APR FORM revised May 2015 FORM NO.

002
NAME AND ADDRESS OF BAGANGA NATIONAL HIGH SCHOOL AGENCY ACCT. CODE
REQUESTING AGENCY BAGANGA NATIONAL HIGH SCHOOL AGENCY CONTROL No.
TEL. NOS. 9099575036
AGENCY PROCUREMENT REQUEST PS APR No.

To: PROCUREMENT SERVICE 11/5/2021

DBM Compound, RR Road (Date Prepared)
Cristobal St., Paco, Manila

PLEASE CHECK (√ ) APPROPRIATE BOX ON ACTION REQUESTED ON THE ITEM/S LISTED BELOW

[ ] Please issue common-use supplies/materials per Price List No. __________________________ dated __________________________
Mode of delivery: [ ] Pick-up (Fast Lane) [ ] Pick-up (Schedule) [ ] Delivery (door-to-door)

In case fund is not sufficient:[ ] Reduce Quantity [ ] Bill Us [ ] Charge to Unutilized Deposit, APR No.:___________Date:________

[ ] Please purchase for our agency non-common items. Attached herewith :

[ ] Complete Specifications [ ] Obligation Request (ObR) [ ] Others, pls. specify_______________
[ ] Certificate of Budget Allocation (CBA) [ ] Payment _______________________________

This form shall be prepared for requisitions of Common-Use goods from the PS Depots & Sub-Depots; and for orders of Consumables
& Non-Common Use Supplies from the PS Main.
For PS Main-Common Use Supplies, please use Form 001 R or Form 001 B
ITEM ITEM AND DESCRIPTION/SPECIFICATIONS/STOCK No. QUANTITY UNIT UNIT PRICE AMOUNT
No.
1 Multi Purpose Paper A4 305 reams 151.29 46,143.45
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
27
28
29
30
31

TOTAL AMOUNT ₱ 46,143.45

NOTE: ALL SIGNATURES MUST BE OVER PRINTED NAME
STOCKS REQUESTED ARE CERTIFIED TO BE FUNDS CERTIFIED AVAILABLE: APPROVED:
WITHIN APPROVED PROGRAM:

DINRYL P. BASIGSIG MARIANNE GRACE G. LIWANA GARRY P. LARA

AGENCY HEAD/AUTHORIZED SIGNATURE
AGENCY PROPERTY/SUPPLY OFFICER AGENCY CHIEF ACCOUNTANT
[ ] FUNDS DEPOSITED WITH PS [ ] ___________________ CHECK No. ____________________
IN THE AMOUNT OF: ____________________________________________________________ (P _____________________) ENCLOSED
APR FORM revised May 2015 FORM NO. 002
NAME AND ADDRESS OF BAGANGA NATIONAL HIGH SCHOOL AGENCY ACCT. CODE
REQUESTING AGENCY AGENCY CONTROL No.
TEL. NOS. 9099575036
AGENCY PROCUREMENT REQUEST PS APR No.

To: PROCUREMENT SERVICE 3/17/2021

DBM Compound, RR Road (Date Prepared)
Cristobal St., Paco, Manila

PLEASE CHECK (√ ) APPROPRIATE BOX ON ACTION REQUESTED ON THE ITEM/S LISTED BELOW

[ ] Please issue common-use supplies/materials per Price List No. __________________________ dated __________________________
Mode of delivery: [ ] Pick-up (Fast Lane) [ ] Pick-up (Schedule) [ ] Delivery (door-to-door)

In case fund is not sufficient:[ ] Reduce Quantity [ ] Bill Us [ ] Charge to Unutilized Deposit, APR No.:___________Date:________

[ ] Please purchase for our agency non-common items. Attached herewith :

[ ] Complete Specifications [ ] Obligation Request (ObR) [ ] Others, pls. specify_______________
[ ] Certificate of Budget Allocation (CBA) [ ] Payment _______________________________

This form shall be prepared for requisitions of Common-Use goods from the PS Depots & Sub-Depots; and for orders of Consumables
& Non-Common Use Supplies from the PS Main.
For PS Main-Common Use Supplies, please use Form 001 R or Form 001 B
ITEM ITEM AND DESCRIPTION/SPECIFICATIONS/STOCK No. QUANTITY UNIT UNIT PRICE AMOUNT
No.
1 PAPER, MULTI-COPY (Legal, 80gsm) 250 ream 133.85 33,462.50
2 FLOOR WAX, PASTE, RED, 2kg./can 8 can 324.66 2,597.28
3 Alcohol Ethyl 20 bot 69.76 1,395.20
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
27
28
29
30
31

TOTAL AMOUNT ₱ 37,454.98

NOTE: ALL SIGNATURES MUST BE OVER PRINTED NAME
STOCKS REQUESTED ARE CERTIFIED TO BE FUNDS CERTIFIED AVAILABLE: APPROVED:
WITHIN APPROVED PROGRAM:

DINRYL P. BASIGSIG MARIANNE GRACE G. LIWANA GARRY P. LARA

AGENCY HEAD/AUTHORIZED SIGNATURE
AGENCY PROPERTY/SUPPLY OFFICER AGENCY CHIEF ACCOUNTANT
[ ] FUNDS DEPOSITED WITH PS [ ] ___________________ CHECK No. ____________________
IN THE AMOUNT OF: ____________________________________________________________ (P _____________________) ENCLOSED
APR FORM revised May 2015 FORM NO. 002
NAME AND ADDRESS OF BAGANGA NATIONAL HIGH SCHOOL AGENCY ACCT. CODE
REQUESTING AGENCY AGENCY CONTROL No.
TEL. NOS. 9099575036
AGENCY PROCUREMENT REQUEST PS APR No.

To: PROCUREMENT SERVICE 11/19/2020

DBM Compound, RR Road (Date Prepared)
Cristobal St., Paco, Manila

PLEASE CHECK (√ ) APPROPRIATE BOX ON ACTION REQUESTED ON THE ITEM/S LISTED BELOW

[ ] Please issue common-use supplies/materials per Price List No. __________________________ dated __________________________
Mode of delivery: [ ] Pick-up (Fast Lane) [ ] Pick-up (Schedule) [ ] Delivery (door-to-door)

In case fund is not sufficient:[ ] Reduce Quantity [ ] Bill Us [ ] Charge to Unutilized Deposit, APR No.:___________Date:________

[ ] Please purchase for our agency non-common items. Attached herewith :

[ ] Complete Specifications [ ] Obligation Request (ObR) [ ] Others, pls. specify_______________
[ ] Certificate of Budget Allocation (CBA) [ ] Payment _______________________________

This form shall be prepared for requisitions of Common-Use goods from the PS Depots & Sub-Depots; and for orders of Consumables
& Non-Common Use Supplies from the PS Main.
For PS Main-Common Use Supplies, please use Form 001 R or Form 001 B
ITEM ITEM AND DESCRIPTION/SPECIFICATIONS/STOCK No. QUANTITY UNIT UNIT PRICE AMOUNT
No.
1 PAPER, MULTI-PURPOSE, 70 gsm., size: 216mm x 330mm (Legal) 250 ream 145.65 36,412.50
2 Staple Wire #35 20 box 22.11 442.20
3 FLOOR WAX, PASTE, RED, 2kg./can 8 can 324.66 2,597.28
4 BATTERY, dry cell, AA, 2 pieces per blister pack 10 pack 38.04 380.40
5 CORRECTION TAPE, 1 piece in individual plastic 20 pc 12.24 244.80
6 CUTTER KNIFE, for general purpose 2 pc 35.03 70.06
7 ENVELOPE, DOCUMENTARY, for legal size document, 500 pieces p 1 box 971.74 971.74
8 ALCOHOL, ethyl, 68%-70%, scented, 500ml (-5ml) 15 bot 45.67 685.05
9 DETERGENT POWDER, all purpose, 1kg per plastic pouch 3 kg 39.23 117.69
10 DUST PAN, non-rigid plastic, w/ detachable handle 5 pc 26.03 130.15
11 BROOM, SOFT (TAMBO 5 pc 142.79 713.95
12 TOILET TISSUE PAPER 2-plys sheets, 150 pulls, 12 rolls in a pack 3 pack 91.56 274.68
13 Trashbag, GPP specs, black, 10pcs per roll/pack 5 roll 141.16 705.80
14 TAPE, ELECTRICAl 5 roll 19.57 97.85
15 TAPE, PACKAGING, width: 48mm (±1mm) 15 roll 20.93 313.95
16 NOTEPAD, STICK-ON, 2X3, 100 sheets per pad 3 pad 38.84 116.52
17 SCISSORS, symmetrical, blade length: 65mm, 1 piece in individual 5 pair 42.51 212.55
18 FACE SHIELD 10 pc 130.80 1,308.00
19
20
21
22
23
24
27
28
29
30
31

TOTAL AMOUNT ₱ 45,795.17

NOTE: ALL SIGNATURES MUST BE OVER PRINTED NAME
STOCKS REQUESTED ARE CERTIFIED TO BE FUNDS CERTIFIED AVAILABLE: APPROVED:
WITHIN APPROVED PROGRAM:

DINRYL P. BASIGSIG MARIANNE GRACE G. LIWANA GARRY P. LARA

AGENCY HEAD/AUTHORIZED SIGNATURE
AGENCY PROPERTY/SUPPLY OFFICER AGENCY CHIEF ACCOUNTANT
[ ] FUNDS DEPOSITED WITH PS [ ] ___________________ CHECK No. ____________________
IN THE AMOUNT OF: ____________________________________________________________ (P _____________________) ENCLOSED
APR FORM revised May 2015 FORM NO. 002
NAME AND ADDRESS OF BAGANGA NATIONAL HIGH SCHOOL AGENCY ACCT. CODE
REQUESTING AGENCY AGENCY CONTROL No.
TEL. NOS. 9099575036
AGENCY PROCUREMENT REQUEST PS APR No.

To: PROCUREMENT SERVICE 10/8/2020

DBM Compound, RR Road (Date Prepared)
Cristobal St., Paco, Manila

PLEASE CHECK (√ ) APPROPRIATE BOX ON ACTION REQUESTED ON THE ITEM/S LISTED BELOW

[ ] Please issue common-use supplies/materials per Price List No. __________________________ dated __________________________
Mode of delivery: [ ] Pick-up (Fast Lane) [ ] Pick-up (Schedule) [ ] Delivery (door-to-door)

In case fund is not sufficient:[ ] Reduce Quantity [ ] Bill Us [ ] Charge to Unutilized Deposit, APR No.:___________Date:________

[ ] Please purchase for our agency non-common items. Attached herewith :

[ ] Complete Specifications [ ] Obligation Request (ObR) [ ] Others, pls. specify_______________
[ ] Certificate of Budget Allocation (CBA) [ ] Payment _______________________________

This form shall be prepared for requisitions of Common-Use goods from the PS Depots & Sub-Depots; and for orders of Consumables
& Non-Common Use Supplies from the PS Main.
For PS Main-Common Use Supplies, please use Form 001 R or Form 001 B
ITEM ITEM AND DESCRIPTION/SPECIFICATIONS/STOCK No. QUANTITY UNIT UNIT PRICE AMOUNT
No.
1 PAPER, MULTICOPY, 80gsm, size: 216mm x 330mm (Legal) 250 ream 190.14 47,535.00
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
27
28
29
30
31

TOTAL AMOUNT ₱ 47,535.00

NOTE: ALL SIGNATURES MUST BE OVER PRINTED NAME
STOCKS REQUESTED ARE CERTIFIED TO BE FUNDS CERTIFIED AVAILABLE: APPROVED:
WITHIN APPROVED PROGRAM:

DINRYL P. BASIGSIG MARIANNE GRACE G. LIWANA GARRY P. LARA

AGENCY HEAD/AUTHORIZED SIGNATURE
AGENCY PROPERTY/SUPPLY OFFICER AGENCY CHIEF ACCOUNTANT
[ ] FUNDS DEPOSITED WITH PS [ ] ___________________ CHECK No. ____________________
IN THE AMOUNT OF: ____________________________________________________________ (P _____________________) ENCLOSED
APR FORM revised May 2015 FORM NO. 002
NAME AND ADDRESS OF BAGANGA NATIONAL HIGH SCHOOL AGENCY ACCT. CODE
REQUESTING AGENCY AGENCY CONTROL No.
TEL. NOS. 9099575036
AGENCY PROCUREMENT REQUEST PS APR No.

To: PROCUREMENT SERVICE

DBM Compound, RR Road (Date Prepared)
Cristobal St., Paco, Manila

PLEASE CHECK (√ ) APPROPRIATE BOX ON ACTION REQUESTED ON THE ITEM/S LISTED BELOW

[ ] Please issue common-use supplies/materials per Price List No. __________________________ dated __________________________
Mode of delivery: [ ] Pick-up (Fast Lane) [ ] Pick-up (Schedule) [ ] Delivery (door-to-door)

In case fund is not sufficient:[ ] Reduce Quantity [ ] Bill Us [ ] Charge to Unutilized Deposit, APR No.:___________Date:________

[ ] Please purchase for our agency non-common items. Attached herewith :

[ ] Complete Specifications [ ] Obligation Request (ObR) [ ] Others, pls. specify_______________
[ ] Certificate of Budget Allocation (CBA) [ ] Payment _______________________________

This form shall be prepared for requisitions of Common-Use goods from the PS Depots & Sub-Depots; and for orders of Consumables
& Non-Common Use Supplies from the PS Main.
For PS Main-Common Use Supplies, please use Form 001 R or Form 001 B
ITEM ITEM AND DESCRIPTION/SPECIFICATIONS/STOCK No. QUANTITY UNIT UNIT PRICE AMOUNT
No.
1 Bond Paper Legal 250 ream 145.65 36,412.50
2 ClearBook, 20 Trasparent Socket, for A4 size 2 piece 41.69 83.38
3 ClearBook, 20 Trasparent Socket, for Legal size 20 piece 44.42 888.40
4 Dating and Stamping Machine (Heavy Duty) 1 piece 475.79 475.79
5 Furniture Cleaner, Aerosol type, 300 ml min per can 1 can 125.90 125.90
6 Handbook (RA 9184), 8th Edition 1 book 39.00 39.00
7 Index Card Box, for 127mmx203mm 2 piece 57.80 115.60
8 Monitor Filter, 15" 1 piece 86.15 86.15
9 Tape,Packaging, Width: 48mm 10 piece 20.93 209.30
10 Tape,Trasparent, Width: 48mm 10 piece 20.93 209.30
11 Floor wax, Paste Type, Red 2.0 Kg 4 can 324.66 1,298.64
12
13
14
15
16
17
18
19
20
21
22
23
24
27
28
29
30
31

TOTAL AMOUNT ₱ 39,943.96

NOTE: ALL SIGNATURES MUST BE OVER PRINTED NAME
STOCKS REQUESTED ARE CERTIFIED TO BE FUNDS CERTIFIED AVAILABLE: APPROVED:
WITHIN APPROVED PROGRAM:

DINRYL P. BASIGSIG MARIANNE GRACE G. LIWANA GARRY P. LARA

AGENCY HEAD/AUTHORIZED SIGNATURE
AGENCY PROPERTY/SUPPLY OFFICER AGENCY CHIEF ACCOUNTANT
[ ] FUNDS DEPOSITED WITH PS [ ] ___________________ CHECK No. ____________________
IN THE AMOUNT OF: ____________________________________________________________ (P _____________________) ENCLOSED
APR FORM revised May 2015 FORM NO. 002
NAME AND ADDRESS OF BAGANGA NATIONAL HIGH SCHOOL AGENCY ACCT. CODE
REQUESTING AGENCY AGENCY CONTROL No.
TEL. NOS. 9099575036
AGENCY PROCUREMENT REQUEST PS APR No.

To: PROCUREMENT SERVICE 9/15/2020

DBM Compound, RR Road (Date Prepared)
Cristobal St., Paco, Manila

PLEASE CHECK (√ ) APPROPRIATE BOX ON ACTION REQUESTED ON THE ITEM/S LISTED BELOW

[ ] Please issue common-use supplies/materials per Price List No. __________________________ dated __________________________
Mode of delivery: [ ] Pick-up (Fast Lane) [ ] Pick-up (Schedule) [ ] Delivery (door-to-door)

In case fund is not sufficient:[ ] Reduce Quantity [ ] Bill Us [ ] Charge to Unutilized Deposit, APR No.:___________Date:________

[ ] Please purchase for our agency non-common items. Attached herewith :

[ ] Complete Specifications [ ] Obligation Request (ObR) [ ] Others, pls. specify_______________
[ ] Certificate of Budget Allocation (CBA) [ ] Payment _______________________________

This form shall be prepared for requisitions of Common-Use goods from the PS Depots & Sub-Depots; and for orders of Consumables
& Non-Common Use Supplies from the PS Main.
For PS Main-Common Use Supplies, please use Form 001 R or Form 001 B
ITEM ITEM AND DESCRIPTION/SPECIFICATIONS/STOCK No. QUANTITY UNIT UNIT PRICE AMOUNT
No.
1 Bond Paper Legal 250 ream 190.14 47,535.00
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
27
28
29
30
31

TOTAL AMOUNT ₱ 47,535.00

NOTE: ALL SIGNATURES MUST BE OVER PRINTED NAME
STOCKS REQUESTED ARE CERTIFIED TO BE FUNDS CERTIFIED AVAILABLE: APPROVED:
WITHIN APPROVED PROGRAM:

DINRYL P. BASIGSIG MARIANNE GRACE G. LIWANA GARRY P. LARA

AGENCY HEAD/AUTHORIZED SIGNATURE
AGENCY PROPERTY/SUPPLY OFFICER AGENCY CHIEF ACCOUNTANT
[ ] FUNDS DEPOSITED WITH PS [ ] ___________________ CHECK No. ____________________
IN THE AMOUNT OF: ____________________________________________________________ (P _____________________) ENCLOSED