Reference Number: BatStateU-FO-PRO-02 Effectivity Date: May 14, 2021 Revision No: 03

Title: PURCHASE REQUEST FORM

Agency/ Batangas State University Date: June 04, 2021
Procuring (Central) Name of Project: “CALL for VOLUNTEERS for Bangon
Entity: Batangas: S&T-based Assistance to Taal
Volcano’s Internally Displaced
Population”
Department Research, Development and Extension Services Project Location: BatStateU Central Administration & Pablo
/Office: Borbon
Section: Extension Services PR No: PRO-2021-06-1-0421
UNIT ITEM DESCRIPTION QTY UNIT COST TOTAL COST
with Specifications
Extension, Programs, Activities and Projects (PAPS)
set Day 1 -Snacks for the Volunteers of Bangon Batangas 10 350.00 3,500.00
AM Snacks- Marble Cake , Coke
Lunch- Rice, Pork Caldereta, Veggies and water
PM Snacks- C2 , Chicken Sandwich
set Day 2 -Snacks for the Volunteers of Bangon Batangas 10 350.00 3,500.00
AM Snacks- Pansit and C2 Solo
Lunch- Rice, mixed vegetable, chicken adobo, water
PM Snacks- Cheese Pineapple Sandwich and Pineapple
Juice
set Day 3- Snacks for the Volunteers of Bangon Batangas 10 350.00 3,500.00
AM Snacks- Tuna Sandwich , C2
Lunch- Vegetable, Fried Chicken, Banana, Rice and Water
PM Snacks- Pansit, Bread and Coke
set Day 4- Snacks for the Volunteers of Bangon Batangas 10 350.00 3,500.00
AM Snacks – Cheese Pimiento Sandwich and C2
Lunch- Fish, Vegetable, Rice, Banana and Water
PM Snacks- Spaghetti and Coke

TOTAL COST Php 14,000.00

Purpose: For the Implementation of the Extension Service Activity entitled, “CALL for VOLUNTEERS for Bangon
Batangas: S&T-based Assistance to Taal Volcano’s Internally Displaced Population” on June 14- 17 , 2021

PRO-2021-06-1-0421 Page 1 of 2
 Prepared/Requested by: Certified Funds Available:

MR. ARMANDO V. MENDOZA JR. MS. KATHLEEN F. FANOGA

Director OIC-Assistant Director, Accounting

Date Signed: Date Signed:

Recommending Approval: Recommending Approval:

Included in the APP Complete Specifications

ENGR. ALBERTSON D. AMANTE ATTY. LUZVIMINDA C. ROSALES

Vice President for Research, Development and Extension Vice President for Administration and Finance
Services

Date Signed:
Date Signed:
Approved: Remarks:

DR. TIRSO A. RONQUILLO

University President

Date Signed:

Tracking Number:_____________

PRO-2021-06-1-0421 Page 2 of 2

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