Annex 15

PURCHASE ORDER
SK of Barangay: City/Municipality:
Tel. No.: Province:
Supplier: ___________________________________________ PO No.: ____________________________
Address: __________________________________________ Date: ______________________________
Tel. No.:____________________TIN: ___________________ Mode of Procurement: _________________
Gentlemen: Please deliver to this office the following articles subject to the terms and conditions contained herein:
Place of Delivery: ___________________________ Delivery Term: _____________________________
Date of Delivery: ___________________________ Payment Term: _____________________________
Unit of
Item No. Item Description Quantity Unit Cost Amount
Measurement

(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,

____________________________________ ___________________________________________
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:

_________________________________________________________ ____________________
Signature over Printed Name of Budget Monitoring Officer Date
 PURCHASE ORDER
SK of Barangay: Sampaloc City/Municipality: CABATUAN
Tel. No.: Province: ISABELA

Supplier: PO No.:

Address:
Tel. CABATUAN ISABELA Date:
No.:____________________TIN: Mode of Procurement: _________________
___________________
Gentlemen: Please deliver to this office the following articles subject to the terms and conditions contained herein:
Place of Delivery:
Delivery Term: _____________________________
___________________________
Date of Delivery:
Payment Term: _____________________________
___________________________
Unit of
Item No. Item Description Quantity Unit Cost Amount
Measurement
pcs. masking tape 6 38.00 228.00
pc volleyball net 1 1,200.00 1,200.00
pc volleyball ball 1 2,500.00 2,500.00
pcs. whistle 2 15.00 30.00
pcs. packing tape 5 54.00 270.00

TOTAL 4,228.00
(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,

MICAH D. IGNACIO
Signature over Printed Name of Signature over Printed Name of SK Chairperson
Supplier

Availability of the budget or funds received for specific purpose:

RHODA S. MONTE
Signature over Printed Name of Budget Monitoring Officer
Date