FORM "B"

Republic of the Philippines

Department of SANGGNUNIANG BAYAN

VICE MAYOR'S OFFICE

NAME OF BUREAU OF OFFICE

WEEKLY REPORTS ON
(To be accomplished for each Vehicle Operator)

Date :

Operator: RICHEL M. BALA

Date DISTANCE
(km.) DIESOLINE / GAS OIL USED GREASED REMARKS
CONSUMED IN LITERS (In Liters) USED
9/21/2018 160 10.00 consumed
10/2/2018 3 7.48 consumed
10/5/2018 4 6.00 consumed
10/9/2018 5243 8.00 consumed
10/13/2018 261 36.45 consumed
10/15/2018 260 30.60 consumed
10/19/18 4 6.00 consumed
10/23/2018 245 36.30 consumed
10/28/2018 355 43.76 consumed
10/29/2018 8 10.00 consumed
10/30/2018 9 14.00 consumed
11/5/2018 391 44.53 consumed
11/12/2018 390 40.52 consumed
11/5/2018 9 13.00 consumed
11/25/2018 80 10.00 consumed
11/12/2018 160 20.00 consumed
10/5/2018 120 15.00 consumed
10/10/2018 160 20.00 consumed
9/18/2019 8 10.00 consumed
9/28/2018 210 25.00 consumed
9/22/2018 6 7.00 consumed

TOTAL

I Hereby certify to the correctness of the above statement and that the
was used on strictly official business on.

Operator Signature

APPROVED :

ERIC REY G. SIOHAN

Administrating Officer

NOTE:
This report should be accomplish in triplicate copies, duly accomplished by operator record of operation. ( Form A ) should
operation. ( Form A ) should be submitted, thru the adminstrative Officer or his equivqlent, to the Auditor
 FORM "B"
Republic of the Philippines
Department of SANGGNUNIANG BAYAN

VICE MAYOR'S OFFICE

NAME OF BUREAU OF OFFICE

WEEKLY REPORTS ON
(To be accomplished for each Vehicle Operator)

Date :

Operator: RICHEL M. BALA

Date DISTANCE
(km.) DIESOLINE / GAS OIL USED GREASED REMARKS
CONSUMED IN LITERS (In Liters) USED
0
900 100.00 consumed
11/7/2018 910 100.00 consumed
11/7/2018 900 100.00 consumed
11/7/2018 900 100.00 consumed
10/24/2018 478 54.33 consumed
09/23/18 90 15.00 consumed
10/24/2018 260 30.00 consumed

TOTAL 4,438 426.97

I Hereby certify to the correctness of the above statement and that the
was used on strictly official business on.

Operator Signature
APPROVED :

ERIC REY G. SIOHAN

Administrating Officer

NOTE:
This report should be accomplish in triplicate copies, duly accomplished by operator record of operation. ( Form A ) should
operation. ( Form A ) should be submitted, thru the adminstrative Officer or his equivqlent, to the Auditor
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