________

in payment for ___________________________________________________

(Payment for subsistence, services,

(Payment for subsistence, services,

rental or transportation should show inclusive dates,

rental or transportation should show inclusive dates,

purpose, distance, inclusive points or travel, etc.)

purpose, distance, inclusive points or travel, etc.)

PAYEE

PAYEE

Name/Signature: _________________________________________________

Name/Signature: _________________________________________________

Address: ________________________________________________________

Address: ________________________________________________________

Residence Cert. No.: ______________________________________________

Residence Cert. No.: ______________________________________________

Date of Issue: ____________________________________________________

Date of Issue: ____________________________________________________

Place of Issue: ________________

Place of Issue: ___________________________________________________

WITNESS

WITNESS

Name/Signature: _________________________________________________

Name/Signature: _________________________________________________

Address: ________________________________________________________

Address: ________________________________________________________

Residence Cert. No.: ______________________________________________

Residence Cert. No.: ______________________________________________

Date of Issue: ____________________________________________________

Date of Issue: ____________________________________________________

Place of Issue: ___________________________________________________

Place of Issue: ___________________________________________________

______)
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Taxi Fare Voiture Taxi 17689 06/25/15 82./Docketed No.00 Taxi Fare Arlyn Mea Taxi 2318 06/25/15 92.Summary of Expenses Program / Activity ROD MYPA Description Payee GRAND TOTAL Prepared by: WENA C.00 Taxi Fare RGSM Taxi 25405 06/26/15 92.326.00 Taxi Fare Davtransco Taxi 011390 07/03/15 50.00 Taxi Fare Datts Taxi 6658 06/22/15 274.50 Taxi Fare Mabuhay Taxi 2201 06/08/15 61.TINIO TESDS II Date 10225 07/03/15 1.00 Taxi Fare Maro Taxi 14107 06/26/15 131.00 Amount Meals (Snacks) Greenwich Meals (Lunch) Penongs Lanang 01010343 07/03/15 1.001.50 Taxi Fare Visa Cab 11135 06/22/15 274.00 Fare & Softdrinks Conduct of Compliance Audit (Assessment) Receipt No.550.50 Taxi Fare Lago Grande 164 06/25/15 103.50 3.50 RER 07/03/15 62.50 .

00 Pinakbet Edong's Lechon Manok 017193 08/28/15 280.00 Jeepney Fare RER 08/28/15 32. TESDS Description Payee Receipt No.00 Softdrinks & Rice RER 08/28/15 99. GONZALES SR.00 2. Date Amount Meals Uloy's Ihaw-ihaw 31444 08/28/15 600.00 Meals Freemont Foods Corporation 11003 08/28/15 360.00 Meals Freemont Foods Corporation 11006 08/28/15 643.014.Summary of Expenses Program / Activity RE-ECHO ON ENHANCE CURRICULUM GRAND TOTAL Prepared by: JEAN C.00 .

00 Purpose: For MoNet and Scholarship use REQUESTED BY : Signature Printed Name Designation APPROVED BY : ARLYN S. Rimas St. CESO III Regional Director . Aquino Subd.000. Davao City 616 Interior 2.D. ROD GASPAR S. JP Laurel Avenue.000.00 12.. Ph.. Davao City Regional Office XI (Agency) Department: Section ROD Stock No. BANDONG Chief.TESDA Standard Form Number: SF-GOODE-59 Revised On: May 24.. 2004 Standard Form Title: Purchase Request Project Reference Number: Name of Project: Location of the Project: N/A N/A N/A PURCHASE REQUEST Technical Education and Skills Development Authority.000.00 06-Aug-15 Total Cost 12. Unit unit PR No : SAI N o : Item Description Computer Monitor 19" Date : Date : Quantity Unit Cost 2 6. GAYONA.

: Company Name: ______________________________________________________________________________ Address: ____________________________________________________________________________________ Please quote your lowest price on the item/s listed below. Aquino Subd. 2004 Standard Form Title : Request for Quotation Date: Aug. I/ We quote you on the item at prices noted above.subject to the General Conditions on the last page. 2. G-EPS REGISTRATION CERTIFICATE SHALL BE ATTACHED UPON SUBMISSION OF THE QUOTATION. BIDDERS SHALL SUBMIT ORIGINAL BROCHURES SHOWING CERTIFICATIONS OF THE PRODUCT BEING OFFERED. Davao City Telephone Nos. Printed Name & Signature _____________________ Tel.. ONE YEAR FOR EQUIPMENT. 6.. 4. ALL ENTRIES MUST BE TYPEWRITTEN. 221-8778/222-2294 Standard Form Number: SF-GOOD-60 Revise on: May 24. 2015 Quotation No. JP Laurel Avenue./ Cellphone # e-mail address _______________________ Date . stating the shortest time of delivery and submit your quotation duly signed by your representative not later than _________________ in the return envelop attached herewith. 6. 5. FROM THE DATE OF ACCEPTANCE OF THE PROCURING ENTITY. WARRANTY SHALL BE FOR A PERIOD OF SIX (6) MONTHS FOR SUPPLIES & MATERIALS. No. Rimas St.Project Reference Number: N/A Name of the Project: N/A Location of the Project: N/A TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY 616 Interior 2. 1 ITEM & DESCRIPTION Computer Monitor 19" QTY 2 UNIT PRICE units For MoNet and Scholarship use Brand & Model: __________________________ Delivery Period: __________________________ Warranty: __________________________ Price Validity: __________________________ After having carefully read and accepted your General Conditions. ITEM NO. UDALVE Procurement Officer NOTE: 1. WILMA G. DELIVERY PERIOD WITHIIN __________ CALENDAR DAYS 3. PRICE VALIDITY SHALL BE FOR A PERIOD OF ___________ CALENDAR DAYS.

JP Laurel Avenue. TESDA Office XI of the following: TO BE DELIVERED WITHIN_________ WORKING DAYS AFTER RECEIPTS OF AWARD No. No___________________________ TIN _________________________________________________________ Total Price P____________ . 616 Interior 2.Republic of the Philippines TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY XI Regional Office. Ph. Date: 6-Aug-15 NOTICE TO BIDDERS: Sealed bids subject to the conditions consigned herein will be received at the Technical Education and Skills Development Authority Office XI. ________2014 publicly opened for the furnishing POB. Aquino Subd.D. or Non Vat Taxpayer Reg. Davao City on or before 10:00 Am dated on ... 221-8778.. Unit NAMES AND DESCRIPTION OF ARTICLES 1 1 unit Router Unit Price P_____________ TERESITA Y. GAYONA. Name of Establishment________________________________________ Business/Trade Name_________________________________________ Principal Place of Business____________________________________ Vat No. RODA GASPAR S. 222-2294. CESO III Canvasser Regional Director The above are our quoted for items called for and I/We hereby certify that the above articles are our bonafide stock. In case of failure on our part to furnish the above materials and or equipment within____working days from the date of receipt of the order we agree to pay the penalty imposed one tenth (1/10) of the percent per day of delay the diferent in price should there be any other expenses that the government may incure in securing articles from the dealers and therefore authorizing the TESDA Disbursing Officer to deduct the value of the penalty imposed from any money due or which may become due us. Qty. Rimas St. Davao City Telephone Nos.

JP Laurel Avenue. CAGUIAT Accountant IV Name of End User Check No.. O.00 . Ph.TESDA Standard Form Number: SF-GOODE-58 Revised On: May 24.00 unit Optical Mini Mouse 1 680.. Davao City 616 Interior 2. Delivery Term: Payment Term: Unit Description Quantity Unit Cost units Computer Monitor 19" 2 5. GONZALES GASPAR S.014. JEAN C.D.00 11. 2004 Standard Form Title: Purchase Order Project Reference Number: Name of Project: Location of the Project: PURCHASE ORDER Technical Education and Skills Development Authority..: 2. Davao City Name of Procuring Entity Supplier JEAN C. Aquino Subd.590. TIN Gentlement Please furnish this office the following articles subject to the terms and conditions contained herein : Place of Delivery Date of Delivery Stock No. GAYONA.00 680. GONZALES P. Address Date Email Address Mode of Procurement Telephone No.00 In case of failure to make the full delivery the time specified above.00 (Total Amount in Words) Eleven thousand eight hundred sixty pesos only 2.: Amount: Source of Fund: MIREY LOVE C. Rimas St.014. CESO III (Signature Over Printed Name) Regional Director (Authorized Officials) (Date) Date Funds Available: OR No. of one-tenth (1/10) of one percent for every day of delay shall be imposed. a penalty .180.

Davao City (Agency) Supplier: JEAN C.00 Registered Programs and Accredited Assessment Centers Inspected.00 Partial (pls. 2 Unit Date : 12/31/14 Total 10. Unit page Invoice No.000. verified and found OK as to quantity and specifications JOEL A. GONZALES IAR No : PO No. Stock No. UDALVE Supply Officer .000. Requisitioning Office/Dept. specify quantity) WILMA G.Appendix 64 INSPECTION & ACCEPTANCE REPORT Technical Education and Skills Development Authority.0140 Description Publication of 2014 Compendium of Qty. ATABLANCO Inspection Officer For Property Officer Use 20.000.00 20.

111. RAÑON Provisional Member ADONIS F.00 2. 2014 NO. 221-8778 and 222-2294 July 18. 1 is Nanay Bebeng Culinary Enterprises. BANDONG Chairman . Unit 1 5 pax Description Meals . LAUREL Vice-Chair ARLYN S. Inc. GONZALES Reg. 2. QTY. CULAS Provisional Member JEAN C. Inc. due to lower costs MELBA A. Member DORLITA B.200.Dinner Nanay Bebeng Culinary Enterprises.325.Republic of the Philippines Technical Education and Skills Development Authority XI ABSTRACT OF BIDS Tel. Nos.20 Chippens Yellow Fin Seafood Restaurant 2.00 Item no.

JUMDANA JEAN C.00 Registered Programs and Accredited Assessment Centers Purpose: Requested By : JEAN C. TESDS . XI 616 Interior 2. 2004 Standard Form Title: Requisition and Issuance Slip REQUISITION AND ISSUANCE SLIP Technical Education and Skills Development Authority. SAI No. No. RequIsItIon Stock No.Appendix 50 TESDA Standard Form Number SF-GOOD-61 Revised on: May 24.00 Approved By : WILMA G. JP Laurel Avenue. Rimas Street.Regional Office RIS No.00 20. Asst.000. GONZALES Sr. Davao City Regional Office XI. 221-8778 DIVISION: ROD OFFICE: TESDA XI .000. UDALVE Supply Officer V Issued By : Received By : MALANGKA S. Tel. TESDS 20. GONZALES Adm.000. Unit page Description Publication of 2014 Compendium of Quantity 2 Unit Remarks 10. Aquino Subdivision. III Sr.

OBLIGATION REQUEST Payee JEAN C.014. Allotment available and obligated for the Purpose as indicated above Supporting documents valid.. Charges to appropriation/allotment necessary. Rimas St.014.. proper and legal Signature Printed Name A . A Certified . ROD Printed Name B . BANDONG Chief.A Account Code Amount To reimbursement of expenses spent during re-echo on enhanced curriculum as per supporting papers hereto attached in the amount of… A. GONZALES Office Address Davao City Responsibility Center P.00 Total Certified B .00 2. Davao City Regional Office XI No. VILLAFLOR Administrative Officer V Head. JP Laurel Avenue. lawful and under my direct supervision 2. Aquino Subd. Requesting Officer/Authorized Representative Date YOLANDA S. Position Signature ARLYN S. Budget Unit/Authorized Representative Date . Position Head.Annex A1 Republic of the Philippines TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY 616 Interior 2.P.

CESO III Regional Director Agency Head/Authorized Representative Date Date Bank Name Date Printed Name D JEV NO. Signature Official Receipt/Other Documents Date: . Payee Others OR/BUR No.014. CAGUIAT Accountant IV Printed Name Position Head. Rimas St. Commercial Check ADA TIN/Employee No. Aquino Subd.D.. GONZALES Office/Unit/Project Address Code Davao City EXPLANATION AMOUNT To reimbursement of expenses spent during re-echo on enhanced curriculum as per supporting papers hereto attached in the amount of… 0 2.Annex B Republic of the Philippines TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY 616 Interior 2.00 A Certified: B Approved for Payment: Cash Available Supporting documents complete and proper Subject to ADA (where available) Signature Signature Printed Name Position MIREY LOVE C.00 0 2. Davao City Regional Office XI DISBURSEMENT VOUCHER MODE OF PAYMENT MDS Check No. GAYONA. JP Laurel Avenue.014. JEAN C. ADA No. Ph. Accounting Unit/Authorized Representative Date C Received Payment: Check/ GASPAR S...

GASPAR S. land transport. GAYONA. Davao City You are hereby directed to travel on official business via Cebu Pacific. Place : Duration: Purpose: Davao del Sur Dcember 10. 2014 Attendance to the Local Poverty Reduction Action Team Orientation It is understood that a report shall be submitted upon completion of this travel.D. and/or sea transport. 2014 Attendance to the Local Poverty Reduction Action Team Orientation It is understood that a report shall be submitted upon completion of this travel. land transport.. and/or sea transport. _________ Name : ADONIS F.TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY Region XI. CESO III Regional Director Authorized Representative TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY Region XI. CULAS Station : TESDA XI . GAYONA.D. CESO III Regional Director Authorized Representative . Ph. Ph.RO. Davao City TRAVEL ORDER No. CULAS Station : TESDA XI . _________ Name : ADONIS F. Davao City TRAVEL ORDER No. GASPAR S.RO. Davao City You are hereby directed to travel on official business via Cebu Pacific. Place : Duration: Purpose: Davao del Sur Dcember 10..

10-Dec-14 Davao City .00 Prepared by: I certify that : (1) I have reviewed the foregoing itinerary . BANDONG Supervisor ADONIS F.00 . GAYONA.. Davao City Region XI No. Arrival Transpo. CULAS Attendance to the LPRAT Orientation TIME Date Expenses Places to be Visited Means of Depart. CESO III Regional Director Total 320. Aquino Subd. ARLYN S. Name: Purpose of Travel: ADONIS F.. CULAS Official/Employee Approved by: GASPAR S. (2) the travel is necessary to the service.D. Rimas St. Ph.Davao del Sur 6:30 AM 9:00 AM RP Vehicle 10-Dec-14 Davao del Sur .00 320.00 320. (3) the period foregoing itinerary . (2) the travel is covered is reasonable and (4) the expenses claimed are proper. JP Laurel Avenue.Davao City 6:30 PM 9:00 AM RP Vehicle TOTAL FARE ALLOW - 0..00 320.Appendix 46 ITINERARY OF TRAVEL TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY 616 Interior 2.

CESO III Agency Head Regional Director Position TESDA Regl. Other deviations as explained below: Explanation or justification: Evidence of Travel: x Appendix B Plane Ticket/Bus x Certificate of Appearance Others: Respectfully Submitted: ADONIS F. R.. Office XI Station 10-Dec-14 DATE I CERTIFY THAT I have completed the travel authorized in Itinerary of Travel No.D. was refunded under O.TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY Agency CERTIFICATE OF TRAVEL COMPLETED GASPAR S. GAYONA. CULAS Sr. TESDS On evidence and information of which I have knowledge. Extended as explained below. _________. BANDONG Supervisor . Ph. the travel was actually undertaken. additional itinerary was submitted. 2012 under conditions indicated below: x Strictly in accordance in the approved itinerary. ARLYN S. Cut short as explained below. dated December 26. payment in the amount of P ________. No. dated ______________.

_____________DTD_________ AMOUNT TO BE REIMBURSE A Certified: Correctness of the A above date ALBERT N. 2012 ### 2.00 TOTAL AMOUNT SPENT AMOUNT OF CASH ADVANCE PER DV NO. Date: 8-Oct-12 Responsibility Center Code: ALBERT N.Appendix 58 LIQUIDATION REPORT TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY (Agency) No. . MANINGO B Certified: Purpose of travel/cash advance duly accomplished ARLYN S. No. 12-08-900 Dtd.00 2. MANINGO PARTICULARS AMOUNT Liquidation of cash advance granted for traveling expenses during the ROD Team B at Surigao del Sur on October 4-6.400. AMOUNT REFUNDED PER OR NO.400. BANDONG Immediate Supervisor Claimant C Certified: Supporting documents complete and proper MIREY LOVE C. CAGUIAT Accountant IV JEV.

Republic of the Philippines TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY Rimas St.400.00 Each Official whose name appears above has been paid the amount indicated opposite his/her name.P. CAGUIAT Accountant IV Noted by: ARLYN S. Aquino Village.75 Total Number of Hours Total 32 1. PEDARIOS Cashier MIREY LOVE C. J. ROD . of Working days Gross Minutes Late 350 4 1400. Davao City PAYMENT OF SALARY December 2013 NAME OF PERSONNEL JESSIELO C. Laurel Avenue.. BANDONG Chief TESD Specialist.00 0 Rate per Undertime hour hours 43. GUBALANI Rate per Day No. Certified by: EVANGELINE C.

Rimas St. CAGUIAT Accountant IV Noted by: ARLYN S..50 0 8 Total 8. MANINGO Rate per Day No.P. Certified by: KRISTI DONNA N. of Working days Gross Minutes Late 620 13 8060. 2. Davao City PAYMENT OF SALARY December 16-31. PAREDES HRMO MIREY LOVE C.00 0 Rate per Undertim Overtime hour e (in hours) 77.00 Each Official whose name appears above has been paid the amount indicated opposite his/her name. BANDONG Chief TESD Specialist. J. Laurel Avenue. Aquino Village. ROD .Republic of the Philippines TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY 616 Int.680. 2014 NAME OF PERSONNEL ALBERT N.

040. Prepared by: EVANGELINE C.960. JP Laurel Avenue..00 THELMA M.00 ALBERT N.840..00 TOTAL Each Official whose name appears above has been paid the amount indicated opposite his/her name. REQUILLO TESDS II 1. MANINGO JOB ORDER 1. BANDONG CHIEF ROD 1.040. Rimas St. PEDARIOS Cashier 4.Republic of the Philippines TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY 616 Interior 2.00 SIGNATURE .00 ARNULFO L. PELAYO DRIVER 1. Davao City PAYROLL NAME OF PERSONNEL DESIGNATION AMOUNT ARLYN S. Aquino Subd.040.

2014 PANTAWID PAMILYA BENEFICIARIES AS OF MAY 20. 2014 PANTAWID PAMILYA BENEFICIARIES AS OF MAY 20. 2014 PANTAWID PAMILYA BENEFICIARIES AS OF MAY 20.PANTAWID PAMILYA BENEFICIARIES AS OF MAY 20. 2014 .