DepEDR3-PPS-019

DEPARTMENT OF EDUCATION REGION III

Matalino St. D.M. Government Center, Maimpis, City of San Fernando (P) Version No. 1 Rev. No. 01

2.0 02
Payment Processing Sheet - Goods 03
Payee: MCX INTERNATIONAL INC.
Voucher Number:
Obligation Number:
CHECKLIST OF SUPPORTING DOCUMENTS
NO. PARTICULARS ü REMARKS

A. DOOR TO DOOR DELIVERY OF: TVL MATERIALS, TOOLS AND EQUIPMENT FOR SHS (PUBLIC BIDDING): LOT
B.1 SHIELDED METAL ARC WELDING (NC I)
Minimum Documentary Requirements as per COA Circular No. 2012-001 dated June 14, 2012
1 Purchase Request (PR) 2016-02-078 P 32,240,051.63 69 schools
2 Delivery Receipt (DR)/Sales Invoice (SI) SI No. 4189 07/31/2018 P 10,928,011.25
3 Purchase Order (PO)/Notice to Proceed Contract 08/28/17 execution w/in 90 calendar days
4 Transmittal of documentary requirements submitted to COA. (Within 5 days from the
execution of the contract)
5 Performance Bond as required in the Bid Data Sheet 9001110 06/08/17 P 1,307,640.56
6 Copy of Approved Contract 9 items (345 qty) 68 sch P 26,152,811.25
7 Abstract of Bids
8 PhilGeps Publication for the Invitation to Bid Ref No. 3970238
9 Post-Qualification Evaluation Report
10 Resolution to Award
11 PhilGeps Publication for the Award of Winning Bidder
12 Notice of Award
13 Certificate of Inspection and Acceptance including Travel Report of Inspectors, if applicable
14 Drawings/Technical Specifications
15 Approved Distribution List
16 Inventory Custodian Slip / Property Acknowledge Receipt
17 Warranties and After Sales Service, if any
18 Results of Test Analysis, if applicable
19 Tax receipts from the Bureau of Customs or BIR indicating the exact specifications and/or serial
number of the equipment procured by the government as proof of payment of all taxes and duties
due on the same equipment, supplied or sold to the government [Administrative Order (AO) No.
200 dated November 21, 1990], if applicable
20 Such other documents peculiar to the contract and/or mode of procurement and considered
necessary in the auditorial review and in the technical evolution thereof
20.1 Request for payment from Contractor
20.2 Recommendation for Payment

Early Release of 10% Retention:

1 Letter Request from Contractor
2 Surety Bond as required in the Bid Data Sheet
3 Certificate of Completion and Turnover
4 Certificate of Final Inspection

**All Documentary Requirements by COA are as prescribed under COA Circular No. 2012-001 dated June 14, 2012

To: __________________________________
Respectfully returned due to the following:

Released: ____________________
Date: __________ Time: ________

Processor:
 DepEDR3-PPS-019
DEPARTMENT OF EDUCATION REGION III
Matalino St. D.M. Government Center, Maimpis, City of San Fernando (P) Version No. 1 Rev. No. 01

2.0 02
Payment Processing Sheet - Goods 03
Payee: MCX INTERNATIONAL INC.
Voucher Number:
Obligation Number:
CHECKLIST OF SUPPORTING DOCUMENTS
NO. PARTICULARS ü REMARKS

A. DOOR TO DOOR DELIVERY OF: TVL MATERIALS, TOOLS AND EQUIPMENT FOR SHS (PUBLIC BIDDING): LOT
B. 3 SHIELDED METAL ARC WELDING (NC II)
Minimum Documentary Requirements as per COA Circular No. 2012-001 dated June 14, 2012
1 Purchase Request (PR) 2016-02-079 P 45,353,324.63 61 schools
2 Delivery Receipt (DR)/Sales Invoice (SI) SI No. 4190 07/31/2018 P 14,422,705
3 Purchase Order (PO)/Notice to Proceed Contract 08/28/17 execution w/in 90 calendar days
4 Transmittal of documentary requirements submitted to COA. (Within 5 days from the
execution of the contract)
5 Performance Bond as required in the Bid Data Sheet 9001111 06/08/17 P 1,999,511.38
6 Copy of Approved Contract 11 items (305qty) 60sch P 39,990,227.50
7 Abstract of Bids
8 PhilGeps Publication for the Invitation to Bid Ref No. 3970238
9 Post-Qualification Evaluation Report
10 Resolution to Award
11 PhilGeps Publication for the Award of Winning Bidder
12 Notice of Award
13 Certificate of Inspection and Acceptance including Travel Report of Inspectors, if applicable
14 Drawings/Technical Specifications
15 Approved Distribution List
16 Inventory Custodian Slip / Property Acknowledge Receipt
17 Warranties and After Sales Service, if any
18 Results of Test Analysis, if applicable
19 Tax receipts from the Bureau of Customs or BIR indicating the exact specifications and/or serial
number of the equipment procured by the government as proof of payment of all taxes and duties
due on the same equipment, supplied or sold to the government [Administrative Order (AO) No.
200 dated November 21, 1990], if applicable
20 Such other documents peculiar to the contract and/or mode of procurement and considered
necessary in the auditorial review and in the technical evolution thereof
20.1 Request for payment from Contractor
20.2 Recommendation for Payment

Early Release of 10% Retention:

1 Letter Request from Contractor
2 Surety Bond as required in the Bid Data Sheet
3 Certificate of Completion and Turnover
4 Certificate of Final Inspection

**All Documentary Requirements by COA are as prescribed under COA Circular No. 2012-001 dated June 14, 2012

To: __________________________________
Respectfully returned due to the following:

Released: ____________________
Date: __________ Time: ________

Processor: