Republic of the Philippines

Barangay Lapasan

INSPECTION AND ACCEPTANCE REPORT

Barangay : LAPASAN Invoice No. IAR No. Date:

P.O. No. Date: Invoice Date: RIS No. Date:

UNIT DESCRIPTION QUNATITY

TOTAL
Date Inspected: Date Received:

Inspected, verified and found OK Complete

as to quntify and specification:
Partial (pls. specify quantity received)

CRISTINA POQUITA FIL OCTAVIO S. AUTOR

Inspector Barangay Treasurer
 Republic of the Philippines
Cagayan de Oro City
Barangay Lapasan
REPORT OF INSPECTION AND DELIVERIES
Supplier
Address
Invoice No.
Amount: Php

ARTICLES INSPECTED

DATE DESCRIPTION UNIT QUANTITY SPECIFICATION

TOTAL
I HEREBY CERTIFY that the supply materials delivered and received of services rendered conformed to the
Specificaation to quantity and quality.

HON. JULITO D. OGSIMER

Requisitioner
REMARKS:
WE HEREBY CERTIFY that we have inspected the above articles at the Barangay Hall dated
and that this report is true and correct.
CRISTINA POQUITA FIL OCTAVIO S. AUTOR
Inspector Barangay Treasurer
 Republic of the Philippines
City of Cagayan de Oro
Barangay Lapasan

PURCHASE ORDER

Barangay : LAPASAN City/Municipality : CAGAYAN DE ORO

Tel. No. : (08822) 881-9850 Province : MISAMIS ORIENTAL

Supplier LAPARAN FLOWER SHOP P.O. No. :

Addrress : Cagayan de Oro City Date : Aug-22
TIN : Mode of Procurement :
Bidding Negotiated

Gentlemen:
Please deliver to this Office the following articles subject to the terms and conditions contained herein:
Place of Delivery : Delivery Term :
Date of Delivery : Payment Term :

ITEM NO. PARTICULARS QUANTITY UNIT UNIT COST

1 STANDEE 1 PCS 600.00
2 LATIS 1 PCS 700.00
3 LATIS 1 PCS 700.00
4 LATIS 1 PCS 700.00
5 LATIS 1 PCS 700.00
6 STANDEE 2 PCS 600.00
7 STANDEE 1 PCS 600.00
8 LATIS 1 PCS 700.00
9 STANDEE 1 PCS 600.00
10 STANDEE 2 PCS 600.00
11 STANDEE 2 PCS 600.00
12 STANDEE 1 PCS 600.00
13 LATIS 1 PCS 700.00
14 STANDEE 2 PCS 600.00

Total Estimated Amount in words : THREE THOUSAND FIVE HUNDRED SIXTY-NINE AND THIRTY-FOUR HUNDREDTHS
In case of failure to make full delivery within the time specified above, a penalty of one-tenth (1/10) of
one percent (1%) for everyday of delay shall be imposed.

Very truly yours,

HON. JULITO D. OGSIMER

Barangay Chairman

Conforme: Existence of Available Appropriations:

KAG. ASPIRINO N. BACONGA

Signature Over Printed Name Chairman Committee on Appropriation

Date
E ORO
RIENTAL

Shopping X

AMOUNT COST
600.00
700.00
700.00
700.00
700.00
1,200.00
600.00
700.00
600.00
1,200.00
1,200.00
600.00
700.00
1,200.00

11,400.00
(1/10) of

GA
priation
 DV No. 2018 - 07 -

DISBURSEMENT VOUCHER Date

Barangay :LAPASAN City/Municipality : Cagayan de Oro

Tel. No. (08822 )881-9850 Province : Misamis Oriental

Payee/Office : FIL-OCTAVIO S. AUTOR Employee No. Fund: MOOE

Address : Cagayan de Oro City TIN No. TRAINING & SEMINARS

PartIculars Amount

To cash advance for the Registration Fee for Barangay Official

and support staff for two (2) day seminar workshop as per supporting
documents attached hereto or in the amount of ……………………….. Php 4,500.00

A: Certified B: Certified C: Certified

Existence of available appropriation Funds (cash) Available As to validity, propriety and
for the charges/expenses indicated above. legality:
Approved : For Payment
Signature: Signature: Signature:
KAG. ELSIE P. LOPOY FIL-OCTAVIO S. AUTOR HON. JULITO D. OGSIMER
Position: Chairman Comm on Position: Barangay Treasurer Position: Barangay Cgairman
Appropriation
Date : Date : Date :

D: Certified

Check No.:
Signature over Printed Name Bank Name : DBP
Date : Date :
O.R Number: