Appendix 43

CASH DISBURSEMENTS REGISTER

Entity Name: DEPARTMENT OF EDUCATION Name of Accountable Officer: CARMENCITA L BOOC
Sub-Office/District/Division: DIVISION OF ZAMBOANGA SI BUGAY Official Designation: ELEMENTARY SCHOOL PRINCIPAL II
Municipality/City/Province: TALUSAN, ZAMBOANGA SIBUGAY Station: TALUSAN CENNTRAL ELEMENTARY SCHOOL
Fund Cluster : MOOE Register No. :
Sheet No. : 1

Advances for
Operating Expenses BREAKDOWN OF PAYMENTS
(19901010)
DV/Payroll/
Date Particulars Amount OTHERS
Check No. Traveling
Training
Office Repairs and
Electricity Water
Communication Internet
Janitorial Security
Fidelity
Labor and
Fuel, Oil and
Expenses Supplies Maintenance Expenses Subscription Bond Lubricants
Expenses Expenses Expenses Services Services Wages
Local Expenses School Buildings (Mobile Load) Expenses Premiums Expenses
Cash Account UACS Object
Payments Balance Description Code
Amount
Advance
(50201010) (50202010) (50203010) (50213040) (50204020) (50204010) (50205020) (50205030) (50212020) (50212030) (50215020) (50216010) (50203090)

-
-
-
-
-
-
-
-
117

-
-
-
-
-
-
-
-
-
-
-
-
Totals
- - - - - - - - - - - - - -
Recapitulation:
Account UACS Object
Amount
Description Code

Total
-

The total of the ‘Advances for Operating Expenses – Payments’ column must always be equal to the sum of the totals of the ‘Breakdown of Payments’ columns.

CERTIFIED CORRECT: Noted by: RECEIVED BY:

CARMENCITA L BOOC EUSEBIO O. MOMO, Ed. D. AHMAD J. AMIL

Elementary School Principal II Public School District Supervisor Administrative Assistant III
Signature over Printed Name Signature over Printed Name Signature over Printed Name
Date: ____________________ Date: ____________________ Date: _________________________
 Project: WATER MAINTENANCE
Amount in Words: THREE THOUSAND PESOS
POW/JO No.: 21-10-001
POW Date: 29-Sep-21
JO Date: 30-Sep-21
Started: 01-Oct-21 1 (Winner)
Finished: 31-Dec-21 Bidder: FELIX VIOLON
Date paid: 09-Dec-21 Address: Balansag, RTLim, Z/Sibu
OR No.:
Grand Total

ENTER
Item No. Unit Item Specification Quantity
Unit Price

1 months WATER MAINTENANCE UTILITY 3 1,000.00

 1 (Winner) 2 3
IX VIOLON None None
ansag, RTLim, Z/Sibugay
Grand Grand
3,000.00 Total - Total -

ENTER ENTER
Total Price Total Price Total Price
Unit Price Unit Price

3,000.00 - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
District: R. T. LIM DISTRICT
School&Address: Balansag ES, Balansag, RTLim, Z/Sibugay
School: BALANSAG ELEM. SCHOOL
Address: Balansag, RTLim, Zamboanga Sibugay
School Head: ARNULFO A. SANTISAS
BAC Chair: ALDO A. BALENSUA
Vice Chair: MARICRIS M. BALANSAG
Member ELIZABETH J. BUCABAL
Secretary: CERILA T. BORRES
Supply Officer: MARICRIS M. BALANSAG
Property Custodian: MARICRIS M. BALANSAG
Inspectorate: CERILA T. BORRES
Budget Officer: ELIZABETH J. BUCABAL
Bookkeeper: MELODY T. ENDONG
 Appendix 32
Fund Cluster :
REGULAR

Date : 09-Dec-21
DISBURSEMENT VOUCHER DV No. :

Mode of
MDS Check Cash ADA Others (Please specify)
Payment
_______________________________________
TIN/Employee No.: ORS/BURS No.:
Payee FELIX VIOLON

Address Balansag, RTLim, Z/Sibugay

Responsibility
Particulars MFO/PAP Amount
Center
Payment of
WATER MAINTENANCE 3,000.00
Period of 01-Oct-21 to 31-Dec-21
MOOE-EE 302050002
Amounting to
THREE THOUSAND PESOS
Amount Due 3,000.00
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

ALDO A. BALENSUA
BAC Chairman

B. Accounting Entry:
Account Title UACS Code Debit Credit
LABOR & WAGES 50216010-00 3,000.00
CASH 3,000.00

C. Certified: D. Approved for Payment of

Cash available
Subject to Authority to Debit Account (when applicable) WATER MAINTENANCE
Sup Period of
proper
Signature Signature
Printed
MELODY T. ENDONG Printed Name ARNULFO A. SANTISAS
Name
Administrative Assistative III School Head/Principal I
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date 09-Dec-21
E. Receipt of Payment JEV No.
Check/ Date : Bank Name & Account Number:
ADA No. :
Date : Printed Name: Date
Signature :
09-Dec-21 FELIX VIOLON 09-Dec-21
Official Receipt No. & Date/Other Documents Job order, DTR, Payroll
 R. T. LIM DISTRICT
BALANSAG ELEM. SCHOOL
Balansag, RTLim, Zamboanga Sibugay

BAC RESOLUTION
WHEREAS, an opening of bids was conducted on 29-Sep-21 , at
Balansag ES, Balansag, RTLim, Z/Sibugay
, by the Chair & Members of the School Bids & Awards
Committee;

WHEREAS, a careful evaluation of the bids was done as offered by the following bidders with their
corresponding bids:

NAME OF BIDDER AMOUNT

1. FELIX VIOLON 3,000.00
2. None -
3. None -

WHEREAS, the SCHOOL BAC found FELIX VIOLON as the lowest bidder for the
labor in terms of WATER MAINTENANCE UTILITY to be rendered at BALANSAG ELEM. SCHOOL

Wherefore, RESOLVED as it is hereby RESOLVED to declare FELIX VIOLON

as having bid the lowest in labor services and mode of procurement is REQUEST OR QUOTATION.

Prepared by:

CERILA T. BORRES
BAC Secretariat

I hereby certify to the correctness of the above resolution.

ALDO A. BALENSUA
BAC Chair
 Minutes of the Meeting Taken During the Opening of Bids
on 29-Sep-21 at Balansag ES, Balansag, RTLim, Z/Sibugay

Present:
MARICRIS M. BALANSAG Vice Chair
ELIZABETH J. BUCABAL Member
CERILA T. BORRES Member/Secretary

The BAC Vice Chair acknowledged the presence of the members of the School
BAC and called to order of the meeting for the opening of bids submitted by the following
interested bidders:

Name of Bidders Address Amount

1 FELIX VIOLON Balansag, RTLim, Z/Sibugay 3,000.00
2 None - -
3 None - -

for the WATER MAINTENANCE to be rendered/delivered at

Balansag ES, Balansag, RTLim, Z/Sibugay

After thorough review and evaluation of the bids submitted, the Committee
declared FELIX VIOLON as the winning bidder.

The BAC meeting adjourned at 10:05 .

Prepared by:

CERILA T. BORRES
BAC Secretariat

I hereby certify to the correctness of the above minutes.

ALDO A. BALENSUA
BAC Chair
 R. T. LIM DISTRICT
BALANSAG ELEM. SCHOOL
Balansag, RTLim, Zamboanga Sibugay

BAC CERTIFICATION
This is to certify that NO OTHER SERVICE PROVIDERS BID during opening of bids conducted
on 29-Sep-21 at BALANSAG ELEM. SCHOOL , by the Chair & Members of the School Bids &
Awards Committee;

And that a careful evaluation of the bids was done as offered by the following bidder with his
corresponding bid:

NAME OF BIDDER AMOUNT

1. FELIX VIOLON ₱ 3,000.00

Therefore the Bids and Awards Committee to resolved to finally hire FELIX VIOLON
as having bid for the pertinent labor services.

Prepared by:

CERILA T. BORRES
BAC Secretariat

I hereby certify to the correctness of the above resolution.

ALDO A. BALENSUA
BAC Chair
 REQUEST FOR QUOTATION
No.: 21-10-001

29-Sep-21
Date
To: All Eligible Bidders
1. Please quote your lowest price inclusive of VAT on the items listed below, subject to the Terms and Conditions of this RFQ. Submit your
quotation duly signed by your authorized representative at the DepEd Division of Zamboanga Sibugay, Pangi, Ipil, Zamboanga Sibugay
not later than 29-Sep-21 . Receipt of at least one (1) of this quotation is sufficient to proceed with the evaluation.

2. Term and Conditions

a. All entries must be READABLE.
b. Please fill up the blank section/ columns (Unit price, total price including the grand total).
c. Delivery period must be on the specified date indicated in the P.O. / Contract.
d. Price validity must be within sixty (60) calendar days.
Note: Mayor’s Permit and Tax Clearance must be duly authenticated or certified true copy by issuing
Agency and PhilGEPS Certification.
e. Warranty shall be for a period of six (6) months for supplies and materials, one (1) year for equipment
and other services from date of acceptance by the procuring entity.

FAILURE TO DO SO WILL MEAN DISQUALIFICATION OF YOUR BID PROPOSAL

3. Quotation that exceeds the Approved Budget for the Contract (ABC) shall be automatically disqualified.

ALDO A. BALENSUA
BAC Chairman

Note: The Head of the Procuring Entity reserves the right to review the quotation of the bidders and reject any and all bids, declare failure of the
procurement process at any time prior to the contract award or not to award the contract pursuant to existing guidelines, without incurring any liability.

Please return in sealed envelope and indicate the RFQ number.

Item
No. Unit Item Specification Quantity Unit Price Total Price
1 months WATER MAINTENANCE UTILITY 3
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
ABC = 00,000.00 GRAND TOTAL =
Purpose:
Water supply maintenance

This is to submit our price quotation indicated above subject to the terms and conditions of this RFQ
Suppliers Company Name: Date:
Address: Tel. No.:
TIN: Cell. No.:
Supplier's Signature Over Email Add:
Printed Name: Fax No.:
 R. T. LIM DISTRICT
BALANSAG ELEM. SCHOOL
Balansag, RTLim, Zamboanga Sibugay

PROVISIONAL PAYROLL
No. 21-10-001

I/We acknowledge receipt of the sum shown opposite my/our names as full compensation
for services rendered and specified hereunder.

Amount
Name Position Inclusive Date Signature
Due
WATER
FELIX VIOLON MAINTENANCE 01-Oct-21 31-Dec-21 ₱ 3,000.00
UTILITY

TOTAL ₱ 3,000.00

Certified: Services have duly rendered. Certified: Each employee whose name
appears above has been paid the
amount indicated opposite his/her
name.

ARNULFO A. SANTISAS ELIZABETH J. BUCABAL

School Head School Budget Officer

FUNDS AVAILABLE
APPROVED:
 R. T. LIM DISTRICT
BALANSAG ELEM. SCHOOL
Balansag, RTLim, Zamboanga Sibugay

JOB ORDER
No. 21-10-001
Date: 30-Sep-21

FELIX VIOLON
Balansag, RTLim, Z/Sibugay

This is to advise you of your job with the following description, to wit:

1. Ground grasscutting
2. Period of 3 months
3. Report to duty starting 01-Oct-21 until 31-Dec-21
4. Tap water source to the school water connection on its allotted daily schedule;
5. Fill all water containers;
6. Ensure cleanliness of water and containers;
7. A total compensation of ₱3,000 will be received upon availability of the
MOOE fund appropriated for the above-mentioned month/s.
Shall you agree on the terms and conditions specified herein, you are therefore hereby
ordered to report to duty as specified above.

ARNULFO A. SANTISAS
School Head

Conformed:

FELIX VIOLON
Signature Over Printed Name

Date signed: 30-Sep-21

 R. T. Lim District
Balansag Elementary School

PROGRAM OF WORKS
PROJECT : WATER MAINTENANCE No.: 21-10-001
LOCATION : BALANSAG ELEM. SCHOOL Date: 29-Sep-21
PERIOD : 01-Oct-21 ꟷ 31-Dec-21

NO DESCRIPTION UNIT QTY. UNIT COST TOTAL COST

1 WATER MAINTENANCE UTILITY months 3 1,000.00 3,000.00

-
-
-
-
-
-
-
-
-
-
-
-
-
-
I. MATERIAL COST - - - - - - - - - -
II. LABOR COST (MC * 10%) - - - - - -

III. PTA Assistant - - - - - - - - - - -

TOTAL: (I+II+III) - - - - - - ₱ 3,000.00

Prepared by:

Approved by:
ALDO A. BALENSUA
School BAC
ARNULFO A. SANTISAS
School Head
 R. T. LIM DISTRICT
BALANSAG ELEM. SCHOOL
Balansag, RTLim, Zamboanga Sibugay

COMPLETION REPORT
Project Title: WATER MAINTENANCE
Place of Project: BALANSAG ELEM. SCHOOL
Contractor: FELIX VIOLON
Job
J.O. Description:
No.: WATER MAINTENANCE UTILITY
21-10-001 Date: 30-Sep-21
Requisitioning Office/Dept.: School Head
Contract Term:
Date Started: 01-Oct-21
______________
Payment Term:
Date Finished: 31-Dec-21
______________
Description Status
WATER MAINTENANCE ON-GOING

INSPECTION ACCEPTANCE
Date Inspected: 09-Dec-21 Date Received: 09-Dec-21
Inspected, verified, and found OK [ ] Complete
as to description and status. [ ] Incomplete
[ ] On-going

MARICRIS M. BALANSAG ARNULFO A. SANTISAS

Property Custodian School Head