APARRI BRANCH CLASS D PROCUREMENT REQUEST FORM. ‘nit PRF No: 2021-016. Ths BRANCHIUNIT eal procore the Rema Inted below, Tews requiiioned Ware necessary and willbe used forthe purpose sated. {CE Retest inden the PPMP/APP CY 2020 Int Requisition and witin the Asset Allocation Policy (AAP) per LBP E.O. No, U3, semes of 2006, [] Replacement of Unservieeable tem, Attached is inventory & Inspection Report dated [Not within AAP (Subject to CAPEX Commitee Approval) [tna ems —————Namberoeiting Units Alle mabe of unt per AAP: Suggsted Mods of Procaremen “Rarve eile of rosea GOODS AND SERVICES [Crete ning og Procurement [JU Source Biting []Diret Conacting| Jorn []Shoping (lawn works Sal Vale Prorat [Citic bing [see Procurement [Jeoxsuurinc services Cte mitng (see Procurement [—]lat. Source Bing PURPOSE arcana Taco Be ad frPlipin Tanication Stem (ISD Reiraion Sie Pot ie apes vat Item Description! | Quantity Famed Cot] Balance ee es Esamaied Tai Cost [Tosi —| on Hand Reguson | Monta to Use rice TABLET a 6,000.00 72,000.00 zal ama |PREPARED BY: 7: (Per CASA Section. te LAURA C. DE GUZMAN Cntomer Attcite DMB Head Date Prepared: 620872021 [apposed By: The CAPEX COMMITTEE Testo No Con Na. =r ve Dear Das Cored as EXP. SUPPLIES name | sm — [nosaramoarumano |} 4) ‘CAOO/AC HEAD CERTIFICATE OF ACCEPTANCE heey ceri tote ceed cach and every atic divert ervice ender bya liste inthe ached nice No dated vhich haohave been ingpected and was/were found tobe in accordance with the specifications sipuled under Purchase Order No. dated ‘Name of Property Supply Officer: _LAURAC.DEGUZMAN __Signature/Date:_ ft 2.9