2nd Quarter

Appendix 3.2.
2
DEPARTMENT OF EDUCATION Fund Cluster :
Division of Himamaylan City 01
Date :
DISBURSEMENT VOUCHER DV No. :
Mode of MDS Check Commercial Check ADA Others (Please specify)

Payment
TIN: Employee No.: ORS/BURS No.:
Payee MELCHORITA N. JAINGA
CUSTODIO CASTRO ELEM. SCHOOL
Address
DISTRICT OF HIMAMAYLAN I
Responsibility
Particulars Center
MFO/PAP Amount
To payment of the 1ST QTR. MOOE CASH ADVANCE ₱61,350.00

C.Y 2020 of CUSTODIO CASTRO ELEM. SCHOOL as per
supporting papers hereto attached…
Repair & Maintenance - School Bldg. 50213040-02 ₱30,000.00

General Services - Watchman / Utility 50212990-00 ₱6,000.00
Travel Expenses 50201010-00 ₱1,000.00
Electricity Expense 50204020-00 ₱3,000.00
Mobile / Communication Bill 50205020-01 ₱3,000.00
Internet Subscription 50205020-01 DO - ELEM 310400100002000 ₱3,000.00
Fedility Bond Premiums 50215020-00 ₱1,500.00
Medical, Dental, & Laboratory Supplies 50203080-00 ₱13,850.00
LBP Account #: 1176140700

District
Branch : LBP - Bacolod Main
Amount Due ₱61,350.00

A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.
BERNIE L. LIBO-ON, PhD

OIC-ASST.SCHOOLS DIVISION SUPERINTENDENT
B. Accounting Entry:
Account Title UACS Code Debit Credit
Advances to Operating Expenses 19901010 00 61,350.00
Cash, MDS - Regular 10104040 00 61,350.00
TOTAL 61,350.00 61,350.00

C. Certified: D. Approved for Payment
Cash available
Subject to Authority to Debit Account (when applicable)
Sup Supporting documents complete and amount claimed

proper
Signature Signature
Printed Name ERIC JOHN T. COÑATE, CPA, MBA Printed Name REYNALDO G. GICO, EdD, CESO VI
Accountant III OIC-Schools Division Superintendent
Position Position
Head, Accounting Unit/Authorized Representative OSDS-HIMAMAYLAN DIVISION
Date Date
E. Receipt of Payment JEV No. :
Check/ Bank Name & Account Number:
Date :
ADA No. : LBP Account #: 1176140700
MELCHORITA N. JAINGA Date :
Signature : Date :
Printed Name
Official Receipt No. & Date/Other Documents
Please indi pag islan or e erase :)
Indicate the purpose of Cash Advance and Breakdown the expenses as enumerated in the
Budgetary Requirements for the Quarter.
you may CHANGE/DELETE Account not applicable

me
nt
of
the
1S
T Appendix 3.2.3
QT
OBLIGATION
R. REQUEST AND STATUS Serial No. :
M
DEPARTMENT OF EDUCATION Date :
O
OE Division of Himamaylan City Fund Cluster: 01
CA
Payee MELCHORITA
SH
N. JAINGA
AD
Office CUSTODIO CASTRO ELEM. SCHOOL
VA
NC
Address DISTRICT OF HIMAMAYLAN I
E
C.
Responsibility Y. UACS Object
Center Particulars MFO/PAP Code Amount
201
7 To obligate the payment of the 1ST
of
QTR. MOOE CASH ADVANCE C.Y. 2019 31040010000
DO - ELEM TE 2000
of CUSTODIO CASTRO ELEM. SCHOOL
A
as per supporting papers hereto attached…
M
IN
AY
AU Repair & Maintenance - School Bldg. 50213040 02 30,000.00
AN General Services - Watchman / Utility 50212990 00 6,000.00
EL Travel Expenses 50201010 00 1,000.00
E Electricity Expense 50204020 00 3,000.00
M. Mobile / Communication Bill 50205020 01 3,000.00
SC
Internet Subscription 50205020 01 3,000.00
H
O Fedility Bond Premiums 50215020 00 1,500.00
OL Medical, Dental, & Laboratory Supplies 50203080 00 13,850.00
as
per
sup
por
tin
g TOTAL ₱61,350.00
pap
A. Certified: ers
Charges to appropriation/alloment are B. Certified: Allotment available and
her
necessary, lawful and under my direct supervision;and obligated for the purpose/adjustment
eto
supporting documents valid, proper and legal: necessary as indicated above:
atta
che
d…
Signature
Printed Signature:
:Name:
___________ Printed
___________ BERNIE L. LIBO-ON, PhD Name:
Joh An May A. Villalva, MBA
___________
___
Position : OIC-Asst. Schools Division Superintendent Position: Administrative Officer V - Finance
Head, Budget Division/Unit/Authorized
Head, Requesting Office/Authorized Representative
Representative
Date : Date:
C. STATUS OF OBLIGATION
Reference Amount
Balance
Obligat
ion Payable Payment Not Yet Due and
Date Particulars ORS/JEV/Check/ADA/TRA No.
Due Demandable
(a) (b) (c) (a-b) (b-c)
Responsibility Center MFO/PAP
Elementary 302050002
High School 302050003
Expenses UACs Object Code

TRAVEL 50201010 00
TRAINING 50202010 00
OFFICE SUPPLIES 50203010 00
FUEL, OIL & OTHER LUBRICANTS 50203090 00
OTHER SUPPLIES & MAT. EXP. 50203990 00
WATER 50204010 00
ELECTRICITY 50204020 00
TELEPHONE EXPENSE - MOBILE 50205020 01
REPAIR & MAINT. - SCHL. BLDG. 50213040 02
FIDELITY BOND PREMIUNS 50215020 00
LABOR & WAGES (HS Watchman) 50216010 00
Agricultural & Marine Expenses 50203100 00
OTHER GENERAL SERVICES (ELEM Watchman) 50212990 00
DRUGS & MEDICINES 50203070 00
Si Mam Joh An May A. Vilalva na di ang ga Sign… kag sir Bernie

Appendix 3.2.4
ORDER OF PAYMENT
DepEd - Division of Himamaylan City
Date
THE CASH COLLECTING OFFICER
Cash Unit
Please issue Official Receipt in favor of:
Name
in the amount of
for payment of (be specific)
Purpose
Cash Advance:
per Bill No. Amount Spent:
dated Refund ₱ -
Please deposit in the collections under/bank account/s
No. Name of Bank Amount
LBP (Treasury) ₱ -
ERIC JOHN T. COÑATE, CPA,MBA

Accountant III
District:
School:
Cash Advance: -
Disbursement Voucher No.:
Amount: -
Check / ADA No.:
Date of Check / ADA:
Type of Fund:
Journal Entry Voucher for payment of refund

ACCOUNT
ACCOUNTS TITLE DEBIT CREDIT
CODE
₱ -
₱ -
TOTAL ₱ - ₱ -
Current Year: Subsidy from National Government 40300000 - 00
Prior Years: Accumulated Surplus (Deficit) 30101010 - 00

Appendix 3.2.5
Serial No. :
NOTICE OF OBLIGATION REQUEST AND STATUS ADJUSTMENT
Date :
DEPARTMENT OF EDUCATION Fund Cluster : 01
For:
Administrative Officer V- Budget
Please adjust ORS No. dated

due to the following changes:
Responsibility Center to
Particulars from
Particulars to
MFO / PAP from
MFO / PAP to
Account Code from
Account Code to
Amount to
Please adjust RAOD for excess/under obligation per attached

JEV No. dated
Prepared by: Approved by:
Senior Bookkeeper /Administrative Officer II Accountant III
Certified Correct: Verified by:
School Head Administrative Officer V- Budget

Appendix 3.2.6
LIQUIDATION REPORT Serial No.:
For the Period: 1ST TRANCHE. C.Y. 2019 Date:
Entity Name : DEPARTMENT OF EDUCATION Responsibility Center Code:

Fund Cluster : 07-001-08-06006 DO - ELEM
PARTICULARS AMOUNT
To Liquidate the 1ST TRANCHE SBFP CASH ADVANCE

C.Y. 2019 of Doña Gregoria Ramos Mem. School with Php 75,600.00
ADA # 101-09-274__________________ dated Sept. 18, 2019
Lot 1 Vegetables and Other Items 12,600.00

Lot 2 Groceries 16,800.00
Lot 3 Fish, Meat and Poultry 37,800.00
Lot 4 Other Commodities 8,400.00
District VI
TOTAL AMOUNT SPENT 75,600.00
AMOUNT OF CASH ADVANCE PER DV No.: 19-09-3779 dated: 09/16/19 75,600.00
AMOUNT OF REFUNDED O.R. No.: dated: 0.00
AMOUNT TO BE REIMBURSED 0.00
Certified : Correctness of the Certified: Purpose of Tavel / Certified: Supporting documents

above data: Cash Advance duly accomplished: complete and proper:
ALEXANDER A. SAMSON ARLENE E. YAP,PhD ERIC JOHN T. COÑATE, CPA, MBA

School Head SGOD Chief Accountant III
JEV No.:
Date: Date: Date:
To be filled-up by the Accounting
personnel.
Amount of Cash Advance
Breakdown of Expenses
DELETE nyo lang ang Account nga

wala unod
Kindly Fill-up the DV number and Date.

personnel.
Appendix 3.2.6
LIQUIDATION REPORT Serial No.:
For the Period: 1ST QTR. C.Y. Date:
Entity Name : DEPARTMENT OF EDUCATION Responsibility Center Code:

Fund Cluster : 01 DO - ELEM
PARTICULARS AMOUNT
To Liquidate the 1ST QTR. MOOE CASH ADVANCE

C.Y. 2019 of CUSTODIO CASTRO ELEM. SCHOOL with Php 58,150.00
ADA # _______________________ dated ____________
Office Supplies Expense 25,000.00

Other Supplies & Materials 18,750.00
Other General Services - Watchman 6,000.00
Telephone Expense-Mobile 900.00
Internet Subcription Expense 1,500.00
Drugs & Medicines Expenses 6,000.00
District 1
TOTAL AMOUNT SPENT 58,150.00
AMOUNT OF CASH ADVANCE PER DV No.: dated: 58,150.00
AMOUNT OF REFUNDED O.R. No.: dated: 0.00
AMOUNT TO BE REIMBURSED 0.00
Certified : Correctness of the Certified: Purpose of Tavel / Certified: Supporting documents

above data: Cash Advance duly accomplished: complete and proper:
MELCHORITA N. JAINGA ARLENE E. YAP,PhD ERIC JOHN T. COÑATE, CPA, MBA

School Head SGOD Chief Accountant III
JEV No.:
Date: Date: Date:
personnel.
Amount of Cash Advance
Breakdown of Expenses
DELETE nyo lang ang Account nga

wala unod
Kindly Fill-up the DV number and Date.

personnel.
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region VI - Western Visayas
Schools Division of Himamaylan City
Vallega St., Himamaylan City, Negros Occidental
District Vl
HIMAMAYLAN CENTRAL SCHOOL Indicate the Name of your Schoo
CASH DISBURSEMENTS REGISTER

For the Period: ________ CY________
TYPE OF WORKING FUND: MOOE C.Y. 2019
ADVANCES FOR OPERATING EXPENSES (19901010-00) B R E A K D O W N OF P A Y M E N T S

REFERENC
E AMOUNT
DATE PAYEE/ PARTICULARS Other supplies & TOTAL
(OR/RER/ Food Supplies Expenses Other General Services (cook)
CHECK #) materials
BALANCE
AMOUNT RECEIVED PAYMENTS (6=4-
5) 50203050 00 50203990-00 50212990-00
(1) (2) (3) (4) (5) (6) (7) (8) (10) (12) (19) (20)
1 10.00 10.00 Breakdown every transactions per OR
2 Lot 1 Vegetable & Other Items 1.00 9.00 1.00 1.00

3 Lot 2 Grocery Items 2.00 7.00 2.00 2.00 Arrange every transactions in C
4 Lot 3 Meat, Fish & Poultry Items 3.00 4.00 3.00 3.00 per transact
5 Lot 4 Operational Expenses 4.00 0.00 3.00 1.00 4.00
6 Training Include the expenses paid in the R
7 Expenses
8 Travel Include the expenses paid during
9 Expenses diem)
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
TOTAL 10.00 10.00 0.00 1.00 2.00 3.00 3.00 1.00 10.00
CERTIFIED CORRECT: CERTIFIED SUPPORTING DOCUMENTS COMPLETE:
JAMIELYN V. DAVID ERIC JOHN T. COÑATE, CPA, MBA

School Head/Accountable Officer Administrative Assistant III Accountant III
DATE: DATE : DATE:
Note: Breakdown of Accounts can be change base on what is needed and CERTIFIED correct should be signed by School Head or whoever the Fedility bond is attached
e Name of your School in CAPITAL LETTERS
every transactions per OR #, RER #, DV #, Invoice #, etc.
every transactions in CHRONOLOGICAL ORDER

per transaction/s.
expenses paid in the REGISTRATION & TRAININGs CONDUCTED ONLY.
expenses paid during the travel (e.g. fare & per

diem)
Appendix 3.2.7
Schools Division of Himamaylan City
Vallega St., Brgy. I Pob.,Himamaylan City, Negros Occidental
District I
CUSTODIO CASTRO ELEMENTARY SCHOOL

For the Period: 1ST QTR. C.Y. 2019
ADVANCES FOR OPERATING EXPENSES
(19901010-00) B R E A K D O W N OF P A Y M E N T S
REFERENC
E AMOUNT Travel Repair & Fuel, Oil & Drugs & Telephone
DATE PAYEE/ PARTICULARS Training Fidelity Bond Office Supplies Other supplies Internet Security Other General TOTAL
(OR/RER/ Expense Maintenance -Sch. Other Medicines Expense-
CHECK #) Expenses Premiums Expense Bldg. & materials Subsciption Services Services
BALANCE (Local) Lubricants Expenses Mobile
AMOUNT
PAYMENTS
RECEIVED
(6=4-5) 50201010-00 50202010-00 50215020-00 50203010-00 50213040-02 50203990-00 50203090-00 50203070-00 50205020-01 50212030-00 50212990-00
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (19) (20)
.
1 3/25/2020 101-01-001 RODNEL A. MONCERA 58,150.00 58,150.00
2 5/15/2020 1926 ACGG GENERAL MEACHANDIZE 11,410.00 46,740.00 11,410.00 11,410.00
7 5/15/2020 DV RODEL A. PAREDES 6,000.00 8,400.00 6,000.00 6,000.00
8 5/15/2020 200028 FLORETE'S DRUG HAUS 1,767.00 6,633.00 1,767.00 1,767.00
11 5/15/2020 1931 ACGG GENERAL MEACHANDIZE 900.00 1,500.00 900.00 900.00
12 5/15/2020 1932 ACGG GENERAL MEACHANDIZE 1,500.00 0.00 1,500.00 1,500.00
TOTAL 58,150.00 58,150.00 0.00 0.00 0.00 0.00 25,000.00 0.00 18,750.00 1,500.00 0.00 6,000.00 900.00 0.00 6,000.00 58,150.00
CERTIFIED CORRECT: CERTIFIED SUPPORTING DOCUMENTS COMPLETE: NOTED:
MELCHORITA N. JAINGA JOHN R. VILLAVICENCIO ERIC JOHN T. COÑATE, CPA, MBA

DATE: DATE : DATE:
Division of Negros Occidental
Vallega St., Brgy. I Pob.,Himamaylan City, Negros Occidental
DISTRICT 1

For the Period: 1ST QTR. C.Y. 2019
ADVANCES FOR OPERATING EXPENSES
(19901010-00) B R E A K D O W N OF P A Y M E N T S
REFERENC
E AMOUNT Travel Repair & Fuel, Oil & Drugs & Telephone
DATE PAYEE/ PARTICULARS Training Fidelity Bond Office Supplies Other supplies Internet Security Other General TOTAL
(OR/RER/ Expense Maintenance -Sch. Other Medicines Expense-
CHECK #) Expenses Premiums Expense Bldg. & materials Subsciption Services Services
BALANCE (Local) Lubricants Expenses Mobile
AMOUNT
PAYMENTS
RECEIVED
(6=4-5) 50201010-00 50202010-00 50215020-00 50203010-00 50213040-02 50203990-00 0 50203090-00 50203070-00 50205020-01 50212030-00 50212990-00
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (19) (20)
BALANCE FORWARDED 58,150.00 58,150.00 0.00 0.00 0.00 0.00 25,000.00 0.00 18,750.00 1,500.00 0.00 6,000.00 900.00 0.00 6,000.00 58,150.00
23 0.00 0.00
24 0.00 0.00
25 0.00 0.00
26 0.00 0.00
27 0.00 0.00
28 0.00 0.00
29 0.00 0.00
30 0.00 0.00
31 0.00 0.00
32 0.00 0.00
33 0.00 0.00
34 0.00 0.00
35 0.00 0.00
36 0.00 0.00
37 0.00 0.00
38 0.00 0.00
39 0.00 0.00
40 0.00 0.00
GRAND TOTAL 58,150.00 58,150.00 0.00 0.00 0.00 0.00 25,000.00 0.00 18,750.00 1,500.00 0.00 6,000.00 900.00 0.00 6,000.00 58,150.00
CERTIFIED CORRECT: CERTIFIED SUPPORTING DOCUMENTS COMPLETE: NOTED:
MELCHORITA N. JAINGA JOHN R. VILLAVICENCIO ERIC JOHN T. COÑATE, CPA, MBA

DATE: DATE : DATE:
Indicate the Name of your School in CAPITAL LETTERS
Breakdown every transactions per OR #, RER #, DV #, Invoice #, etc.
Arrange every transactions in CHRONOLOGICAL ORDER

per transaction/s.
Training Include the expenses paid in the REGISTRATION & TRAININGs CONDUCTED ONLY.
Expenses
Travel Include the expenses paid during the travel (e.g. fare & per
Expenses diem)
Appendix 3.2.9- A
DIVISION OF HIMAMAYLAN
Vallega St., Brgy. I Pob., Himamaylan City
_______________ SENIOR HIGH SCHOOL
January 03, 2019
__________________________
OIC-Schools Division Superintendent
OSDS-HIMAMAYLAN DIVISION
Ma'am:
We would like to request for the processing and release of our 1ST
QTR./ TRANCHE MOOE CASH ADVANCE C.Y. 2019
for the following purposes:
Office Supplies ---------- ₱0.00

Description Unit Qty Amount
Semi-expandable Expenses ---------- ₱0.00

Travel Expenses -------------- ₱0.00
Personel Purpose Venue Date Amount

Appendix 3.2.9- B
Training Expenses -------------- ₱0.00
Title:
Purpose:
Date :
Venue
Repair and Maintenance Expense -------------- ₱0.00
Materials :
Total
Labor: Amount
Reproduction Expense -------------- ₱0.00
Purpose:
Recipients:
No. of Copies:
No. of Recipients:
Electricity Expense -------------- ₱0.00
Month Amount
Water Expense -------------- ₱0.00
Month Amount
Grand Total ₱0.00
SPG President Teacher League President PTA President

Barangay Captain Principal
CHANGE/DELETE nyo lang
ang Account nga wala unod
Appendix 3.2.11
DIVISION OF HIMAMAYLAN CITY
Vallega St., Brgy. I Pob., Himamaylan City, Neg. Occ.
BUDGETARY REQUIREMENTS FOR THE QUARTER

C.Y. 2020
2nd QUARTER:
- Repair & Maintenance - School Bldg. ₱30,000.00

- General Services - Watchman / Utility ₱6,000.00
- Travel Expenses ₱1,000.00
- Electricity Expense ₱3,000.00
- Mobile / Communication Bill ₱3,000.00
- Internet Subscription ₱3,000.00
- Fedility Bond Premiums ₱1,500.00
- Medical, Dental, & Laboratory Supplies ₱13,850.00
TOTAL ₱61,350.00
PRINCESS ANN G. CANON ERLINDA T. GARCIA RODEL A. PAREDES

SPG President Teacher League President PTA President
EDGAR T. GABIETA RODNEL A. MONCERA

LGU Representative School Head
Recommending Approval:
BERNIE L. LIBO-ON, PhD

OIC-Asst.Schools Division Superintendent
Approved:
REYNALDO G. GICO, EdD,CESO VI

Appendix 3.2.12
District I
PROGRAM OF WORKS
Name of Project:
School/Location: CUSTODIO CASTRO ELEM. SCHOOL

Fund Source: C.Y.__________ MOOE (GOP)
Scope of Work:
No. QTY. UNIT DESCRIPTION UNIT COST TOTAL COST
1 0.00
2 0.00
3 0.00
4 0.00
5 0.00
6 0.00
7 0.00
8 0.00
9 0.00
10 0.00
TOTAL 0.00
Total Cost of Materials 0.00

Labor Cost (35%) 0.00
Total Cost of Project 0.00
Prepared By: Approved By:
TIC / SPC Principal
Noted by: OK as to Fund:

BERNIE L. LIBO-ON,PhD ERIC JOHN T. COÑATE, CPA, MBA
OIC-ASDS Accountant III
ARLENE E. YAP, PhD REYNALDO G. GICO,EdD,CESO VI

SGOD Chief OIC-Schools Division Superintendent
PakiChange lang sang DESIGNATION ka IN
CHARGE SANG PROJECT
Kindly indicate the DESIGNATION of the

School Head
Appendix 3.2.13
PURCHASE REQUEST
Entity Name: DEPARTMENT OF EDUCATION Fund Cluster: 01

Office / Section: CUSTODIO CASTRO ELEM. SCHOOL PR No.: Date:
DISTRICT OF HIMAMAYLAN I Responsibility Center Code: DO - ELEM
Stock /
Property UNIT ITEM/DESCRIPTION QTY. UNIT COST TOTAL COST
No.
1 pieces Cellcards (Mobile Load) 3
Purpose: FOR MOBILE (COMMUNICATION PURPOSES)

Requested By: Approved:
Signature
Printed Name RODNEL A. MONCERA REYNALDO G. GICO, EdD, CESO VI
Designation School Head OIC-School Division Superintendent
PURCHASE REQUEST DATE should be BEFORE your Quotation Date.
Please LEAVE BLANK lng ang UNIT COST and TOTAL COST.
Indicate if ano ang PURPOSE SANG

CASH ADVANCE
Indicate if ANO ANG DESIGNATION sang in

charge sa project
Appendix 3.2.13
PURCHASE REQUEST

Stock /
No.
1 pieces Cellcards (Internet Load) 3
Purpose: PROCUREMENT OF OTHER OFFICE SUPPLIES

Signature

CASH ADVANCE

charge sa project
Appendix 3.2.13
PURCHASE REQUEST

Stock /
No.
1 piece Binding Machine 1
2 piece Water Heater 1
3 pieces Hedge Shear ( Heavy Duty) 4
4 piece Rice Cooker (10 cups) 1
5 piece Swivel Chair 1
6 pieces Rake 2
7 piece Wifi (Router) Globe 1
8 piece Wall Fan 1
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
Purpose: PROCUREMENT OF OTHER OFFICE SUPPLIES

Signature

CASH ADVANCE

charge sa project
Appendix 3.2.13
PURCHASE REQUEST

Stock /
No.
1 pcs Ferrous Sulfate 225
2 pcs Ascordic Acid 225
3 box Paracetamol 2
4 box Dicycloverine 4
5 pack Cotton Balls 3
6 pack Sanitary Napkin 4
7 bottle Rubbing Alchohol 500ml 3
8 roll Gauze Bandage 6 x 6 yards 2
9 pcs Sprain Binder/ Plaster Cast 2
10 pack Paper Tape (plaster) Big 3
11 bottle Pau De Arco 2
12 bottle Liquid Hand Wash 2
13 box Cooton 100g 2
14 bottle Efficasent Oil 50ml 2
15 bottle White Flower 4
16 bottles Betadine Oral 120 ml 2
17 bottle Toilet Bowl Cleaner (500ml) Domex 3
18 pack Safeguard Soap 90g 4
19 pcs BandAidWash Proof 45
20 pcs Citirizine 75
21 pcs Toilet Tissue 25
22 pcs Vicks 10
23 pcs Wipes 10
Purpose: PROCUREMENT OF DRUGS & MEDICINE

Signature

CASH ADVANCE

charge sa project
Appendix 3.2.13
PURCHASE REQUEST

Stock /
No.
1 reams Bond Paper A4 20
2 reams Bond Paper Long 20
3 pieces Ballpen (Faber Castel) Red 12
4 pieces Ballpen (Faber Castel) Black 12
5 pieces Correction Tape 20
6 pack Laminating Film (100/pack) 1
7 pieces Record Books 5
8 pieces Scissors (Big) 5
9 pieces Scotch Tape (2 inches) 5
10 pieces Sign Pen (Pilot) 24
11 sets Velum Long 10
12 pieces Cartolina Assorted Color 100
13 pieces Cutter Heavy Duty 5
14 pieces DTR 50
15 pieces Diploma Jacket 15
16 pieces Double Sided Tape 10
17 piece External Drive 1000 TB 1
18 pieces Masking Tape 5
19 pieces Stapler Remover 4
20 pieces Ribbons (3 Colors) 5
21 piece Dating & Stamping Machine 1
22 pieces Extended Folder Long (Blue) 25
23 box Fastener 10
24 pieces Folder with Plastic Cover 18
25 piece Paper Cutter 1
26
27
Purpose: PROCUREMENT OF OFFICEE SUPPLIES

Signature

CASH ADVANCE

charge sa project
Appendix 3.2.14
Vallega St., Brgy. I Pob., Himamaylan City, Neg.Occ
REQUEST FOR QUOTATION (RFQ) FOR GOODS
To all Eligible Suppliers:
I. Please qoute your lowest price inclusive of VAT on the item(s) listed below, subject to the Terms and Conditions of this RFQ. Submit or send your
quotation(s), duly signed by you or your representative, inside an (a sealed) envelope to the Bids and Awards Committee or its Secretariat on or before
_________, 0.00 AM at ________ Custodio Castro Elem. School, Brgy. Cabanbanan, Himamaylan City care of MARY SHARON T. GATA,
School Property Custodian. Please write the RFQ No.: ________, your business name and contact no. in front of your envelope. Quotation that exceeds the
approved budget for the Contract (ABC) per lot shall be rejected. Evaluation and award shall be done on a per lot basis. For more information please call us at
Mobile no.: 09108795775 care of MARY SHARON T. GATA. Prospective supplier shall be responsible to verify herein items from Team Custodio Castro
Elem. School, Brgy. Cabanbanan, Himamaylan City at Mobile no. 09108795775
Opening of RFQ will be on _________, 0:00 PM at _______, Custodio Castro Elem. School, Brgy. ________, Himamaylan City
ERLINDA T. GARCIA
BAC Chairman
II. Particulars
Approved QUANTITY AND SPECIFICATIONS / TOTAL

Item/Lot ITEM & DESCRIPTION / Budget for the BRAND / MODEL UNIT
UNIT OF PRICE IN
No. TECHNICAL SPECIFICATION Contract (ABC) No. (for Bidders to Fill- COST
in Php MEASURES PESOS
out)
1 Bond Paper A4 20 reams

2 Bond Paper Long 20 reams
3 Ballpen (Faber Castel) Red 12 pieces
4 Ballpen (Faber Castel) Black 12 pieces
5 Correction Tape 20 pieces
6 Laminating Film (100/pack) 1 pack
7 Record Books 5 pieces
8 Scissors (Big) 5 pieces
9 Scotch Tape (2 inches) 5 pieces
10 Sign Pen Pilot 24 pieces
11 Velum Long 10 sets
12 Cartolina Assorted Color 100 pieces
13 Cutter Heavy Duty 5 pieces
14 DTR 50 pieces
15 Diploma Jacket 15 pieces
16 Double Sided Tape 10 pieces
17 External Drive 1000 TB 1 piece
18 Masking Tape 5 pieces
19 Staple Remover 4 pieces
20 Ribbons (3 Colors) 5 pieces
21 Dating & Stamping Machine 1 piece
22 Extended Folder Long (Blue) 25 pieces
23 Fastener 10 pieces
24 Folder with Plastic Cover 18 pieces
25 Paper Cutter 1 piece
TOTAL 0.00
Delivery Peri
Delivered To
Payment:
This is to submit our price quotations a indicated above subject to the terms and conditions of this RFQ.
Supplier's
Business TIN:
Name:
Address:
Telephone No.: Fax No.: E-mail:
Supplier's
Authorized
representati
ve's Date:
Signature
over Printed
Name:
Page 1 of 1
Appendix 3.2.14
ERLINDA T. GARCIA
BAC Chairman
II. Particulars

UNIT OF PRICE IN
out)
1 Binding Machine 1 pc
2 Water Heater 1 pc
3 Hedge Shear ( Heavy Duty) 3 pcs
4 Rice Cooker (10 cups) 1 pc
5 Swivel Chair 1 pc
6 Rake 3 pcs
7 Wifi (Router) Globe 1 pc
8 Wall Fan 1 pc
TOTAL 0.00
Delivery Peri
Delivered To
Payment:
Supplier's
Business TIN:
Name:
Address:
Supplier's
Authorized
representati
ve's Date:
Signature
over Printed
Name:
Page 1 of 1
Appendix 3.2.14
ERLINDA T. GARCIA
BAC Chairman
II. Particulars

UNIT OF PRICE IN
out)
1 CELLCARDS FOR INTERNET 3 pcs
TOTAL
Delivery Peri
Delivered To
Payment:
Supplier's
Business TIN:
Name:
Address:
Supplier's
Authorized
representati
ve's Date:
Signature
over Printed
Name:
Page 1 of 1
Appendix 3.2.14
ERLINDA T. GARCIA
BAC Chairman
II. Particulars

UNIT OF PRICE IN
out)
1 Ferrous Sulfate 225 pcs

2 Ascordic Acid 225 pcs
3 Paracetamol 2 box
4 Dicycloverine 4 box
5 Cotton Balls 3 pack
6 Sanitary Napkin 4 pack
7 Rubbing Alchohol 500ml 3 bottle
8 Gauze Bandage 6 x 6 yards 2 roll
9 Sprain Binder/ Plaster Cast 2 pcs
10 Paper Tape (plaster) Big 3 pack
11 Pau De Arco 2 bottle
12 Liquid Hand Wash 2 bottle
13 Cooton 100g 2 box
14 Efficasent Oil 50ml 2 bottle
15 White Flower 4 bottle
16 Betadine Oral 120 ml 2 bottles
17 Toilet Bowl Cleaner (500ml) Domex 3 bottle
18 Safeguard Soap 90g 4 pack
19 BandAidWash Proof 45 pcs
20 Citirizine 75 pcs
21 Toilet Tissue 25 pcs
22 Vicks 10 pcs
23 Wipes 10 pcs
TOTAL 0.00
Delivery Peri
Delivered To
Payment:
Supplier's
Business TIN:
Name:
Address:
Supplier's
Authorized
representati
ve's Date:
Signature
over Printed
Name:
Page 1 of 1
Appendix 3.2.15
Division of Himamaylan
ABSTRACT OF SEALED CANVASS
Office / End User : CUSTODIO CASTRO ELEM. SCHOOL P.R.: 0

Date / Place : / :
Package :0
S U P P L I E R / C O N T R A C T O R / P R O V I D E R
QTY UNIT ITEM / DESCRIPTION
ACGG CELINAS TRENDS BEST DEPT. STORE
1 pieces Cell Card for Internet (Load) 3,000.00 3,150.00 3,300.00
TOTAL 3,000.00 3,150.00 3,300.00
MARY SHARON T. GATA MARIS D. TOTOL ERLINDA T. GARCIA

School Property Cutodian School Treasurer School League President
RODNEL A. MONCERA
School Head
ABSTRACT DATE is THE SAME with your BID OPENING
DATE.
5 OR 7 MEMBERS ang Signatories dependi sa kadakuon sang School

PakiChange lang sang ila Designation
Appendix 3.2.15

Date / Place : / :
Package :0
ACGG MGP STORE BEST DEPT. STORE
1 pieces Cell Card for Internet Load 1,500.00 1,515.00 1,530.00
TOTAL 1,500.00 1,515.00 1,530.00
MARY SHARON T. GATA JANICE G, PAREDES ERLINDA T. GARCIA

RODNEL A. MONCERA
School Head
DATE.

Appendix 3.2.15

Date / Place : / :
Package :0
FLORETES DRUG HAUS GBX PHARMACY VALYN DRUG STORE
225 pcs Ferrous Sulfate 337.50 450.00 450.00
225 pcs Ascorbic Acid 337.50 450.00 450.00
2 box Paracetamol 200.00 300.00 310.00
4 box Dicycloverine 400.00 400.00 400.00
3 pack Cotton Ball 48.00 54.00 60.00
4 pack Sanitary Napkin 88.00 96.00 96.00
3 bottles Rubbing alchohol 500 ml 240.00 240.00 255.00
2 roll Gauze Bandage 6 x 6 yards 116.00 116.00 120.00
2 pcs Sprain Binder/Plaster Cast 100.00 100.00 100.00
3 pack Paper Tape (plaster) Big 150.00 150.00 150.00
2 bottles Pau de Arco 260.00 270.00 270.00
2 bottles Liquid Hand Wash 240.00 240.00 240.00
2 box Cotton 100g 100.00 110.00 110.00
2 bottles Efficasent Oil 50ml 130.00 130.00 130.00
4 bottles White Flower 260.00 260.00 260.00
2 bottles Betadine Oral 120 ml 380.00 400.00 500.00
3 bottles Toilet Bowl Cleaner (500ml) Domex 300.00 300.00 300.00
4 pack Safeguard Soap 90g 128.00 120.00 140.00
45 pcs Bangd Aid wash Proof 585.00 585.00 675.00
75 pcs Citirizine 450.00 450.00 450.00
25 pcs Toilet Tissue 300.00 300.00 300.00
10 pcs Vicks 500.00 550.00 550.00
10 pcs Wipes 350.00 350.00 350.00
TOTAL 6,000.00 6,421.00 6,666.00

RODNEL A. MONCERA
School Head
DATE.

Appendix 3.2.15

Date / Place : / :
Package :0
ACGG CELINAS TRENDS & NOVELTIES BEST DEPT. STORE
20 reams Bond Paper A4 4,000.00 4,100.00 4,200.00
20 reams Bond Paper Long 4,500.00 4,600.00 4,700.00
12 pieces Ballpen (Faber Castel) Red 180.00 192.00 204.00
12 pieces Ballpen (Faber Castel) Black 180.00 192.00 204.00
20 pieces Correction Tape 600.00 640.00 660.00
1 pack Laminating Film (100/pack) 1,250.00 1,350.00 1,450.00
5 pieces Record Books 450.00 475.00 500.00
5 pieces Scissors (Big) 250.00 275.00 300.00
5 pieces Scotch Tape (2 inches) 225.00 230.00 235.00
24 pieces Sign Pen Pilot 1,920.00 2,040.00 2,160.00
10 sets Velum Long 400.00 450.00 500.00
100 pieces Cartolina Assorted Color 800.00 900.00 900.00
5 pieces Cutter Heavy Duty 1,125.00 1,150.00 1,175.00
50 pieces DTR 50.00 100.00 150.00
15 pieces Diploma Jacket 750.00 825.00 900.00
10 pieces Double Sided Tape 300.00 320.00 330.00
1 piece External Drive 1000 TB 3,990.00 4,050.00 4,050.00
5 pieces Masking Tape 200.00 205.00 205.00
4 pieces Staple Remover 120.00 132.00 132.00
5 pieces Ribbons (3 Colors) 925.00 950.00 975.00
1 piece Dating & Stamping Machine 150.00 155.00 160.00
25 pieces Extended Folder Long (Blue) 625.00 650.00 675.00
10 pieces Fastener 400.00 450.00 500.00
18 pieces Folder with Plastic Cover 360.00 396.00 414.00
1 piece Paper Cutter 1,250.00 1,260.00 1,270.00
TOTAL 25,000.00 26,087.00 26,949.00

RODNEL A. MONCERA
School Head
DATE.

Appendix 3.2.15

Date / Place : / :
Package :0
ACGG CELINAS TRENDS & NOVELTIES BEST DEPT. STORE
1 piece Binding Machine 8,190.00 8,290.00 8,390.00
1 piece Water Heater 550.00 560.00 570.00
4 pieces Hedge Shear ( Heavy Duty) 2,580.00 2,720.00 2,760.00
1 piece Rice Cooker (10 cups) 1,400.00 1,450.00 1,500.00
1 piece Swivel Chair 1,780.00 1,785.00 1,790.00
2 pieces Rake 800.00 425.00 450.00
1 piece Wifi (Router) Globe 1,050.00 1,060.00 1,070.00
1 piece Wall Fan 2,400.00 2,450.00 2,500.00
TOTAL 18,750.00 18,740.00 19,030.00

RODNEL A. MONCERA
School Head
DATE.

Appendix 3.2.16
PURCHASE ORDER
Supplier: ACGG MERCHANDISE P.O. No.: 0

Address: BINALBAGAN, NEGROS OCCIDENTAL Date:
Small Value
TIN: Mode of Procurement: Procurement
Gentlemen:
Please furnish this Office the following articles subject to the terms and conditions contained herein:
Place of Delivery: CUSTODIO CASTRO ELEM. SCHOOL Delivery Term: 10 working days
Date of Delivery: Payment Term: Cash on Delivery
STOCK /
PROPERTY No. UNIT ITEM/DESCRIPTION QTY. UNIT COST AMOUNT
1 pcs Thermal Scanner 1 0.00
2
3
4
5
6
7
8
TOTAL 0.00
Total Amount in Words:
In case of failure to make the full delivery within the time specified above, a penalty of one-tenth
(1/10) or one (1) percent for every day of delay shall be imposed on the undelivered item/s
Conforme: Very truly yours,
JOANA ALUMIA REYNALDO G. GICO,EdD, CESO VI

Signature over Printed Name of Supplier

Date Designation
Fund Cluster : 01 ORS/BURS No. :

Funds Available: ORS/BURS Date :
Allotment/ Appropriation Amount: ₱61,350.00
Available:
ERIC JOHN T. COÑATE,CPA,MBA JOH AN MAY A. VILLALVA, MBA

Accountant III Administrative Officer- Budget
Note that your PO Date must be after your Abstract
Date.
Kindly CHECK sang inyo DELIVERY TERM kag

DATE OF DELIVERY if gaCOINCIDE
Your AMOUNT is the TOTAL AMOUNT OF

YOUR CASH ADVANCE.
Appendix 3.2.16
PURCHASE ORDER
Supplier: ACGG MERCHANDISE P.O. No.: 0

Address: BINALBAGAN, NEGROS OCCIDENTAL Date:
Small Value
TIN: Mode of Procurement: Procurement
Gentlemen:
Please furnish this Office the following articles subject to the terms and conditions contained herein:
Place of Delivery: CUSTODIO CASTRO ELEM. SCHOOL Delivery Term: 10 working days
Date of Delivery: Payment Term: Cash on Delivery
STOCK /
PROPERTY No. UNIT ITEM/DESCRIPTION QTY. UNIT COST AMOUNT
1 pcs Cellcards for Internet Load 3 1,000.00 3,000.00
TOTAL 3,000.00
Total Amount in Words:
In case of failure to make the full delivery within the time specified above, a penalty of one-tenth
(1/10) or one (1) percent for every day of delay shall be imposed on the undelivered item/s
Conforme: Very truly yours,
JOANA ALUMIA REYNALDO G. GICO,EdD, CESO VI

Signature over Printed Name of Supplier

Date Designation
Fund Cluster : 01 ORS/BURS No. :

Funds Available: ORS/BURS Date :
Allotment/ Appropriation Amount: ₱61,350.00
Available:

Accountant III Administrative Officer- Budget
Note that your PO Date must be after your Abstract
Date.
Kindly CHECK sang inyo DELIVERY TERM kag

DATE OF DELIVERY if gaCOINCIDE
Your AMOUNT is the TOTAL AMOUNT OF

YOUR CASH ADVANCE.
Appendix 32

Division of Himamaylan City MOOE C.Y. 2019 1ST
Date :

Payment
TIN/Employee No.: ORS/BURS No.:
Payee FLORETE'S DRUG HAUS 122-019-453-000
DON PEDRO R. YULO ST., STO. ROSARIO, BINALBAGAN, NEGROS OCCIDENTAL

Address
Responsibility
Particulars Center
MFO/PAP Amount
To payment of the School Medicine & Drugs ₱6,000.00
DISTRICT I
Amount Due ₱6,000.00


Cash available

#ADDIN?
Sup
proper
Signature Signature
Printed
Name MARIS D. TOTOL Printed Name RODNEL A. MONCERA
School Treasurer SCHOOL HEAD
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
Date :
ADA No. :
FLORETE'S DRUG HAUS Date :
Signature : Date :
Printed Name
Provide School Based DV No. for School Reference.
iuop[- n
Amount here
Indicate the purpose of your DV such as payment for your Office Supplies,
Other General Services (Watchman), etc.
Appendix 32

Division of Himamaylan City MOOE C.Y. 2019 1ST
Date :

Payment
TIN/Employee No.: ORS/BURS No.:
Payee
POBLACION I
Address
HIMAMAYLAN CITY
Responsibility
Particulars Center
MFO/PAP Amount
To payment of the
DISTRICT VI
Amount Due ₱0.00


Cash available

#ADDIN?
Sup
proper
Signature Signature
Printed
Name
Printed Name BERNIE L. LIBO-ON, PhD
School Treasurer OIC-Asst. Schools Division Superintendent
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
Date :
ADA No. :
0 Date :
Signature : Date :
Printed Name
Provide School Based DV No. for School Reference.
Amount here
Indicate the purpose of your DV such as payment for your Office Supplies,
Other General Services (Watchman), etc.
Appendix 3.2.18
JOB REQUEST
DepEd - Division of Himamaylan City
(Agency)
Department: DISTRICT OF HIMAMAYLAN I JR No.: Date:
Section/School: CUSTODIO CASTRO ELEM. SCHOOL SAL No.: Date:
ALOBS No.: Date:
STOCK ESTIMATED UNIT ESTIMATED
UNIT JOB DESCRIPTION QTY
No. COST COST
TOTAL
Purpose:
Signature:
Name: REYNALDO G. GICO, EdD,CESO VI
Designation: School Head OIC-Schools Division Superintendent
Date:
JOB REQUEST DATE should be BEFORE your Quotation Date.
Ang ALOBS No. amo na siya ang ORS No.
Appendix 3.2.19
Office / End User : CUSTODIO CASTRO ELEM. SCHOOL J.R.: 0

Date / Place : / :
Package :
SUPPLIER / CONTRACTOR / PROVIDER

QTY ITEM / DESCRIPTION
GRAND TOTAL 0.00 0.00 0.00 0.00
1 2 3
BAC Member BAC Member BAC Member
BAC Member BAC Chairman

DATE.

JOB ORDER
Job Order No.: Date:

Job Request No.: Date:
Description of Works:
UNIT PRICE TOTAL
P__________
Received By:
Date Received:
Project Fund: MOOE C.Y. ____

Date Work Begin: Date Work Completed:
Inspected By: Date of Inspection:
School Inspector
REYNALDO G. GICO, EdD, CESO VI

School Head OIC-Schools Division Superintendent
Funds availability: Allotment Availability:

Accountant III Administrative Officer V- Budget
Appendix 3.2.20
pines
CATION
isayas
ylan
amaylan City
TOTAL
P__________
Kindly COMPLETE THE DATA. Wala ko idea if when nagsugod ang

project, when natapos kag when kamo nag inspect :)
REYNALDO G. GICO, EdD, CESO VI Kindly INDICATE THE CORRECT DESIGNATION

hen nagsugod ang
ON
Appendix 3.2.21

PRE - REPAIR INSPECTION REPORT
Item / Description:
Property Number: Property Accountability Receipt:
Aquisition Cost: Acquisition Date:
Nature and Scope of Last Repair if any:
Complaints / Defects:
Parts / Components to be Repaired / Replaced:
FINDINGS / OBSERVATIONS:
Property Inspector / Date
POST - REPAIR INSPECTION REPORT
Job Order No.: Amount: Invoice No.: Amount:
FINDINGS / COMMENTS:
Property Inspector / Date
JOB ORDER NO. same sang Job Request No. Ang
AMOUN, amount sang Labor. Then ang INVOICE NO. ang
OR No. kag ang AMOUNT amount sng materials.
Appendix 3.2.22

Date
CERTIFICATE OF COMPLETION
Name of Project:
School & Address:

Fund Source:
Appropriation:
Mode of Implementation:
We hereby certify that the above stated projects has been duly accomplished as of
and all works incorporated herein was done in accordance with the approved Program of Work, Plans and Specifications.
TIC / SPC School Head
CERTIFICATE OF INSPECTION
This is to certify that the above stated / named project with details listed above has been inspected
and verified in accordance with the Program of Work, plan/s and specification/s and workmanship on (date of
inspection and was found 100% completed, hence, recommended for full payment.
ARLENE E. YAP, PhD

SGOD Chief SPC / Designated School Inspector
CERTIFICATE OF ACCEPTANCE
Date
We hereby accept the above stated project that was found to be 100% completed in ccordance with the approved
Program of Works, plan/s and specification/s, and the workmanship is satisfactory.
TIC / SPC School Head
Appendix 3.2.23
REQUISITION AND ISSUE SLIP
Division: DIVISION OF NEGROS OCCIDENTAL Responsibility Center Code: DO - ELEM

Office: CUSTODIO CASTRO ELEM. SCHOOL RIS No.:
REQUISITION STOCK AVAILABLE? ISSUE
Stock No. Unit Description Qty Yes No Qty Remarks
1 pcs Ferrous Sulfate 225 / 225 Completed

2 pcs Ascorbic Acid 225 / 225 Completed
3 box Paracetamol 2 / 2 Completed
4 box Dicycloverine 4 / 4 Completed
5 pack Cotton Ball 3 / 3 Completed
6 pack Sanitary Napkin 4 / 4 Completed
7 bottle Rubbing alchohol 500 ml 3 / 3 Completed
8 roll Gauze Bandage 6 x 6 yards 2 / 2 Completed
9 pcs Sprain Binder/Plaster Cast 2 / 2 Completed
10 pack Paper Tape (plaster) Big 3 / 3 Completed
11 bottle Pau de Arco 2 / 2 Completed
12 bottle Liquid Hand Wash 2 / 2 Completed
13 box Cotton 100g 2 / 2 Completed
14 bottle Efficasent Oil 50ml 2 / 2 Completed
15 bottle White Flower 4 / 4 Completed
16 bottles Betadine Oral 120 ml 2 / 2 Completed
17 bottle Toilet Bowl Cleaner (500ml) Domex 3 / 3 Completed
18 pack Safeguard Soap 90g 4 / 4 Completed
19 packs Bangd Aid wash Proof 45 / 45 Completed
20 pcs Citirizine 75 / 75 Completed
21 pcs Toilet Tissue 25 / 25 Completed
22 pcs Vicks 10 / 10 Completed
23 pcs Wipes 10 / 10 Completed
Purpose:
Requested by: Approved: Issued by: Received by:
Signature
Printed Name MARIS D. TOTOL RODNEL A. MONCERA MARY SHARON T. GATA MARIS D. TOTOL
Designation School League President School Head School Property Custodian School League President
Date
Provide School Based RIS No. for School Reference.
REQUESTED BY and RECEIVED BY the TEACHER or END

USER or WHOEVER REQUESTED FOR IT.
Ferrous Sulfate
Ascorbic Acid
Paracetamol
Dicycloverine
Cotton Ball
Sanitary Napkin
Rubbing alchohol 500 ml
Gauze Bandage 6 x 6 yards
Sprain Binder/Plaster Cast
Paper Tape (plaster) Big
Pau de Arco
Liquid Hand Wash
Cotton 100g
Efficasent Oil 50ml
White Flower
Betadine Oral 120 ml
Toilet Bowl Cleaner (500ml) Domex
Safeguard Soap 90g
Bangd Aid wash Proof
Citirizine
Toilet Tissue
Vicks
Wipes
Appendix 3.2.17
INSPECTION AND ACCEPTANCE REPORT
Entity Name : DEPARTMENT OF EDUCATION Fund Cluster: 01
Supplier: ACGG GENERAL MERCHANDISE IAR No.:

P.O. No. / Date: / 12/30/99 Date:
Requisitioning Office / Dept.: CUSTODIO CASTRO ELEM. SCHOOL Invoice No.:
Responsibility Center Code : DO - ELEM Date:
Stock / Property
No.:
Description Unit Quantity
1 pcs 3
INSPECTION ACCEPTANCE
Date Inspected: Dated Received:
x Inspected, verified and found in x Complete

order as to quantity and
specifications Partial (please specify quantity)
MARIS D. TOTOL
MARY SHARON T. GATA

ERLINDA T. GARCIA Supply and / or Property Custodian
Inspection Officer / Inspection Committee
INVOICE NO. kag INVOICE DATE
same sang OR NO. kag OR DATE
DATE INSPECTED kag DELIVERY DATE parehas lang.

Diba pagDeliver ginaInspect man dayon if OK kag
Complete???
Please CHANGE sang "NAME OF INSPECTOR" sang

ACTUAL NAME KA TEACHER… Sa babaw sng line sya
dayon maPerma
Appendix 3.2.23
REQUISITION AND ISSUE SLIP
Division: DIVISION OF NEGROS OCCIDENTAL Responsibility Center Code: DO - ELEM

Office: CUSTODIO CASTRO ELEM. SCHOOL RIS No.:
REQUISITION STOCK AVAILABLE? ISSUE
Stock No. Unit Description Qty Yes No Qty Remarks
1 reams Bond Paper A4 20 / 20 Completed

2 reams Bond Paper Long 20 / 20 Completed
3 pieces Ballpen (Faber Castel) Red 12 / 12 Completed
4 pieces Ballpen (Faber Castel) Black 12 / 12 Completed
5 pieces Correction Tape 20 / 20 Completed
6 pack Laminating Film (100/pack) 1 / 1 Completed
7 pieces Record Books 5 / 5 Completed
8 pieces Scissors (Big) 5 / 5 Completed
9 pieces Scotch Tape (2 inches) 5 / 5 Completed
10 pieces Sign Pen Pilot 24 / 24 Completed
11 sets Velum Long 10 / 10 Completed
12 pieces Cartolina Assorted Color 100 / 100 Completed
13 pieces Cutter Heavy Duty 5 / 5 Completed
14 pieces DTR 50 / 50 Completed
15 pieces Diploma Jacket 15 / 15 Completed
16 pieces Double Sided Tape 10 / 10 Completed
17 piece External Drive 1000 TB 1 / 1 Completed
18 pieces Masking Tape 5 / 5 Completed
19 pieces Staple Remover 4 / 4 Completed
20 pieces Ribbons (3 Colors) 5 / 5 Completed
21 piece Dating & Stamping Machine 1 / 1 Completed
22 pieces Extended Folder Long (Blue) 25 / 25 Completed
23 pieces Fastener 10 / 10 Completed
24 pieces Folder with Plastic Cover 18 / 18 Completed
25 piece Paper Cutter 1 / 1 Completed
Purpose:
Requested by: Approved: Issued by: Received by:
Signature
Printed Name MARIS D. TOTOL RODNEL A. MONCERA MARY SHARON T. GATA MARIS D. TOTOL
Designation School League President School Head School Property Custodian School League President
Date
Provide School Based RIS No. for School Reference.
REQUESTED BY and RECEIVED BY the TEACHER or END

USER or WHOEVER REQUESTED FOR IT.
Appendix 3.2.24
INVENTORY CUSTODIAN SLIP

Entity Name: DEPARTMENT OF EDUCATION
Fund Cluster: 07-001-08-06006 ICS No.: 2ndMOOE-007
AMOUNT ESTIMATED
INVENTORY
QUANTITY UNIT DESCRIPTION ITEM No.
USEFUL LIFE
Unit Cost Total Cost (In Years)
1 piece ₱8,190.00 ₱8,190.00 Binding Machine 1 5

1 piece ₱550.00 ₱550.00 Water Heater 2 3
4 pieces ₱645.00 ₱2,580.00 Hedge Shear (Heavy Duty) 3 3
1 piece ₱1,400.00 ₱1,400.00 Rice Cooker (10cups) 4 5
1 piece ₱1,780.00 ₱1,780.00 Swivel Chair 5 3
2 piece ₱400.00 ₱800.00 Rake 6 3
1 piece ₱1,050.00 ₱1,050.00 Wifi (router) Globe 7 5
1 piece ₱2,400.00 ₱2,400.00 Wall Fan 8 5
Received from: Received by:
MARY SHARON T. GATA MARIS D. TOTOL

Signature Over Printed Name Signature Over Printed Name
SPC School League President

Position / Office Position / Office
Date Date
Provide School Based ICS NO.
Appendix 3.2.25
JOB ORDER
PERIOD OF EMPLOYMENT FUNDING

NAME DESIGNATION RATE/DAY OFFICE OF ASSIGNMENT ACKNOWLEDGEMENT
FROM TO CHARGES
RODEL PAREDES UTILITY 100.00 January 6, 2020 March 31, 2020 MOOE 1st Quarter Custodio Castro Elementary School
The said Job Order shall automatically cease upon the expiration as stipulated above, unless renewed. However, services of any or all of the above-names be terminated prior to the expiration of this Job Order for
lack of funds or when their services are no longer needed. The above-named hereby attest that he/she is not related within the third degree (fourth degree in case of LGU's) of consanguinity or affinity of the 1.) hiring
authority and of 2.) representative of the hiring agency, that he/she has not been previously dismissed from government service by reason of an administrative offense; that he/she has not already reached the
compulsory retirement age of sixty five (65). Furthermore, the service rendered hereunder is not considered or will never be accredited as government service. That the said appointee does not possess false eligibility.
Prepared by: Certified as to existence of available appropriations / Recommending Approval: Approved:

obligations:
RODNEL A. MONCERA JOH AN MAY A. VILLALVA, MBA BERNIE L. LIBO-ON,PhD REYNALDO G. GICO,EdD,CESI VI
School Head Administrative Officer V- Budget OIC-Assist. Schools Division Superintendent OIC-Schools Division Superintendent
Indicate the Name of your School in CAPITAL LETTERS
This Job Order is applicable only for the Watchman.
Kindly indicate the Designation of the School Head, e.g.

Principal I, Principal II, Principal III, Head Teacher I - III.
Appendix 3.2.28

--------------------------------------------------------------------
ITINERARY OF TRAVEL
Entity Name : DEPARTMENT OF EDUCATION

Fund Cluster: 07-001-08-06006
Name: JUANA DE LA CRUZ Date of Travel:

Position PRINCIPAL I Purpose of Travel:
Official Station: CUSTODIO CASTRO ELEM. SCHOOL
TIME Means of Per

Date Place to be visited Transportation Others TOTAL
Departure Arrival Transportation Diems
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
TOTAL -
Prepared by :
I certify that: (1) I have reviewed the foregoing itinerary,

(2) the travel is necessary to the service, (3) the period covered is
reasonable and (4) the expenses claimed are proper. Official/ Employee
Approved :
BERNIE L. LIBO-ON, PhD REYNALDO G.GICO,EdD,CESO VI

OIC - ASDS OIC - Schools Divivsion Superintendent
Appendix 3.2.28

--------------------------------------------------------------------
ITINERARY OF TRAVEL
Entity Name : DEPARTMENT OF EDUCATION

Fund Cluster: 07-001-08-06006
Name: JUANA DE LA CRUZ Date of Travel:

Position PRINCIPAL I Purpose of Travel:
Official Station: CUSTODIO CASTRO ELEM. SCHOOL
TIME Means of Per

Date Place to be visited Transportation Others TOTAL
Departure Arrival Transportation Diems
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
TOTAL -
Prepared by :
I certify that: (1) I have reviewed the foregoing itinerary,

(2) the travel is necessary to the service, (3) the period covered is
reasonable and (4) the expenses claimed are proper. Official/ Employee
Approved :

School Head OIC - Schools Division Superintendent
Appendix 3.2.29
CERTIFICATION OF TRAVEL COMPLETED
Schools Division Superintendent Station

I HEREBY CERTIFY THAT I have completed the travel as authorized in the Travel
Order / Itinerary of Travel No. dated under conditions indicated below:
( x ) Strictly in accordance with the approved itinerary.
( ) Cut short as explained below. Excess payment in the amount of Php

was refund on O.R. No. dated .
( ) Extended as explained below, additional itinerary was submitted.
( ) Other deviation as explained below.
Explanation or Justification:
Evidence of travel:
Travel Order, Certificate of Appearance, Itinerary of Travel, Tickets, Receipts, etc.
Respectfully submitted:
Official / Employee
On evidence and information of which I have the knowledge, the travel was actually
undertaken.
Approved:

OIC - Schools Division Superintendent
Appendix 3.2.29
CERTIFICATION OF TRAVEL COMPLETED
Schools Division Superintendent Station

I HEREBY CERTIFY THAT I have completed the travel as authorized in the Travel
Order / Itinerary of Travel No. dated under conditions indicated below:
( x ) Strictly in accordance with the approved itinerary.
( ) Cut short as explained below. Excess payment in the amount of Php

was refund on O.R. No. dated .
( ) Extended as explained below, additional itinerary was submitted.
( ) Other deviation as explained below.
Explanation or Justification:
Evidence of travel:
Travel Order, Certificate of Appearance, Itinerary of Travel, Tickets, Receipts, etc.
Respectfully submitted:
Official / Employee
On evidence and information of which I have the knowledge, the travel was actually
undertaken.
Approved:
School Head
Appendix 3.2.10
Region VI- Western Visayas
CERTIFICATION OF NO UNLIQUIDATED CASH ADVANCE

To whom it may concern: To who
Name : HONEY JOY G. VILLACANAS

Position : HEAD TEACHER I
School : CATINGIB ELEMENTARY SCHOOL
School District : DISTRICT OF HIMAMAYLAN VII
Purpose of Cash Advance Request : 2ND TRANCHE SBFP CASH ADVANCE
FOR 60 DAYS
C.Y. 2020
This is to certify that the school head whose name appears above has
liquidated 1ST Tranche SBFP Cash advance C.Y.2019. liquidat
This certification is issued for the above stated purpose/s only.
Issued this 4th day of JULY, 2020 at Accounting Section, Division Office,
Bacolod City, Negros Occidental. Bacolod
JAMIELYN V. DAVID
ADAS III
Appendix 3.2.10
Region VI- Western Visayas
0
CERTIFICATION OF NO UNLIQUIDATED CASH ADVANCE

To whom it may concern:
Name : MELCHORITA N. JAINGA

Position : HEAD TEACHER III
School : TALABAN ELEMENTARY SCHOOL
School District : DISTRICT OF HIMAMAYLAN II
Purpose of Cash Advance Request : 2ND TRANCHE SBFP CASH ADVANCE
FOR 60 DAYS
C.Y. 2020
This is to certify that the school head whose name appears above has
liquidated 1ST Tranche SBFP Cash advance C.Y.2019.
This certification is issued for the above stated purpose/s only.
Issued this 4th day of JULY, 2020 at Accounting Section, Division Office,
Bacolod City, Negros Occidental.
JOHN R. VILLAVICENCIO
ADAS III
Appendix 3.2.8
DISTRICT OF HIMAMAYLAN
PALOYPOY INTEGRATED SCHOOL (ELEMENTARY)
REQUEST FOR CASH ADVANCE
April 07, 2020
REYNALDO G. GICO,EdD,CESO VI
Sir:
We would like to request for the processing and release of our 1ST Tranche SBFP Cash Advance CY 2020 for
the following purposes:
Lot 1 Vegetable & Other Items ------------ ₱27,510.00

Lot 2 Grocery Items ------------ 29,167.50
Lot 3 Meat, Fish & Poultry Items ------------ 45,082.50
Lot 4 Operational Expenses ------------ 12,720.00
TOTAL ------------ ₱114,480.00
That in my capacity as Accountable Officer, I hereby DECLARE and ASSUME full responsibility in the
orderly procurement and the processes of my school pursuant to RA 9184 and other related laws under this
jurisdiction.
That I likewise DECLARE and ASSUME full and complete responsibilities for all transactions in connection
with the conduct of above process.
Requested by:
EDMON EDCA HONEY JOY G. VILLACANAS

Head Teacher I Accountable Officer ( if any )
Noted by:
SPG President Teacher League President
PTA President Barangay Captain
Recommending Approval: Approved:
BERNIE L. LIBO-ON, PhD REYNALDO G. GICO, EdD, CESO VI

Assistant Schools Division Superintendent Schools Division Superintendent
Appendix 3.2.8
July 02, 2021
Sir:
We would like to request for the processing and release of our JULY MOOE Cash Advance CY 2021 for the
following purposes:
Other Supplies & Materials Expenses (Graduation Expenses) ------------ ₱1,872.00

Office Supplies Expenses ------------ 1,127.00
Mobile E Load Communication ------------ 1,000.00
internet E Load Subscription ------------ 1,000.00
Other General Services - Utility ------------ 2,000.00
Fedility Bond ------------ 1,500.00
Travel Expenses ------------ 1,200.00
------------
TOTAL ------------ ₱9,699.00
That in my capacity as Accountable Officer, I hereby DECLARE and ASSUME full responsibility in the orderly
procurement and the processes of my school pursuant to RA 9184 and other related laws under this jurisdiction.
That I likewise DECLARE and ASSUME full and complete responsibilities for all transactions in connection with the
conduct of above process.
Requested by:
RODNEL A. MONCERA
School Head
Noted by:
CHRISLIE JOY B. GABIETA MARIS D. TOTOL

SALVACION JAMELANO EDGAR T. GABIETA

PTA President LGU Representative
MICHELL L. ACOYONG REYNALDO G. GICO, EdD, CESO VI

Assistant Schools Division Superintendent Schools Division Superintendent
Appendix 3.2.8
#REF!
#REF!
July 02, 2021
Sir:
We would like to request for the processing and release of our JULY MOOE Cash Advance CY 2021 for the
following purposes:
Other Supplies & Materials Expenses (Graduation Expenses) ------------ ₱1,872.00

Office Supplies Expenses ------------ 1,127.00
Mobile E-Load Communication ------------ 1,000.00
Internet E-Load Subscription ------------ 1,000.00
Other General Services - Utility ------------ 2,000.00
Fedility Bond ------------ 1,500.00
Travel Expenses ------------ 1,200.00
------------
TOTAL ------------ ₱9,699.00
That in my capacity as Accountable Officer, I hereby DECLARE and ASSUME full responsibility in the
orderly procurement and the processes of my school pursuant to RA 9184 and other related laws under this
jurisdiction.
That I likewise DECLARE and ASSUME full and complete responsibilities for all transactions in connection
with the conduct of above process.
Requested by:
RODNEL A. MONCERA
School Head
Noted by:
CHRISLIE JOY B. GABIETA MARIS D. TOTOL

SALVACION JAMELANO EDGAR T. GABIETA

PTA President LGU Representative
MICHELL L. ACOYONG REYNALDO G. GICO, EdD, CESO VI

Assistant Schools Division Superintendent OIC- Asst. Schools Division Superintendent
Appendix 3.2.8
Cash Advance CY 2021 for the
₱1,872.00
1,127.00
1,000.00
1,000.00
2,000.00
1,500.00
1,200.00
₱9,699.00
E full responsibility in the

elated laws under this
r all transactions in connection
RIS D. TOTOL
er League President
AR T. GABIETA
U Representative
G. GICO, EdD, CESO VI
ools Division Superintendent

2nd Quarter

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Appendix 3.2.

Mode of MDS Check Commercial Check ADA Others (Please specify)

To payment of the 1ST QTR. MOOE CASH ADVANCE ₱61,350.00

Repair & Maintenance - School Bldg. 50213040-02 ₱30,000.00

LBP Account #: 1176140700

Amount Due ₱61,350.00

BERNIE L. LIBO-ON, PhD

TOTAL 61,350.00 61,350.00

Subject to Authority to Debit Account (when applicable)

Sup Supporting documents complete and amount claimed

you may CHANGE/DELETE Account not applicable

Expenses UACs Object Code

Si Mam Joh An May A. Vilalva na di ang ga Sign… kag sir Bernie

Please issue Official Receipt in favor of:

for payment of (be specific)

Please deposit in the collections under/bank account/s

No. Name of Bank Amount

ERIC JOHN T. COÑATE, CPA,MBA

Journal Entry Voucher for payment of refund

Prior Years: Accumulated Surplus (Deficit) 30101010 - 00

Please adjust ORS No. dated

Please adjust RAOD for excess/under obligation per attached

Prepared by: Approved by:

Senior Bookkeeper /Administrative Officer II Accountant III

Certified Correct: Verified by:

School Head Administrative Officer V- Budget

LIQUIDATION REPORT Serial No.:

For the Period: 1ST TRANCHE. C.Y. 2019 Date:

Entity Name : DEPARTMENT OF EDUCATION Responsibility Center Code:

To Liquidate the 1ST TRANCHE SBFP CASH ADVANCE

Lot 1 Vegetables and Other Items 12,600.00

TOTAL AMOUNT SPENT 75,600.00

AMOUNT OF CASH ADVANCE PER DV No.: 19-09-3779 dated: 09/16/19 75,600.00

AMOUNT OF REFUNDED O.R. No.: dated: 0.00

AMOUNT TO BE REIMBURSED 0.00

Certified : Correctness of the Certified: Purpose of Tavel / Certified: Supporting documents

ALEXANDER A. SAMSON ARLENE E. YAP,PhD ERIC JOHN T. COÑATE, CPA, MBA

Amount of Cash Advance

DELETE nyo lang ang Account nga

Kindly Fill-up the DV number and Date.

To be filled-up by the Accounting

LIQUIDATION REPORT Serial No.:

For the Period: 1ST QTR. C.Y. Date:

Entity Name : DEPARTMENT OF EDUCATION Responsibility Center Code:

To Liquidate the 1ST QTR. MOOE CASH ADVANCE

Office Supplies Expense 25,000.00

TOTAL AMOUNT SPENT 58,150.00

AMOUNT OF CASH ADVANCE PER DV No.: dated: 58,150.00

AMOUNT OF REFUNDED O.R. No.: dated: 0.00

AMOUNT TO BE REIMBURSED 0.00

Certified : Correctness of the Certified: Purpose of Tavel / Certified: Supporting documents

MELCHORITA N. JAINGA ARLENE E. YAP,PhD ERIC JOHN T. COÑATE, CPA, MBA

Amount of Cash Advance

DELETE nyo lang ang Account nga

Kindly Fill-up the DV number and Date.

To be filled-up by the Accounting

CASH DISBURSEMENTS REGISTER

ADVANCES FOR OPERATING EXPENSES (19901010-00) B R E A K D O W N OF P A Y M E N T S

1 10.00 10.00 Breakdown every transactions per OR

2 Lot 1 Vegetable & Other Items 1.00 9.00 1.00 1.00

CERTIFIED CORRECT: CERTIFIED SUPPORTING DOCUMENTS COMPLETE:

JAMIELYN V. DAVID ERIC JOHN T. COÑATE, CPA, MBA

every transactions per OR #, RER #, DV #, Invoice #, etc.