GENERAL SERVICES DIVISION – GSD GENERAL SERVICES DIVISION – GSD

INSPECTION AND ACCEPTANCE REPORT FORM INSPECTION AND ACCEPTANCE REPORT FORM

Bureau/Office: Section/Division: Bureau/Office: Section/Division:

ANTI-RED TAPE AUTHORITY RFO 3 SOUTHERN LUZON ANTI-RED TAPE AUTHORITY RFO 3 SOUTHERN LUZON
Supplier: IAR No.: Supplier: IAR No.:

GOLD'N E ENTERPRISES 2023-05-005 GOLD'N E ENTERPRISES 2023-05-005

Invoice No.: TIN No.: Date: Invoice No.: TIN No.: Date:
162-745-220-000 162-745-220-000

STOCK NO. UOM ITEM/DESCRIPTION QTY TOTAL AMOUNT STOCK NO. UOM ITEM/DESCRIPTION QTY TOTAL AMOUNT

Book Shelf Book Shelf

dimensions: 33 cm (l) x 40 cm (w) x dimensions: 33 cm (l) x 40 cm (w) x
109 cm (h); 109 cm (h);
unit 2 ₱6,000.00 unit 2 ₱6,000.00
4-layer shelf made up of laminated and 4-layer shelf made up of laminated and
powder-coated particle board; colored powder-coated particle board; colored
light oak light oak

***nothing follows*** ***nothing follows***

TOTAL 2 ₱6,000.00 TOTAL 2 ₱6,000.00

INSPECTION ACCEPTANCE INSPECTION ACCEPTANCE
Date Inspected: Date Received: Date Inspected: Date Received:

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

ATTY. KEIRVIN ANTHONY BELTRAN-VIADO JHANA AIRA P. PENALES ATTY. KEIRVIN ANTHONY BELTRAN-VIADO JHANA AIRA P. PENALES
Legal Assistant III, Investigation and Enforcement Project Development Officer I, Southern Luzon Legal Assistant III, Investigation and Enforcement Project Development Officer I, Southern Luzon
Division RFO Division RFO
Inspection Officer/Inspection Committee End-User Inspection Officer/Inspection Committee End-User