ACKNOWLEDGEMENT RECEIPT

Date :

I, _____________________________________, received the amount___________________

Name of Payee amount paid

for __________________________ ______________________from _______________________

Name of Payor

____________________________________________ .

Signature over printed name (Payee)

ACKNOWLEDGEMENT RECEIPT
Date :

I, ___________________________________, received the amount__________________________

Name of Payee amount paid

for __________________________________________ from _______________________________________

Name of Payor

____________________________________________ .

Signature over printed name (Payee)

ACKNOWLEDGEMENT RECEIPT
Date :

I, ___________________________________, received the amount__________________________

Name of Payee amount paid

for __________________________________________ from _______________________________________

Name of Payor

____________________________________________ .
Signature over printed name (Payee)
 ABSTRACT OF QUOTATIONs

SLPA Name:_________________________________
Brgy:___________________________ Municipality: ______________________ Province: __________________

Unit of Name of Supplier Name of Supplier Name of Supplier

Item No. Description/ Specifications Qty.
Measurement
Unit Price Total Unit Price Total Unit Price Total

Sub-Total
(for 2 or more pages)
--Page 1 of (tota l no. pa ge s)--
(for 2 or more pages)
---Nothing follows---
(after the last Item)
TOTAL

Review and Recommending Committee

SIGNATURE OVER PRINTED NAME SIGNATURE OVER PRINTED NAME SIGNATURE OVER PRINTED NAME
 B.1
Name of Association

Address of Association

CASH / CHECK DISBURSEMENT VOUCHER

Paid to: _________________ DV no._________________

Address: ________________ Date: __________________

Particulars Amount

Prepared by: Checked & Approved by:

_________________ ___________________
Treasurer President

Reviewed by: Received by:

_________________
Officer Date:___________
 A.4
Name of SLPA

Address

PURCHASE ORDER FOR GOODS

Name of Supplier:__________________________ P.O. No:

Address: _________________________________________ Date: _________________

In accordance with the quotation dated ( ), the Sustainable Livelihood Program Association (SLPA)
of Barangay Bulod requests you to supply and deliver the items detailed below:

Description / Unit
Item No. Quantity Unit Total Amount
Specification Price

Sub-Total
(for 2 or more pages)
--Page 1 of (total
no. pages)---
(for 2 or more pages)
---Nothing
follows---
(after the last Item)
TOTAL CONTRACT AMOUNT
AMOUNT IN WORDS:

in delivery, Liquidated Damages (LD) will be deducted to the final payment. The basis of computation of
LD is one percent (1%) of the cost of all the goods, scheduled for delivery or to be performed, after the

Payment Mode is by Crossed Check upon acceptance of completed delivery.

The SLPA reserves the right to accept or reject any part of the items delivered which are not in accordance with the
specifications.

Very truly yours,

(SIGNATURE OVER PRINTED NAME )

SLPA President

Funds Available:

(SIGNATURE OVER PRINTED NAME) Date:

SLPA Treasurer

Conformed: (SIGNATURE OVER PRINTED NAME) Date:

Registered Owner/ Authorized Representative

Inspected/Tested by: (SIGNATURE OVER PRINTED NAME) Date:

Monitoring and Inspection Team

Received by: (SIGNATURE OVER PRINTED NAME) Date:

Purchasing Sub-Com/Storekeeper/Bodegero
Note: For staggered delivery and staggered payment, please ensure that each delivery period must have
separate Inspection and Acceptance prior to payment.

TERMS AND CONDITIONS

1. All prices quoted herein are valid, binding and effective at least within forty five (45) (the number

days may vary depending on the period of delivery) calendar days from date of quotation.

2. AWARDEE shall be responsible for the source(s) of his supplies/materials/equipment and shall
make deliveries in accordance with schedule, quality and specifications required in the Purchase Order.
Failure by the AWARDEE to comply with the same shall be ground for cancellation of the award and
purchase order and for re-awarding the PO to the ALTERNATE AWARDEE.

3. Subject to the provisions of the preceding paragraph, where AWARDEE has accepted a
Purchase Order but fails to deliver the required products(s) within the time called for in the same Order,
shall be extended a maximum of fifteen (15) calendar days under liquidated damages to make good his
delivery. Thereafter if AWARDEE has not completed delivery within the extended period, the subject
Purchase Order shall be cancelled.

4. All deliveries by supplier/contractor shall be subject to inspection and acceptance by the SLPA through
(insert name of representative). All necessary laboratory tests undertaken by the SLPA through (insert name of
representative) on the item(s) shall be for the account of the supplier/contractor.

5. Rejected deliveries shall be construed as non-delivery of product(s)/item(s) ordered and shall be

subject to liquidated damages, subject to the terms and conditions prescribed under paragraph 4 hereof.

6. Supplier shall guarantee his deliveries to be free from defects. Any defective item(s) / product(s) therefore
that may be discovered by the SLPA through (insert the name of SLPA president) within three (3) months after
acceptance of the same, shall be replaced by the supplier with five (5) calendar days upon receipt of a written
notice to that affect.

7. In case of delay in delivery, Liquidated damages (LD) will be deducted to the final payment. The basis
of computation of LD is one percent (1%) of the cost of all the goods undelivered, after the deadline until
completion of the deliverables.

8. All duties, excise and other taxes and revenue charges, if any, shall be for the

supplier’s/contractor’s account.

Instructions to the User:

 REQUEST FOR QUOTATION

Name of SLPA Association

Address
Date:_________________
To: (Name of Supplier)
Address:

May we request you to indicate your prices for the items listed below. Please return this
form to the canvasser.

Description/Specs of Items Qty Unit Unit Cost Total Item Cost

Prepared by:

Name and signature

Canvassing Sub-committee

Canvassed submitted by:

Signature over printed name

Registered Owner

Registered Business Name: _________________________

Date of quotation of the Supplier: __________________