PROVINCIAL GOVERNMENT OF LA UNION PROVINCIAL GOVERNMENT OF LA UNION

OFFICE OF THE PROVINCIAL PLANNING AND DEVELOPMENT COORDINATOR OFFICE OF THE PROVINCIAL PLANNING AND DEVELOPMENT COORDINATOR

REQUEST FOR CANVASS FORM CANVASS FORM

DATE PREPARED _____________________________________________________________________ RFC NO. 2023-__________________ DATE PREPARED _____________________________________________________________________ CF NO. 2023-________________
UNIT _____________________________________________________________________ UNIT _____________________________________________________________________
AIP REFERENCE CODE _____________________________________________________________________ AIP REFERENCE CODE _____________________________________________________________________
PPA TITLE _____________________________________________________________________ PPA TITLE _____________________________________________________________________
ALLOTED BUDGET _____________________________________________________________________ ALLOTED BUDGET _____________________________________________________________________
DATE OF IMPLEMENTATION _____________________________________________________________________ DATE OF IMPLEMENTATION _____________________________________________________________________

Venue Venue Specification Cost Remarks

No. of Pax No. of Pax

Food Requirement Food Requirement

Facility Requirement Facility Requirement

Equipment Needed Equipment Needed

SOA Provision SOA Provision

Other Detail/s Other Detail/s

No. of Days No. of Days

Preferred Supplier/s Preferred Supplier/s

Items Quantity Unit Material Color Size Functionality Other Specification/s Preferred Supplier/s Items Specification Cost Remarks

1 1

2 2

3 3

4 4

5 5

6 6

7 7

8 8

9 9

10 10
Kindly utilize a separate sheet for entries exceeding ten items. Kindly utilize a separate sheet for entries exceeding ten items.

Service Service Specification Cost Remarks

Terms of Reference Terms of Reference

MOA MOA

Other Detail/s Other Detail/s

Preferred Supplier/s Preferred Supplier/s

REMARKS: REMARKS:

PREPARED BY: PREPARED BY:

REVIEWED BY: REVIEWED BY:
RECEIVED BY: ___________ RECEIVED BY: ______________

____________________________________ ____________________________________ DATE RECEIVED: ___________ ____________________________________ ____________________________________ DATE RECEIVED: ______________
Project Lead Unit Head Finance Lead Administrative Head