New Purchase-Request

PURCHASE REQUEST
Entity Name: Mayor Fund Cluster: General Fund

Office/Section :_________ PR NO.:__________________ Date:_______________
Resoponsibilty Center Code:_____________
Stock/Property No. Unit Item Description Quantity Unit Cost Total Cost
1 pax snacks 52 85.00 4,420.00
4,420.00
Purpose : For Peace and Order Meeting on August 31, 2018.
Requested by : Approved by:

Signature: __________________________ ____________________________
Printed Name: ANGELES R. CARLOTO II ANGELES R. CARLOTO II
Designation: Municipal Mayor Municipal Mayor
PURCHASE REQUEST
RHU Fund Cluster: TF-PFPR
Resoponsibilty Center Code:_______
1 pax meals 16 250.00 4,000.00
Total 4,000.00
Purpose : For Medical/Dental/Surgical Outreach at Brgy. Situbo , Tampilisan,Z.N. on May 16, 2018

Signature: __________________________ ____________________________
Printed Name: CARMEL MATHILDA B. LADEZA ANGELES R. CARLOTO II
Designation: Mun. Health Officer Municipal Mayor
PURCHASE REQUEST
MDRRMO Fund Cluster: General Fund

1 kg dress chicken 30 170.00 5,100.00
2 tray egg 1 190.00 185.00
3 bot oil 30 20.00 600.00
4 doz noodles (lucky me) 5 100.00 500.00
5 pc crispy fry 30 17.00 510.00
6 pck tocino 30 50.00 1,500.00
7 bot water 10 20.00 200.00
8 pc soy sauce 30 6.00 180.00
9 pc catsup 30 13.00 390.00
10 pc venigar 30 5.00 150.00
11 kg garlic 1 120.00 120.00
12 kg onion 1 120.00 120.00
13 kg salt 1 20.00 20.00
14 pck magic sarap 1 38.00 38.00
15 pc ajinomoto 13 2.00 26.00
16 pck ham 30 50.00 1,500.00
17 pc paminta 30 5.00 150.00
18 tie kopiko 70 12.00 780.00
19 pc milo 10 9.00 840.00
20 pc paminta 1 1.00 1.00
Total 12,910.00
Purpose: For LDRRMO operations/ food for the responders.

Signature: __________________________ ____________________________
Printed Name: ENGR. GODFREY B. GIMON ANGELES R. CARLOTO II
Designation: MDRRMODesignate/Municipal Assessor Municipal Mayor
Total -
Purpose : For LDRRM Operations /food for the responders.

Signature: __________________________ ____________________________
Designation: MDRRMO/ Mun. Assessor Municipal Mayor
PURCHASE REQUEST
MDRRMO Fund Cluster:

1 kg assorted spices 120.00 49.00
2 pck banana blossoms 2 5.00 10.00
3 kg banana 21.00
4 pck egg 6 7.00 42.00
5 pck oil 4 10.00 40.00
6 pck tidbits 1 18.00 18.00
7 can black beans 1 15.00 15.00
8 pck salt 1 5.00 5.00
9 pck salt 1 2.00 2.00
10 pc ajinomoto 1 2.00 2.00
11 pck venigar 1 7.00 7.00
12 pck venigar 1 5.00 5.00
13 pc magic sarap 1 4.00 4.00
14 kg sari2x vegetable 19.00
15 kg pork 1.5 190.00 285.00
16 pc twin blanca
17
18
19
20
21
Total 524.00

Signature: __________________________ ____________________________
Designation: MDRRMO/Mun.Assessor Municipal Mayor
PURCHASE REQUEST
Mayors Office Fund Cluster: General Fund

sub-total #REF!
85 pc. tarpaulin 4x5 1 1,400.00 1,400.00
86 pcs. Puto 800 2.50 2,000.00
87 pc. cake 1 650.00 650.00
88 pc. lechon 1 4,700.00 4,700.00
89 rental sound system 1,500.00
90 kl fish 2 101.50 203.00
91 boat hired to bayangan island 1,000.00
92 meters trapal 10 98.00 980.00
93 ball strawless 1 120.00 120.00
94 meals 1,580.00
95 pack styro 30 38.00 1,140.00
96 meters Pepsi 25 15.00 375.00
97 assorted items 1,239.00
98 Firewood & uling 1,500.00
99 case softdrinks 8 175.00 1,400.00
100 bot wine 6 250.00 1,500.00
100 liter Diesel 15.38 32.50 500.00
Purpose : For Civil Service Family Day September 9, 2017.

Signature: __________________________ ____________________________
PURCHASE REQUEST
DEP ED Fund Cluster: SEF
1 pcs. volleyball ball 2 860.00 1,720.00
2 pc. volleyball net 1 710.00 710.00
3 pc. basketball ball 1 1,000.00 1,000.00
4 pc. table tennis net 1 885.00 885.00
5 tubes table tennis ball 2 605.00 1,210.00
Total 5,525.00
Purpose : For District Games

Signature: __________________________ ____________________________
Printed Name: ANTONIO S. GUMELA.E.M.D ANGELES R. CARLOTO II
Designation: District Supervisor Municipal Mayor
PURCHASE REQUEST

1 kg dress chicken 30 170.00 5,100.00
2 tray egg 1 190.00 185.00
3 bot oil 30 20.00 600.00
5 pc crispy fry 30 17.00 510.00
6 pck tocino 30 50.00 1,500.00
7 bot water 10 20.00 200.00
8 pc soy sauce 30 6.00 180.00
9 pc catsup 30 13.00 390.00
10 pc venigar 30 5.00 150.00
11 kg garlic 1 120.00 120.00
12 kg onion 1 120.00 120.00
13 kg salt 1 20.00 20.00
15 pc ajinomoto 13 2.00 26.00
16 pck ham 30 50.00 1,500.00
17 pc paminta 30 5.00 150.00
18 tie kopiko 70 12.00 780.00
19 pc milo 10 9.00 840.00
20 pc paminta 1 1.00 1.00
Total 12,910.00

Signature: __________________________ ____________________________
Total -

Signature: __________________________ ____________________________
PURCHASE REQUEST

3 kg banana 21.00
4 pck egg 6 7.00 42.00
5 pck oil 4 10.00 40.00
6 pck tidbits 1 18.00 18.00
8 pck salt 1 5.00 5.00
9 pck salt 1 2.00 2.00
11 pck venigar 1 7.00 7.00
12 pck venigar 1 5.00 5.00
15 kg pork 1.5 190.00 285.00
16 pc twin blanca
17
18
19
20
21
Total 524.00

Signature: __________________________ ____________________________
PURCHASE REQUEST

sub-total #REF!
85 pc. tarpaulin 4x5 1 1,400.00 1,400.00
86 pcs. Puto 800 2.50 2,000.00
87 pc. cake 1 650.00 650.00
88 pc. lechon 1 4,700.00 4,700.00
90 kl fish 2 101.50 203.00
92 meters trapal 10 98.00 980.00
93 ball strawless 1 120.00 120.00
94 meals 1,580.00
95 pack styro 30 38.00 1,140.00
96 meters Pepsi 25 15.00 375.00
99 case softdrinks 8 175.00 1,400.00
100 bot wine 6 250.00 1,500.00
100 liter Diesel 15.38 32.50 500.00

Signature: __________________________ ____________________________
PURCHASE REQUEST
MTO Fund Cluster: General
1 pack Disposable spoon 1 25.00 25.00
2 pc. paper clip big 1 35.00 35.00
3 pc. paper clip small 1 15.00 15.00
4 pack rebisco 1 48.00 48.00
5 bot wilkins 10 10.00 100.00
6 pc. nescafe 1 178.00 178.00
Total 401.00

Signature: __________________________ ____________________________
PURCHASE REQUEST

1 kg dress chicken 30 170.00 5,100.00
2 tray egg 1 190.00 185.00
3 bot oil 30 20.00 600.00
5 pc crispy fry 30 17.00 510.00
6 pck tocino 30 50.00 1,500.00
7 bot water 10 20.00 200.00
8 pc soy sauce 30 6.00 180.00
9 pc catsup 30 13.00 390.00
10 pc venigar 30 5.00 150.00
11 kg garlic 1 120.00 120.00
12 kg onion 1 120.00 120.00
13 kg salt 1 20.00 20.00
15 pc ajinomoto 13 2.00 26.00
16 pck ham 30 50.00 1,500.00
17 pc paminta 30 5.00 150.00
18 tie kopiko 70 12.00 780.00
19 pc milo 10 9.00 840.00
20 pc paminta 1 1.00 1.00
Total 12,910.00

Signature: __________________________ ____________________________
Total -

Signature: __________________________ ____________________________
PURCHASE REQUEST

3 kg banana 21.00
4 pck egg 6 7.00 42.00
5 pck oil 4 10.00 40.00
6 pck tidbits 1 18.00 18.00
8 pck salt 1 5.00 5.00
9 pck salt 1 2.00 2.00
11 pck venigar 1 7.00 7.00
12 pck venigar 1 5.00 5.00
15 kg pork 1.5 190.00 285.00
16 pc twin blanca
17
18
19
20
21
Total 524.00

Signature: __________________________ ____________________________
PURCHASE REQUEST

sub-total #REF!
85 pc. tarpaulin 4x5 1 1,400.00 1,400.00
86 pcs. Puto 800 2.50 2,000.00
87 pc. cake 1 650.00 650.00
88 pc. lechon 1 4,700.00 4,700.00
90 kl fish 2 101.50 203.00
92 meters trapal 10 98.00 980.00
93 ball strawless 1 120.00 120.00
94 meals 1,580.00
95 pack styro 30 38.00 1,140.00
96 meters Pepsi 25 15.00 375.00
99 case softdrinks 8 175.00 1,400.00
100 bot wine 6 250.00 1,500.00
100 liter Diesel 15.38 32.50 500.00

Signature: __________________________ ____________________________
PURCHASE REQUEST
1 kilos rice 25 60.00 1,500.00
2 kilos pork 20 195.00 3,900.00
3 kilos chicken 20 165.00 3,300.00
4 assorted spices 1,100.00
Total 9,800.00

Signature: __________________________ ____________________________
PURCHASE REQUEST

1 kg dress chicken 30 170.00 5,100.00
2 tray egg 1 190.00 185.00
3 bot oil 30 20.00 600.00
5 pc crispy fry 30 17.00 510.00
6 pck tocino 30 50.00 1,500.00
7 bot water 10 20.00 200.00
8 pc soy sauce 30 6.00 180.00
9 pc catsup 30 13.00 390.00
10 pc venigar 30 5.00 150.00
11 kg garlic 1 120.00 120.00
12 kg onion 1 120.00 120.00
13 kg salt 1 20.00 20.00
15 pc ajinomoto 13 2.00 26.00
16 pck ham 30 50.00 1,500.00
17 pc paminta 30 5.00 150.00
18 tie kopiko 70 12.00 780.00
19 pc milo 10 9.00 840.00
20 pc paminta 1 1.00 1.00
Total 12,910.00

Signature: __________________________ ____________________________
Total -

Signature: __________________________ ____________________________
PURCHASE REQUEST

3 kg banana 21.00
4 pck egg 6 7.00 42.00
5 pck oil 4 10.00 40.00
6 pck tidbits 1 18.00 18.00
8 pck salt 1 5.00 5.00
9 pck salt 1 2.00 2.00
11 pck venigar 1 7.00 7.00
12 pck venigar 1 5.00 5.00
15 kg pork 1.5 190.00 285.00
16 pc twin blanca
17
18
19
20
21
Total 524.00

Signature: __________________________ ____________________________
PURCHASE REQUEST

sub-total #REF!
85 pc. tarpaulin 4x5 1 1,400.00 1,400.00
86 pcs. Puto 800 2.50 2,000.00
87 pc. cake 1 650.00 650.00
88 pc. lechon 1 4,700.00 4,700.00
90 kl fish 2 101.50 203.00
92 meters trapal 10 98.00 980.00
93 ball strawless 1 120.00 120.00
94 meals 1,580.00
95 pack styro 30 38.00 1,140.00
96 meters Pepsi 25 15.00 375.00
99 case softdrinks 8 175.00 1,400.00
100 bot wine 6 250.00 1,500.00
100 liter Diesel 15.38 32.50 500.00

Signature: __________________________ ____________________________
PURCHASE REQUEST
Entity Name: RHU Fund Cluster: PFPR

Resoponsibilty Center Code:____________
1 pcs. 16x20 frame 7 190.00 1,330.00
2 pc. construction frame 1 98.00 98.00
3 pcs. 8.5x13 frame 5 70.00 350.00
4 pcs. 8.5x13 frame 3 75.00 225.00
5 pcs. 8.5x13 frame 3 68.00 204.00
6 pcs. scented paper 11 38.00 418.00
7 pc. packing 1 85.00 85.00
8 pcs. glitters 1 50.00 50.00
9 pcs. plain puzzle mat 2 120.00 240.00
10 pc. brazo de mercedes 1 320.00 320.00
11 assorted cake 1 1,100.00 1,100.00
12 pcs. pineapple juice can 56 25.00 1,400.00
13 pcs, C2 juice 18 10.00 180.00
6,000.00
Purpose : 1st Quaterly Meeting Local Health Board, March 16, 2018.

Signature: __________________________ ____________________________
Designation: Municipal Health Officer Municipal Mayor
PURCHASE REQUEST
Entity Name: MTO Fund Cluster: General Fund

1 pack Tissue 12" 1 84.25 84.25
2 pc. stapler 1 95.00 95.00
3 box staple wire 1 41.00 41.50
4 pc. cash book 1 600.00 600.00
5 pcs. SAM tray 7 11.50 80.50
6 pc. tape 1 5.00 5.00
7 pc. packing tape 1 48.00 48.00
8 pc. sign pen 1 72.00 72.00
9 pc. pen 2 5.50 11.00
10 pc. pen 5.00
11 pc. sign pen 27.00
12 pc. sel inking stamp 800.00
13 assorted office supplies 756.50
2,625.75
Purpose : For MTO use.

Signature: __________________________ ____________________________
Printed Name: PRAXIDES C. ARCINO ANGELES R. CARLOTO II
Designation: Acting Municipal Treasurer Municipal Mayor
PURCHASE REQUEST
Entity Name: Mayor's Office Fund Cluster:

1 bot Tarpaulin 5x8 1 1,000.00 1,000.00
2 pcs. cake 60 250.00 15,000.00
3 pc. Tarpaulin 1 2,000.00 2,000.00
4 lit diesel 39.28 42.00 1,650.00
5 kls. cwn #4 10 49.00 490.00
6 video & photo coverage 8,000.00
7 bot mismo 100 15.00 1,500.00
8 kilos Fish 14 200.00 2,800.00
9 1 lechon 5,500.00
10 gal. cooking oil 4 47.50 190.00
11 gal. soy sauce 1/2 80.00
12 vetsin 10.00
13 vinegar 30.00
14 flour 20.00
15 spring onion 75.00
16 kilo red onion 1 120.00
17 kilo tomotoe 1 50.00
18 kilo garlic 1 140.00
19 kilo bell pepper 160.00
20 kilo ginger 45.00
21 kilo salt 10.00
22 kilos native chicken 15 175.00 2,625.00
23 boxes thumbtacks 10 20.00 200.00
24 pcs. plastic tape 2 30.00 60.00
25 pads steel pins 20 5.00 100.00
26 ribbon 70.00
41,925.00
Purpose : Budgetary Expenses for Kasalan ng Bayan on February 14, 2018.

Signature: __________________________ ____________________________
#REF!
19
PURCHASE REQUEST
Entity Name: RHU Fund Cluster: MCP

1 bot Paint thinner 1 35.00 35.00
2 pc. paint brush 1 104.00 104.00
3 pcs. curtain 9 250.00 2,250.00
4 pcs. pcs. Celopane 2 20.00 40.00
5 pcs. screw bolt 20 1.75 35.00
6 gal gallon 46 15.00 690.00
7 pc. mp carry box 1 408.00 408.00
8 pc. sherlock 2 98.00 196.00
9 pc. leha 1 20.00 20.00
10 pc. laquer thinner 1 45.00 45.00
11 lit enamel white 1 160.00 160.00
12 bot paint thinner 2 35.00 70.00
13 gal paint white latex 2 600.00 1,200.00
14 pc. tarpaulin 1 810.00 810.00
15 pcs. wall paper 2 170.00 340.00
16 pc. photo frame 8 115.00 920.00
17 pcs. stickers 3 100.00 300.00
18 ream folder long 1 475.00 475.00
19 ream construction paper 1 210.00 210.00
20 meters ribbon 15 22.60 340.00
21 meter cloth 1/2 200.00 100.00
22 meter cloth 1 180.00 180.00
23 pcs. trash can 3 160.00 480.00
24 pcs. frame 4 150.00 600.00
25 pc. stapler 1 150.00 150.00
26 pc scissor 2 68.00 136.00
27 pc. packing tape 2 45.00 90.00
28 pc. cleaning bag 1 122.00 122.00
29 pc. glue 2 85.00 170.00
30 unit JHP chest of drawers 1 2,495.00 2,495.00
-
-
13,171.00
Purpose : For RHU use.

Signature: __________________________ ____________________________
Entity Name: Mayor Office Fund Cluster: General Fund
1 pc. T shirt w/ print 51 200.00 10,200.00
2 pc. tarpaulin 1 800.00 800.00
3 lodging for 3 days 5,000.00
4 pax meals and snacks for 3 days 40 250.00 30,000.00
5 pax meals and snacks for 3 days 5 250.00 11,250.00
6 pax meals for facilatator 1,505.00
7 pcs food color 100 0.95 95.00
58,850.00
Purpose : Budgetary Expenses for Standard Aid Training & Basic Life Support and Disaster Risk
Reduction Management Courses on Feb 5-7, 2018.

Signature: __________________________ ____________________________
PURCHASE REQUEST

1 pax meals 28 117.85 3,300.00
3,300.00
Purpose : Meals for Ocular Inspection of Business Establishments/Market Stalls and Meeting on the
Implementation of Bus. One Stop Shop on January 5 and 9, 2018.

Signature: __________________________ ____________________________
Designation: OIC-Municipal Treasurer Municipal Mayor
76 pc.. Tarpaulin 4x6 1 800.00 800.00

77 1 room rental 2 night 2 600.00 1,200.00
78 pcs. medal 18 35.00 630.00
79 table tennis official ball 1,670.00
80 BARECOM Referre 35,500.00
Grand Total 39,800.00
Purpose : For Araw ng Tampilisan on December 20-22, 2017.

Signature: __________________________ ____________________________
37,800.00
PURCHASE REQUEST

1 pcs. mugs 100 100.00 10,000.00
2 pcs. supreme chicken sotanghon 180 29.00 5,220.00
3 pcs. eggs 180 7.00 1,260.00
4 pcs. mineral water 180 15.00 2,700.00
5 pcs. fudgee bar 10 82.00 820.00
6 pcs. tarpaulin 2 1,000.00 2,000.00
22,000.00
Purpose : For Mass blood donation on February 22, 2018.

Signature: __________________________ ____________________________
Balance forwarded 183,343.50
46 Sound rental 85,000.00
47 soft drinks 530.00
48 grocery 20 400.00 8,000.00
49 spoon 80 19.00 1,520.00
50 hair dryer 1 560.00 560.00
51 kilos Oil 8 60.00 480.00
52 softdrink 2 50.00 100.00
53 pcs. juice 25 25.00 625.00
54 pack choco 2 55.00 110.00
55 pack. monmom 1 132.00
56 pack lava 1 55.00
57 1 head pig 22,470.00
58 1 head pig 11,235.00
59 assorted spices 4,220.00
60 1 head pig 11,025.00
61 2 head pig 24,150.00
62 1 lechon 4,800.00
63 lawn tennis ball 1,260.00
64 rice 1,141.00
65 labor for lechon 800.00
66 mtrs. Lei 8 75.00 600.00
67 mtrs. Lei 4 55.00 220.00
68 pcs. glue stick 10 5.00 50.00
69 pcs. pencil mongol 2 10 7.00 70.00
70 pcs. folder 6 10.00 60.00
71 lit diesel 33.34 29.99 1,000.00
72 pc.. Tarpaulin 4x6 1 800.00 800.00
73 1 room rental 2 night 2 600.00 1,200.00
74 pcs. medal 18 35.00 630.00
76 Tarpaulin 4x6 1 800.00 800.00
77 room rental 2 night 2 600.00 1,200.00
78 medal 18 35.00 630.00
80 BARECOM Referre 35,500.00
less 10% discount Tshirt (3,039.00)
Grand Total 404,617.50

Signature: __________________________ ____________________________
1 pax meals 128 117.19 15,000.00
2 pcs T shirt Printing 320 35.00 11,200.00
3 pcs. T shirt Red 50 95.00 4,750.00
4 pcs T shirt Apple Geen 30 95.00 2,850.00
5 pcs. T shirt Lavender 50 95.00 4,750.00
6 pcs T shirt Yellow Gold 50 95.00 4,750.00
7 pcs. T shirt Royal blue 27 95.00 2,565.00
8 pcs T shirt black 1 95.00 95.00
9 pcs. Ladies palin acid black 2 90.00 180.00
10 pcs T shirt Gray 50 95.00 4,750.00
11 pcs. T shirt Orange 60 95.00 5,700.00
12 pax meals during Agro Fair 320 157.50 50,400.00
13 pcs. Tennis Net with bag 1 1,999.00 1,999.00
14 dotted balloons transparent 2,462.50
15 asstd. Cloth 2,000.00
16 balloon 548.00
17 pcs. tarpaulin 4x8 2 1,500.00 3,000.00
18 packs dotted balloons transparent 14 99.57 1,394.00
19 c/s Pepsi 8 oz 40 165.00 6,600.00
20 kilos Chicken drumstick 80 170.00 13,600.00
21 kilos Fish 20 160.00 3,200.00
22 sack rice 10 1,200.00 12,000.00
23 kilos Cooking oil 8 60.00 480.00
24 bot sprite 3 50.00 150.00
25 case mineral water 315.00
26 rolls plastic tape 4 20.00 80.00
27 roll Ribbon 160.00
28 pc. glue gun 130.00
29 pcs. glue stick 15 5.00 75.00
30 mtrs. Ribbon satin 25 8.00 200.00
31 mtrs. ribbon 35 3.00 105.00
32 pcs. certificate holder 30 75.00 2,250.00
33 pcs. scotch tape 5 20.00 100.00
34 pc. hack saw blade 1 75.00 75.00
35 toyo 2 120.00 240.00
36 UFC 4kg. 2 169.00 338.00
37 vinegar 110.00
38 tray egg 2 170.00 340.00
39 can alpine full cream 6 49.00 294.00
40 can pine apple slice 822 G 6 77.00 462.00
41 kl corn starch ram 2 78.00 156.00
42 kl corn starch ram 450G 10 27.00 270.00
43 can black beans 6 20.00 120.00
44 case biscuits 20 575.00 11,500.00
45 box juice 200 58.00 11,600.00
Sub-Total 183,343.50

Signature: __________________________ ____________________________
91,990.00
64,950.00
62,062.00
127,012.00
15,500.00
142,512.00
Entity Name: Mayor Office Fund Cluster: General Fund
1 c/s Lava cake 15 660.00 9,900.00
9,900.00
Purpose : Snacks for Rizal Day Celebration on December 30, 2017

Signature: __________________________ ____________________________
PURCHASE REQUEST

1 sack Rice 11 1,610.00 17,710.00
2 sack Corn 5 810.00 3,000.00
20,710.00
Purpose : For PNP/PA/SCAA Camul Compaq and Sto. Niño for the period covered
August 30 to September 02, 2018.

Signature: __________________________ ____________________________
PURCHASE REQUEST
Entity Name: Mayor's Office Fund Cluster:

1 sheets Marine Plywood 1/4 50 400.00 20,000.00
2 sheets Marine Plywood 1/4 24 950.00 22,800.00
3 sheets Ordinary Plywood 1/2 4 910.00 3,640.00
4 kls. cwn #3 7 85.00 595.00
5 kls. cwn #4 8 74.00 592.00
6 kls. cwn #5 5 75.00 375.00
7 pcs. hose nozzle (DS) 6 108.00 648.00
8 pcs. PVC male adaptor 3/4 3 55.00 165.00
9 pcs. PVC coupling 3/4 2 55.00 110.00
10 kls. cwn # 1 1/2 3 84.00 252.00
11 mtrs. flat cord # 16 140 48.00 6,720.00
55,897.00
Purpose : For Construction of Municipal Plaza Castle and Stage during Araw ng Tampilisan.

Signature: __________________________ ____________________________
42,800.00
8965
37,560.00
8965
46,932.00
19
PURCHASE REQUEST
Entity Name: RHU Fund Cluster: General Fund

1 box Dental Anesthesia 40 1,690.00 67,600.00
2 box Dental Needle 15 800.00 12,000.00
3 box Clean Gloves 15 350.00 5,250.00
4 box Face Mask 12 750.00 9,000.00
5 Roll Cotton 5 450.00 2,250.00
6 Gal. Lysol 1 2,800.00 2,800.00
7 Bot Alcohol 500ml 9 100.00 900.00
99,800.00
Purpose : For Dental use only.

Signature: __________________________ ____________________________
PURCHASE REQUEST

1 reams US Bond Paper Long 20 130.00 2,600.00
2 reams US Bond Paper short 14 120.00 1,680.00
3 box carbon paper long 1 450.00 450.00
4 pad yellow pad paper 1 60.00 60.00
5 pcs mailing envelop brown 50 2.00 100.00
6 pcs. folder long ordinary 50 5.00 250.00
7 doz pencil 1 90.00 90.00
8 box staple wire#35 8 45.00 360.00
9 boxes rubber band small 4 70.00 280.00
10 rolls scotch tape#4 2 30.00 60.00
11 pcs. correction tape big 12 30.00 360.00
12 pcs. rubber eraser 10 20.00 200.00
13 box paper clip (small) 1 250.00 250.00
14 boxes ball pen 1 400.00 400.00
15 pcs. Pilot pen 2 40.00 80.00
16 pcs. Sign Pen 6 50.00 300.00
17 pcs. RPTA (cards) 100 12.00 1,200.00
18 pcs. BTA (cards) 100 5.00 500.00
19 pcs. stick note 6 15.00 90.00
20 pcs. computer cartrige #704 4 500.00 2,000.00
21 set colored ink #664 (4 sets) 4 450.00 1,800.00
22 bot computer ink black 8 450.00 3,600.00
23 pcs. record book 5000's 3 80.00 240.00
23 pcs. columnar book 12 column 3 40.00 120.00
24 pcs. calculator 12 digits 1 800.00 800.00
9,220.00
Purpose : Mun. Treasurer's Office use.

Signature: __________________________ ____________________________
Designation: Acting Municipal Treasurer Municipal Mayor
Entity Name: Mayor's Office Fund Cluster: General Fund
1 sack half sack rice 1 1,200.00 1,200.00
2 case mineral water 15 225.00 3,375.00
3 pack monde mamon 10 132.00 1,320.00
4 pcs. mismo softdrinks 10 135.00 1,350.00
5 pcs. styro 2 29.00 58.00
6 pack spoon 2 20.00 40.00
7 pack oil 1 60.00 60.00
8 pack suka 2 6.00 12.00
9 pack toyo 2 8.00 16.00
10 pack magic sarap 1 32.00 32.00
11 meters trapal 15 100.00 1,500.00
12 kls. Fish 10 160.00 1,600.00
13 kls. Pork 6 170.00 1,020.00
14 kls. dress chicken 5 160.00 800.00
15 fire wood & oling 517.00
12,900.00
Purpose : For MDRRM Volunteers on November 1-2, 2017.

Signature: __________________________ ____________________________
PURCHASE REQUEST
Entity Name: Market Fund Cluster: General Fund

1 kls Chlorine 1 120.00 120.00
2 kilos powder soap 2 98.00 196.00
3 pc. Toilet Brush 1 58.00 58.00
374.00
Purpose : Public Market Toilet use.

Signature: __________________________ ____________________________
PURCHASE REQUEST
Entity Name: DEP ED Fund Cluster: General Fund

1 pcs. T - shirt Apple green 24 166.66 4,000.00
2 pcs. Square pants 10 75.00 750.00
3 pcs. LDS Shoes 6 130.00 780.00
4 pcs. LDS Sandal 3 60.00 180.00
5 pc. Kids shoes 1 145.00
6 pcs. Off shoulder H.S. F Wear 5 305.00 1,525.00
7 pc. make up kit 149.00
8 pc. sponge 29.00
9 pc. BB Cream 39.00
10 pcs. sleeveless 3 267.63 802.87
11 pc. clothe 1 99.13 99.13
12 pc. pencil case 2 40.00 80.00
13 pc. correction tape 1 17.00 17.00
14 pc. glue 1 20.00 20.00
15 pc. hair pliat 2 10.00 20.00
16 pcs. aspen exce 2 7.00 14.00
17 pck. 978e-20 ALPH Card 1 50.00 50.00
18 pk. Cards 1 30.00 30.00
19 pcs. SS3022- SANRIO 2 20.00 40.00
20 pc. 24815-2 #2 PINS 1 22.00 22.00
21 pcs. M-18 XMAS DÉCOR 10 15.00 150.00
22 pcs. Spiderman Mask 2 27.00 54.00
23 asstd grocery 2,299.50
24 kls. rice 5 50.00 250.00
25 pc. tarpaulin 3x3 2 400.00 800.00
26 pcs. T shirt printing uniform 24 100.00 2,400.00
27 pcs. Printing dancer's uniform 18 100.00 1,800.00
28 lit Diesel 11.82 35.35 418.00
29 lit Diesel 14.37 34.79 500.00
17,463.50
Purpose : Budgetary Expenses for Provincial meet and Special Games 6th Division SPED Festival
for CSNs on October 12-14 and 28-31, 2017.

Signature: __________________________ ____________________________
Printed Name: VIVIAN N. UBAGAN ANGELES R. CARLOTO II
Designation: MSWDO Municipal Mayor
5,040.00 ticket van
418.00 gasoline
500.00 gasoline
497.00 meals
575.00 meals
230.00 meals
7,260.00
24,723.50
24,723.50
(1,276.50)
PURCHASE REQUEST
Entity Name: RHU Fund Cluster: TF-PFPR

1 pcs. Toilet Bowl Molder 5 3,500.00 17,500.00
17,500.00
Purpose : For RHU use.

Signature: __________________________ ____________________________
PURCHASE REQUEST

1 box rubber band # 16 2 100.00 200.00
2 pcs folder long/F4 100 3.00 300.00
3 pcs. folder expanded 100 8.00 800.00
4 reams bond paper long 10 131.50 1,315.00
5 bot. elmers glue 2 30.00 60.00
6 box sign pen 1 200.00 200.00
7 box staple wire#35 6 100.00 600.00
8 pcs. record book 300 leaves 5 80.00 400.00
9 bot. printer ink (L210/220) black 4 350.00 1,400.00
10 pcs. hp cartridge black 704 2 500.00 1,000.00
11 set epson colored 1 750.00 750.00
12 pcs. correction pen 2 45.00 90.00
13 pc. scissor big 1 85.00 85.00
14 bot. stamp pad ink 2 100.00 200.00
15 pc. dust pan 1 200.00 200.00
16 pcs. rubbing alcohol 3 60.00 180.00
7,780.00
Purpose : Mun. Treasurer's Office use.

Signature: __________________________ ____________________________
Designation: OIC-Municipal Treasurer Municipal Mayor
PURCHASE REQUEST

1 pcs. disposable glass 10 25.00 250.00
2 gal. ultra sound gel 1 1,750.00 1,750.00
3 set urine strips 1 800.00 800.00
4 set typing sera 1 1,000.00 1,000.00
5 cylinder Aviator refill 2 280.00 560.00
4,360.00
Purpose : RHU use.

Signature: __________________________ ____________________________
PURCHASE REQUEST
Entity Name: DSDWO Fund Cluster: General Fund

1 pax 4 meals and 8 snacks 30 250.00 30,000.00
2 pcs. plastic rule 24 10.00 240.00
3 pcs. expanded envelop 24 13.00 312.00
4 pcs. pencil 24 7.00 168.00
5 pcs. pentel pen 10 40.00 400.00
6 reams construction paper 2 200.00 400.00
7 pcs. scissors 26 20.00 520.00
8 pcs. lesson plan 24 75.00 1,800.00
9 packs scented paper 4 70.00 280.00
10 pcs. cartolina 48 10.00 480.00
11 pc. tarpaulin 3x4 2 700.00 1,400.00
36,000.00
Purpose : For 4 Day Roll-out Trainig for CDWs on NELC.

Signature: __________________________ ____________________________
Printed Name: VIVIAN N. UBAGAN ANGELES R. CARLOTO II
Designation: MSWDO Municipal Mayor
PURCHASE REQUEST
Mayors Office: Mayor's Office Fund Cluster: General Fund

1 mtrs. cloth white 20 65.00 1,300.00
2 pcs. ballpen 60 6.00 360.00
3 pcs. manila paper 5 6.00 30.00
4 pcs. T shirt 65 212.30 13,800.00
5 pcs. ink, black,cyan 8 300.00 2,400.00
6 reams bond paper 14 112.15 1,570.10
7 cart ink cart,epson yellow 2 272.00 544.00
8 cart ink cart,epson cyan 2 272.00 544.00
9 pack paper parchment 1 97.80 97.80
10 pcs. notebook, stenographer, spiral 60 13.00 780.00
11 pcs. marker,permanent 5 10.25 51.25
12 box fastener,metal 70m 1 61.00 61.00
13 room Room rental( 4 night) 4 600.00 2,400.00
14 pcs. cartolina 40 12.00 480.00
15 pcs. manila paper 40 6.00 240.00
16 pcs. pilot pen 12 30.00 360.00
17 pcs. masking tape 6 30.00 180.00
18 pcs. marker pen 6 45.00 270.00
19 pcs. packing tape 3 40.00 120.00
20 meters cellophane cover 40 18.00 720.00
21 box staple wire 2 95.00 190.00
22 pcs. stapler big 3 250.00 750.00
23 pcs. scissors 3 115.00 345.00
24 case coke 8 oz 279 10.00 2,790.00
25 box juice 360 10.00 3,600.00
26 asstd. Bread 3,600.00
27 sack rice 2 1,200.00 2,400.00
28 kls. pork 40 170.00 6,800.00
29 kls. dressed chicken 50 150.00 7,500.00
30 kls. fish 20 250.00 5,000.00
31 fuits 1,500.00
32 spices 2,000.00
33 lechon 2 4,800.00 9,600.00
34 kls. beef 40 280.00 11,200.00
35 labor 2,400.00
Sub-Total 85,983.15
Purpose : Supplies use for 3 Day Basic Incident Command System Training Couse on Sept. 18-20, 2017

Signature: __________________________ ____________________________
85,983.15
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
85,983.15

Signature: __________________________ ____________________________
3,648.15
4,216.85
PURCHASE REQUEST
1 pcs. T shirt w/ print 60 260.00 15,600.00
Total 15,600.00

Signature: __________________________ ____________________________
PURCHASE REQUEST

1 kg dress chicken 30 170.00 5,100.00
2 tray egg 1 190.00 185.00
3 bot oil 30 20.00 600.00
5 pc crispy fry 30 17.00 510.00
6 pck tocino 30 50.00 1,500.00
7 bot water 10 20.00 200.00
8 pc soy sauce 30 6.00 180.00
9 pc catsup 30 13.00 390.00
10 pc venigar 30 5.00 150.00
11 kg garlic 1 120.00 120.00
12 kg onion 1 120.00 120.00
13 kg salt 1 20.00 20.00
15 pc ajinomoto 13 2.00 26.00
16 pck ham 30 50.00 1,500.00
17 pc paminta 30 5.00 150.00
18 tie kopiko 70 12.00 780.00
19 pc milo 10 9.00 840.00
20 pc paminta 1 1.00 1.00
Total 12,910.00

Signature: __________________________ ____________________________
Total -

Signature: __________________________ ____________________________
PURCHASE REQUEST

3 kg banana 21.00
4 pck egg 6 7.00 42.00
5 pck oil 4 10.00 40.00
6 pck tidbits 1 18.00 18.00
8 pck salt 1 5.00 5.00
9 pck salt 1 2.00 2.00
11 pck venigar 1 7.00 7.00
12 pck venigar 1 5.00 5.00
15 kg pork 1.5 190.00 285.00
16 pc twin blanca
17
18
19
20
21
Total 524.00

Signature: __________________________ ____________________________
PURCHASE REQUEST

sub-total #REF!
85 pc. tarpaulin 4x5 1 1,400.00 1,400.00
86 pcs. Puto 800 2.50 2,000.00
87 pc. cake 1 650.00 650.00
88 pc. lechon 1 4,700.00 4,700.00
90 kl fish 2 101.50 203.00
92 meters trapal 10 98.00 980.00
93 ball strawless 1 120.00 120.00
94 meals 1,580.00
95 pack styro 30 38.00 1,140.00
96 meters Pepsi 25 15.00 375.00
99 case softdrinks 8 175.00 1,400.00
100 bot wine 6 250.00 1,500.00
100 liter Diesel 15.38 32.50 500.00

Signature: __________________________ ____________________________

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PURCHASE REQUEST

Entity Name: Mayor Fund Cluster: General Fund

Purpose : For Peace and Order Meeting on August 31, 2018.

Requested by : Approved by:

Requested by : Approved by:

MDRRMO Fund Cluster: General Fund

Requested by : Approved by:

Purpose : For LDRRM Operations /food for the responders.

Requested by : Approved by:

MDRRMO Fund Cluster:

Purpose : For LDRRM Operations /food for the responders.

Requested by : Approved by:

Mayors Office Fund Cluster: General Fund

Purpose : For Civil Service Family Day September 9, 2017.

Requested by : Approved by:

Requested by : Approved by:

MDRRMO Fund Cluster: General Fund

Requested by : Approved by:

Purpose : For LDRRM Operations /food for the responders.

Requested by : Approved by:

MDRRMO Fund Cluster:

Purpose : For LDRRM Operations /food for the responders.

Requested by : Approved by:

Mayors Office Fund Cluster: General Fund

Purpose : For Civil Service Family Day September 9, 2017.

Requested by : Approved by:

Requested by : Approved by:

MDRRMO Fund Cluster: General Fund

Requested by : Approved by:

Purpose : For LDRRM Operations /food for the responders.

Requested by : Approved by:

MDRRMO Fund Cluster:

Purpose : For LDRRM Operations /food for the responders.

Requested by : Approved by:

Mayors Office Fund Cluster: General Fund

Purpose : For Civil Service Family Day September 9, 2017.

Requested by : Approved by:

Requested by : Approved by:

MDRRMO Fund Cluster: General Fund

Requested by : Approved by:

Purpose : For LDRRM Operations /food for the responders.

Requested by : Approved by:

MDRRMO Fund Cluster:

Purpose : For LDRRM Operations /food for the responders.

Requested by : Approved by:

Mayors Office Fund Cluster: General Fund

Purpose : For Civil Service Family Day September 9, 2017.

Requested by : Approved by:

Entity Name: RHU Fund Cluster: PFPR

Requested by : Approved by:

Entity Name: MTO Fund Cluster: General Fund

Purpose : For MTO use.

Requested by : Approved by:

Entity Name: Mayor's Office Fund Cluster:

Purpose : Budgetary Expenses for Kasalan ng Bayan on February 14, 2018.

Requested by : Approved by:

Entity Name: RHU Fund Cluster: MCP

Purpose : For RHU use.

Requested by : Approved by:

Requested by : Approved by:

Entity Name: MTO Fund Cluster: General Fund

Requested by : Approved by:

76 pc.. Tarpaulin 4x6 1 800.00 800.00