CHECKLIST FOR FEEDING PROGRAM

@16.00 @2.00 REMARKS

Liquidation Report

Cash Disbursement Register

Summary of Expenditures (SOE)

Purchase Request (for Daily/Weekly Purchases)

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Request for Quotation Canvass

Bidder 1
Bidder 2
Bidder 3

Abstract of Quotation

Purchase Order (for Daily/Weekly Purchases)

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Inspection and Acceptance Report

Delivery Receipt / Acknowledgment Receipt

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 DTI
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WFP
REMARKS
 LIQUIDATION REPORT No. 2021-07-
Department of Education Date: July 14, 2021
Division of Rizal
DISTRICT OF CAINTA
Janssenville Elementary School

PARTICULARS AMOUNT

To liquidate Cash Advance in the amount of

THREE HUNDRED EIGHTY TWO THOUSAND THREE HUNDRED TWENTY PESOS
(Php. 382,320.00)
382,320.00
for SCHOOL-BASED FEEDING PROGRAM SY 2020-2021 of
Janssenville Elementary School

Total Amount Spent 382,320.00

Amount of Cash Advance per Check No. _________ Dtd. _______ 382,320.00
Amount refunded under OR No.
Amount Available -

A. Certified: Correctness of the above B. Certified: Supporting documents complete &

data proper

LILIA H. CAPISTRANO ATTY. FILIPINO F. MENDOZA

Principal Accountant III
 LIQUIDATION REPORT No. _____________
Department of Education Date: _____________
Division of Rizal
DISTRICT OF _______________________
__________________________________________ (school)

PARTICULARS AMOUNT

balance forwarded………………………………………………………. -

To liquidate Cash Advance in the amount of

___________________________________________________ 405,000.00
for SCHOOL-BASED FEEDING PROGRAM SY 2018 - 2019 of
__________________________________________ (school)

Total Amount Spent 405,000.00

Amount of Cash Advance per Check No. _________ Dtd. _______ 472,500.00
Amount refunded under OR No.
Amount Available (67,500.00)

A. Certified: Correctness of the above B. Certified: Supporting documents

data complete & proper

________________________ ATTY. FILIPINO F. MENDOZA

Principal Accountant III
NAME OF DIVISION: DEPED - DIVISION OF RIZAL
NAME OF DISTRICT: DISTRICT OF CAINTA
NAME OF SCHOOL: JANSSENVILLE ELEMENTARY SCHOOL
FOR THE PERIOD: MAY 3, 2021 TO JUNE 30, 2021

CASH DISBURSEMENT REGISTER

TYPE OF WORKING FUND : SCHOOL-BASED FEEDING PROGRAM (NFP) SY 2020-2021

CASH ADVANCE BREAKDOWN OF PAYMENTS

REFERENC
DATE E (OR/ PAYEE / PARTICULARS FOOD
AMOUNT OPERATIONAL
RER) PAYMENTS BALANCE SUPPLIES
RECEIVED EXPENSE (755)
EXPENSE (758)

March 15, 2021 CASH LILIA H. CAPISTRANO ₱ 382,320.00

July 1, 2021 0 ALLYCEL GENERAL MERCHANDISE -
- -

TOTAL 382,320.00 - - - -

Certified Correct: Noted:

LILIA H. CAPISTRANO ATTY. FILIPINO F. MENDOZA

Principal Accountant III
BURSEMENT REGISTER

BREAKDOWN OF PAYMENTS

OTHER
MOOE (969)

ATTY. FILIPINO F. MENDOZA

Accountant III
 Department of Education
STATEMENT OF EXPENDITURES
Division Summary Sheet

Category: SCHOOL-BASED FEEDING PROGRAM (NFP) SY 2020-2021

Period Covered: MAY 3, 2021 TO JUNE 30, 2021
Region: IVA-CALABARZON
Division: RIZAL

REFERENCE DESCRIPTION OF
PAYEE NAME OF SCHOOL AMOUNT GRANTED AMOUNT UTILIZED BALANCE
EXPENSES

Date Received

School-Based Feeding
JANSSENVILLE
LILIA H. CAPISTRANO Php 382,320.00 March 15, 2021 Php 382,320.00 - Program & Operational
ELEMENTARY SCHOOL
Expenses

Prepared by: Certified Correct:

JACKIELYN P. FRANCISCO LILIA H. CAPISTRANO

Feeding Program Coordinator Principal
 PURCHASE ORDER

Supplier: ALLYCEL GENERAL MERCHANDISE PO No. 2021-03-0001

Address: 106 MAGSAYSAY AVE. BRGY. SAN GABRIEL TERESA,RIZAL Date March 29, 2021
TIN: 159-794-473 Mode of SHOPPING/CANVAS
Procurement
GENTLEMEN:
Please furnish this Office the following articles subject to the terms and conditions contained herein.
Place of Delivery: JANSSENVILLE ELEMENTARY SCHOOL Delivery Term : DAILY/WEEKLY
Date of Delivery: _______________________________ Payment Term: COD

Stock No. UNIT DESCRIPTION QUANTITY UNIT COST

1 piece Cheese Bread 100gms 2,124 ₱ 14.00

2 piece Apple 40-80gms 4,248 ₱ 23.00
3 piece Cheese Roll 100gms 1,416 ₱ 14.00
4 piece Peras 40-80gms 2,124 ₱ 23.00
5 piece Ube Bread 100gms 1,416 ₱ 14.00
6 piece Ponkan 40-80gms 1,416 ₱ 22.00
7 piece Ensaymada Bread 100gms 1,416 ₱ 14.00
8 piece Star Bread 100gms 1,416 ₱ 14.00
9 piece Banana(Lacatan) 40-80gms 2,124 ₱ 25.00
10 piece Catagalugan Bread 100gms 708 ₱ 12.00
11 piece Pandesal with Malunggay 100gms 708 ₱ 10.00
12 piece Dalandan 40-80gms 708 ₱ 18.00
13 piece Spanish Bread 708 ₱ 10.00
14 piece Pinagong/Monay Bread 100gms 708 ₱ 10.00

Total
Amount in Words THREE HUNDRED EIGHTY-FIVE THOUSAND FIVE HUNDRED SIXTY PESOS ONLY
In case of failure to make the fully delivery within the time specified above, a penalty of one tenth of one percent for everyday

of delay shall be imposed.

Conformed: Very truly yours,
MARICEL P. SANTIAGO LILIA H. CAPISTRANO
Signature over Printed Name of Supplier Principal
Stock No. UNIT DESCRIPTION QUANTITY UNIT COST
E ORDER

2021-03-0001
March 29, 2021
SHOPPING/CANVASS

Delivery Term : DAILY/WEEKLY

AMOUNT
COST
₱ 29,736.00
₱ 97,704.00
₱ 19,824.00
₱ 48,852.00
₱ 19,824.00
₱ 31,152.00
₱ 19,824.00
₱ 19,824.00
₱ 53,100.00
₱ 8,496.00
₱ 7,080.00
₱ 12,744.00
₱ 7,080.00
₱ 7,080.00

382,320.00
FIVE THOUSAND FIVE HUNDRED SIXTY PESOS ONLY

LILIA H. CAPISTRANO
Principal
AMOUNT
COST
 INSPECTION AND ACCEPTANCE REPORT
Department of Education

Supplier: ALLYCEL GENERAL MERCHANDISE OR No. 0001 IAR No: 2021-03-0001

PO No.: 2021-03-0001 Date: July 1, 2021 Date : July 1, 2021
Requisitioning Office/Dept. JANSSENVILLE ELEMENTARY SCHOOL

Item No. Unit DESCRIPTION QUANTITY

1 piece Cheese Bread 100gms 2,124
2 piece Apple 40-80gms 4,248
3 piece Cheese Roll 100gms 1,416
4 piece Peras 40-80gms 2,124
5 piece Ube Bread 100gms 1,416
6 piece Ponkan 40-80gms 1,416
7 piece Ensaymada Bread 100gms 1,416
8 piece Star Bread 100gms 1,416
9 piece Banana(Lacatan) 40-80gms 2,124
10 piece Catagalugan Bread 100gms 708
11 piece Pandesal with Malunggay 100gms 708
12 piece Dalandan 40-80gms 708
13 piece Spanish Bread 708
14 piece Pinagong/Monay Bread 100gms 708

INSPECTION ACCEPTANCE
DATE INSPECTED: JULY 1, 2021 DATE RECEIVED: JULY 1, 2021
Inspected, verified and found OK Complete
as to Quantity and specifications Partial

RODNEY M. AREVALO JACKIELYN P. FRANCISCO

BAC Member Feeding Program Coordinator
NAME OF THE PROCURING ENT : JANSSENVILLE ELEMENTARY SCHOOL
: Janssen Ave, Janssenville Subd. Brgy San Juan, Cainta Rizal
Address :
___
:
Contact No. :___ 9163351867
___
Contact Person :___
___ JACKIELYN P. FRANCISCO
:___
___
___
___
___
___
___
___ ABSTRACT OF QUOTATION
___
___
___
___
___
Project Name ___
___ SCHOOL-BASED FEEDING PROGRAM SY 2020-2021 Date of Opening: MARCH 29, 2021
___
___
Project Location ___
___ Janssen Ave, Janssenville Subd. Brgy San Juan, Cainta Rizal
___
___
___
___
___
___
Implementing Office ___ JANSSENVILLE ELEMENTARY SCHOOL
___
___
___
Approved Budget for the Contract ___:___
___ ₱ 382,320.00
___
___
___
___
___
___
___
___
___ DESCRIPTION BIDDER 1 BIDDER 2 BIDDER 3
___
___
___
___
Delivery of Food Supplies for ALLYCEL GEN. MERCHANDISE INFINITE ENTERPRISES BETTY LOVE FOOD SERVICES
___
School-Based Feeding Program SY
2020-2021

ALLYCEL GEN.
Remarks LOWEST BIDDER ₱ 382,320.00
MERCHANDISE

Recommending award as
Quotation No. Name of Supplier: Amount in Pesos:
follows:
RFQ 2021-03-0001 MARICEL P. SANTIAGO ₱ 382,320.00

RFQ 2021-03-0001 ELIZABETH PEREZ ₱ 390,915.00

RFQ 2021-03-0001 LYN SAN JOSE ARCIA ₱ 393,711.00

RODNEY M. AREVALO ROMNICK L. ARENAS LIZEL P. VILLAROYA LOPE J. JEBUNAN JR. JACKIELYN P. FRANCISCO
BAC CHAIRMAN BAC VICE-CHAIRMAN BAC MEMBER BAC MEMBER BAC MEMBER