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TESDA-OP-CO-01-F13

(Rev.No.00-03/08/17)
LIST OF TOOLS
(As listed in the respective TR)

Program : BRAED AND PASTRY PRODUCTION


Name of Institution/Company: ACCELERATED METAL TECHNOLOGY AND CONSTRUCTION, INC.

Name of Tools Specification Quantity Required Quantity on Site Difference Inspector's Remarks

(1) (2) (3) (4) (5) (6)


Measuring cup, solid 8 unit 8 unit
Measuring cup (250 &500 ml) 1 unit 1 unit
Measuring Spoon 1 unit 1 unit
Cake turner Table 8 unit 8 unit
Decorating tips 1 unit 1 unit
Rolling pins 2 unit 2 unit
Pie pan sizes 6, 8, 10 2 unit 2 unit
Sheet pans 1 unit 1 unit
Pie cutter 8 unit 8 unit
Rubber scrapper 2 unit 2 unit
Palette knife 1 unit 1 unit
Cake stand with tier 4 pcs 4 pcs
Cake pillar 2 unit 2 unit
Sauce pan s/s 4 pcs 4 pcs
Ladles s/s 4 pcs 4 pcs
knives s/s with plastic handle 4 unit 4 unit
chopping board, color coded 8 pcs 8 pcs
Scale 2, 10kg 4 pcs 4 pcs
Grater 1 unit 1 unit
Wooden spoons 8 pcs 8 pcs
Beaters 2 unit 2 unit
Mixing bowl (6 pcs per set) 4 unit 4 unit
Wire whisk 1 unit 1 unit
Muffin pan Small 6 pcs 6 pcs
Muffin pan meduim 6 pcs 6 pcs
Muffin pan large 6 pcs 6 pcs
loaf pan small 6 pcs 6 pcs
loaf pan meduim 6 pcs 6 pcs
loaf large 6 pcs 6 pcs
reactangular pan 1x8x8 4 pcs 4 pcs
Round pan 6,8,10, 12,14,16 6 pcs 6 pcs
Pie pan 6 pcs 6 pcs
Flour sifter 6 pcs 6 pcs
Strainer 6 pcs 6 pcs
Double boiler 3 pcs 3 pcs
Coupler
Piping bags
Note: Columns 1-4 to be filled out by Institution/Company; Columns 5-6 to be filled out by PO/Expert
Continue in additional sheet
Submitted By: Attested By:
CHARISMA S. ABAD ENGR. ANTONIO M. TUMOLVA
TVI/Company Representative TVI/Company Head
Date: _____________ Date: _____________
Inspected By:
______________________________________ ___________________________________
PO UTPRAS Focal Person Expert
Date: ______________ Date: _____________
TESDA-OP-CO-01-F14
(Rev.No.00-03/08/17)
LIST OF EQUIPMENTS
(As listed in the respective TR)

Program : BRAED AND PASTRY PRODUCTION


Name of Institution/Company: ACCELERATED METAL TECHNOLOGY AND CONSTRUCTION, INC.

Inspector's
Name of Equipments Specification Quantity Required Quantity on Site Difference
Remarks

(1) (2) (3) (4) (5) (6)


Commercial mixer with complete
attachment 6 6
Mechanical Dough Roller 1 1
Decker oven 1 1
Compressor 1 1
gas range 4 4
Upright Frezeer 1 1
Refrigerator 1 1

Note: Columns 1-4 to be filled out by Institution/Company; Columns 5-6 to be filled out by PO/Expert
Continue in additional sheet

Submitted By: Attested By:


CHARISMA S. ABAD ENGR. ANTONIO M. TUMOLVA
TVI/Company Representative TVI/Company Head
Date:_____________ Date: _____________
Inspected By:
______________________________________ ___________________________________
PO UTPRAS Focal Person Expert
Date: ______________ Date: _____________
TESDA-OP-CO-01-F15
(Rev.No.00-03/08/17)

LIST OF CONSUMABLES/MATERIALS
(As listed in the respective TR)

Program : BRAED AND PASTRY PRODUCTION


Name of Institution/Company: ACCELERATED METAL TECHNOLOGY AND CONSTRUCTION, INC.

Inspector's
List of Consumables/Materials Specification Quantity Required Quantity on Site Difference
Remarks

(1) (2) (3) (4) (5) (6)


Cake Flour
Break Flour
All- purpose flour
sugar
yeast
butter
margarine
butter french bread)
Cooking oil
Lard
All-purpose cream
Whipping Cream
Confectionary sugar
Knox gelatin
Flaxed almonds
chocolate chips
chocolate shredded
Cherries with stem
Cherries
Food Colors
Tropical fruits
Whole wheat, rye, multi grain
Cream Cheese
Paper cups
Tulip paste
Sugar Lace
Pineapple juice
Cointreau

Note: Columns 1-4 to be filled out by Institution/Company; Columns 5-6 to be filled out by PO/Expert
Continue in additional sheet

Submitted By: Attested By:


CHARISMA S. ABAD ENGR. ANTONIO M. TUMOLVA
TVI/Company Representative TVI/Company Head
Date:____________ Date: _____________
Inspected By:
______________________________________ ___________________________________
PO UTPRAS Focal Person Expert
Date: ______________ Date: _____________
TESDA-OP-CO-01-F16
(Rev.No.00-03/08/17)

LIST OF INSTRUCTIONAL MATERIALS/LIBRARY HOLDINGS

Program : BRAED AND PASTRY PRODUCTION


Name of Institution/Company: ACCELERATED METAL TECHNOLOGY AND CONSTRUCTION, INC.

Inspectors
Title Classification* Date of Publication No. of Copies (where applicable)
Remarks

Wilton Decorating Magazine, video book 2001 1


Good Housekeeping Baking Book book 2012 1
the big book baking book 2008 1

Note *Classify whether journal, book, magazine, electronic materials aveilable on electronic media or in the
internet, etc.
Columns 1-4 to be filled out by Institution/Company; Column 5 to be filled out by PO/Expert
Continue in additional sheet

Submitted By: Attested By:


CHARISMA S. ABAD ENGR. ANTONIO M. TUMOLVA
TVI/Company Representative TVI/Company Head
Date: ______________ Date: _____________
Inspected By:
______________________________________ ___________________________________
PO UTPRAS Focal Person Expert
Date: ______________ Date: _____________
TESDA-OP-CO-01-F18
(Rev.No.00-03/08/17)

LIST OF OFF-CAMPUS PHYSICAL FACILITIES


Program : _________________________________
Name of Institution/Company: ________________________

Title Description Quantity Inspector's Remark

NONE

Note: Columns 1-3 to be filled out by Institution/Company; Columns 4 to be filled out by PO/Expert
Continue in additional sheet

Submitted By: Attested By:


CHARISMA S. ABAD ENGR. ANTONIO M. TUMOLVA
TVI/Company Representative TVI/Company Head
Date: ______________ Date: _____________
Inspected By:
______________________________________ ___________________________________
PO UTPRAS Focal Person
Date: ______________ Date:
TESDA-OP-CO-01-F13
(Rev.No.00-03/08/17)
LIST OF TOOLS
(As listed in the respective TR)

Program : COOKERY NCII


Name of Institution/Company: ACCELERATED METAL TECHNOLOGY AND CONSTRUCTION, INC.

Name of Tools Specification Quantity Required Quantity on Site Difference Inspector's Remarks

(1) (2) (3) (4) (5) (6)


Chef's knife 10 pcs 10 pcs
boning knife 8 pcs 8 pcs
Oyster knifes 4 pcs 4 pcs
Cleaver knifes 2 pcs 2 pcs
Tendenizer medium, small 8 pcs 8 pcs
Skimmer fine 8 pcs 8 pcs

Wire skimmer small 8 pcs 8 pcs


Skimmers spider 8 pcs 8 pcs
Strainer, small fine 8 pcs 8 pcs
Siever small 8 pcs 8 pcs
Strainer, medium fine 8 pcs 8 pcs
Turner "3x 6" 8 pcs 8 pcs
Spatula 8 pcs 8 pcs
Wooden spoons 8 pcs 8 pcs
Parisienne scoop 8 pcs 8 pcs
Zester 8 pcs 8 pcs
Piping bag 8 pcs 8 pcs
Pastry tubes 8 pcs 8 pcs
Strainer Chinois , small 3 pcs 3 pcs
Strainer Chinois , medium 2 pcs 2 pcs
Funnel small 4 pcs 4 pcs
Funnel medium 4 pcs 4 pcs
Measuring spoon 6 sets 6 sets
Tong 8 inches 10 pcs 10 pcs
Tong 12 inches 8 pcs 8 pcs
Measuring cup 8 sets 8 sets
Measuring urn 4 pcs 4 pcs
Ice cream scoop 2 pcs 2 pcs
Cheese Cloth 10 pcs 10 pcs
Serving spoon 24 pcs 24 pcs
Pepper and salt mill 4 sets 4 sets
Weighing Scale 5 kg 2 units 2 units
weighimh scale 1000grams 4 units 4 units
Apple corer 8 pcs 8 pcs
Wire whisk, small 8 pcs 8 pcs
Wire whisk, medium 8 pcs 8 pcs
Wire whisk heavy duty 2 pcs 2 pcs
Can opener 1 pc 1 pc
Kitchen scissors 8 pcs 8 pcs
Soup Ladle, 3 oz 8 pcs 8 pcs
Soup ladle 6 oz 8 pcs 8 pcs
Soup ladle 8 oz 3 pcs 3 pcs
Soup ladle 12oz 2 pcs 2 pcs
Note: Columns 1-4 to be filled out by Institution/Company; Columns 5-6 to be filled out by PO/Expert
Continue in additional sheet
Submitted By: Attested By:
CHARISMA S. ABAD ENGR. ANTONIO M. TUMOLVA
TVI/Company Representative TVI/Company Head
Date: _____________ Date: _____________
Inspected By:
______________________________________ ___________________________________
PO UTPRAS Focal Person Expert
Date: ______________ Date: _____________

TESDA-OP-CO-01-F14
(Rev.No.00-03/08/17)
LIST OF EQUIPMENTS
(As listed in the respective TR)

Program : COOKERY NCII


Name of Institution/Company: ACCELERATED METAL TECHNOLOGY AND CONSTRUCTION, INC.

Name of Equipments Specification Quantity Required Quantity on Site Difference Inspector's Remarks

(1) (2) (3) (4) (5) (6)


Office Equipment
Electric fan 1 unit 1 unit
First and cabinet 3 unit 3 unit
Filing cabinet 3 layers compartment 1 unit 1 unit
TV 1 unit 1 unit
Video player 2 unit 2 unit
Fire extinguisher 1 unit 1 unit
Emergency Light 1 unit 1 unit
Directional signage/s for each rooms 1 pc 1 pc
air condition 1 unit 1 unit
telephone 1 unit 1 unit
computer with internet connection 3 unit 3 unit
Fax machine 1 unit 1 unit
LCD 2 unit 2 unit
Laboratory Equipment
Air conditioner 1 unit 1 unit
Fire extinguisher 2 unit 2 unit
Emergency Light 1 unit 1 unit
combination of broiler and griddle-small 1 unit 1 unit
Exhaust hood 3 unit 3 unit
Dish washing machine (optional) 1 unit 1 unit
Blender machine 1 unit 1 unit
Pressure cooker medium Salamander griller 1 unit 1 unit
Braising pan - meduim 8 unit 8 unit
Note: Columns 1-4 to be filled out by Institution/Company; Columns 5-6 to be filled out by PO/Expert
Continue in additional sheet

Submitted By: Attested By:


CHARISMA S. ABAD ENGR. ANTONIO M. TUMOLVA
TVI/Company Representative TVI/Company Head
Date:_____________ Date: _____________
Inspected By:
______________________________________ ___________________________________
PO UTPRAS Focal Person Expert
Date: ______________ Date: _____________
TESDA-OP-CO-01-F15
(Rev.No.00-03/08/17)

LIST OF CONSUMABLES/MATERIALS
(As listed in the respective TR)

Program : COOKERY NCII


Name of Institution/Company: ACCELERATED METAL TECHNOLOGY AND CONSTRUCTION, INC.

List of Consumables/Materials Specification Quantity Required Quantity on Site Difference Inspector's Remarks

(1) (2) (3) (4) (5) (6)


MEAT
Beef
Pork
Lamp/mutton
Veal
POULTRY
Chicken
Duck
Turkey
Pigeon, etc.
SEAFOOD
Fish
Shellfish
Crustacean
PERISHABLES
Vegestables
Fruits
Dairy product
Processed food
DRY GOODS (GROCERIES)
Sauces
Spices and Herbs
Seasoning
Canned fruits
Canned vegestables
Noodles
Pasta
Rice
Flour
Sugar
Micellaneneous
Charcoal
Tooth picks
Aluminum foil
Wax paper
Cling wrap
Tissue paper
Paper towel
Liquid soap
Note: Columns 1-4 to be filled out by Institution/Company; Columns 5-6 to be filled out by PO/Expert
Continue in additional sheet

Submitted By: Attested By:


CHARISMA S. ABAD ENGR. ANTONIO M. TUMOLVA
TVI/Company Representative TVI/Company Head
Date:____________ Date: _____________
Inspected By:
______________________________________ ___________________________________
PO UTPRAS Focal Person Expert
Date: ______________ Date: _____________

TESDA-OP-CO-01-F16
(Rev.No.00-03/08/17)

LIST OF INSTRUCTIONAL MATERIALS/LIBRARY HOLDINGS

Program : COOKERY NCII


Name of Institution/Company: ACCELERATED METAL TECHNOLOGY AND CONSTRUCTION, INC.

Title Classification* Date of Publication No. of Copies (where applicable) Inspectors Remarks

the illustrated cook book of Ingredients 2010 1


recipes healthy kids 2012 1
food day cook book 2012 1
antonietta's cook book 2010 1

Note *Classify whether journal, book, magazine, electronic materials aveilable on electronic media or in the
internet, etc.
Columns 1-4 to be filled out by Institution/Company; Column 5 to be filled out by PO/Expert
Continue in additional sheet

Submitted By: Attested By:


CHARISMA S. ABAD ENGR. ANTONIO M. TUMOLVA
TVI/Company Representative TVI/Company Head
Date: ______________ Date: _____________
Inspected By:
______________________________________ ___________________________________
PO UTPRAS Focal Person Expert
Date: ______________ Date: _____________
TESDA-OP-CO-01-F18
(Rev.No.00-03/08/17)

LIST OF OFF-CAMPUS PHYSICAL FACILITIES


Program : _________________________________
Name of Institution/Company: ________________________

Title Description Quantity Inspector's Remark

Note: Columns 1-3 to be filled out by Institution/Company; Columns 4 to be filled out by PO/Expert
Continue in additional sheet

Submitted By: Attested By:


CHARISMA S. ABAD ENGR. ANTONIO M. TUMOLVA
TVI/Company Representative TVI/Company Head
Date: ______________ Date: _____________
Inspected By:
______________________________________ ___________________________________
PO UTPRAS Focal Person Expert
Date: ______________ Date:
TESDA-OP-CO-01-F13
(Rev.No.00-03/08/17)
LIST OF TOOLS
(As listed in the respective TR)

Program : COOKERY NCII


Name of Institution/Company: ACCELERATED METAL TECHNOLOGY AND CONSTRUCTION, INC.

Name of Tools Specification Quantity Required Quantity on Site Difference Inspector's Remarks
(1) (2) (3) (4) (5) (6)
Kitchen spoon 8 pcs 8 pcs
Kitchen spoon slooted 8 pcs 8 pcs
Kitchen fork 8 pcs 8 pcs
Carving knifes 3 pcs 3 pcs
Pocket/pin thermometer 3 pcs 3 pcs
Peelers 8 pcs 8 pcs
Stock pot, large 2 pcs 2 pcs
Frying pan small 12 pcs 12 pcs
Frying pan meduim 5 pcs 5 pcs
Frying pan Large 2 pcs 2 pcs
Colander small 4 pcs 4 pcs
Colander meduim 2 pcs 2 pcs
Cutting board 16 pcs 16 pcs
Fish poacher, meduim 1 pc 1 pc
Casserole, small 12 pcs 12 pcs
Casserole, meduim 4 pcs 4 pcs
Wok small 4 pcs 4 pcs
Wok meduim 1 pc 1 pc
Double boiler meduim 1 pc 1 pc
Paella pan 8 pcs 8 pcs
Glass rack 12 pcs 12 pcs
Soup cup rack 12 pcs 12 pcs
Plate rack 12 pcs 12 pcs
Baking tray, small 8 pcs 8 pcs
Utility tray, stainless 12 pcs 12 pcs
Roasting pan 4 pcs 4 pcs
Note: Columns 1-4 to be filled out by Institution/Company; Columns 5-6 to be filled out by PO/Expert
Continue in additional sheet
Submitted By: Attested By:
CHARISMA S. ABAD ENGR. ANTONIO M. TUMOLVA
TVI/Company Representative TVI/Company Head
Date: _____________ Date: _____________
Inspected By:
______________________________________ ___________________________________
PO UTPRAS Focal Person Expert
Date: ______________ Date: _____________
LIST OF EQUIPMENTS
(As listed in the respective TR)

Program : COOKERY NCII


Name of Institution/Company: ACCELERATED METAL TECHNOLOGY AND CONSTRUCTION, INC.

Name of Equipments Specification Quantity Required Quantity on Site Difference Inspector's Remarks

(1) (2) (3) (4) (5) (6)


Laboratory Equipment
Braising pan meduim 8 unit 8 unit
Meat slicer small 1 unit 1 unit
Meat chopper machine 1 unit 1 unit
Preparation table w/ sink& shelves (approx 45x28) 8 unit 8 unit
Bain Marie- table w/4 compartments 1 unit 1 unit
Working sink tables w/ 3 compartment 2 unit 2 unit
Condiments cabinet 2 unit 2 unit
Washing sink tables w/ 3 compartment 1 unit 1 unit
Utility shelving 8 unit 8 unit
Stainless steel rack shelves 2 unit 2 unit
Utility cart 1 unit 1 unit
Floor mops 4 pcs 4 pcs
Mop Squeezer 2 unit 2 unit
Broom(tambo) 4 pcs 4 pcs
Dust pan 4 pcs 4 pcs
Garbage bin (4gals.) 4 unit 4 unit
Liquid soap dispenser 8 pcs 8 pcs
Paper towel dispenser 4 pcs 4 pcs
Reach-in freezer 1 unit 1 unit
Office Equipment
Reach-in refrigerator 2 unit 2 unit
4 burner gas range w/ oven 4 unit 4 unit
Stock pan burner 1 unit 1 unit

Note: Columns 1-4 to be filled out by Institution/Company; Columns 5-6 to be filled out by PO/Expert
Continue in additional sheet

Submitted By: Attested By:


CHARISMA S. ABAD ENGR. ANTONIO M. TUMOLVA
TVI/Company Representative TVI/Company Head
Date:_____________ Date: _____________
Inspected By:
______________________________________ ___________________________________
PO UTPRAS Focal Person Expert
Date: ______________ Date: _____________
TESDA-OP-CO-01-F13
(Rev.No.00-03/08/17)
LIST OF TOOLS
(As listed in the respective TR)

Program : Barista NCII


Name of Institution/Company: ACCELERATED METAL TECHNOLOGY AND CONSTRUCTION, INC.

Name of Tools Specification Quantity Required Quantity on Site Difference Inspector's Remarks
(1) (2) (3) (4) (5) (6)
Hand tampers 2 2
Bar spoon 3 3
Tamping pads 2 2
Espresso cleanning tools (brushes) 1 set 1 set
Cleaning chemical 1 1
Screw drivers 1 set 1 set
Thermometer w/ clip 2 2
Shot glasses 12 12
Demitasse caps w/ saucers 12 12
Cappuccino cups w/ cups w/ saucers 12 12
latte cups w/ saucers 12 12
20 oz steaming pitcher 6 6
32 oz steaming pitcher 4 4
10 or 12 oz steaming pitcher 2 2
demitasse 1 doz 1 doz
demistasse teacpoons 1 doz 1 doz
teaspoons 1 doz 1 doz
water goblets 6 6
colin or pilsner 12 12
irish glass 6 6
Note: Columns 1-4 to be filled out by Institution/Company; Columns 5-6 to be filled out by PO/Expert
Continue in additional sheet
Submitted By: Attested By:
CHARISMA S. ABAD ENGR. ANTONIO M. TUMOLVA
TVI/Company Representative TVI/Company Head
Date: _____________ Date: _____________
Inspected By:
______________________________________ ___________________________________
PO UTPRAS Focal Person Expert
Date: ______________ Date: _____________
TESDA-OP-CO-01-F14
(Rev.No.00-03/08/17)
LIST OF EQUIPMENTS
(As listed in the respective TR)

Program : Barista NCII


Name of Institution/Company: ACCELERATED METAL TECHNOLOGY AND CONSTRUCTION, INC.

Inspector's
Name of Equipments Specification Quantity Required Quantity on Site Difference
Remarks

(1) (2) (3) (4) (5) (6)


2 group ( semi- automatic commercial types espresso 1 1
1 group semi automatic commercial type espresso machine 2 2
Refrigerator or cooler for milk/ cream 1 1
Doser grinder (commercial type) 1 1
Chiller/ Refrigerator 1 1
French press 2 2
Sypon 2 2
Pour over/ V60 Hnad drip 3 3
Moka pot/stove top espresso maker 1 1
Automatic drip coffee maker 1 1
Table top stove; camping stove 1 1
Commercial blender with extra pitcher 1 1
knock box 2 2
Hand stopwatches 3 3
3 in 1 Cocktail Shaker 2 2
Note: Columns 1-4 to be filled out by Institution/Company; Columns 5-6 to be filled out by PO/Expert
Continue in additional sheet

Submitted By: Attested By:


CHARISMA S. ABAD ENGR. ANTONIO M. TUMOLVA
TVI/Company Representative TVI/Company Head
Date:_____________ Date: _____________
Inspected By:
______________________________________ ___________________________________
PO UTPRAS Focal Person Expert
Date: ______________ Date: _____________
TESDA-OP-CO-01-F15
(Rev.No.00-03/08/17)

LIST OF CONSUMABLES/MATERIALS
(As listed in the respective TR)

Program : Barista NCII


Name of Institution/Company: ACCELERATED METAL TECHNOLOGY AND CONSTRUCTION, INC.

Inspector's
List of Consumables/Materials Specification Quantity Required Quantity on Site Difference
Remarks

(1) (2) (3) (4) (5) (6)


Coffe beans (Fresh roasted whole) 25 kilos 25 kilos
Fresh milk 30 cases 30 cases
Liquid cream 1 case 1 case
Assorted Flavored syrups with pumps 2 bottle 2 bottle
Assorted Fruit pureeers/ sauces with pumps 1 jar each 1 jar each
stirers 1 pack 1 pack
Straws 1 pack 1 pack
Lint free rags (3 colors) 30 pcs 30 pcs
Whipped crean dispenser with nozzle 2 2
Whipped cream charger 2 boxes 2 boxes
Paper filer 1 pack 1 pack
blind filter 1 1
Roubd bar trays 5 5
Milk carafe 2 2
Squeezer bottles 3 3
Water pitcher 2 2
Coller/ chest box 1 1
All purpose tongs 2 2
All purpose tongs 2 2
Spatula 1 1
Note: Columns 1-4 to be filled out by Institution/Company; Columns 5-6 to be filled out by PO/Expert
Continue in additional sheet

Submitted By: Attested By:


CHARISMA S. ABAD ENGR. ANTONIO M. TUMOLVA
TVI/Company Representative TVI/Company Head
Date:____________ Date: _____________
Inspected By:
______________________________________ ___________________________________
PO UTPRAS Focal Person Expert
Date: ______________ Date: _____________
TESDA-OP-CO-01-F16
(Rev.No.00-03/08/17)

LIST OF INSTRUCTIONAL MATERIALS/LIBRARY HOLDINGS

Program : Barista NCII


Name of Institution/Company: ACCELERATED METAL TECHNOLOGY AND CONSTRUCTION, INC.

Inspectors
Title Classification* Date of Publication No. of Copies (where applicable)
Remarks

coffee ninja barista manual 1


coffee creation 1
coffee recipes 1
hot cold bold 1
barista recipes book 1
barista training 1

Note *Classify whether journal, book, magazine, electronic materials aveilable on electronic media or in the
internet, etc.
Columns 1-4 to be filled out by Institution/Company; Column 5 to be filled out by PO/Expert
Continue in additional sheet

Submitted By: Attested By:


CHARISMA S. ABAD ENGR. ANTONIO M. TUMOLVA
TVI/Company Representative TVI/Company Head
Date: ______________ Date: _____________
Inspected By:
______________________________________ ___________________________________
PO UTPRAS Focal Person Expert
Date: ______________ Date: _____________
TESDA-OP-CO-01-F18
(Rev.No.00-03/08/17)

LIST OF OFF-CAMPUS PHYSICAL FACILITIES


Program : _________________________________
Name of Institution/Company: ________________________

Title Description Quantity Inspector's Remark

Note: Columns 1-3 to be filled out by Institution/Company; Columns 4 to be filled out by PO/Expert
Continue in additional sheet

Submitted By: Attested By:


CHARISMA S. ABAD ENGR. ANTONIO M. TUMOLVA
TVI/Company Representative TVI/Company Head
Date: ______________ Date: _____________
Inspected By:
______________________________________ ___________________________________
PO UTPRAS Focal Person
Date: ______________ Date:

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