Department of Education

DIVISION OF SAMAR
PURCHASE ORDER

Supplier: PO. No.

Address: Date:
TIN No.: Mode of Procurement:
Gentlemen:
Please furnish this Office the following articles subject to the terms & conditions contained herein:

Stock
Unit Qty. Item Description Unit Cost Total Cost
No.

TOTAL
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 evryday delay shall be imposed.

Very truly yours,

SCHOOL HEAD/TIC
Conformed:

Signature over printed name of supplier

Date
Funds Available: O.S. No. : _________________________
Amount: __________________________
ALONA G. ABIA
ADAS III
 INSPECTION AND ACCEPTANCE REPORT

Name of School: Botaera ES, Zumarraga

Supplier: ___________________________ A.R. ____________________________________

PO No. ______________ Date: _______________ Invoice No. ________Date: ___________
Requisition Office: ____________________________________________________________
Item No. Unit Description Quantity
pc. Baong 1
doz. Plates 2
doz. Spoon 3
doz. Fork 3
doz. Plastic glass 5
sets Cup & Saucer 6
pcs Rake 2
pc. Shovel - big 1
pcs. Water Sprinkler 2
pc. Pvawving shever 1
pc. bolo 1
pcs. Pick Mattok 2
pcs. Hoe Mattok 2
kls. Chicken 20
trays eggs 15
pcs Chicken 20
sacks rice 3
kls. B/sugar 60
sacks rice 1
kls. Chicken 30
trays eggs 10
sacks rice 2
gal. cooking oil 2
packs bearbrand - milk 5
sacks rice 3
cans angel edap 12
kls. B - sugar 2
kls. Chicken 2
cans Alasca cond. 3
pcs. Alasca Cream 5
cans Venigar 1
cans soysauce 1
kls. bihon 40
kls. Chicken 20
sacks rice 2
kls. nieke 40
sacks rice 1

INSPECTION ACCEPTANCE
Date Inspection: __________________________ Date Received:

/ / verified and found OK as to Quantity / / complete

and specification / / Partial

Inspection Officer Property Officer

 INSPECTION AND ACCEPTANCE REPORT

Name of School:Botaera ES, Zumarraga

Supplier: ___________________________ A.R. ____________________________________

PO No. ______________ Date: _______________ Invoice No. ________Date: ___________
Requisition Office: ____________________________________________________________
Item No. Unit Description Quantity
2 Cooking oil gal.
15 Squash kls.
20 cabbage kls.
10 ampalaya kls.
1 1/2 sebuyas kls.
1 bawang kls.
2 luya kls.
35 pork meat kls.

INSPECTION ACCEPTANCE
Date Inspection: __________________________ Date Received:

/ / verified and found OK as to Quantity / / complete

and specification / / Partial

Inspection Officer Property Officer

 INSPECTION AND ACCEPTANCE REPORT

Name of School: Botaera ES, Zumarraga

Supplier: ___________________________ A.R. ____________________________________

PO No. ______________ Date: _______________ Invoice No. ________Date: ___________
Requisition Office: ____________________________________________________________
Item No. Unit Description Quantity
rms Long bond paper 2
" Short bond paper 2
pcs. Cartolina 100
" Manila paper 100
" Calculator 5
" Pentel pen 10
btls. Ink 5
Assorted groceries
Assorted groceries
sack rice 2
pcs. Vida hotdog 4
doz plates 1
pcs. Pork & spoon 6
pcs. House ware plastic 2
pcs. Magic sarap 1
pcs. crystal gal. 8
pcs. Nestle 7
pcs. alaska milk 9
doz plates 1
doz plates 1
set drinking set 2
sack rice 8
tray egg 20
kls. chichen 15
cans Argentina 20
gal C-oil 1
box choco 5
tray egg 6
kl. beffer 1
pork
kl. Garlic 2 1/2
kl Onion 7
kls. fresh tomato 6
kls. Ampalaya 12
kls. potato 9
kls. Cabage 8
kls. pork 30
Notarial fee
kl. Black peapper 2

INSPECTION ACCEPTANCE
Date Inspection: __________________________ Date Received:

/ / verified and found OK as to Quantity / / complete

and specification / / Partial
Inspection Officer Property Officer