DEPARTMENT OF EDUCATION

Division of Himamaylan City

DISBURSEMENT VOUCHER
Mode of MDS Check Commercial Check ADA
Payment
TIN:
Payee SIBUCAO INTEGRATED SCHOOL
SO. SIBUCAO, BRGY. BUENAVISTA, HIMAMAYLAN CITY
Address
DISTRICT I, CLUSTER 7
Responsibility
Particulars Center
MFO/PA

To payment of the MONTH OF JULY MOOE CASH ADVANCE

C.Y 2021SO. of
SIBUCAO, BRGY. BUENAVISTA, HIMAMAYLANas CITY
per
supporting papers hereto attached…

Travel Expenses 720.00

Office Supplies (Modules) 24,785.00
Office Supplies Expenses 754.00
Telephone Expense - Mobile 1,000.00
Printing and Publication Expenses 240.00

DO - ELEM 31040010000

District I, LBP Account #: 4492-1006-80

CLUSTER VII Branch : LBP - HIMAMAYLAN

Amount Due
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

ROSELYN V. GEÑEGA
TEACHER - IN - CHARGE

B. Accounting Entry:
Account Title UACS Code Debit
Advances to Operating Expenses 19901010 00
Cash, MDS - Regular 10104040 00

TOTAL
C. Certified: D. Approved for Payment
Cash available

Subject to Authority to Debit Account (when applicable)

SuppSupporting documents complete and amount claimed

proper

Signature Signature

Printed Name ERIC JOHN T. COÑATE, CPA, MBA Printed Name REYNAL
Accountant III OIC-
Position Position
Head, Accounting Unit/Authorized Representative OSD
Date Date
E. Receipt of Payment
Bank Name & Account Number:
Check/
Date :
ADA No. : LBP Account #:
SIBUCAO INTEGRATED SCH
Signature : Date :
Printed Name
Official Receipt No. & Date/Other Documents
 Appendix 3.2.2
Fund Cluster :
01 Please indi pag islan or e erase :)
Date :
DV No. :

Others (Please specify)

Employee No.: ORS/BURS No.:

MFO/PAP Amount

₱27,499.00

Indicate the purpose of Cash Advance and Breakdow

Budgetary Requirements for the Quarter.

you may CHANGE/DELETE Account

310400100002000

₱27,499.00

Debit Credit
 27,499.00
27,499.00

27,499.00 27,499.00
oved for Payment

REYNALDO G. GICO, EdD, CESO VI

OIC-Schools Division Superintendent
OSDS-HIMAMAYLAN DIVISION

JEV No. :
me & Account Number:
4492-1006-80

BUCAO INTEGRATED SCHOOL Date :

Printed Name
 Please indi pag islan or e erase :)

e purpose of Cash Advance and Breakdown the expenses as enumerated in the

Requirements for the Quarter.

y CHANGE/DELETE Account not applicable

travel TRAINING
ROSELYN 892.00 300
860.00 450 2802.00
QUENNIE 300

MIRA 700
1752.00 1750

12725
4200
16925
 pay
me
nt
of
the
1S
T
OBLIGATION
QT REQUEST AND STATUS Serial No. :
R. DEPARTMENT OF EDUCATION Date :
M Division of Himamaylan City Fund Cluster:
OO
Payee SIBUCAO INTEGRATED SCHOOL
E
CA
Office SH
SIBUCAO INTEGRATED SCHOOL (ELEM), DISTRICT I CLUSTER VII
AD
VA
Address So.
NC
Sibucao, Brgy. Buenavista, Himamaylan City
Responsibility E UACS Object
Center C. Particulars MFO/PAP Code
Y.
To obligate the payment of the MONTH OF
201
OF JULY MOOE CASH ADVANCE CY 2021 310400100002
DO - ELEM 7 of 000
of
TE SIBUCAO INTEGRATED SCHOOL (ELEM)
AM
as per supporting papers hereto attached…
IN
AY
AU Travel Expenses 5020101000
AN
Office Supplies (Modules) 5020301002
EL
EM Office Supplies Expenses 5020301002
. Telephone Expense - Mobile 5020502001
SC Printing and Publication Expenses 5029902000
HO
OL
as
per
sup
port
ing
pap
ers
her TOTAL
eto
A. atta
Certified: Charges to appropriation/alloment are B. Certified: Allotment available and
che and under my direct supervision;and
necessary, lawful obligated for the purpose/adjustment
d…
supporting documents valid, proper and legal: necessary as indicated above:

Printed
Signature : Signature:
Name:
___________ Printed
___________ ROSELYN V. GEÑEGA Name:
Joh An May A. Villalva, MB
___________
___
Position : SCHOOL HEAD - TIC Position: Administrative Officer V - Fina
 Head, Budget Division/Unit/Autho
Head, Requesting Office/Authorized Representative
Representative
Date : Date:

C. STATUS OF OBLIGATION
Reference Amount

ORS/JEV/Check/ADA/TRA Obligation Payable Payment

Date Particulars
No.
(a) (b) (c)
 Appendix 3.2.3

01

RICT I CLUSTER VII Responsibility Center MFO/PAP

Elementary 302050002
y High School 302050003

Amount
Expenses UACs Object Code
TRAVEL 50201010 00
TRAINING 50202010 00
OFFICE SUPPLIES 50203010 00
FUEL, OIL & OTHER LUBRICANTS 50203090 00
OTHER SUPPLIES & MAT. EXP. 50203990 00
WATER 50204010 00
720.00 ELECTRICITY 50204020 00
24,785.00 TELEPHONE EXPENSE - MOBILE 50205020 01
754.00 REPAIR & MAINT. - SCHL. BLDG. 50213040 02
1,000.00 FIDELITY BOND PREMIUNS 50215020 00
240.00 LABOR & WAGES (HS Watchman) 50216010 00
Agricultural & Marine Expenses 50203100 00
OTHER GENERAL SERVICES (ELEM
50212990 00
Watchman)
DRUGS & MEDICINES 50203070 00

₱27,499.00

Allotment available and

or the purpose/adjustment
s indicated above:

Joh An May A. Villalva, MBA

Si Mam Joh An May A. Vilalva na di ang ga Sign… kag sir
Bernie
Administrative Officer V - Finance
Head, Budget Division/Unit/Authorized
Representative

Amount
Balance
Not Yet
Due and Demandable
Due
(a-b) (b-c)
 LIQUIDATION REPORT Serial No.:

For the Period: 2ND QTR. C.Y. 2021 Date:

Entity Name : DEPARTMENT OF EDUCATION Responsibility Center Code:

Fund Cluster : 01 DO - ELEM

PARTICULARS AMOUNT

To Liquidate the 2ND QTR. MOOE CASH ADVANCE

C.Y. 2021 of SO. SIBUCAO, BRGY. BUENAVISTA, HIMA with Php
ADA # 101-04-043-2021 dated April 29, 2021
as per supporting papers hereto attached…

Travel Expenses
Office Supplies (Modules)
Office Supplies Expenses
Telephone Expense - Mobile
Printing and Publication Expenses
0
0
0
0

DISTRICT I, CLUSTER
VII

TOTAL AMOUNT SPENT

AMOUNT OF CASH ADVANCE PER DV No.: 2021-04-00236 dated: 04/28/21

AMOUNT OF REFUNDED O.R. No.: dated:

AMOUNT TO BE REIMBURSED

Certified : Correctness of the Certified: Purpose of Tavel / Certified: Supporting documen

above data: Cash Advance duly accomplished: complete and proper:
 ROSELYN V. GEÑEGA ARLENE E. YAP,PhD ERIC JOHN T. COÑATE, CPA, MB
School Head SGOD Chief Accountant III
JEV No.:
Date: Date: Date:
 Appendix 3.2.6
To be filled-up by the Accounting
personnel.

Responsibility Center Code:

DO - ELEM

AMOUNT

88,063.50 Amount of Cash Advance

720.00
24,785.00
754.00 Breakdown of Expenses
1,000.00
240.00
0.00
0.00 DELETE nyo lang ang Account nga
wala unod
0.00

27,499.00

88,063.50 Kindly Fill-up the DV number and Date.

60,564.50

(60,564.50)

Certified: Supporting documents

complete and proper:
ERIC JOHN T. COÑATE, CPA, MBA
Accountant III
To be filled-up by the Accounting
personnel.
 DEPA
R
Schools
Vallega St., Brgy.
DIS
SIBUCAO IN

CASH DI

TYPE OF WORKING FUND: MOOE C.Y. 2021

ADVANCES FOR OPERATING EXPENSES
(19901010-00)

REFERENCE
AMOUNT
DATE (OR/RER/ CHECK PAYEE/ PARTICULARS
#)
BALANCE
AMOUNT
PAYMENTS
RECEIVED
(6=4-5)

(1) (2) (3) (4) (5) (6)

1 04/29/21 101-04-043-2021 ROSELYN V. GEÑEGA 88,063.50 88,063.50

2 0000007801 ROSELYN V. GEÑEGA 1,125.00 86,938.50
3 0000007802 GAVIN HARDWARE 19,210.00 67,728.50
4 0000007804 RENJI O. EVANGELISTA 6,723.50 61,005.00
5 0000007805 LUIGI AND EMBER MART 25,380.00 35,625.00
6 0000007805 LUIGI AND EMBER MART 8,435.00 27,190.00
7 0000007805 LUIGI AND EMBER MART 3,000.00 24,190.00
8 0000007805 LUIGI AND EMBER MART 8,000.00 16,190.00
9 0000007805 LUIGI AND EMBER MART 7,440.00 8,750.00
10 0000007803 RANIE D. MARCELINO 8,750.00 0.00
11
12
13
14
15
TOTAL 88,063.50 88,063.50 0.00

CERTIFIED CORRECT: CERTIFIED SUPPORTING DOCUMENTS COMPLETE:

ROSELYN V. GEÑEGA JAMIELYN V. DAV

School Head/Accountable Officer Administrative Assista
DATE: DATE :
 Note: Breakdown of Accounts can be change base on what is needed

DEPA
Div
R
Vallega St., Brgy.
DIS
SIBUCAO IN

CASH DI

TYPE OF WORKING FUND: MOOE C.Y. 2019

ADVANCES FOR OPERATING EXPENSES
(19901010-00)

REFERENCE
AMOUNT
DATE (OR/RER/ CHECK PAYEE/ PARTICULARS
#)
BALANCE
AMOUNT
PAYMENTS
RECEIVED
(6=4-5)

(1) (2) (3) (4) (5) (6)

BALANCE FORWARDED 88,063.50 88,063.50 0.00
23 0.00

24 0.00

25 0.00

26 0.00

27 0.00

28 0.00

29 0.00

30 0.00

31 0.00

32 0.00

33 0.00

34 0.00
 35 0.00

36 0.00

37 0.00

38 0.00

39 0.00

40 0.00

GRAND TOTAL 88,063.50 88,063.50 0.00

CERTIFIED CORRECT: CERTIFIED SUPPORTING DOCUMENTS COMPLETE:

ROSELYN V. GEÑEGA JAMIELYN V. DAV

School Head/Accountable Officer Administrative Assista
DATE: DATE :
 Republic of the Philippines
DEPARTMENT OF EDUCATION
Region VI - Western Visayas
Schools Division of Himamaylan City
Vallega St., Brgy. I Pob.,Himamaylan City, Negros Occidental
DISTRICT I, CLUSTER VII
SIBUCAO INTEGRATED SCHOOL (ELEM)

CASH DISBURSEMENTS REGISTER

For the Period: 2ND QTR. C.Y. 2021

B R E A K D O W N OF P A Y M E N T S
Semi-
Travel Office Supplies Repair &
Training Fidelity Bond Expendable Other Supplies Medical
Expense Expense Maintenance -Sch.
Expenses Premiums Bldg. Medical and Materials Supplies
(Local) (MODULES)
Equipment

50201010-00 50202010-2 5021304002 50203010-02 50213040-02 5020321010 5020399000 5020308000

(7) (8) (9) (10) (11) (12) (13) (14)

.

1,125.00

19,210.00

6,723.50

25,380.00

8,435.00

8,000.00

7,440.00

0.00 0.00 1,125.00 25,380.00 25,933.50 8,000.00 8,435.00 7,440.00

DOCUMENTS COMPLETE: NOTED:

JAMIELYN V. DAVID ERIC JOHN T. COÑAT

Administrative Assistant III Accountant
DATE:
 Republic of the Philippines

DEPARTMENT OF EDUCATION
Division of Negros Occidental
Region VI - Western Visayas
Vallega St., Brgy. I Pob.,Himamaylan City, Negros Occidental
DISTRICT I, CLUSTER VII
SIBUCAO INTEGRATED SCHOOL (ELEM)

CASH DISBURSEMENTS REGISTER

For the Period: 2ND QTR. C.Y. 2020

B R E A K D O W N OF P A Y M E N T S
Semi-
Travel Office Supplies Repair &
Training Fidelity Bond Expendable Other Supplies Medical
Expense Expense Maintenance -Sch.
Expenses Premiums Bldg. Medical and Materials Supplies
(Local) (MODULES)
Equipment

50201010-00 50202010-2 5021304002 50203010-02 50213040-02 5020321010 5020399000 5020308000

(7) (8) (9) (10) (11) (12) (13) (14)

0.00 0.00 1,125.00 25,380.00 25,933.50 8,000.00 8,435.00 7,440.00
 0.00 0.00 1,125.00 25,380.00 25,933.50 8,000.00 8,435.00 7,440.00

DOCUMENTS COMPLETE: NOTED:

JAMIELYN V. DAVID ERIC JOHN T. COÑAT

Administrative Assistant III Accountant
DATE:
 Appendix 3.2.7

Indicate the Name of your S

A Y M E N T S
Drugs & Telephone TOTAL
Security Other General
Medicines Expense-
Services Services
Expenses Mobile

50203070-00 50205020-01 50212030-00 50212990-00

(15) (16) (17) (19) (20)

Breakdown every transactions

1,125.00
19,210.00 Arrange every transactions
6,723.50 trans
25,380.00
8,435.00
Include the expenses paid in
3,000.00 3,000.00
8,000.00 Include the expenses paid d
7,440.00 d
8,750.00 8,750.00

0.00 3,000.00 0.00 8,750.00 88,063.50

ERIC JOHN T. COÑATE, CPA, MBA

Accountant III
A Y M E N T S
Drugs & Telephone TOTAL
Security Other General
Medicines Expense-
Services Services
Expenses Mobile

50203070-00 50205020-01 50212030-00 50212990-00

(15) (16) (17) (19) (20)

0.00 3,000.00 0.00 8,750.00 88,063.50
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
 0.00
0.00
0.00
0.00
0.00

0.00

0.00 3,000.00 0.00 8,750.00 88,063.50

ERIC JOHN T. COÑATE, CPA, MBA

Accountant III
Indicate the Name of your School in CAPITAL LETTERS

Breakdown every transactions per OR #, RER #, DV #, Invoice #, etc.

Arrange every transactions in CHRONOLOGICAL ORDER per

transaction/s.

Include the expenses paid in the REGISTRATION & TRAININGs CONDUCTED ONLY.

Include the expenses paid during the travel (e.g. fare & per
diem)
 Appendix 3.2.12
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region VI - Western Visayas
DIVISION OF HIMAMAYLAN CITY
Vallega St., Brgy. I Pob., Himamaylan City
District VII

PROGRAM OF WORKS

Name of Project: IMPROVEMENT OF PERIMETER FENCE

School/Location: SIBUCAO INTEGRATED SCHOOL (ELEM)

Fund Source: C.Y.2ND QUARTER MOOE (GOP)
Scope of Work:

No. QTY. UNIT DESCRIPTION UNIT COST

1 15 pcs Mesh Wire B.I. 4x8 430.00

2 5 bags cement 250.00
3 15 pcs G.I. Pipe 1 x 20 Sched 480.00
4 5 kls Tie Wire 80.00
5 2 cu.m Sand 800.00
6 1 cu.m Gravel 1,000.00
7 2 gal Metal Primer 450.00
8 4 bot Thinner 40.00
9 2 pcs Brush 4" 50.00
10 2 pcs Brush 2" 35.00
11 2 pcs Cutting disk 40.00

TOTAL

Total Cost of Materials

Labor Cost (35%)
 Total Cost of Project

Prepared By: Approved By:

TIC / SPC Principal

Noted by: OK as to Fund:

MICHELL L. ACOYONG ERIC JOHN T. COÑATE, CPA, MBA

OIC-ASDS Accountant III

ARLENE E. YAP, PhD REYNALDO G. GICO,EdD,CESO VI

SGOD Chief OIC-Schools Division Superintendent
Appendix 3.2.12

TOTAL COST

6,450.00
1,250.00
7,200.00
400.00
1,600.00
1,000.00
900.00
160.00
100.00
70.00
80.00

19,210.00

19,210.00
6,723.50
 25,933.50

PakiChange lang sang DESIGNATION ka IN

CHARGE SANG PROJECT

Kindly indicate the DESIGNATION of the School

ipal Head

ÑATE, CPA, MBA

tant III

CO,EdD,CESO VI
on Superintendent
 Appendix 3.2.13
PURCHASE REQUEST

Entity Name: DEPARTMENT OF EDUCATION Fund Cluster: 01

Office / Section: SIBUCAO INTEGRATED SCHOOL (ELEM) PR No.: Date:
DISTRICT 1, CLUSTER 7 Responsibility Center Code: DO - ELEM

Stock /
Property UNIT ITEM/DESCRIPTION QTY. UNIT COST TOTAL COST
No.
1 ream Bond Paper A4 100 215.00 21,500.00
2 bot Printer's Ink ( Black ) 15 100.00 1,500.00
3 bot Printer's Ink ( C ) 4 100.00 400.00
4 bot Printer's Ink ( M ) 4 100.00 400.00
5 bot Printer's Ink ( Y ) 4 100.00 400.00
6 box Staple wire 9 65.00 585.00

24,785.00
To ensure the availability of SLMs in all grade levels and all learning areas to be distributed to
Purpose:
116 learners
o Approved:
Signature
Printed Name APRIL JOY M. SAMILO ROSELYN V. GEÑEGA
Designation Property Custodian Teacher - In - Charge
 Appendix 3.2.13

11-Jun-21
PURCHASE REQUEST DATE should be BEFORE your Quotation Date.
DO - ELEM

TOTAL COST

21,500.00
1,500.00
Please LEAVE BLANK lng ang UNIT COST and TOTAL COST.
400.00
400.00
400.00
585.00

24,785.00
as to be distributed to Indicate if ano ang PURPOSE SANG
CASH ADVANCE

GEÑEGA Indicate if ANO ANG DESIGNATION sang in

- Charge charge sa project
 Republic of the Philippines
DEPARTMENT OF EDUCATION
Region VI - Western Visayas
DIVISION OF HIMAMAYLAN CITY
Vallega St., Brgy. I Pob., Himamaylan City, Neg.Occ

REQUEST FOR QUOTATION (RFQ) FOR GOODS

To all Eligible Suppliers:

I. Please qoute your lowest price inclusive of VAT on the item(s) listed below, subject to the Terms and Conditions of this RFQ. Submit or
quotation(s), duly signed by you or your representative, inside an (a sealed) envelope to the Bids and Awards Committee or its Secretariat on
24,2021__, _______ AM at ________ Sibucao Integrated School, So. Sibucao, Brgy. Buenavista Himamaylan City care of APRIL JOY
School Property Custodian. Please write the RFQ No.: ________, your business name and contact no. in front of your envelope. Quotation
approved budget for the Contract (ABC) per lot shall be rejected. Evaluation and award shall be done on a per lot basis. For more informati
Mobile no.: 09461506036 care of April Joy M. Samilo Prospective supplier shall be responsible to verify herein items from Sibucao Integra
Sibucao, Brgy. Buenavista Himamaylan City at Mobile no. 09156283816.

Opening of RFQ will be on JUNE 24, 2021 , _______PM at Sibucao Integrated School (ELEM), So. Sibucao, Brgy. Buenavista, Him

` QUEENIE V. JIMENEZ
BAC Chairman

II. Particulars

Approved QUANTITY
ITEM & DESCRIPTION / Budget for the SPECIFICATIONS / BRAND /
Item/Lot No. AND UNIT OF
TECHNICAL SPECIFICATION Contract (ABC) MODEL No. (for Bidders to Fill-out)
in Php MEASURES

1 Bond Paper A4 215.00 100 ream

2 Printer's Ink ( Black ) 100.00 15 bot

3 Printer's Ink ( C ) 100.00 4 bot

4 Printer's Ink ( M ) 100.00 4 bot

5 Printer's Ink ( Y ) 100.00 4 bot

6 Staple wire 65.00 9 box

 TOTAL 24,785.00

Delivery Perio
Delivered To:
Payment:

This is to submit our price quotations a indicated above subject to the terms and conditions of this RFQ.

Supplier's
Business TIN:
Name:
Address:
Telephone No.: Fax No.: E-mail:
Supplier's
Authorized
representative
Date:
's Signature
over Printed
Name:

Page 1 of 1
 Appendix 3.2.14

ION

CITY
ity, Neg.Occ

Q) FOR GOODS

ms and Conditions of this RFQ. Submit or send your

and Awards Committee or its Secretariat on or before _JUNE
sta Himamaylan City care of APRIL JOY M. SAMILO,
act no. in front of your envelope. Quotation that exceeds the
done on a per lot basis. For more information please call us at
to verify herein items from Sibucao Integrated School, So.

M), So. Sibucao, Brgy. Buenavista, Himamaylan City.

QUEENIE V. JIMENEZ
BAC Chairman

TOTAL TOTAL
SPECIFICATIONS / BRAND /
UNIT COST PRICE IN UNIT COST PRICE IN
MODEL No. (for Bidders to Fill-out)
PESOS PESOS

210.00 21,000.00 215.00 21,500.00

98.50 1,477.50 99.00 1,485.00
98.50 394.00 99.00 396.00
98.50 394.00 99.00 396.00
98.50 394.00 99.00 396.00
66.75 600.75 65.00 585.00
 24,260.25 24,758.00

of this RFQ.

JUNE 16, 2021

 TOTAL PRICE
UNIT COST
IN PESOS

215.00 21,500.00
100.00 1,500.00
100.00 400.00
100.00 400.00
100.00 400.00
64.00 576.00
24,776.00
 Republic of the Philippines
DEPARTMENT OF EDUCAT
Region VI - Western Visayas
Division of Himamaylan
Vallega St., Brgy. I Pob., Himamaylan

ABSTRACT OF SEALED CAN

Office / End User : SIBUCAO INTEGRATED SCHOOL (ELEM)

Date / Place : APRIL 17,2021 / : HIMAMAYLAN CITY
Package : REPRODUCTION OF SLMs

QTY UNIT ITEM / DESCRIPTION

100 ream Bond Paper A4

15 bot Printer's Ink ( Black )
4 bot Printer's Ink ( C )
4 bot Printer's Ink ( M )
4 bot Printer's Ink ( Y )
9 box Staple wire

TOTAL

IRESH C. GALIMBA APRIL JOY M. SAMILO

School Facilities Coordinator Property Custodian

MIRA L. MONGCAL
BAC Member
 Appendix 3.2.15
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region VI - Western Visayas
Division of Himamaylan
Vallega St., Brgy. I Pob., Himamaylan City

STRACT OF SEALED CANVASS

P.R.:
TY

S U P P L I E R / C O N T R A C T O R / P R O V I D E R
LUIGI & EMBER MART SJ BAN STORE ACGG GEN. MDSE
21,000.00 21,500.00 21,500.00
1,477.50 1,485.00 1,500.00
394.00 396.00 400.00
394.00 396.00 400.00
394.00 396.00 400.00
600.75 585.00 576.00

24,260.25 24,758.00 24,776.00

L JOY M. SAMILO QUEENIE V. JIMENEZ

operty Custodian BAC Member

ROSELYN V. GEÑEGA, MEd

Teacher - In - Charge
 Appendix 3.2.15

P R O V I D E R

UEENIE V. JIMENEZ
BAC Member
 ABSTRACT DATE is THE SAME with your BID OPENING
DATE.

5 OR 7 MEMBERS ang Signatories dependi sa kadakuon sang School

PakiChange lang sang ila Designation

h your BID OPENING
 Republic of the Philippines
DEPARTMENT OF EDUCATI
Region VI - Western Visayas
Division of Himamaylan
Vallega St., Brgy. I Pob., Himamaylan

ABSTRACT OF SEALED CAN

Office / End User : SIBUCAO INTEGRATED SCHOOL (ELEM)

Date / Place : / HIMAMAYLAN CITY
Package : MOBILE COMMUNICATION

QTY UNIT ITEM / DESCRIPTION

1 pc Mobile Load

TOTAL

IRESH C. GALIMBA APRIL JOY M. SAMILO

School Facilities Coordinator Property Custodian

MIRA L. MONGCAL
BAC Member
 Appendix 3.2.15
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region VI - Western Visayas
Division of Himamaylan
Vallega St., Brgy. I Pob., Himamaylan City

TRACT OF SEALED CANVASS

P.R.:
Y

S U P P L I E R / C O N T R A C T O R / P R O V I D E R
LUIGI & EMBER MART SJ BAN STORE ACGG GEN. MDSE.
1,000.00 1,000.00 1,000.00

1,000.00 1,000.00 1,000.00

L JOY M. SAMILO QUEENIE V. JIMENEZ

operty Custodian BAC Member

ROSELYN V. GEÑEGA, MEd

Teacher - In - Charge
 Appendix 3.2.15

ABSTRACT DATE i
DATE.

P R O V I D E R

UEENIE V. JIMENEZ
BAC Member
5 OR 7 MEMBERS ang Signato

PakiChange lang sang ila D

 ABSTRACT DATE is THE SAME with your BID OPENING
DATE.

MEMBERS ang Signatories dependi sa kadakuon sang School

ange lang sang ila Designation

 PURCHASE ORDER
DEPARTMENT OF EDUCATION

Supplier: LUIGI AND EMBER MART P.O. No.:

Address: HIMAMAYLAN CITY Date:
TIN: Mode of Procurement:

Gentlemen:
Please furnish this Office the following articles subject to the terms and conditions cont

Place of Delivery: SIBUCAO INTEGRATED SCHOOL (ELEM) Delivery Term:

Date of Delivery: Payment Term:
STOCK /
PROPERTY No. UNIT ITEM/DESCRIPTION QTY.
1 ream Bond Paper A4 100
2 bot Printer's Ink ( Black ) 15
3 bot Printer's Ink ( C ) 4
4 bot Printer's Ink ( M ) 4
5 bot Printer's Ink ( Y ) 4
6 box Staple wire 9

TOTAL
Total Amount in Words:
In case of failure to make the full delivery within the time specified above, a penalty
(1/10) or one (1) percent for every day of delay shall be imposed on the undelivered item/s

Conforme: Very truly yours,

ROSELYN V. GEÑEGA
Signature over Printed Name of Supplier

june 28, 2021 Teacher - In - Charge

Date Designation

Fund Cluster : 01 ORS/BURS No. :

Funds Available: ORS/BURS Date :
Allotment/ Appropriation Amount:
Available:
ERIC JOHN T. COÑATE,CPA,MBA JOH AN MAY A. VILLALVA, MBA
Accountant III Administrative Officer- Budget
 Appendix 3.2.16

ON

June 28, 2021 Note that your PO Date must be after your Abstract
Small Value Date.
Mode of Procurement: Procurement

bject to the terms and conditions contained herein:

Kindly CHECK sang inyo DELIVERY TERM kag

Delivery Term: 10 working days
DATE OF DELIVERY if gaCOINCIDE
Payment Term: Cash on Delivery

UNIT COST AMOUNT

210.00 21,000.00
98.50 1,477.50
98.50 394.00
98.50 394.00
98.50 394.00
66.75 600.75

24,260.25

he time specified above, a penalty of one-tenth

vered item/s

y yours,

ROSELYN V. GEÑEGA

Teacher - In - Charge
Designation

ORS/BURS No. :
ORS/BURS Date :
Amount:
Your AMOUNT is the TOTAL AMOUNT OF
YOUR CASH ADVANCE.
Your AMOUNT is the TOTAL AMOUNT OF
YOUR CASH ADVANCE.
ust be after your Abstract
te.

DELIVERY TERM kag

RY if gaCOINCIDE

TOTAL AMOUNT OF
H ADVANCE.
TOTAL AMOUNT OF
H ADVANCE.
 Republic of the Philippines
DEPARTMENT OF EDUCATION
Region VI - Western Visayas
DIVISION OF HIMAMAYLAN
Vallega St., Brgy. I Pob., Himamaylan City, Neg. Occ.
--------------------------------------------------------------------
ITINERARY OF TRAVEL

Entity Name : SIBUCAO INTEGRATED SCHOOL (ELEM)

Fund Cluster: 01

Name: ROSELYN V. GEÑEGA Date of Travel: May 18, 2021

Position Teacher - In - Charge Purpose of Travel: SEE ATTACHED TRA
Official Station: SO. SIBUCAO, BRGY. BUENAVISTA, HIMAMAY

TIME Means of
Date Place to be visited Transportation
Departure Arrival Transportation
05/18/21 Himamaylan City to Bacolod City 6:00 AM 8:00AM
Bacolod City to Himamaylan City 4:00 PM 6:00PM

TOTAL
Prepared by :

I certify that: (1) I have reviewed the foregoing itinerary,

(2) the travel is necessary to the service, (3) the period covered is ROSELYN V. GEÑEGA
reasonable and (4) the expenses claimed are proper. Official/ Employee
 I certify that: (1) I have reviewed the foregoing itinerary,
(2) the travel is necessary to the service, (3) the period covered is
reasonable and (4) the expenses claimed are proper.

Approved :

REYNALDO G. GICO,EdD,CES
OIC - Schools Division Superintend
 Appendix 3.2.28

g. Occ.
---------

May 18, 2021

SEE ATTACHED TRAVEL ORDER

Transportation Per Diems Others TOTAL

360.00 360.00
180.00 180.00
180.00 180.00

720.00

OSELYN V. GEÑEGA
Official/ Employee
LDO G. GICO,EdD,CESO VI
Schools Division Superintendent