PURCHASE REQUEST

PROVINCIAL GOVERNMENT OF SORSOGON

PGSO No.
PR. No.
Information and Communication Technology PO. No. Date:
Dept./Div.
Division SAL. No.
Section/Unit ALOBS No.
Estimated Unit
Stock No. Item Description Quantity Unit of
Cost
Total Cost

TOTAL 0.00
Purpose:

Requested by: Cash Availability Approved by:

 Printed Name: CARMELO H. GRIARTE EDWIN "BOBOY" B. HAMOR
Designation: ITO / ICT Division Chief Acting Provincial Treasurer Governor
OPAG
 PURCHASE ORDER
PROVINCIAL GOVERNMENT OF SORSOGON

P.O. No.
Supplier
Date:
Mode of Procurement
Address

Gentleman: Please furnish this Office the following to the terms and conditions contained herein:

Place of Delivery: Delivery Term

Date of Delivery Payment Term

Item No. Unit Quantity DESCRIPTION Unit Cost Amount

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

Signature Over Printed Name EDWIN "BOBOY" B. HAMOR

Authorized Official

Date Date
 Republic of the Philippines
PROVINCIAL GOVERNMENT OF SORSOGON
Sorsogon, Sorsogon

OBLIGATION REQUEST Number:

Payee
Office
Address
Responsibility
Center PARTICULARS F.P.P.
Account Code
Amount

Amount in words
TOTAL

A. Certified B. Certified

Change to appropriation/allotment necessary,

lawful & under my direct supervision Existence of available appropriation
Supporting documents valid proper and legal
Signature Signature

Printed Name EDWIN "BOBOY" B. HAMOR Printed Name MA. CRISTINA M. LABAY
Governor Provincial Budget
Position Position
Agency Head/Authorized Representative Agency Head/Authorized Representative
Date Date
 Republic of the Philippines
PROVINCIAL GOVERNMENT OF SORSOGON
Sorsogon, Sorsogon

DISBURSEMENT VOUCHER Number

MODE OF
PAYMENT CHECK CASH OTHERS
TIN/EMPLOYEE No. OBLIGATION REQUEST No.
PAYEE
ADDRESS

EXPLANATION AMOUNT

A. Certified B. Certified

Allotment obligated for the purpose as indicated above

Existence of available appropriation
Supporting documents complete

Signature Signature

Printed Name RENA M. GARCIA Printed Name MA. LORILYN D. TE

Position Provincial Accountant Position Provincial Treasurer
Agency Head/Authorized Representative Agency Head/Authorized Representative
Date Date
C. Approved for Payment D. RECEIVED PAYMENT
Check Number
Signature
Signature

Printed Name EDWIN "BOBOY" B. HAMOR Printed Name

Governor OR No./Other Documents JEV Number Date
Position
Agency Head/Authorized Representative
Date