Annex 16

INSPECTION AND ACCEPTANCE REPORT

SK of Barangay: San Francisco IAR No.: 2019-03-001
City/Municipality: Quezon City Date: March 01, 2019
Province: Manila
Supplier: Hidalgo Enterprises Invoice No.: 190228-002
PO No.: 2019-02-001 Date: Feb 04 2019 Date: February 28, 2019
Requesting SK Official: Maria Reyes
Unit of
Item No. Item Description Quantity
Measurement
1 Folder, Standard/A-4 piece 100
2 Paper, Bond, Standard/A-4 ream 50
3 Toner, TN 3370, 6180DW Super High Yield piece 5
4 Computer Desktop set 1

****** Nothing Follows *****

INSPECTION ACCEPTANCE

Date Inspected: March 01, 2019 Date Received: March 01, 2019

Inspected, verified as to quantity Complete

and specifications

Partial (Pls. specify quantity

Received)

Josby Cruz Rene Santos

Signature over Printed Name Signature over Printed Name
Head, Inspection and Appraisal Committee SK Treasurer