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

Title: PURCHASE REQUEST FORM

Agency/ Batangas State University Date: June 21, 2021
Procuring (Central) Name of Project: Bangon Batangas Tech Transfer
Entity:
Department Research, Development and Extension Services Project Location: BatStateU Central Administration (Rizal
/Office: Avenue, Extension Batangas City)
Section: Research PR No: PRO-2021-06-1-0451
UNIT ITEM DESCRIPTION QTY UNIT COST TOTAL COST
with Specifications
Foods
set Food for Bangon Batangas Tech Transfer Personnels 10 350.00 3,500.00
AM Snacks- C2 , Chicken Sandwich
Lunch- Rice, Pork Adobo, Veggies and water
PM Snacks- Marble Cake , Coke

TOTAL COST Php 3,500.00

Purpose: Food for the proponents and staff of Bangon Batangas Tech Transfer project who will distribute the relief
goods to Agoncillo Batangas on June 23, 2021

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-2021-06-1-0451 Page 1 of 1

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