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PURCHASE REQUEST

Entity Name: ITDI - DOST Fund Cluster: __________________


Office/Section:
NMD/VFSS PR No.: ______________ Date: 23 May 2019
___________________ Responsibility Center Code : ___________
Stock/
Unit Supply Quantity Unit Cost Total Cost
Property No.
pc H2O Pump (Rewind) 1 3,000 3,000
Specification:

Total: 3,000

Purpose: for repairing the water pump

Charge to: NML Use of Income


_______________________________________________________________

Requested by: Approved by:


Signature : _________________ _____________________
Printed Name : JOSE MARCO D. LATOSA AURORA V. KIMURA
Designation : Science Research Specialist I Chief, NMD

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