Department of Education

Region III
Division of Bulacan
District of San Rafael West
DAGAT-DAGATAN ELEMENTARY SCHOOL
Form 1
SCHOOL LIQUIDATION FORM
PERIOD COVERED CY 2021
SCHOOL: MAGUINAO ELEMENTARY
Dagat-Dagatan SCHOOL
Elementary School DATE: May ,2021
ADDRESS: DAGAT-DAGATAN, SAN RAFAEL, BULACAN SERMF CASH ADVANCE: P9,131.44
REGION: III ADA NO.:
DIVISION: BULACAN DISTRICT: SAN RAFAEL WEST DATE OF CHECK:

ACTUAL COST (PESOS)

SUPPORTING
ESTIMATED DATE TOTAL BALANCE REMARKS
Item No. DESCRIPTION OF WORK (1) DATE NO. OF MATERIALS CONTRACT DOCUMENTS
COST(2) COMPLETED LABOR (8) (6+7+8=9) (10) (11) ATTACHED (12)
STARTED (3) DAYS (5) (6) (7)
(4) (9)

Painting of School 9,131.44 May 2,2021 May 5, 2021 4 6,731.44 - 2,400.00 9,131.44 full Receipt / Pictures
Information Corner and
1 rehabilitation of septic tank

9,131.44
* Attached Principal's/Schol Memorandum on the creation of School Repair & Maintenance Committee and designation of Chairman

Prepared by: Reviewed: Approved:

BRIAN PAUL DG. SANTIAGO ERLINDA L. BERNARDO YOLANDA L. VALDIZNO

Member, School Repair & Maintenace Committee Teacher/ SBRM Chairman Head Teacher I
TO BE FILLED UP BY PPD/TEAM/SEMP-PMO:
FINDINGS: INSPECTED BY:
 Department of Education
Region III
Division of Bulacan
San Rafael West District
Dagat-Dagatan Elementary School
Dagat-Dagatan, San Rafael, Bulacan

QUOTATION PRICE
DATE:
SUPPLIER:
ADDRESS:

Sir / Madam :
Please quote lowest price, taxes included on each of the following articles.

ITEM QTY. UNIT Item Description Unit Price Amount

1 2 ltr AC T.blue
2 2 ltr AC T. red
3 4 pcs Omega Pipe
4 4 pcs N. Elbow
5 5 bgs Republic Cement
6 3 ltr Paint
7 2 pcs Brush
8 1 pcs roller
9 340 pcs door knob

TOTAL
The items quoted herein be delivered to the office of the Principal of Dagat-Dagatan Elementary School
Dagat-Dagatan, San Rafael, Bulacan 2 days after serving the award.

BRIAN PAUL DG. SANTIAGO

BAC Chairman
To the School Head
Dagat-Dagatan Elementary School
Our quotation is indicate opposite each articles indicated above.
`
_________________________
Signature of Supplier
bott
 Republic of the Philippines
Department of Education
Region III
DIVISION OF BULACAN
City of Malolos
DAGAT-DAGATAN ELEMENTARY SCHOOL

PURCHASE REQUEST
School: Dagat-Dagatan Elementary School PR No:
SI No.: Date: May 01 , 2020
Section:

Unit of Estimated unit

Stock No. Item Description Quantity Estimated Cost
Issue Cost

1 ltr AC T.blue 2 73.00 146.00

2 ltr AC T. red 2 73.00 146.00
3 pcs Omega Pipe 4 646.50 2,586.00
4 pcs N. Elbow 4 123.50 494.00
5 bgs Republic Cement 5 229.00 1,145.00
6 ltr Paint 3 618.33 1,855.00
7 pcs Brush 2 25.50 51.00
8 pcs roller 1 48.44 48.44
9 pcs door knob 1 350.00 350.00

TOTAL 6,821.44

Purpose: Repair Materials

Requested by: Approved by:

Signature
Printed Name
Designation BRIAN PAUL D.G. SANTIAGO YOLANDA L. VALDIZNO
Industrial Art Teacher Head Teacher I
 orig
153.00 136.00 136 146
153.00 136.00 136 146
2,593.00 2,576.00 2576 2586
501.00 484.00 484 494
1,152.00 0.00 1135 1145
1,862.00 0.00 1845 1855
58.00 41.00 41 51
38.44 38.44 48.44
340.00 340 350
 Republic of the Philippines
Department of Education
Region III
City of Malolos
PURCHASE ORDER
Supplier: L SQUARE LUMBER AND HARDWARE SUPPLIES PO No.:
Address: Date: May 5, 2021
TIN: Mode of Procurement: Check
Gentlemen:
Please furnish this office the following articles subject to the terms and conditions contained herein:
Place of Delivery: Dagat-Dagatan Elementary School Delivery Item:
Date of Delivery: Payment Term: CHECK

Estimated Unit
Stock No. Unit Item Description Quantity Estimated Cost
Cost

1 ltr AC T.blue 2 68.00 136.00

2 ltr AC T. red 2 68.00 136.00
3 pcs Omega Pipe 4 644.00 2,576.00
4 pcs N. Elbow 4 121.00 484.00
5 bgs Republic Cement 5 227.00 1,135.00
6 ltr Paint 3 615.00 1,845.00
7 pcs Brush 2 20.50 41.00
8 pcs roller 1 38.44 38.44
9 pcs door knob 1 340.00 340.00

(Total Amount in Words)

Six thousand seven hundred thirty one pesos and 44/100 6,731.44
In case of failure to make the full delivery within the time specified above, a penalty of one-tenth (1/10)
of one percent for everyday of delay shall be imposed.
Very Truly yours,

YOLANDA L. VALDIZNO
Head Teacher I
Conformed:

Signature Over Printed Name

Date
Funds Available: ALOBS No. ______________________________

JENELYN N. VELASCO Amount: ______________________

Administrative Assistant III
 Republic of the Philippines
Department of Education
Region III
SCHOOLS DIVISION OF BULACAN
DAGAT-DAGATAN ELEMENTARY SCHOOL
Dagat-Dagatan, San Rafael, Bulacan

ABSTRACT OF CANVASS
SCHOOL DAGAT-DAGATAN ELEMENTARY SCHOOL AOC NO. 2021-5-00
DEPARTMENT FACULTY DATE:
BHIPOLITO
L Square Lumber And
QTY ITEMS DESCRIPTION CONSTRUCTION JLO Hardware
Supplies
pcs TRADING
2 ltr AC T.blue 139.00 136.00 141.00
2 ltr AC T. red 139.00 136.00 141.00
4 pcs Omega Pipe 2,579.00 2,576.00 2,581.00
4 pcs N. Elbow 487.00 484.00 489.00
5 bgs Republic Cement 1,138.00 1,135.00 1,140.00
3 ltr Paint 1,848.00 1,845.00 1,850.00
2 pcs Brush 44.00 41.00 46.00
1 pcs roller 41.44 38.44 43.44
1 pcs door knob 343.00 340.00 345.00

6,758.44 6,731.44 6,776.44

We hereby certify that the above mentioned abstract is true and correct and that award is recommended to be made to:
L SQUARE LUMBER AND HARDWARE SUPPLIES

Prepared by:

JAACIEL M. SALVACION FRANCIS R. GONZALES

BAC Secretariat PTA (Observer)
Approved:

BRIAN PAUL DG. SANTIAGO ERLINDA L. BERNARDO PRINCESS DIANNE M. INONCILLO

BAC Chairman Member Member

YOLANDA L. VALDIZNO
Head Teacher I
 Republic of the Philippines
Department of Education
Region III
DIVISION OF BULACAN
City of Malolos

INSPECTION AND ACCEPTANCE

Supplier: L Square Lumber and Hardware supplies OR No:

PO No.: 2021-05-0 Date: May 2021 Invoice No.: Date: 05/5 / 2021
Requisitioning Office/Department: DAGAT-DAGATAN ELEMENTARY SCHOOL

Estimated
Stock No. Unit Item Description Quantity Estimated Cost
Unit Cost

1 ltr AC T.blue 2 68.00 136.00

2 ltr AC T. red 2 68.00 136.00
3 pcs Omega Pipe 4 644.00 2,576.00
4 pcs N. Elbow 4 121.00 484.00
5 bgs Republic Cement 5 227.00 1,135.00
6 ltr Paint 3 615.00 1,845.00
7 pcs Brush 2 20.50 41.00
8 pcs roller 1 38.44 38.44
9 pcs door knob 1 340.00 340.00

6,731.44

INSPECTION ACCEPTANCE
Date Inspected: May 5, 2021 Date Received: May 5, 2021

√ Inspected, verified and found √ Complete

as to quantity and specifications
Partial
Qty. is in good condition YES
As to specification NO

BRIAN PAUL DG. SANTIAGO DANICA RODRIGUEZ

BAC Chairman Property Custodian

GINA M. LAPUZ YOLANDA L. VALDIZNO

Industrial Arts Teacher Head Teacher I
 Department of Education
Region III
Division of Bulacan
District of San Rafael
DAGAT-DAGATAN ELEMENTARY SCHOOL

PROGRAM OF WORK
Name of School: DAGAT-DAGATAN ELEMENTARY SCHOOL District/Municipality: SAN RAFAEL SBRMS Allocation: P9,131.44

Estimated Project Cost

No. Description of Work Materials Labor
Qty. Unit Article Unit Cost Total Cost Scheme Cost Total Cost
1 Rehabilitation of Office Wall and 2 ltr AC T.blue 68.00 136.00 Pakyaw 2,400
furniture Paint 2 ltr AC T. red 68.00 136.00
4 pcs Omega Pipe 644.00 2,576.00
4 pcs N. Elbow 121.00 484.00
5 bgs Republic Cement 227.00 1,135.00
3 ltr Paint 615.00 1,845.00
2 pcs Brush 20.50 41.00
1 pcs roller 38.44 38.44
1 pcs door knob 340.00 340.00

TOTAL 6,731.44 2,400 9,131.44

Prepared by: Reviewed by:

BRIAN PAUL DG. SANTIAGO ERLINDA L. BERNARDO

Member, School Repair&Maintenance Committee Teacher/SBRM Chairman

Approved by:
YOLANDA L. VALDIZNO
Head Teacher I
 Department of Education
Region III
Division of Bulacan
City of Malolos

QUOTATION:
You are hereby invited yo quote your price on the articles for delivery within ______ if available in your stocks, please
submit your quotation place inside a sealed envelope at the Office of the Chairman-BIDS and AWARDS COMMITTEE Dagat-
Dagatan Elementary School, Dagat-Dagatan, San Rafael, Bulacan on 0r before 10:00 A.M./o'clock____________20____
We may purchase from you all or any articles in quoatation subject to the existing rules and regulation covering purchases
in the event that your offer should be the most advantageous to the government.
Failure on your part to submit your Bid proposal means you waive your privilege as Bidder.

BRIAN PAUL DG. SANTIAGO LEOPOLDO A. IGNACIO JR.

Chairman BAC Committee Head Teacher I

APPROVED BUDGET FOR THE CONTRACT P16344.28

INVITATION FOR QUOTATION

ITEM NO. QTY. UNIT DESCRIPTION OF ARTICLES UNIT PRICE TOTAL COST
1 1 pc S/S Pressure Tank 82 gals. 8,800.00 8,800.00
2 1 pc Jack Pump 6,700.00 6,700.00
3 2 pc Tee Assembly 450.00 900.00
4 1 pc Pressure Gauge 280.28 280.28
5 1 pc GI Bushing 3/4 x 1/4 100.00 100.00
6 3 pc Teflon 25.00 75.00

16,855.28
We hereby agree to furnish and deliver in accordance with the specification and the prices quoted all or any articles above
and that delivery will be made in the presence of the Inspector of the Auditor aand or his representatives.

Signature of Bidder

Address

REMARKS:
The dealer are requested to cooperate by giving the
Government the lowest and best price for the sake of
the people.
 Department of Education
Region III
Division of Bulacan
City of Malolos

QUOTATION:
You are hereby invited yo quote your price on the articles for delivery within ______ if available in your stocks, please
submit your quotation place inside a sealed envelope at the Office of the Chairman_BIDS and AWARDS COMMITTEE DepEd-
Division Office, City of Malolos on or before 10:00 a.m. __________________________, 2012.
We may purchase from you all or any articles in quoatation subject to the existing rules and regulation covering purchases
in the event that your offer should be the most advantageous to the government.
Failure on your part to submit your Bid proposal means you waive your privilege as Bidder.

MARIFE T. SANTOS
BAC Chairman

APPROVED BUDGET FOR THE CONTRACT P _____________________

INVITATION FOR QUOTATION

ITEM NO. QTY. UNIT DESCRIPTION OF ARTICLES UNIT PRICE TOTAL COST

We hereby agree to furnish and deliver in accordance with the specification and the prices quoted all or any articles above
and that delivery will be made in the presence of the Inspector of the Auditor aand or his representatives.

Signature of Bidder
 Address

REMARKS:
The dealer are requested to cooperate by giving the
Government the lowest and best price for the sake of
the people.

Department of Education
Region III
Division of Bulacan
City of Malolos

QUOTATION:
You are hereby invited yo quote your price on the articles for delivery within ______ if available in your stocks, please
submit your quotation place inside a sealed envelope at the Office of the Chairman_BIDS and AWARDS COMMITTEE DepEd-
Division Office, City of Malolos on or before 10:00 a.m. __________________________, 2012.
We may purchase from you all or any articles in quoatation subject to the existing rules and regulation covering purchases
in the event that your offer should be the most advantageous to the government.
Failure on your part to submit your Bid proposal means you waive your privilege as Bidder.

MARIFE T. SANTOS
BAC Chairman

APPROVED BUDGET FOR THE CONTRACT P _____________________

INVITATION FOR QUOTATION

ITEM NO. QTY. UNIT DESCRIPTION OF ARTICLES UNIT PRICE TOTAL COST

We hereby agree to furnish and deliver in accordance with the specification and the prices quoted all or any articles above
and that delivery will be made in the presence of the Inspector of the Auditor aand or his representatives.

Signature of Bidder

Address

REMARKS:
The dealer are requested to cooperate by giving the
Government the lowest and best price for the sake of
the people.
 Republic of the Philippines
Department of Education
Region III
DIVISION OF BULACAN
City of Malolos
ABSTRACT OF CANVASS
Location: Dagat-Dagatan Elementary School Opening of Canvass: January ,2020
Municipality: San Rafael, Bulacan Canvass Opened at: 10:00 am
DESCRIPTION OF ARTICLE
BHIPOLITO JLO Ocampo Compact
Hardware &
Item CONSTRUCTIO Construction Lumber and
QTY Unit Item Description N TRADING Hardware
No. Supply

1 1 pc CHB #4 2,715.00 2,765.00 2,805.00

2 1 bags Cement 6,615.00 6,665.00 6,705.00
3 2 elf White Sand 5,000.00 5,050.00 5,090.00
4 1 elf Gravel 2,800.00 2,850.00 2,890.00
5 1 pcs Tansi 48.52 55.00 60.00

TOTAL 17,178.52 17,385.00 17,550.00

We hereby certify that the above mentioned abstract is true and correct and that award is recom-
mended to be made to:
COMPACT HARDWARE

BIDS AND AWARDS COMMITTEE

LEOPOLDO A. IGNACIO JR.

Head Teacher I

BRIAN PAUL DG. SANTIAGO JAACIEL M. SALVACION

Chairperson Member

OLIVIA B. CANUZO ERLINDA L. BERNARDO PRINCESS DIANNE M. INONCILLO

Member Member Member