Appendix 65

WASTE MATERIALS REPORT

Entity Name : _DENR CENRO Imelda Z.S.___________________________________

Fund Cluster : _____________________
Place of Storage : __DENR CENRO Imelda Z.S._________________________________________
Date : 08/29/2017

ITEMS FOR DISPOSAL

Record of Sales
Item Quantity Unit Description Official Receipt
No. Date Amount
1 1 pc. TYPE WRITER REPAIR 7335 8/29/2017 Php. 2,800.00

TOTAL Php. 2,800.00

Certified Correct : Disposal Approved :
SHEILA LEAH B. BODIONGAN DIOMIDES M. PABLO
Signature over Printed Name of Supply Signature over Printed Name of Head of
and/or Property Custodian Agency/Entity or his/her Authorized
Representative

CERTIFICATE OF INSPECTION

I hereby certify that the property enumerated above was disposed of as follows:

Item________0_____Destroyed
Item ________ Sold at private sale
Item ________ Sold at public auction
Item ________ Transferred without cost to __(Name of the Agency/Entity)__

Certified Correct: Witness to Disposal:

SHEILA LEAH B. BODIONGAN ABDULLAH A. MAMA

Signature over Printed Name of Inspection Officer Signature over Printed Name of Witness

161