PURCHASE REQUEST

Barangay: Imelda Bliss Village P.R No.

City/Municipality: City of Ilagan Date:09/08/2022

REQUESTING
Item Number Qty Unit of Item Description Estimat Estimated
Measurement ed Cost Amount
1 4 Pcs 2x3ft tarpaulin for spot trap 1250.00 5000.00
2 3 Roll Colored tape 45.00 135.00
3 3 Set Ink epson l300 1000.00 3000.00
4 1 Pc Lan wifi extender 4000.00 4000.00
5 3 Pcs USB 666.00 2000.00
6 8 Pcs Toxs w/ screw 50.00 400.00
7 1 Pc Masonry drill bit 6mm 1100.00 1100.00

Total Estimated Amount Fifteen thousand three hundred eighty one pesos only
Purpose:
Various Exp

Requested by: Approved:

JOCELYN D. TALAUE EVELYN L. LLAMELO

Requisitioner Punong Barangay

________________ ________________
Date Date
 PURCHASE ORDER
Barangay: Imelda Bliss Village City/ Municipality: City of Ilagan
Tel. No.:_________________ Province: Isabela
Supplier : ________________ P.O No.:
Address: _________________ Date: 09/08/22
TIN : ___________________ Mode of Procurement:
____ Bidding ___ Negotiated ____ Over the
Counter
Gentlemen:
Please deliver to this office the following articles subject to the terms and conditions
herein:
Place of Delivery: ________________ Delivery Term: ________________________
Date of Delivery: _________________ Payment Term: _______________________
Unit Particulars Quantity Unit Cost Amount
Pcs 2x3ft tarpaulin for spot trap 4 1250.00 5000.00
Roll Colored tape 3 45.00 135.00
Set Ink epson l300 3 1000.00 3000.00
Pc Lan wifi extender 1 4000.00 4000.00
Pcs USB 3 666.00 2000.00
Pcs Toxs w/ screw 8 50.00 400.00
Pc Masonry drill bit 6mm 1 1100.00 1100.00

(Total Amount in Words) Fifteen thousand three hundred eighty one pesos only
In Case of Failure to make full delivery within the time specified above, a penalty of one-cent
(1/10) of one percent for everyday of delay shall be imposed.
Very Truly yours,

EVELYN L. LLAMELO
Punong Barangay

Conform: Existence of Available Appropriations of

Supplier JOEY M. BINGAYAN

 Chairman, Committee on Appropriation

ACCEPTANCE & INSPECTION REPORT

BLISS VILLAGE, CITY OF ILAGAN, ISABELA

LGU
_____________________________________________________________________
Supplier: ____________________ AIR NO. ____________________
PO No. ___ _ Date: 07/27/2022 Invoice No. __________ Date: __________
Requisitioning office / Department _______________________________

Item No. Unit Description Quantity

1 2x3ft tarpaulin for spot trap

Pcs 4
2 Colored tape
Roll 3

3 Set Ink epson l300 3

4 Pc Lan wifi extender 1

5 Pcs USB 3

6 Pcs Toxs w/ screw 8

7 Pc Masonry drill bit 6mm 1

8 Pcs 2x3ft tarpaulin for spot trap 4

9 Roll Colored tape 3

10 Set Ink epson l300 3

 ACCEPTANCE INSPECTION

Date Received: Date Inspected : ______________________

_______________
 Inspected, verified and found ok as to
 Complete quantity are Specification

_____ Partial 1. JAY D. SORIANO __________________

2. ARNOLD C. MARAMAG __________________
JOCELYN D. TALAUE 3. MICHAEL S. BACANI ____________________
Property Officer