DV No.

20-01-20
DISBURSEMENT VOUCHER
DATE : 01/06/20

BARANGAY GOVERNMENT OF PAMUCUTAN City/Municipality : ZAMBOANGA CITY

Province :
Payee : EL CAPITAN MOBILE SOUND SYSTEM Employee No.: Fund: 10% sk fund
ADDRESS: Zamboanga City TIN No:
PARTICULARS AMOUNT

To payment for rent expenses of SOUND SYSTEM

in the amount of …………………………. 40.000.00

A. CERTIFIED B. CERTIFIED C. CERTIFIED:

Existence of Available appropriations Funds (Cash) Available As to validity, propriety,
for the charges/expenses indicated above and legality of claim

Approved:
For Payment

Signature: Signature: Signature:

Printed Name: ALBERTO B. BANTAY Printed Name: SOLITO P. ROJAS Printed Name: ROBERTO V. CARPIO

Position: Chairman,Committee on Position: Barangay Treasurer Position: Punong Barangay

Appropriation
Date: Date: Date:
D. Received Payment:

EL CAPITAN MOBILE SOUND SYSTEM Check No. : 728495 Date:

Signature Over Printed Name Bank Name: LBP-Zamboanga (KCC)
O. R. No. : ___________ Date:
Date : _____________

E. Accounting Entries
Account
Account Debit Credit
Code

Prepared By:

SUSAN S. BAUTISTA
Barangay Bookkeeper Date

Approved By:

City Municipal Account Date

 INSPECTION AND ACCEPTANCE REPORT

BARANGAY GOVERNMENT OF CALARIAN City: ZAMBOANGA CITY

Tel No. 955-3520 Province: Zamboanga Peninsula

Supplier: Z.C Petron Gas Station & Services Invoice No. Various IAR NO.: various RIS No.
Center
P.O.: C-1504-00018 Date: 27-Apr Date: Various Date: various Date: 4/01/15

UNIT DESCRIPTION QUANTITY

Ltrs Diesel Fuel 1,116
Ltrs Gasoline (Xtra) 27
Ltrs Gasoline (Unleaded) 25
qrtz Trekker (Engine Oil) 12
qrtz ATF (Engine Oil) 1
qrtz Extra Ultron (Engine Oil) 1
qrtz Brake Fluid 1

Date Inspected: Date Received:

( ) Inspected Verifed as to quantity and specification. ( ) Complete
( ) Partial (Pls. Specify quantity Received

TERESITA R. TABI MARICRIS F. RAMASASA

Signature over Printed Name Barangay Treasurer
Authorized Inspector
BARANGAY GOVERNMENT OF CALARIAN Project Reference Number :
Standard Form Number (SF) SERVICES - 02 Name of the Project : Purchase of Goods
Location of the Project : Calarian, Zamboanga

APPROVED BUDGET FOR THE CONTRACT

Fuel. Oil & Lubricants
Name of Project & Location

VAT, Other Other Cost Factors (Cost of

Item No. Description Quantity Unit Current Taxes and/or Freight and Other Indirect Supply, Inflation, Currency Total Cost Unit Cost
Market Value Duties Insurance Cost Valuation Adjustment)
Applicable % Value
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10 ) (11 ) (12 )
1 Diesel Fuel 154 Ltrs 5,448.14 308.39 5,756.52 37.38
2 Diesel Fuel 227 Ltrs 8,239.09 466.36 8,705.45 38.35
3 Diesel Fuel 207 Ltrs 7,865.82 445.23 8,311.05 40.15
4 Diesel Fuel 344 Ltrs 13,136.81 743.59 13,880.40 40.35
5 Diesel Fuel 40 Ltrs 1,508.61 85.39 1,594.00 39.85
6 Diesel Fuel 38 Ltrs 1,394.70 78.95 1,473.64 38.78
7 Diesel Fuel 106 Ltrs 3,736.97 211.53 3,948.50 37.25
8 Gasoline (Xtra) 12 Ltrs 628.28 35.56 663.84 55.32
9 Gasoline (Xtra) 6 Ltrs 316.81 17.93 334.74 55.79
10 Gasoline (Xtra) 9 Ltrs 478.70 27.10 505.80 56.20
11 Gasoline (Unleaded) 25 Ltrs 1,316.01 74.49 1,390.50 55.62
12 Trekker Oil (Engine Oil) 12 qrtz 2,464.50 139.50 2,604.00 217.00
13 ATF (Engine Oil) 1 qrtz 202.54 11.46 214.00 214.00
14 Extra Ultron (Engine Oil) 1 qrtz 175.09 9.91 185.00 185
15 Brake Fluid 1 qrtz 286.77 16.23 303.00 303

GRAND TOTAL P 49,870.44

Submitted by: Recommending Approval: Approved:

MARICRIS F. RAMASASA ARNEL

TERESITA
M. SORIANO
R. TABI EL KING K. OMAGA
Barangay Treasurer Chairman, Committee on Appropriation Punong Barangay
 PURCHASE REQUEST

BARANGAY GOVERNMENT OF CALARIAN P.R. No. C-1504-00018

City : ZAMBOANGA CITY Date: April 01, 2015
REQUISITION

Item Unit of Estimated Estimated

Qty.
Number Measurement ITEM DESCRIPTION Unit Cost Amount
1 154 liters Diesel Fuel 37.38 5,756.52
2 227 liters Diesel Fuel 38.35 8,705.45
3 207 liters Diesel Fuel 40.15 8,311.05
4 344 liters Diesel Fuel 40.35 13,880.40
5 40 liters Diesel Fuel 39.85 1,594.00
6 38 liters Diesel Fuel 38.78 1,473.64
7 106 liters Diesel Fuel 37.25 3,948.50
8 12 liters Gasoline (xtra) 55.32 663.84
9 6 liters Gasoline (xtra) 55.79 334.74
10 9 liters Gasoline (xtra) 56.20 505.80
11 25 liters Gasoline (unleaded) 55.62 1,390.50
12 12 qrts Trekker (Engine Oil) 217.00 2,604.00
13 1 qrts ATF (Engine Oil) 214.00 214.00
14 1 qrts Extra Ultron (Engine Oil) 185.00 185.00
15 1 qrts Brake Fluid 303.00 303.00

TOTAL ESTIMATED AMOUNT : FORTY NINE THOUSAND EIGHT HUNDRED SEVENTY & 44/100
ONLY P 49,870.44
Purpose:

For Official Use in the Office of the Sangguniang Barangay

Requested By: Approved:

JOSEPH MORALES EL KING K. OMAGA

Brgy. Utility Punong Barangay
April 1, 2015 April 1, 2015
Date Date
 PURCHASED ORDER
Barangay: Calarian City/Municipality: Zamboanga City
Tel. No.: 955-3520 Province: Zamboanga Del Sur
Supplier: Z.C Petron Gas Station & P.O No.: C-1504-00018
Services Center Date April 27, 2015
Address: Tumaga Main Road, Mode of Procurement:
Tumaga, Zamboanga City ( X ) Bidding ( ) Negotiated ( ) Over the Counter

Gentlemen:
Please deliver to this office the following articles subject to the terms and conditions contanied herein.

Place of delivery: Barangay Calarian Delivery Term: Two (02) days upon receipt
Date of Delviery: Various Payment Term: n/20
Unit Particulars Qty Unit Cost Amount:
Ltrs Diesel Fuel 154 37.38 5,756.52
Ltrs Diesel Fuel 227 38.35 8,705.45
Ltrs Diesel Fuel 207 40.15 8,311.05
Ltrs Diesel Fuel 344 40.35 13,880.40
Ltrs Diesel Fuel 40 39.85 1,594.00
Ltrs Diesel Fuel 38 38.78 1,473.64
Ltrs Diesel Fuel 106 37.25 3,948.50
Ltrs Gasoline (Xtra) 12 55.32 663.84
Ltrs Gasoline (Xtra) 6 55.79 334.74
Ltrs Gasoline (Xtra) 9 56.20 505.80
Ltrs Gasoline (Unleaded) 25 55.62 1,390.50
qrtz Trekker Oil (Engine Oil) 12 217.00 2,604.00
qrtz ATF (Engine Oil) 1 214.00 214.00
qrtz Extra Ultron (Engine Oil) 1 185.00 185.00
qrtz Brake Fluid 1 303.00 303.00

49,870.44
Total Amount: Forty Nine Thousand Eight Hundred Seventy & 44/100 Pesos Only (P*49,870.44)

Incase failure to make full delivery within the time specified above, a penalty of one-tenth(1/10) of
one percent everyday of delay shall be imposed.

Respectfully yours,

EL KING K. OMAGA
Barangay Captain

03/31/15
Date

Conformed: Existence of Available Appropriations: P49,870.44

of: Forty Nine Thousand Eight Hundred Seventy &
44/100 Only
Z.C Petron Gas Station & Services Center Teresita R. Tabi
Signature Over Pinted Name: Signature Over Pinted Name:
Supplier Chairman, Committee on Appropriations
April 27, 2015 April 27, 2015
Date Date