Appendix 62

Republic of the Philippines

School
logo DEPARTMENT OF EDUCATION
NATIONAL CAPITAL REGION
DIVISION OF CITY SCHOOLS - MANILA
ELEMENTARY SCHOOL
School Address

INSPECTION AND ACCEPTANCE REPORT

Drop Off Points: STA. ANA ELEMENTARY SCHOOL

Entry Name : Department of Education - AMD Fund Cluster : OSEC

Supplier : HACIENDA MACALAUAN, INC. IAR No.

PO No. / Date : Date :
Requisitioning Office/Dept. : AMD Invoice No.
Responsibilty Center Code : HA 08 Date :
Quantity
No. of STYRO BOX
Description Unit No. of STYRO BOX
No. of STYRO No. of STYRO
BOX Receive BOX Damage RETURN (Good
Condition)

AGUINALDO ELEMENTARY SCHOOL pcs. 74 3 71

TOTAL 1L Tetra Pack

TOTAL No. of STYRO BOX 74 3

INSPECTION ACCEPTANCE

Date Inspected : Date Received :

Inspected, verified and found in order as Complete
to quantity and specifications Partial (pls. specify quantity)

JOSEFINO A. MENDOZA II
Name
Principal

IAN HERBERT Y. MONFORTE

Name
School Property Custodian IAN HERBERT Y. MONFORTE
Name
JESUSA T. TEOTICO Supply and or Property Custodian
Name
School Feeding Coordinator