Annex 7

Republic of the Philippines

Province of Antique
Municipality of Caluya
Masanag, Caluya, Antique

DISBURSEMENT VOUCHER
SK of Barangay: MASANAG DV. No. :
City/Municipality: CALUYA Date:
Province: ANTIQUE
Payee: SARINIE J. GABE
Address: POBLACION, CALUYA, ANTIQUE
TIN:

PARTICULARS AMOUNT

To Payment of Office Supplies and Materials of SK Barangay Salamento,

Caluya, Antique
23,245.28
amounted to..

Less 1% Withholding tax ₱ 207.55

5% VAT ₱ 1,037.74 ₱ 1,245.28 1,245.28

22,000.00
A. Certified as to availability of B. Certified as to availability of cash C. Certified as to necessity, validity,
the Budget or funds received and completeness and propriety preperty, and legality of claim and
for specific purpose. of supporting documents Approved for payment.

ROMMEL A. CALINOG REANIE R. MANONGOL EDWARD E . MAGAN, JR.

Budget Monitoring Officer SK Treasurer SK Chairperson

Date: ____________________ Date: ____________________ Date: ____________________

D. Received Payment: Check No.:

Date:
Bank Development Bank of the
SARINIE J. GABE Name: Philippines
Signature Over Printed Name of Payee/ Bank San Jose, Antique Branch
Authorized Representative Branch:
O.R No.
Date:
 Annex 15

PURCHASE ORDER

SK of Barangay: SALAMENTO City/Municipality: CALUYA

Tel. No.: Province: ANTIQUE
Supplier: SARINIE J. GABE PO No.: ____________________________
Address: POBLACION, CALUYA, ANTIQUE Date: ______________________________
Tel. No.:______________TIN: _______________ Mode of Procurement: ____________

Gentlemen: Please deliver to this office the following articles subject to the terms and conditions contained
herein:
Delivery Term:
Place of Delivery: ___________________________
_____________________________
Payment Term:
Date of Delivery: ___________________________
_____________________________
Item Unit of
Item Description Quantity Unit Cost Amount
No. Measurement
1 pcs. BasketBall 5
2 pcs. Volleyball Net 5
3 pcs. Volleyball 5
4 pcs. Sepak Takraw Net 5
5 pcs. Sepak Takraw ball 5
6 pcs. Badminton 4
7 pcs. Badminton Net 4
8 set Badminton Shuttlecock (12pcs.) 2
9 pcs. Chess Board 3
10 pcs. Scrabble Board 3
TOTAL -
(Total Amount in words)

In case of failure to make full delivery within the time specified above, a penalty of one-tenth (1/10) of
one percent for every day of delay shall be imposed on the undelivered item/s.

Conforme: Very truly yours,

SARINIE J. GABE EDWARD E. MAGAN, JR.

Signature over Printed Name of Supplier Signature over Printed Name of SK Chairperson

__________________ ____________________
Date Date

Availability of the budget or funds received for specific purpose:

ROMMEL A. CALINOG ____________________

Signature over Printed Name of Budget Monitoring Officer Date
 Republic of the Philippines
Province of Antique
Municipality of Caluya
Barangay Masanag

Standard Form No. SF-GOOD-60

Revised on May 24, 2004

REQUEST FOR QUOTATION

TO: Various Suppliers/Contractors

Please qoute your lowest price on the item/s listed below, subject to the General Condition
on the last page, stating the shortest time of delivery and submit your condition duly signed
by your representative not later than ___________________ at the Bids and Awards Committee
Secretariat (Caluya) in the return envelope attached herewith.

ROMMEL A. CALINOG
BMO CHAIRMAN

ITEM NO. QTY UNIT ITEM DESCRIPTION UNIT PRICE TOTAL

1 5 pcs. BasketBall
2 5 pcs. Volleyball Net
3 5 pcs. Volleyball
4 5 pcs. Sepak Takraw Net
5 5 pcs. Sepak Takraw ball
6 4 pcs. Badminton
7 4 pcs. Badminton Net
8 2 set Badminton Shuttlecock (12pcs.)
9 3 pcs. Chess Board
10 3 pcs. Scrabble Board
Place and Model/Name of Project
Place of Delivery
Delivery Period:
Warranty:
Price Validity:
After having carefully read and accepted your General Conditions, We quote you on
item at prices noted above.

Company's Name

Company's Address

Printed Name & Signature

Tel. No./Cellphone/Email Add

Note:
1. All entries must be typewritten.
2. Delivery period within ______________ calendar days.
3. Warranty shall be for a period of six (6) months for supplies and materials.