Annex A

Republic of the Philippines

PROVINCIAL GOVERNMENT OF DAVAO ORIENTAL
Municipality of Lupon
BARANGAY CALAPAGAN

OBLIGATION REQUEST No.

Date:
Payee MHR INTERNET CAFE
Office Lupon, Davao Or.
Address Lupon, Davao Or.
Responsibility F.P.P. Account Code Amount
Center Particulars

Payment of diesel fuel P 39, 962.00

Total P 39, 962.00

A.) Certified B.) Certified

( ) Charges to appropriation/ allotment Existence of available appropriation

necessary,Lawful and under my direct
supervision.

( ) Supporting documents valid,proper and

legal

Signature Signature
Printed JONEL B. DELMONTE Printed JIMMY YONGCO
Name Name
Position Barangay Captain Chair,Committee on Appr’n
Heads,Requesting,Office/Authorized Representative Heads,Budget Unit/ Authorized Representative
Date Date
,
 Republic of the Philippines DV No. ____________
Province of Davao Oriental
Municipality of Lupon Date : ____________

DISBURSEMENT VOUCHER
City/Municipality : Lupon
Barangay : CALAPAGAN
Province : Davao Oriental

Payee /Office: ________________ Employee No. ________ Fund :

_____________________

Address : _Lupon,Davao Oriental TIN No. ______________

Particulars Amount
To Payment of diesel fuel for road graveling
as per supporting papers hereto attached in the
total amount of …… P 39, 962.00

A) Certified : B) Certified : C.) Certified :

Existence of available
Appropriation for the Funds (Cash) Available As to validity,propriety,
charges/expenses indicated And legality.
above.

_________________________
Signature Signature Signature

JIMMY P. YONGCO RAYNALDO M. SORIANO JONEL B. DELMONTE

Printed Name Printed Name Printed Name

Chair. Committee on Appr’n. Barangay Treasurer Punong Barangay

Position Position Position

Date Date Date

D) Received Payment:

LARCIA GASOLINE STATION_

Signature Over Printed Name
Check No.:
Date Bank Name :___LBP________
O.R Number : ______________ Date : _____________
 Appendix 8

INSPECTION AND ACCEPTANCE REPORT

Barangay : CALAPAGAN City/Municipality : Lupon
Tel. No. : Province : Davao oriental
Supplier :. Invoice # :________ IAR No.______
P.O No. _______ Invoice Date:______ RIS No. ______ Date :_________
Item No. Unit DESCRIPTION Quantity
1. unit Bulletin board 1
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
24.
25.
INSPECTION ACCEPTANCE
Date Inspected : ___________________ Date Received : ______________________
( ) Complete
( ) Inspected,verified and Found OK ( ) Partial ( Pls. Specify Quantity Received)
As to quantity and specifications.

HON. LERMA M. BAJENTING HON. JOCELYN T. SANCHEZ

Authorized Inspector Authorized Received
 BIDS AND AWARDS COMMIITTEE
BARANGAY CALAPAGAN
LUPON, DAVAO ORIENTAL

Name of Procuring Entity

REQUEST FOR QUOTATION OF PRICES

(CANVASS)
Date: ____________
QUOTATION No.: ____
Company Name:_____________________________
Address: _______________________________

Please quote lowest price on the listed below subject to the GENEAL CONDITION on the last page stating the
shortest time of delivery and submit your quotation duly signed by your representative not later than ________ in the
return envelope attached herewith:

HON. ROSLEN S. ABDURASID HON. JOSE G. MARTINEZ, JR.

BAC Chairman Vice Chairman

HON. PASCIANO A. TAYA HON. IAN JING D. MANILA

BAC Member BAC Member

HON. JIMMY P. YONGCO

BAC Member
Note:
1. All entries must be typewritten.
2. Delivery period within ________________ calendar days.
3. Warrant shall be for a period of six (6) months for supplies, materials one (1) year for equipment from date
of acceptance by the procuring entity.
4. Price validity shall be for a period of _________________ calendar days.
5. G-PES registration certificate shall be attached upon submission of the quotation.
6. Bidders shall submit original brochures showing certification of the product being offered.
ITEM NO. UNIT OF ITEMS AND DESCRIPTION QUANTITY UNIT PRICE
ISSUE
1 set 700x15 DRC LUG 14PLY with 1
interior and flap
XXXXXXX XXXXXXX XXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXX XXXXXXXXX

( ) after having carefully read and accepted your general conditions, if we quote you on the item at
prices noted above.

________________________
Name & Signature of Bidders Supplies HON. JOSE G. MARTINEZ, JR.
Contact No.: ______________ Personal Canvasser
Date: ___________________
 PURCHASE ORDER

Barangay : CALAPAGAN Municipality: LUPON

Tel No. : ____________________ Province :DAVAO ORIENTAL

Supplier : MHR INTERNET CAFE P.O No.: ______________________________

Address: LUPON, DAVAO ORIENTAL Date: ________________________________
Mode of Procurement: ____________________
Bidding: ( X ) negotiated ( )Over the counter

Gentlemen:
Please deliver to this office the following articles subject to the terms and condition
contained herein.

Place of Delivery: ________________________ Delivery Term : _______________________

Date of Delivery: ________________________ Payment Term : _______________________

Item No. Unit Particulars Quantity Unit Cost Amount

1 unit BULLETIN BOARD -1- P 3, 800.00 P 3, 800.00

Total Amount in words:

In case of failure to make full delivery within the time specified above a penalty of one tenth in
(01/10) of one percent for everyday of delay shall be imposed.

Very truly yours,

HON. JONEL B. DELMONTE

Punong Barangay

Conformed: Existence of Availability Appropriations:

MHR INTERNET CAFE ____ HON. JIMMY P. YONGCO

Signature over printed name of the Supplier Chairman, Committee on Appropriation

__________________________ __________________________
Date Date
Barangay Calapagan
Name of Procuring Entity

Standard From Number : SF-GOOD-59

Revised on May 24,2004

PURCHASE REQUEST
Barangay Calapagan
Agency/Procuring Entity

Department : _________________________ P.R No. ____________ Date :_____________

Section : ___________________________ SAI No. ____________ Date:______________

Item No. Unit Item Description Qty. Unit Cost Total Cost
1. Pad Yellow pad 24 20 480
2. Pc. Plastic envelop 24 8 192
3. Pc Record book 150’s 3 50 150
4. Pc Record book 200’s 1 65 65
5. rim Pilot bond paper long 1 160 160
6. Rim Pilot bond short 1 150 150
7. Box Pencil 2 72 144
8. Box Panda pin 2 72 144

Total Amount: P 1, 485

Charge to :
Purpose/ Remarks :
Requested by : Cash Availability Approved by:
Signature
Printed Name IAN JING D. MANILA RAYNALDO SORIANO JONEL B. DELMONTE
Designation Barangay Kagawad Barangay Treasurer Punong Barangay
Date
 Republic of the Philippines
Province of Davao Oriental
Municipality of Lupon
BARANGAY CALAPAGAN

Excerpt from the minutes taken during the BIDS AND AWARDS COMMITTEE on
January 19, 2015. Held in the Barangay Hall, Barangay Calapagan, Lupon, Davao Oriental
9:00 A.M.

Present:
HON. ROSLEN S. ABDURASID - BAC Chairman
HON. JOSE G. MARTINEZ, JR. – BAC Vice-Chairman
HON. IAN JING D. MANILA - BAC Member
HON. PASCIANO A. TAYA - BAC Member
HON. JIMMY P. YONGCO - BAC Member
HON. JOCELYN T. SANCHEZ - BAC Member
HON. LERMA M. BAJENTING - BAC Member
Absent:
NONE

The purchase request was formally submitted to the BAC COMMITTEE at

exactly 10:00 A.M. in the morning on the following items.

 Bulletin board

After careful deliberation on the subject matter, the purchase request was
approved by the BAC COMMITTEE and the BAC meeting was adjourned at exactly 11:00
A.M.

I hereby certify to the correctness of the quoted minutes.

Attested:

GEVA GEQUE L. YONGCO

Barangay Secretary

Conformed:

HON. ROSLEN S. ABDURASID

BAC Chairman
 Republic of the Philippines
Province of Davao Oriental
Municipality of Lupon
BARANGAY CALAPAGAN

Excerpt from the minutes taken during the BIDS AND AWARDS COMMITTEE on
February 2, 2015. Held in the Barangay Hall, Barangay Calapagan, Lupon, Davao Oriental
9:00 A.M.

Present:
HON. ROSLEN S. ABDURASID - BAC Chairman
HON. JOSE G. MARTINEZ, JR. – BAC Vice-Chairman
HON. IAN JING D. MANILA - BAC Member
HON. PASCIANO A. TAYA - BAC Member
HON. JIMMY P. YONGCO - BAC Member
HON. JOCELYN T. SANCHEZ - BAC Member
HON. LERMA M. BAJENTING - BAC Member

Absent:
NONE

The bidding was formally opened at exactly 1:30 P.M. on the following item:

 Bulletin board

After thorough deliberation the Committee decided to grant & award on the following
supplier as follows,

MHR INTERNET CAFE

There is no other matter discussed, the Bidding was adjourned at exactly 2:00 P.M.

I hereby certify to the correctness of the above quoted minutes.

Attested:

GEVA GEQUE L. YONGCO

Barangay Secretary

Conformed:

HON. ROSLEN S. ABDURASID

BAC Chairman
 Republic of the Philippines
Province of Davao Oriental
Municipality of Lupon
BARANGAY CALAPAGAN

Excerpt from the minutes taken during the BIDS AND AWARDS COMMITTEE on
February 2, 2015. Held in the Barangay Hall, Barangay Calapagan, Lupon, Davao Oriental
9:00 A.M.

Present:
HON. ROSLEN S. ABDURASID - BAC Chairman
HON. JOSE G. MARTINEZ, JR. – BAC Vice-Chairman
HON. IAN JING D. MANILA - BAC Member
HON. PASCIANO A. TAYA - BAC Member
HON. JIMMY P. YONGCO - BAC Member
HON. JOCELYN T. SANCHEZ - BAC Member
HON. LERMA M. BAJENTING - BAC Member
MS. GEVA GEQUE L. YONGCO - BAC Secretary

Absent:
NONE

A RESOLUTION RECOMMENDING TO THE BARANGAY CAPTAIN TO AWARD THE

FOLLOWING GOODS TO THE SUPPLIERS WHO OFFERED THE LOWEST PRICE
QUOTATION PURSUANT TO THE SECTION 52 OF THE IMPLEMENTING RULES AND
REGULATIONS OF R.A. 9184

PR RO DESCRIPTION SUPPLIER AMOUNT

unit 1 Bulletin board MHR P 3, 800.00
INTERNET
CAFE

WHEREAS, the Local Chief executive approved the recommendation on the bids and awards
committee that the procurements of goods covered by the aforementioned implementing rules and
regulations R.A. 9184

WHEREAS, shopping was duly conducted to qualified suppliers and after the opening of the
canvass by the committee the corresponding listed suppliers the lowest price

WHEREFORE, on motion of Hon. Jose G. Martinez, Jr. and duly seconded by all members present
it was,

RESOLVED, to recommend to the Barangay Captain to award the above listed purchase request
to their corresponding suppliers who offered the lowest quotation through shopping pursuant to
Section 52 of the implementing rules and regulations of R.A. 9184

We hereby certify the correctness of the above mentioned resolution.

HON. ROSLEN S. ABDURASID

BAC Chairman

HON. JOSE G. MARTINEZ, JR HON. IAN JING D. MANILA HON. PASCIANO A. TAYA
BAC Vice-Chairman BAC Member BAC Member

HON. JIMMY P. YONGCO HON. JOCELYN T. SANCHEZ HON. LERMA M. BAJENTING

BAC Member BAC Member BAC Member

Approved:

HON. JONEL B. DELMONTE

Punong Barangay
BARANGAY CALAPAGAN
Procuring Entity

ABSTRACT QUOTATION RENDERED BY VARIOUS SUPPLIERS

Shopping No. : __________________

Opened On : ___________________
ITEM QTY. UNIT DESCRIPTION SUPPLIER 1 SUPPLIER 2 SUPPLIER 3
MHR LUPON COMLAB
INTERNET GLASS
CAFE
1 1 Unit Bulletin board P 3, 800.00 P 3, 950.00 P 4, 100.00

Supplier/establishment or contractors as support with their quotation.

HON. IAN JING D. MANILA HON. JOSE G. MARTINEZ, JR.

Canvasser Canvasser
In compliance with R.A. 9184 and its implementing rules and regulations and as reflected in the
Resolution No. ____ recommended to be awarded to:

HON. ROSLEN S. ABDURASID HON. LERMA M. BAJENTING HON. JOCELYN T. SANCHEZ

BAC Chairman BAC Member BAC Member

HON. JIMMY P. YONGCO HON. PASCIANO A. TAYA

BAC Member BAC Member