New Bac 2 Doc2

MUNICIPAL GOVERNMENT OF QUEZON Project reference Number
Name of the Project

Location of the Project
Standard Form Number: SF-GOOD-60 Lot No.
Revised on: May 24, 2004 PR No.
BAC Res. No.
Date:
Quotation No.
_________________________________
_________________________________
_________________________________
Please quote your lowest price on the item/s listed below, subject to the General Conditions on the
last page, stating the shortest time of delivery and submit your quotation duly signed by your representative
not later__________________________in the return envelope attached herewith.
NOTE: 1. ALL ENTRIES MUST BE TYPEWRITTEN

2. DELIVERY PERIOD WITHIN __________ CALENDAR DAYS
3. WARRANTY SHALL FOR A PERIOD OF SIX (6) MONTHS FOR SUPPLIES &
MATERIALS, ONE (1) YEAR FOR EQUIPMENT, FROM DATE OF ACCEPTANCE BY
THE PROCURING ENTITY
4. PRICE VALIDITY SHALL BE FOR A PERIOD OF __________CALENDAR DAYS
5. G-EPS REGISTRATION CERTIFICATE SHALL BE ATTACHED UPON SUBMISSION OF
THE QUOTATION
6. BIDDERS SHALL SUBMIT ORIGINAL BROCHURES SHOWING CERTIFICATIONS OF
THE PRODUCT BEING OFFERED
ITEM
UNIT DESCRIPTION QTY.
NO.
1 ream A3 Bond paper 80 gsm 1
2 boxes Ballpe, best quality (blue/black) by box 2
3 pairs Battery(double A, heavy duty, energizer) 6
4 pairs Battery (Triple A, Heavy Duty, energizer) 6
5 packs Computer Genuine Ink,100ml(4+1 bot.)Cyan,magenta,yellow,black,Epson 2
6 bot Correction liquid 1
7 pcs Correction tape, 5m roller type 25
8 pc Cutter, for ge.purpose,plastic molded body 1
9 pcs DTR 500
10 box Enevelope, mailing white, long 70 gsm by box 1
11 pcs Easy file with cover (big) 2
12 box Folder, long: 14 pts., (by box) 1
13 pcs Ink refill (signpen, black, .5) 12
14 pc Optical mouse, USB connection type 1
15 box Paper fastener, 8" long (stainless) 1
16 pc Paste (Jar) 1 1
17 packs Photopaper (good quality) (210 gsm) 2
18 boxes Staple wire no. 35 3
19 pcs USB 4G (flash drive) 2
20 pcs Chlorine bleach Liquid (500 ml) (Zonrox) 2
21 pc Clearbook (long) 200 pages 1
22 bot Dishwashing liquid (200ml) 2
23 pcs Engineer Field Book 2
24 pcs Fabric Conditioner Liquid (Downy sachet 27ml) 8
25 pcs Feather duster 1
26 packs Powder detergent soap (500g) 1
27 pair Rechargeable Battery (AA size, 2500mAh) 1
28 pcs Rugs (floor) 4
29 packs Toilet Deodorant cake, deodorizer/moth proofer 3
Delivery Period
Warranty
Price Validity
After having carefully read and accepted your General Conditions, I/We quote you on the item
at prices noted above.
Printed Name / Signature
_________________________ Tel No. / Cellphone No./

Signature over Printed Name e-mail address
MUNICIPAL GOVERNMENT OF QUEZON
Standard Form Number: SF-GOOD-60

GF-1386 Revised on: May 24, 2004
s. 2017
_________________________________
_________________________________
_________________________________
nditions on the Please quote your lowest price on the item/s listed below, subject to the General Cond
epresentative last page, stating the shortest time of delivery and submit your quotation duly signed by your rep
JOSE I. ILAR, CE; GE

BAC Chairman
MATERIALS, ONE (1) YEAR FOR EQUIPMENT, FROM DATE OF ACCEPTANCE
5. G-EPS REGISTRATION CERTIFICATE SHALL BE ATTACHED UPON SUBMISSIO
THE QUOTATION
6. BIDDERS SHALL SUBMIT ORIGINAL BROCHURES SHOWING CERTIFICATION
ITEM
UNIT PRICE UNIT
NO.
1 bd.ft.
2 bd.ft.
3 bd.ft.
4 bd.ft.
5 bd.ft.
6 bd.ft.
7 bd.ft.
8 bd.ft.
9 bd.ft.
10 bd.ft.
11 bd.ft.
12 bd.ft.
13 pcs.
14 sheets
15 sheets
16 sheets
17 sheets
18 sheets
19 kls.
20 kls.
21 kls.
22 kls.
23 kls.
24 kls.
25 pairs
26 sets
27 pcs.
28 bags
29 length
30 cu.m.
After having carefully read and accepted your General Conditions, I/We quote you on
ame / Signature
Cellphone No./ _________________________

Signature over Printed Name
MUNICIPAL GOVERNMENT OF QUEZON

Revised on: May 24, 2004
_________________________________
_________________________________
_________________________________
Please quote your lowest price on the item/s listed below, subject to the General Cond
last page, stating the shortest time of delivery and submit your quotation duly signed by your rep

MATERIALS, ONE (1) YEAR FOR EQUIPMENT, FROM DATE OF ACCEPTANCE
5. G-EPS REGISTRATION CERTIFICATE SHALL BE ATTACHED UPON SUBMISSIO
THE QUOTATION
6. BIDDERS SHALL SUBMIT ORIGINAL BROCHURES SHOWING CERTIFICATION
ITEM
UNIT
NO.
31 kls.
32 bags
33 length
34 cu.m.
35 kls.
After having carefully read and accepted your General Conditions, I/We quote you on
_________________________
Signature over Printed Name
AL GOVERNMENT OF QUEZON Project reference Number
Name of the Project
d Form Number: SF-GOOD-60 Lot No.
on: May 24, 2004 PR No. SEF-05
BAC Res. No. s. 2017
Date:
Quotation No.
___________________________
___________________________
___________________________
ge, stating the shortest time of delivery and submit your quotation duly signed by your representative
er__________________________in the return envelope attached herewith.

BAC Chairman
1. ALL ENTRIES MUST BE TYPEWRITTEN
THE QUOTATION
DESCRIPTION QTY. UNIT PRICE
18 - 4 x 4 x 8 - Post 192
20 - 2 x 6 x 12 - Girt 240
40 - 2 x 4 x 12 - Bottom Chord 320
30 - 2 x 4 x 12 - Top Chord 240
20 - 2 x 4 x 12 - Web Member 160
130 - 2 x 3 x 12 - Purlins 780
30 - 1 x 8 x 10 - Fascia Board 200
280 - 2 x 3 x 10 - Studs & Bridging 1,400
60 - 2 x 4 x 10 - Door & Window Jambs 400
84 - 2 x 2 x8 - Window Vertical Slats 224
120 - 1 x 2 x 10 - Window Horizontal Slats 200
16 - 2 x 3 x 10 - Shutter Frame 80
½ x 2 x 8 - Amacan Stiffener 360
4' x 8' Bamboo Weave (Amacan) 76
Ga 26 x 10' Gl Corr. Sheet 97
Ga 26 x 8' Gl Corr. Sheet 97
Ga 26 Gl Plain Sheet 8
¼ x 4 x 8 Plywood 12
Umbrella Head Nails 20
CW Nails #5 (25 kls./box) 1
CW Nails # 2½ (25 kls./box) 1
CW Nail #1 1
LP Hinges 3" 12
Hapslock Master 8
4" CHB 1,000
Portland Cement 86
10mm x 6m Rebars 60
Screened Sand 12
Delivery Period
Warranty
Price Validity
s noted above.

AL GOVERNMENT OF QUEZON Project reference Number

Name of the Project
d Form Number: SF-GOOD-60 Lot No.
on: May 24, 2004 PR No. SEF-05
Date:
Quotation No.
___________________________
___________________________
___________________________
ge, stating the shortest time of delivery and submit your quotation duly signed by your representative
er__________________________in the return envelope attached herewith.

BAC Chairman
THE QUOTATION
DESCRIPTION QTY. UNIT PRICE

Gl Tie Wire # 16 2
Portland Cement 163
10mm x 6m Rebars 30
Screened Sand 24
Gl Tie Wire # 16 3
Delivery Period
Warranty
Price Validity
s noted above.

Name of the Project
Revised on: May 24, 2004 PR No. GF-1333
Date:
Quotation No.
_________________________________
_________________________________

BAC Chairman
THE QUOTATION
ITEM
Unit DESCRIPTIONS QTY. UNIT PRICE
NO.
1 Re-wiring labor with materials
Delivery Period :
Warranty :
Price Validity
Name of the Project
Date:
Quotation No.
_________________________________
_________________________________
_________________________________

BAC Chairman
THE QUOTATION
ITEM QTY. UNIT PRICE

UNIT DESCRIPTION
NO.
1 covers Meals 150
Menu:
Rice
Buttered chicken
Beef Pecadillo
Chocolate
Softdrinks or water
2 covers Snacks 150
Chicken sandwich
C2
Delivery Period :
Warranty :
Price Validity

Name of the Project
Date:
Quotation No.
_________________________________
_________________________________
_________________________________
Please quote your highest price on the item/s listed below, subject to the General Conditions on the

BAC Chairman
THE QUOTATION

UNIT DESCRIPTION
NO.
1 pc Jersey shirt with print 7
Brand Model
Delivery Period :
Warranty :
Price Validity

Name of the Project
Date:
Quotation No.
_________________________________
_________________________________
_________________________________

BAC Chairman
THE QUOTATION

UNIT DESCRIPTION
NO.
1 pcs Abstract form 34 x 12 2,000
2 rms Bond paper, long, S20 10
3 rms Bond paper, long, S20 10
4 pcs Ballpen, blue 35
5 assortedChristmas Decorations
6 pcs Correction Tape Applicator 20
7 bxs Staple wire # 35 5
Brand Model
Delivery Period :
Warranty :
Price Validity

Name of the Project
Date:
Quotation No.
_________________________________
_________________________________
_________________________________

BAC Chairman
THE QUOTATION
ITEM
UNIT DESCRIPTION QTY. UNIT PRICE
NO.
1 pcs. Electrical Tape,big 10
2 roll Auto wire # 18 2
3 box Plug-in Fuse 30a 1
4 unit Angle Grinder 4 1
5 pcs. Oil filter C-306 2
6 pc Oil filter C-8313 1
7 pc Leaf Spring #3 front 1
8 pcs. U-bolt 20x92x10 6
9 box Welding rod 1/8 #12 1
10 pcs. Clearance Light, yellow 2
11 pcs. Rubber dumper 2
12 set Brake pad 1
13 pc Flasher 24v 1
14 pcs. Wiper Blade 19" 2
15 pcs. Battery Clamp 10
Brand Model
Delivery Period :
Warranty :
Price Validity

Name of the Project
Revised on: May 24, 2004 PR No. SEF-49
Date:
Quotation No.
_________________________________
_________________________________
_________________________________

BAC Chairman
THE QUOTATION
ITEM
NO.
25 pc. Glue Gun 3
26 pc. Rice Cooker (10 cups) 1
Warranty
Price Validity

Name of the Project
Revised on: May 24, 2004 PR No. 527
Date:
_________________________________ Quotation No.
_________________________________

NOTE: 2. DELIVERY PERIOD WITHIN __________ CALENDAR DAYS JOSE I. ILAR, CE; GE
3. WARRANTY SHALL FOR A PERIOD OF SIX (6) MONTHS FOR SUPPLIES & BAC Chairman
THE QUOTATION
ITEM
NO.
1 Completion of Multi-Purpose Building (Hall of Justice) Phase II
Brand Model
Delivery Period
Warranty
Price Validity

Name of the Project
Revised on: May 24, 2004 PR No. SEF-48
Date:
Quotation No.
_________________________________
_________________________________

1. ALL ENTRIES MUST BE TYPEWRITTEN BAC Chairman
NOTE: 2. DELIVERY PERIOD WITHIN __________ CALENDAR DAYS
THE QUOTATION
ITEM UNIT QTY. UNIT PRICE

DESCRIPTION
NO.
1 rm. Construction Paper 15
2 bot. Computer Ink Refill
Black 2
Yellow 1
Magenta 1
Cyan 1
Brand Model
Delivery Period
Warranty
Price Validity

Tel No. / Cellphone No./

e-mail address
Name of the Project
Revised on: May 24, 2004 PR No. TF-43
Date:
Quotation No.
_________________________________
_________________________________

THE QUOTATION
ITEM Unit QTY. UNIT PRICE

DESCRIPTION
NO.
1 pc. Tarpaulin Printing 1
pc. Tarpaulin Printing 1
Brand Model
Delivery Period :
Warranty :
Price Validity


e-mail address
Name of the Project
Revised on: May 24, 2004 PR No. TF-52
Date:
Quotation No.
_________________________________
_________________________________

THE QUOTATION

DESCRIPTION
NO.
1 pc. Refill Ink Black 1
Brand Model
Delivery Period :
Warranty :
Price Validity


e-mail address
Name of the Project
Date:
Quotation No.
_________________________________
_________________________________

THE QUOTATION

DESCRIPTION
NO.
1 pcs. Abstract Form 34 x 12 1,500
2 pcs. Ballpen, blue 30
3 pcs. Ballpen, black 10
4 pcs. Ballpen, green 10
5 pcs. Ballpen, red 10
6 pcs. Specialty Paper, long 50
7 pcs. Folder, Ordinary, long 50
8 box PVC Cover 300 MIC, 217 X 331 mm 1
9 pcs. Flash Drive 64GB 5
10 bxs. Staple Wire # 35 5
Brand Model
Delivery Period :
Warranty :
Price Validity


e-mail address
Name of the Project
Date:
Quotation No.
_________________________________
_________________________________

THE QUOTATION
DESCRIPTION
NO.
1 pcs. Air Cleaner - DepEd 1 1
2 pcs. Oil Filter - DepEd 1 1
3 pcs. Fuel Filter - DepEd 2 1
4 pcs. Oil Filter - DepEd 2 1
5 pcs. Battery, 17 plates 2
6 mtrs Battery Cable 5
Brand Model
Delivery Period :
Warranty :
Price Validity


e-mail address
Name of the Project
Date:
Quotation No.
_________________________________
_________________________________

THE QUOTATION

DESCRIPTION
NO.
1 hours Equipment Rental (backhoe works) 44.5
Brand Model
Delivery Period :
Warranty :
Price Validity


e-mail address
Name of the Project
Date:
Quotation No.
_________________________________
_________________________________

BAC Chairman
THE QUOTATION

NO.
1 pcs.
2
3 pcs.
4
5
6
7
8 pcs.
9
10
11
12 pcs.
13 pcs.
14
15 pcs.
Brand Model
Delivery Period
Warranty
Price Validity
Name of the Project
BAC Res. No. s.2015
Date:
Quotation No.
_________________________________
BAC Chairman
THE QUOTATION
NO.
1 10W DUMPTRUCKS (A1-Surplus)
Drive type: 6x4
Cab: HW76 cab eith one sleeper bed and
with A/C
Engine Model: WD615.69
Engine Power: 336hp
Gear Box: HW15710
Steering: ZF 8098
Tires: 11.00R20, 10+1 spare Brand new
Fuel Tank Capacity(L): 300
Dump body dimention (mm):

5200x2300x1500
Thickness of body (mm): floor-8, side
and back-6
Lifting type: reinforced "T" type lifting
OR ITS EQUIVALENT
with complete tools and batteries
Brand Model
Delivery Period :

Name of the Project
Revised on: May 24, 2004 PR No. 534 at prices noted above
Date:
Quotation No. ________________
e-mail address
Name of the Project
Date:
Quotation No.
_________________________________
_________________________________

BAC Chairman
THE QUOTATION
NO.
1 pcs. 25
Brand Model
e-mail address
Name of the Project
BAC Res. No. s.2015
Date:
Quotation No.
_________________________________
_________________________________

BAC Chairman
THE QUOTATION

NO.
1 tube 2
Brand Model
Delivery Period :
Warranty :
Price Validity

e-mail address
Name of the Project
BAC Res. No. s.2015
Date:
Quotation No.
_________________________________
_________________________________

BAC Chairman
THE QUOTATION

NO.
1 cover 35covers x 4meals 140
2 cover 35covers x 4snacks 140
SNACKS:
Torta
Softdrinks
Brand Model
Delivery Period :
Warranty :
Price Validity

e-mail address
Name of the Project
Date:
Quotation No. ________________
_________________________________
_________________________________

BAC Chairman
THE QUOTATION

NO.
1 cover 70
2 cover 70
SNACKS: AM
TORTA
SOFTDRINKS
Brand Model
Delivery Period :
Warranty :
Price Validity

e-mail address
Name of the Project
BAC Res. No. s.2015
Date:
Quotation No.
_________________________________
_________________________________

BAC Chairman
THE QUOTATION

NO.
1 cover 35
2 cover 35
Brand Model
Delivery Period :
Warranty :
Price Validity

e-mail address
Name of the Project
Date:
Quotation No. ________________
_________________________________
_________________________________

BAC Chairman
THE QUOTATION

NO.
1 COVER 40
2 COVER 40
SNACKS:
TORTA
SOFTDRINKS
Brand Model
Delivery Period :
Warranty :
Price Validity

e-mail address
Name of the Project
Date:
Quotation No. ________________
_________________________________
_________________________________

BAC Chairman
THE QUOTATION

NO.
1 pcs 6
2 pcs 12
3 length 9
4 pcs 12
5 PACKS 2
6 PC 1
7 PC 1
8 PCS 10
9 length 3
10 PCS 8
11 PCS 7
12 PCS 1
13 PACKS 1
Brand Model
Delivery Period :
Warranty :
Price Validity

e-mail address
Name of the Project
Date:
Quotation No. ________________
_________________________________
_________________________________

BAC Chairman
THE QUOTATION

NO.
1 pc 1
2 pc 1
3 set 1
4 pc 1
5 pcs 6
6 pcs 2
7 pcs 2
8 set 1
9 set 1
10 pc 1
11 pc 1
Brand Model
Delivery Period :
Warranty :
Price Validity

e-mail address
Name of the Project
Date:
Quotation No. ________________
_________________________________
_________________________________

BAC Chairman
THE QUOTATION

NO.
1 ft 16
2 ft 12
3 ft 10
4 pcs 8
Brand Model
Delivery Period :
Warranty :
Price Validity

e-mail address

Name of the Project
Date:
Quotation No. ________________
_________________________________
_________________________________

BAC Chairman
THE QUOTATION

NO.
1 set 1
Brand Model
Delivery Period :
Warranty :
Price Validity

e-mail address

Name of the Project
BAC Res. No.
Date:
Quotation No. ________________
_________________________________
_________________________________

BAC Chairman
THE QUOTATION

NO.
Brand Model
Delivery Period :
Warranty :
Price Validity

e-mail address
Warranty :
Price Validity
prices noted above.

Annex B
Republic of the Philippines
Province of Bukidnon
MUNICIPALITY OF QUEZON
No.
DISBURSEMENT VOUCHER
Mode of
Payment Check Cash
Others
TIN/Employee No. Obligation Request No.
Payee EXECOM COMPUTER SALES AND SERVICES
Responsibility Center
Address Maramag, Bukidnon Code:
EXPLANATION AMOUNT
To payment of 1 unit laptop intended for POPDEV with

supporting papers hereto attached in the amount of…… 52,500.00
A Certified: B Certified:
Allotment obligated for the purpose as indicated above Funds Available
Supporting documents complete
Signature: Signature: Date
Printed Date Printed
MIRAFLOR I. DIVINASFLORES, CPA MELENCIO O. MELGAZO
Name Name
Municipal Accountant Municipal Treasurer
Position Position:
(Head Accounting Unit/Authorized Representative) Treasurer/Authorized Representative Date
Signature: Check No. Bank Name
Printed Date Signature Date
Name GREGORIO LLOREN GUE Printed EXECOM COMPUTER SALES AND SERVICES
Name
Municipal Mayor OR/Other Documents JEV No. Date
Position
Agency Head/Authorized Representative
Annex B
No.
Mode of
Payment Check Cash Others
Payee SMART COMMUNICATION
Address Code:
EXPLANATION AMOUNT
To payment of internet services

as per supporting papers hereto attached in the
amount of………………………… 544.85
Php544.85
Name Name
Position Position:
Name GREGORIO LLOREN GUE Printed
SMART COMMUNICATION
Name
Position
Annex B
No.
Mode of
Payment Check Cash Others
Payee MMU ENTERPRISES & GEN. MDSE.
Address Maramag, Bukidnon Code:
EXPLANATION AMOUNT
To withdrawal of Bid Security in the amount of ………. Php 29,792.00
Name Name
Position Position:
Name GREGORIO LLOREN GUE Printed
MMU ENTERPRISES & GEN. MDSE.
MMU ENTERPRISES & GEN. MDSE.
Name
Position
Standard Form Number: SF-GOOD-58 Project Reference Number Standard Form
Revised on: May 24, 2004 Name of the Project Revised on: Ma
PURCHASE ORDER
LGU - Quezon, Bukidnon
Supplier EXECOM COMPUTER SALES & SERVICES P.O. No. Supplier
Address Maramag, Bukidnon Date Address
E-mail Address Mode of E-mail Addre
Telephone No. P.R. No. Telephone N
TIN TIN
Gentlemen: Gentlemen:
Please furnish this office the following articles subject to the terms and conditions
contained herein: contained he
STOCK NO. UNIT DESCRIPTION QTY UNIT COST AMOUNT STOCK NO.
1 set Intel Core i5 Processor 1 32,018.00 32,018.00
Motherboard with AVL
2GB DDRs Memory -
500GB SATA HDD -
ATX-Casing w/ P-Supply (black) -
15.6 LCD Monitor -
DVD Writer SATA Samsung -
A4tech PS2 Keyboard
A4tech PS2 Mouse
500 w AVR with External Hardisk 1 TB -
2 unit Printer L210 3 - in - 1 1 8,240.00 8,240.00
3 unit CPU 1 19,650.00 19,650.00
Intel Core i5 Processor -
Motherboard with AVL -
2GB DDRs Memory -
500GB SATA HDD
ATX-Casing w/ P-Supply (black)
DVD Writer SATA Samsung
500 w AVR
P 59,908.00
(Total Amount in words) Fifty Nine Thousand Nine Hundred Eight pesos (Total Amount in
In case of failure to make the full delivery within the time specified above, a penalty of one-
tenth (1/10) of one (1) percent for every day of delay shall be imposed. tenth (1/10)
Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor
EXECOM COMPUTER SALES & SERVICES

Signature over printed name of supplier
Date
Standard Form Number: SF-GOOD-58 Project Reference Number

Revised on: May 24, 2004 Name of the Project
URCHASE ORDER
GU - Quezon, Bukidnon
Supplier CEBU SOUTHERN MOTORS INC. P.O. No.
Address Lapasan Highway, Cagayan De Oro City Date
E-mail Address Mode of
Telephone No. Procurement
TIN
Gentlemen:
contained herein:
STOCK NO. Unit DESCRIPTION QTY UNIT COST AMOUNT
19 pc Belt A7C Comppressor 2 900.00 ###

20 pc Belt Cooling Fan 1 1,220.19 ###
21 pc Gauge Oil Level 1 593.80 ###
22 pc Rubber Cushion CAB MTG 3 128.70 ###
23 pc Rubber Cushion 9 452.07 ###
24 pc Blade ASM Wiper 17" 1 313.64 ###
25 pc Blade ASM Wiper RH 22" 1 282.26 ###
26 ltr ATF (Texamatic 1888) 1 232.30 ###
27 ltr GL 5 SAE140 1.75 200.00 ###
28 pc Brake and Clutch Fluid .25LTR 2 80.00 ###
29 ltr CT Narpak Grease 0.5 217.36 ###
30 ltr Engine Oil 6.75 223.00 ###
31 gal Distilled Water 1 90.00 ###
32 pc Sealing Washer 1 47.85 ###
33 ltr Cleaning Solvent 2 80.00 ###
34 Radiator Coolant 1 212.50 ###
35 can Brake Pad Cleaner 0.5 300.00 ###
Sub-Total ###
(Total Amount in words) ###
ull delivery within the time specified above, a penalty of one-

tenth (1/10) of one (1) percent for every day of delay shall be imposed.
Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor
CEBU SOUTHERN MOTORS INC.
Date
Funds Available:
JULIETA D. ROLDAN, CPA

Municipal Accountant
URCHASE ORDER
Supplier TRIAC P.O. No.
Address Date
TIN
Gentlemen:
contained herein:
1 bots. Ascorbic Acid tab. 500mg. 100's BP 15 80.00 ###

2 tubes Bethamethazone Valerate 10grms 20 60.00 ###
3 bots. Cefalexin drop 100mg. 10ml 100 17.00 ###
4 boxes Cimetidine tab. 400mg. 100's BP 10 95.00 ###
5 bots. Dicycloverine syrup 10mg 60ml. 100 13.00 ###
6 bots. Ferrous Sulfate drop 144 15.00 ###
7 boxes Hyoscine Butylbromide HCL 100's BP 5 230.00 ###
8 boxes Guiafenesin syrup 100mg. 60ml 100 14.00 ###
9 bots. Paracetamol Syrup 250mg 60ml 11 13.00 ###
10 bots. Salbutamol tab. 2mg 100's 10 25.00 ###
11 bots. Distilled Water for Injection 6 45.00 ###
Php 11,723.00
(Total Amount in words)

Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor
TRIAC
Date
Funds Available:

URCHASE ORDER
Supplier CEBU SOUTHERN MOTORS INC. P.O. No.
Address Lapasan Highway, Cagayan De Oro City Date
TIN
Gentlemen:
contained herein:
19 pc Belt A7C Comppressor 2 900.00 ###

20 pc Belt Cooling Fan 1 1,220.19 ###
21 pc Gauge Oil Level 1 593.80 ###
22 pc Rubber Cushion CAB MTG 3 128.70 ###
23 pc Rubber Cushion 9 452.07 ###
24 pc Blade ASM Wiper 17" 1 313.64 ###
25 pc Blade ASM Wiper RH 22" 1 282.26 ###
26 ltr ATF (Texamatic 1888) 1 232.30 ###
27 ltr GL 5 SAE140 1.75 200.00 ###
28 pc Brake and Clutch Fluid .25LTR 2 80.00 ###
29 ltr CT Narpak Grease 0.5 217.36 ###
30 ltr Engine Oil 6.75 223.00 ###
31 gal Distilled Water 1 90.00 ###
32 pc Sealing Washer 1 47.85 ###
33 ltr Cleaning Solvent 2 80.00 ###
34 Radiator Coolant 1 212.50 ###
35 can Brake Pad Cleaner 0.5 300.00 ###
Sub-Total ###
(Total Amount in words) ###

Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor
CEBU SOUTHERN MOTORS INC.
Date
Funds Available:

PURCHASE ORDER
Supplier Saturnino A. Noble P.O. No.
Address Quezon, Bukidnon Date
Telephone No. P.R. No.
Gentlemen:
contained herein:
UNIT DESCRIPTION QTY UNIT COST AMOUNT
P 0.00
(Total Amount in Fifty Nine Thousand Nine Hundred Eight pesos
Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor
Saturnino A. Noble
Date
AMOUNT
AMOUNT
AMOUNT
PURCHASE ORDER
Supplier EXECOM COMPUTER SALES AND SERVICES P.O. No.
Address Maramag, Bukidnon Date
Telephone No. PR. No.
TIN
Gentlemen:
contained herein:
STOCK NO. UNIT DESCRIPTION QTY UNIT COST AMOUNT
1 unit Laptop 1 52,500.00 52,500.00

i7 Intel Core
8 GB RAM
1 Tera Byte
15.6 x 8mm screen
P 52,500.00
(Total Amount in words) Fifty Two Thousand Five Hundred pesos
Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor
EXECOM COMPUTER SALES AND SERVICES

Date

PURCHASE ORDER
Supplier LCA SURPLUS P.O. No.
Address Baloy, Tablon, Cagayan de Oro City Date
Telephone No. P.O. No.
TIN
Gentlemen:
contained herein:
1 unit GARBAGE COMPACTOR (A-1 Surplus) 1 1,840,000.00 1,840,000.00

6W, 4T, GIGA,
Diesel Fueled
8.0m3, Push type
OR ITS EQUIVALENT
with complete tools and customs payment certificate
Brand New Tires and Batteries
-
-
P 1,840,000.00
(Total Amount in words) One Million Eight Hundred Forty Thousand Pesos
Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor
LCA SURPLUS
Date
PURCHASE ORDER
TIN
Gentlemen:
contained herein:
1 unit BULLDOZER (A-1 Surplus) Catterpillar D6R 1 4,288,000.00 4,288,000.00
Gross Power: 160 hp w/caven & Ripper -
Power Measured @ 1850 rpm, Displacement: 741.7 cu in
Number of Cylinders; 6, Operating weight: 35692.8 lbs
Fuel Capacity (L): 320
Cooling System fluid Capacity: 16.6 gal
Transmission Type: K-C, transmission forward Gears:3
OR ITS EQUIVALENT
with tools
P 4,288,000.00
(Total Amount in words) Four Million Two Hundred Eighty Eight Thousand Pesos
Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor
LCA SURPLUS
Date
PURCHASE ORDER
Supplier GH OFFICE DEPOT P.O. No.
Address Davao City Date
TIN
Gentlemen:
contained herein:
1 2 Office Table W/3 side drawers and 1 1 lot 52,500.00

center drawer w/ lock
1200x 600x760MM
3 Panels Partition with glass 60x120 CM
1 Panel Partition with glass 1100x1475MM
1 unit Jr. executive table SM-306

veneer type, mahogany color
6 pcs. Hanging shelves, melamine board finish

18MM thickness
P 52,500.00
(Total Amount in words) Fifty Two Thousand Five Hundred Pesos
Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor
GH OFFICE DEPOT
Date
PURCHASE ORDER
TIN
Gentlemen:
contained herein:
1 unit VIBRATORY COMPACTOR (A-1 Surplus) dynapac 1 3,438,000.00 3,438,000.00

8-10 tonner reated Power (kw/rpm);85/200
Operating Wt(kg);12000, static Linear Pressure (N/cm):282
Drum/Tire load (kg): 6000/6000,wt. Burden frt drum (kg) 6000
Wt. Burden-rear wheel (kg):6000, min Turning Radius (mm): 6500
Travel Speed (km.h): 1.9/3.3/9.1, Gradeability (%):30
Vibration Fequency (Hz):28, Nominal Aplitude (mm): 1,8/0.9
Centrifugal Force (kN): 270/160, min. fuel Consumption (g/kw-h): 235
Fuel Tank Capacity (L): 190, Steering Model: Hydraulic
Steering
Axle Type: Middle Reduce + Wheel Hub
Hydraulic Oil Tank Capacity (L): 190, A/C Refrigerating
Capacity (W): 4600
OR ITS EQUIVALENT, with complete tools and -
custom payment certificate -
P 3,438,000.00
(Total Amount in words) Three Million Four Hundred Thirty Eight Thousand Pesos
Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor
LCA SURPLUS
Date

PURCHASE ORDER
TIN
Gentlemen:
contained herein:
1 unit SELF LOADING TRUCK (10W) 1 2,940,000.00 2,940,000.00

A-1 Surplus, Complete Build-Up 8DC9 -
OR ITS EQUIVALENT -
Brand New Tires & Batteries
P 2,940,000.00
(Total Amount in words) Two Million Nine Hundred Forty Thousand
Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor
LCA SURPLUS
Date
PURCHASE ORDER
Supplier BUKIDNON TRADER MARKETING P.O. No.
Address Valencia City Date
TIN
Gentlemen:
contained herein:
1 sacks 7 tonner rice 260 2,183.25 567,645.00
2 kls Pork (lean meat) 981 187.45 183,888.45
3 kls Chicken 654 152.30 99,604.20
4 kls Fish 654 127.80 83,581.20
5 kls Ribs (pork) 654 161.00 105,294.00
6 kls Mongo beans 218 76.00 16,568.00
7 kls Dilis, (small) 108 390.00 42,120.00
8 sets Spaghetti, Noodles 1kilo, cheese sauce 218 225.00 49,050.00
9 cans Corned beef, (big) 436 44.25 19,293.00
10 packs Tableya, (10's packs) 327 39.85 13,030.95
11 kls C-sugar 109 51.55 5,618.95
12 cans Condense milk,(big) 109 32.35 3,526.15
13 kls Fresh miki 218 35.15 7,662.70
14 pcs Eggs 5,232 5.85 30,607.20
15 kls Cooking Oil 218 64.45 14,050.10
16 kls Soy Sauce 218 29.35 6,398.30
17 kls Onion 164 98.40 16,137.60
18 kls Garlic 164 123.00 20,172.00
19 kls Potatoes 654 52.70 34,465.80
20 kls Carrots 327 29.30 9,581.10
21 kls Squash 327 11.75 3,842.25
P 1,332,136.95
(Total Amount in words) One Million Three Hundred Thirty Two Thousand One Hundred Thirty Six Pesos & 95/100
Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor
BUKIDNON TRADER MARKETING

Date
PURCHASE ORDER
Supplier KARASIA, INC. P.O. No.
Address km. 5 J.P. Laurel Ave. Davao City Date
TIN
Gentlemen:
contained herein:
1 unit Vehicle (Ambulance) 1 988,900.00 988,900.00

Amenities/Accessories included
1 set blinker and siren
1 set foldable stretcher and floor lock, with stretcher stopper and rails,
1 set cabinet for medicine, medical apparatus and supply
1 piece spine board with spider strap,
1 lot oxygen tank with gauge regulator strap or holder
1 set ambulance bag with resuscitator
1 set wall mounted BP apparatus with stethoscope,
1 set First aid kit,
1 piece fire extinguisher
1 piece head immobilizer,
1 piece Adjustable C collar - adult
OR ITS EQUIVALENT, with complete tools and -
custom payment certificate -
P 988,900.00
(Total Amount in words) Nine Hundred Eighty Eight Thousand Nine Hundred Pesos
Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor
KARASIA, INC.
Date

PURCHASE ORDER
Supplier EXECOM COMPUTER SALES & SERVICES P.O. No.
Address South Poblacion, Maramag, Bukidnon Date
TIN
Gentlemen:
contained herein:
1 units SM-T116 Samsung Galaxy Tab 3V 3G: 93 7,820.00 727,260.00

Quad Core 1.3GHz Processor/ 7" WSVGA (1024X600)
TFT Display/8GB (up to 32GB)+1GB RAM 2MP(Rear)
+2MP (Front) Camera/Android Kitkat 4.0/3600 mAH
+Battery/3G + Qidi/Single SIM
Tablet Bag
16gb SD Card
Power Bank 5000Mah
2 unit Desktop Computer w/ 1 33,793.75 33,793.75

Motherboard Asus
Processor Intel Core i5
4GB DDP3 Memory
500 GB HDD
Keyboard w/ USB Mouse
Uninterruptible Power Supply
DVD Writer
1 Terabite External Hardisk
w/ 24" Monitor P
761,053.75
(Total Amount in words) Seven Hundred Sixty One Thousand Fifty Three Pesos & 75/100
Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor
EXECOM COMPUTER SALES & SERVICES

Date
OFFICE OF THE BIDS AND AWARDS COMMITTEE
BIDS AND AWARDS
TO WHOM IT MAY CONCERN
(Sec. 53) , IRR-A, R.A. 9184 as provided under par. (a) (b) ( c ) (d), whereby the procuring entity directly negotiate to the herein capable s
Item QTY. Unit DESCRIPTION Estimated Cost

No. per Item / PR
(ABC) NAME OF CAPABLE SUPP
It is hereby recommended to the Head of the Procuring Entity the approval and implementation as to the Notice of Award in con
JOSE I. ILAR, CE, GE ALEJANDRO C. SUMILJIG

BAC CHAIRMAN BAC Vice Chairman BAC Member BAC Member BAC Member
APPROVED :
GREGORIO LLOREN GUE
Municipal Mayor
(Head of Procuring Entity)
TEE
Date
apable supplier, to wit:
REMARKS
E SUPPLIER
rd in conformity with Sec. 37.1 and 37.2.1. .
BAC Member Requisitioning Officer

Provisional BAC Member
Note: Only for the Items
OFFICE OF BIDS AND AWARDS COMMITTEE
ABSTRACT OF BIDS AND AWARDS

We, the undersigned, hereby certify that the following items was procured and conducted in accordance with Sec. 53 a
Negotiated Procurement per BAC Res. No. 's 2016 as approved by the Head of the Procuring Entity, and the limitation of Sec 53.9
Name of Bonafid
Item Estimated Cost
QTY. Unit DESCRIPTION
No. per Item LCA SURPLUS
Cagayan de Oro City
1 4 units 10W DUMPTRUCKS (A1-Surplus ) Supergreat 3,000,000.00 2,742,000.00
Drive type: 8DC11 & 8DC9-3
Cab: HW76 eith one sleeper bed and with A/C
Engine Moderl: WD615.69
Engine Power: 336hp
Gear Box: HW15710
Steering: ZF 8098
Fuel Tank Capacity (L): 300
Dump body dimention (mm): 5200x2300x1500
Thickn ess of body (mm): floor- 8, side and back-6
OR ITS EQUIVALENT
with complete tools and batteries and
customs payment cerificate
As result of price quotations submitted by known bonafide suppliers, we were able to determined and evaluate the lowest bid price
Entity (H.O.P.E.) the approval and implementation as to Notice of Award in conformity with Sec. 37.1 and 37.2.1 lowest bid price suppli
JOSE I. ILAR, GE,CE ALEJANDRO C. SUMILJIG WILFREDO G. TOLEDO ROGER D. LACUBTAN JUDITH D. LASPIÑAS
APPROVED :
GREGORIO LLOREN GUE
Municipal Mayor

Name of Bonafid
Item Estimated Cost
Cagayan de Oro City
1 1 unit GARBAGE COMPACTOR (A-1 Surplus)
6W, 4T, GIGA, 2,000,000.00 1,840,000.00
Diesel Fueled
8.0m3, Push type
OR ITS EQUIVALENT
APPROVED :
GREGORIO LLOREN GUE
Municipal Mayor

Name of Bonafid
Item Estimated Cost
Cagayan de Oro City
1 1 unit SELF LOADING TRUCK (10W) 3,000,000.00 2,940,000.00

A-1 Surplus, Complete Build-Up 8DC9
OR ITS EQUIVALENT
`
APPROVED :
GREGORIO LLOREN GUE
Municipal Mayor

Name of Bonafid
Item Estimated Cost
Cagayan de Oro City
1 1 unit BULLDOZER (A-1 Surplus) Catterpillar D6R 6,000,000.00 4,288,000.00

Gross Power: 160 hp w/caven & Ripper
OR ITS EQUIVALENT
with tools
APPROVED :
GREGORIO LLOREN GUE
Municipal Mayor

Name of Bonafid
Item Estimated Cost
Cagayan de Oro City
1 1 unit VIBRATORY COMPACTOR (A-1 Surplus) dynapac
8-10 tonner reated Power (kw/rpm);85/200 4,000,000.00 3,438,000.00
Steering
Capacity (W): 4600
OR ITS EQUIVALENT, with complete tools and
custom payment certificate
APPROVED :
GREGORIO LLOREN GUE
Municipal Mayor

Name of Bonafid
Item Estimated Cost EXECOM COMPUTER
No. per Item SALE & SERVICES
Maramag, Bukidnon
1 93 units SM-T116 Samsung Galaxy Tab 3V 3G:
Quad Core 1.3GHz Processor/ 7" WSVGA (1024X600) 7,830.00 7,820.00
Tablet Bag
16gb SD Card
Power Bank 5000Mah
2 1 unit Desktop Computer w/ Motherboard Asus 35,384.00 33,793.75
4GB DDP3 Memory 500 GB HDD
DVD Writer
1 Terabite External Hardisk , w/ 24" Monitor
JOSE I. ILAR, GE,CE ALEJANDRO C. SUMILJIG WILFREDO G. TOLEDO ROGER D. LACUBTAN MELENCIO O. MELG
APPROVED :
GREGORIO LLOREN GUE
Municipal Mayor
MMITTEE
ARDS
Date
e with Sec. 53 a par (Revised IRR), Alternative Method of Procurement thru
ation of Sec 53.9.1&2 was properly observe;
ame of Bonafide Supplier

New Ibaraki Engine Lowest Calculated
Engine & Truck Parts DAVAO AMG
Davao City Davao City
NO STOCK 2,750,000.00 LCA SURPLUS
lowest bid price and hereby recommend to the head of the procuring
t bid price supplier IRR-A, R.A. 9184, to the lowest price supplier.
D. LASPIÑAS MELENCIO O. MELGAZO

C Member BAC Member Requisitioning Officer
MMITTEE
ARDS
Date

1,850,000.00 2,400,000.00 LCA SURPLUS

MMITTEE
ARDS
Date

2,950,000.00 2,950,000.00 LCA SURPLUS


MMITTEE
ARDS
Date


MMITTEE
ARDS
Date


MMITTEE
ARDS
Date
Lowest Calculated
INTELLISOFT DATAWORLD
Malaybalay City Valencia City
7,990.00 7,900.00 EXECOM COMPUTER SALES

& SERVICES
35,500.00 34,350.00 EXECOM COMPUTER SALES

& SERVICES
ENCIO O. MELGAZO
C Member Requisitioning Officer
OBLIGATION SLIP
Payee/Office: No.:
Philippine Daily Inquirer Date:
Responsibility
Address: Poblacion, Quezon, Bukidnon

F/P.P.A
Particulars Account Amount

Code
To payment of newspaper……………. P 600.00
Total P 600.00
A. Requested by: B. Funds Available
Certidied: Charges to appropriation/allotment Certified: Appropriation/Allotment available and
necessary, lawful and under my direct obligated for the purpose as indicated
supervision above
Signature: Signature:
Printed Name: MELENCIO O. MELGAZO Printed Name: ROGER D. LACUBTAN
Position: Municipal Treasurer Position: Municipal Budget Officer
Date: Date:
00
ANNEX G-7
INSPECTION & ACCEPTANCE REPORT

Supplier LCA SURPLUS AR No. _________________
PO No. Date Invoice No_______Date ____________
Requisitioning Office/Dept.
Item No. Unit Description Quantity
1 unit VIBRATORY COMPACTOR (A-1 Surplus) dynapac 1

8-10 tonner reated Power (Kw/rpm). 85/200
Operating wt. (kg); 1200, static linear Pressure (N/cm) ;282
Drum/tire load (kg) 6000/6000
Wt. Burden-rear wheel (kg): 6000, min. Turning Radius (mm): 6500
Travel Speed (km.h) 1.9/3.3/9.1, Grade ability (%): 30
Vibration Frequency (Hz); 28, Nominal Aplitude (mm); 1,8/0.9
Centrifugal foce (kn): 270/160, min. fuel consumption (g/kw-h): 235
fuel Tank Capacity (L): 190, 'Steering Model: Hydraulic
Steering
Hydraulic Oil Tank Capacity (L): 190, A/C Refregerating
Capacity (W): 4600
INSPECTION ACCEPTANCE
Date Inspected Date Received
X Inspected, verified and found OK as to quantity and

specifications.
X Complete
ANTONIO ARCAYERA, CE Partial

Inspection Officer
JOSE RATUNIL SENFRONIO AMONGOS, ME

MMO - Representative MEO-Representative Property Officer
CLEMENTINO MANGUBAT
MEO-Representative
ANNEX G-7

Supplier VALENCIA GOODWILL COMMERCIAL, INC. AR No. _________________
1 set TIRE - MRF Super Lug 10 x 20 10

2 set TIRE - MRF Miller 700 x 16 6

specifications.
X Complete

Inspection Officer
JOSE RATUNIL SENFRONIO AMONGOS, ME

MMO - Representative MEO-Representative Property Officer
CLEMENTINO MANGUBAT
MEO-Representative
Supplier DAVAO G.H. ENTERPRISES, INC. AR No. _________________ Supplier
PO No. Date Invoice No_______Date ____________ PO No.
Requisitioning Office/Dept. Requisitioning
Item No. Unit Description Quantity Item No.

54 Panels Partition with Glass and Strip,
1 1200 Meters High, Laminate Partition with 1
Aluminum Powder Coated Frame
17 Panels Table Top, Melamine Board
Finish, 25mm with PVC Edging
19 Units Pedestal Mobile CU-1 with 2
Drawers and Central Locking System
2 Units Executive Table, Melamine Board
Finish with Drawers
5 Units Executive Chair, High Black Mesh
with Chrome Legs
10 Units Visitor Chair,/Mesh Back, Sled
Type Powder Coated Black Steel Support
2 Units Cabinet with Glass, Melamine
Board Finish
2 Units Cabinet, Melamine Board Finish
5 Units Cabinet Filing Melamine Board
Finish
6 Units Sofa Bench with Cushion
Date Inspected Date Received Date Inspec
X Inspected, verified and found OK as to quantity and X

specifications.
X Complete

Inspection Officer
RONIE Y. ISRAEL ARLENE B. JAGAPE RONIE Y.

OMA - Representative MPDO-Representative Property Officer OMA - Repr
RIZALINO V. SINOGAYA, JR. VIRGINIA N. GATILLO RIZALINO

MMO - License MBO- Representative
Supplier
PO No.
Requisitioning
Item No.
Date Inspec
RONIE Y.
OMA - Repr
RIZALINO
Supplier
PO No.
Requisitioning
Item No.
Date Inspec
RONIE Y.
OMA - Repr
RIZALINO
Supplier LR ENTERPRISES AR No. _________________ Supplier
Requisitioning Office/Dept. Requisitioning Offic

1 boxes Amoxicillin cap 500 mg. 100 BP 20
2 bots. Amoxicillin tab. 250 mg. 60 ml. 5
3 bots. Amoxicillin susp. 5 ml 60 ml. 144
4 bots. Amoxicillin drop 100 mg. 1 ml. 10 ml. 54
5 bots. Cefalexin cap. 500 mg. 100's BP 10
6 bots. Cefalexin susp. 250 mg. 60 ml. 144
7 bots. Cefalexin drop. 100 mg. 1 ml. 108
8 boxes Ceprofloxacin 500 mg. tab 100's BP 10
9 bots. Cotrimoxazole cap. 800 mg. 100's BP 10
10 bots. Cotrimoxazole tab. 400 mg. 100 BP 10
11 bots. Cotrimoxazole susp. 200 mg. 5 ml. 60 ml. 108
12 boxes Cloxacillin 500 mg. cap 100's BP 3
13 boxes Cloxacillin 250 mg. tab 100's 5
14 bots. Cloxacillin 250 mg. susp. 60 ml. 27
15 boxes Doxycyline 100 mg. cap 100's BP 8
16 bots. Ery thromycin 250 mg. 5 ml. bot 18
17 boxes Erythromycin 500 mg. cap 100's BP 2
18 boxes Norfloxacine 400 mg. caps 100's BP 5
19 boxes Cefexime 200 mg. cap 20's 2
20 boxes Cefuroxime 200 mg. tab 100's 2
21 boxes Paracetamol 500 mg. tab 100's BP 20
22 bots. Paracetamol susp. 250 mg. 25 ml. 60 ml. 144
23 bots. Paracetamol drop 100 mg. 1 ml. 10 ml. 108
24 boxes Diclofenac tab. 50 mg. 10's BP 10
Date Inspected Date Received Date Inspected
Inspected, verified and found OK as to quantity and X

specifications.
X Complete
ANTONIO ARCAYERA, CE Partial AN

Inspection Officer
RONIE Y. ISRAEL ARLENE B. JAGAPE RONIE Y. ISR

OMA - Representative MPDO-Representative Property Officer OMA - Represe
RIZALINO V. SINOGAYA, JR. VIRGINIA N. GATILLO RIZALINO V. S


25 boxes Mefenamic acid tab. 500 mg. 100's 15
26 boxes Mefinamic acid 250 mg. tab 100's 5
27 bots. Mefinamic acid 50mg/5ml. 60 ml.bot 57
28 boxes Ibuprofen 200 mg. tab 100's 10
29 bots. Lagundi 300 mg. 120 ml bots. 15
30 boxes Lagundi 300 mg. tab. 100's 15
31 bots. Lagundi 300 mg. /5 ml. 60 bots 54
32 boxes Salbutamol 2 mg. tab. 100's 20
33 bots. Salbutamol 2 mg/5 ml. 60 ml.bot 90
34 nebule Salbutamol Nebule 1 mg/1 ml 150
35 boxes Ranitidine 150 mg. tabs. 100's 3
36 boxes Cimitidine 400 mg. tabs 100's 3
37 boxes Losartan 50 mg. tab 100's 2
38 boxes Metopolol 50 mg. tab 100's 5
39 boxes Metronidazole 500m.tab 100's 5
40 boxes Metronidazole 125 mg/5ml. 60ml bot. 27
41 boxes Hyoscine 10mg. Tab 100's 5
42 boxes Dicycloverine 10mg. Tab 100's 2
43 bots. Dicycloverine 10mg./5ml.60ml. 27
44 bots. Phenyl drop 6.25 mg/1ml. 27
45 bots. Phenyl susp. 4 mg/5 ml 60ml. 27
46 boxes Cetirizine tab10 mg. 100's BP 5
47 bots. Cetirizine drop 2.5 mg/ 1 ml.60ml. 42
48 bots. Cetirizine syrup 5 mg./5ml. 60ml. 42

specifications.
X Complete

Inspection Officer



49 bots. Chlorphenamine 2.5 mg. 60 ml. bot. 54
50 bots. Ascorbic acid 100 mg./5 ml. 60 ml. bot. 54
51 boxes Ascorbic acid tab 500 mg. 100's BP 10
52 boxes Multivitamins + iron 500 mg. cap 100's BP 15
53 bots. Multivitamins syrup 60 ml. 72
54 boxes Vitamin B-complex 25
55 drop Zinc sulfate drop 27
56 bots. Zinc sulfate syrup 60 ml. 27
57 boxes Ferrous sulfate w/ folic acid 300mg./ 250 mg. 100's 10
58 boxes Metoclopramide tab. 10 mg. 100's 2
59 bots. Metoclopramide bot 5 mg./5 ml. 60 ml. 5
60 bots. Prednisone 10 mg./ 5 ml. 30 ml. 15
61 boxes Prednisone tab. 20 mg 100's 2
62 boxes Dextrometorphan 10 mg. tab 100's 10
63 boxes Aluminum Hydroxide manesium 20
64 sachet Sambong tab 250 mg. 100's BP 10
65 boxes Sambong tab 500 mg. 100's BP 4
66 boxes Salbutamol inhaler 100 mcg. 28
67 sachet Oresol sachet 25's 6
68 boxes Simvastatin tab. 20 mg. 100's 3

specifications.
X Complete

Inspection Officer


Supplier
PO No.
Requisitioning Offic
Item No.
Date Inspected
AN
RONIE Y. ISR
OMA - Represe
RIZALINO V. S
INSPECTION & ACCEPTANCE REPORT Lot # 1
Supplier JB PHARMA & TRADE CENTER AR No. _________________ Supplier

1 bot. Paracetamol syr. 250mg/5ml 2880
2 bot. Paracetamol drops 100mg 15ml 2880
3 tab. Paracetamol 500mg tab 100,000
4 bot. Amoxicillin 250/5ml susp 1440
5 bot. Amoxicillin drops 100mg 10ml 1440
6 cap. Amoxicillin 500mg cap 30,000
7 bot. Cefalexin drops 100mg 10ml 720
8 bot. Cefalexin susp. 250mg 60ml 720
9 cap. Cefalexin cap 500mg 20,000
10 bot. Lagundi 300mg 60ml 1852
11 tab. Cetirizine tab 10mg 30,000
12 bot. Cetirizine syr. 547
13 cap. Multivitamins w/iron cap 100's 288
14 cap. Amoxicillin 250mg cap 1000
15 cap. Cefalexin 250mg cap 1000
16 tab. Ascorbic 500mg tab 20,000
17 tab. Diclofenac 50mg tab 1,000
18 tab. Vitamin B complex tab 10,000
19 tab. Aluminum magnesium tab 20,000
20 tab. Ferrous Sulfate w/ folic acid 5,000
21 cap. Nifedipine 5mg cap 1,000
22 tab. Salbutamol 2mg tab 5,000
23 tab. Amlodipine 10mg tab 2,000
24 bot. Metronidazole 500mg tab 144

specifications.
X Complete

Inspection Officer



25 tab. Cinnarizine tab 1,000
26 tab. Ibuprofen 200mg tab 1,500
27 tab. Metronidazole 500mg tab 1,000
28 tab. Lozartan 50mg tab 7,000
29 tab. Metoprolol 50mg tab 5,000
30 cap. Doxycycline 100mg cap 3,000
31 tab. Ciprofloxacin 400mg tab 3,000
32 tab. Simvastatin 20mg tab 5,000
33 tab. Sambong 500mg tab 5,000
34 cap. Cloxacillin 500mg cap 1,000
35 bot. Cloxacillin 500mg cap 144
36 bot. Zinc sulfate drop 100
37 bot. Zinc sulfate syr. 100
38 cap. Omeprazole 20mg cap 5,000
39 bot. Salbutamol syr. 60ml 1,954
40 tab. Lagundi 300mg tab 40,000

specifications.
X Complete

Inspection Officer



1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24

specifications.
X Complete

Inspection Officer



1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24

specifications.
X Complete

Inspection Officer


Supplier JB PHARMA & TRADE CENTER AR No. _________________

1 cap Amoxicillin 500mg cap 1,250
2 cap Amoxicillin 250mg cap 375
3 bot. Amoxicillin 250mg/5ml susp. 180
5 cap Cefalexin 500mg cap 1,250
6 bot. Cefalexin 250mg/5ml susp. 180
7 bot. Cefalexin drops 180
8 tab. Ciprofloxacin 500mg 250
9 cap Cloxacillin 500mg cap 750
10 bot. Cloxacillin 250mg/5ml susp 25
11 cap Doxycycline 100mg cap 75
12 cap Cefexime 200mg cap 250
13 tab. Paracetamol 500mg 10,000
14 bot. Paracetamol 250mg/5ml susp. 360
15 bot. Paracetamol drops 360
16 tab. Celecoxib cap 50
17 tab. Diclofenac 50mg 250
18 cap. Mefenamic 250mg 1,250
19 bot. Mefenamic 50mg/5ml susp. 36
20 tab. Ibuprofen 200mg 75
22 bot. Lagundi 300mg/5ml syr. 266.75
23 tab. Salbutamol 2mg tab 750
24 bot. salbutamol 2mg/5ml 72
Inspected, verified and found OK as to quantity and

specifications.
X Complete

Inspection Officer
RONIE Y. ISRAEL ARLENE B. JAGAPE

OMA - Representative MPDO-Representative Property Officer
RIZALINO V. SINOGAYA, JR. VIRGINIA N. GATILLO


25 tab. Omeprazole 20mg 1,250
26 tab. Losartan 50mg 1,250
27 cap. Nifedipine 5mg 125
28 tab. Metoprolol 50mg 250
29 tab. Amlodipine 10mg 750
30 tab. Metronidazole 500mg 250
31 bot. Metronidazole 125mg/5ml 36
32 tab. Levofloxacin 500mg 250
33 tab. Cetirizine 10mg 2,500
34 bot. Cetirizine drops 36
35 bot. Cetirizine syrup 72
36 bot. Ascorbic 100mg/5ml 60ml 72
37 tab. Ascorbic 500mg 2,500
38 cap. Multivitamins + iron 500mg 2,500
39 bot. Multivitamins syr 60ml 180
40 tab. Vitamin B-Complex 5,000
41 bot. Zinc Sulfate drops 10
42 bot. Zinc Sulfate syr 10
43 cap. Ferrous Sulfate w/folic acid 60mg+400mg 495
44 tab. Prednisone tab 125
45 tab. Aluminum Hydroxide Magnesium 1,250
47 tab. Chlorphenamine 4mg tab 1,250
48 inh. Salbutamol inhaler 100mgx200doses 25
49 tab. Simvastatin 20mg 748.75

specifications.
X Complete

Inspection Officer



1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24

specifications.
X Complete

Inspection Officer



1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24

specifications.
X Complete

Inspection Officer


Supplier KARASIA, INC. AR No. _________________

specifications.
X Complete
MANUEL L. REMOROZA,CE Partial

Inspection Officer
EUTEMIO M. GAM SENFRONIO AMONGOS, ME

MPDO - Representative MEO-Representative Property Officer
CLEMENTINO MANGUBAT
MEO-Representative
ANNEX G-7

Supplier MMU ENTERPRISES & GENERAL MERCHANDISE AR No. _________________

1 rolls 50mm. X 60 M.HDPE Pipe SDR 11 10
4 pcs CI TEE 100mm x 50mm M/J 4
5 pcs PE Equal Tee 25mm x 25mm 4
6 pcs PE Male thread adaptor 25mm Ø x ¾" 4
7 pcs PE Reducing Coupler 25mm x 20mm 4
8 pcs PE Reducing Coupler 50mm x 25mm 4
9 pcs PE Male Bend 90 20mm x ½" 10
10 pcs PE Male Tee 20mm x 1/2" 20
11 pcs PE Female thread adaptor 20mm Ø x ½" 20
12 pcs PE Straight coupler 20mm Ø x 20mm 10
13 pcs PE Male thread adaptor 20mm Ø x ½" 60
14 pcs G.I. Nipple 1 ½" x 12" 10
15 pcs Brass Gate Valve 1 ½" dia. 5
16 pcs Brass Gate Valve ¾" dia. 8
17 pcs CI Sleeve Type Coupling 100mm. 2

specifications.
X Complete

Inspection Officer
ARTEMIO APOSTOL NESTOR ABALCE

MEO - Representative MPDO-Representative Property Officer
LOREPIDO RATUNIL
MMO-Representative
ANNEX G-7

Supplier MMU ENTERPRISES & GENERAL MERCHANDISE AR No. _________________

18 bags Portland Cement 10
19 cu.m. Screened Sand 2
20 pcs Water Meter ½" 100
21 pcs Brass angle valve ½" with lock wing 100
22 pcs G.I. Nipple ½" x 3" 200
23 pcs G.I. Elbow ½" dia. 200
25 pcs G.I. Nipple ¾" x 6" 25
26 roll Teflon Tape ½" x 6 m. 60
28 pcs G.I. Elbow ¾" 60
29 pcs G.I. Tee ¾" 80
30 pcs PE End Cap 50mm. 4
31 pcs Brass Faucet 50

specifications.
X Complete

Inspection Officer
ARTEMIO APOSTOL NESTOR ABALCE

MEO - Representative MPDO-Representative Property Officer
LOREPIDO RATUNIL
MMO-Representative
ANNEX G-7

Requisitioning Office/Dept. MEO
1 unit BULLDOZER (A-1 Surplus) Catterpillar D6R 1

OR ITS EQUIVALENT
with tools

specifications.
X Complete

Inspection Officer

ANNEX G-7
1 unit GARBAGE COMPACTOR (A-1 Surplus) 1

6W, 4T, GIGA,
Diesel Fueled
8.0m3, Push type
OR ITS EQUIVALENT

specifications.
X Complete

Inspection Officer

ANNEX G-7
1 unit 10W DUMPTRUCKS (A1-Surplus ) Supergreat 4

Engine Power: 336hp
Gear Box: HW15710
Steering: ZF 8098
OR ITS EQUIVALENT

specifications.
X Complete

Inspection Officer

ANNEX G-7

1 unit VIBRATORY COMPACTOR (A-1 Surplus) dynapac 1

Steering
Capacity (W): 4600

specifications.
X Complete

Inspection Officer

ANNEX G-7

1 unit SELF LOADING TRUCK (10W) 1

A-1 Surplus, Complete Build-Up 8DC9
OR ITS EQUIVALENT

specifications.
X Complete

Inspection Officer

ANNEX G-7

Supplier AR No. _________________
Spare Parts

specifications.
X Complete

Inspection Officer

ANNEX G-7

Supplier AR No. _________________
Spare Parts

specifications.
X Complete

Inspection Officer

ANNEX G-7

Supplier AR No. _________________
Spare Parts

specifications.
X Complete

Inspection Officer

Supplier SB STORE AR No. _163________________
PO No. Date Invoice No_________ Date ____________
1 mtrs Flat Cord wire 35

2 pcs Philip Bulb 25 watts 5
3 pcs Male Plug 5
4 pcs Receptacle 5
746.50

specifications. X Complete
ROSITA Y. BALDWIN Partial

Inspection Officer
FLORENCIO Q. LIRAY,CE JOEL C. SALONOY

MPDO Representative MMO Representative ELADEO LILAWAN
Property Officer
ARTEMIO B. APOSTOL
MEO Representative
Supplier ACE HOSE PARTS AR No. _________________
PO No. Date Invoice No__________ Date ____________
pc Hydraulic Hose Fabrication

ROSITA Y. BALDWIN Partial

Inspection Officer
ROBERT P. CAGUITLA VIOLETA R. MELENDEZ

MTO Representative MEO-Representative
Property Officer
VIRGINIA N. GATILLO BERNABETH B. ISRAEL
MBO Representative MAO Representative
ANNEX G-7
___________
Quantity
ANNEX G-8
Quantity
Municipality of Quezon
ooOoo
STATEMENT OF DAILY MARKET PURCHASED
UNIT TOTAL RECEIVED PAYMENT

QTY UNIT ARTICLE
PRICE VALUE (See receipt attached)
654 kls 50.00 32,700.00

654 kls 50.00 32,700.00
-
10,000.00
75,400.00
I HEREBY CERTIFY that I have purchased the above-mentioned article in the quantity at the prices
selforth and that I paid therefore the total sum of Php. 78,480.00 of the funds advanced to me for such
purposes.
Buyer
Examined and approved:
Purchased inspected and found:
Property Inspector
ANNEX G-7

LGU - Quezon, Bukidnon Supplier
Supplier IAR No. _________________ PO No.
PO No. TF - 84 Date Invoice No_______Date ____________ Requisitioning
Requisitioning Office/Dept. MSWD
Item No.
1 kls Baguio Beans 654

2 kls Cabbage 654
3 Fruits
Ripe banana (lakatan, latundan)
Papaya
Melon
INSPECTION ACCEPTANCE Date Inspec

Date Inspected Date Received X

Inspection Officer
JOEL SAL
RIZALINO V. SINOGAYA,JR. MMO Repre
MMO Representative
Property Officer NESTOR W.
BERNABETH B. ISRAEL ARLENE B. JAGAPE MPDO Repre
MAO Representative MPDO Representative
ANNEX G-7

Supplier BUKIDNON TRADER MARKETING IAR No. _________________
PO No. TF - 83 Date Invoice No_______Date ____________
1 sacks 7 tonner rice 260

2 kls Pork (lean meat) 981
3 kls Chicken 654
4 kls Fish 654
5 kls Ribs (pork) 654
6 kls Mongo beans 218
7 kls Dilis, (small) 108
8 sets Spaghetti, Noodles 1kilo, cheese sauce 218
9 cans Corned beef, (big) 436
10 packs Tableya, (10's packs) 327
11 kls C-sugar 109
12 cans Condense milk,(big) 109
13 kls Fresh miki 218
14 pcs Eggs 5,232
15 kls Cooking Oil 218
16 kls Soy Sauce 218
17 kls Onion 164
18 kls Garlic 164
19 kls Potatoes 654
20 kls Carrots 327
21 kls Squash 327

Inspection Officer
RIZALINO V. SINOGAYA,JR.
MMO Representative
Property Officer
BERNABETH B. ISRAEL ARLENE B. JAGAPE
Supplier CLARENZON MARKETING AR No. _________________
PO No. GF - 661 Date Invoice No_______Date ____________
Requisitioning Office/Dept. MHO

1 boxes Amoxicillin cap 500 mg. 100BP 20
2 bots Amoxicillin tab 250 mg. 60 ml. 5
3 bots Amoxicillin susp. 5 ml 60 ml 144
4 bots Amoxicillin drop 100 mg. 1 ml. 10 ml. 54
5 bots Cefalexin cap. 500 mg. 100's BP 10
6 bots Cefalexin susp. 250 mg. 60 ml. 144
7 bots Cefalexin drop 100 mg. 1 ml. 108
9 bots Cotrimoxazole cap. 800 mg. 100's BP 10
10 bots Cotrimoxazole tab. 400 mg. 100's BP 10
11 bots Cotrimoxazole susp 200 mg. 5 ml. 60 ml. 108
14 bots Cloxacillin 250 mg. susp. 60 ml. 27
16 boxes Norfloxacine 400mg. Caps 100's BP 5
17 bots Celecoxib tab 200 mg. 100's 1
18 boxes Diclofena tab 50 mg. 10's BP 5
19 boxes Mefenamic acid tab 500 mg. 100's 15
20 bots Mefenamic acid 50 mg/5ml. 60 ml bot 57
22 bots Lagundi 300 mg. /5 ml.60 ml. 54
23 bots Salbutamol 2 mg./5ml 60 ml. bot 90
24 nebule Salbutamol nebule 1 mg./1 ml. 150
26 boxes Metropolol 50 mg. tab 100's 5

Inspection Officer
MMO Representative
Property Officer
Supplier CLARENZON MARKETING IAR No. _________________
Requisitioning Office/Dept. MHO

27 boxes Amlodipine 10 mg. 100's 5 Supplier
28 boxes Metronidazole 500 mg. tab 100's 5 PO No.
29 boxes Metronidazole 125 mg./5ml 60 ml. tab 100's 27 Requisitioning
30 bots Phenyl drop 6.25 mg./1ml. 27
31 bots Phenyl susp. 4 mg./5ml 60 ml.. 27 Item No.
32 boxes Cetirizine tab 10 mg. 100's 5
33 bots Cetirizine drop 2.5 mg/1 ml 60 ml. 42
34 bots Cetirizine syrup 5 mg/5 ml. 60 ml 42
35 boxes Tranexamic cap. 500 mg.100' BP 1
36 boxes Multivitamin + iron 500 mg. cap 100's BP 15
37 bots Multivitamin syrup 60 ml. 72
39 bots Zinc suldate syrup 60 ml. 27
40 boxes Metoclopramide tab 10 mg. 100's 2
41 bots Metoclopramide bot 5 mg./5ml. 60 m l. 5
42 boxes Prednisone tab. 20 mg. 100's 2
44 boxes Aluminum Hydroxide magnesium 10
45 boxes Salbutamol inhaler 100 mg. 15
X Inspected, verified and found OK as to quantity and X Complete

specifications. Partial
MANUEL L. REMOROZA,CE Date Inspec
Inspection Officer
X
MMO Representative
Property Officer
BERNABETH
MAO Repre
JB PHARMA TRADE CENTER AR No. _________________

TF - 69 Date Invoice No_______Date ____________
MHO
Unit Description Quantity

1 bots Paracetamol syrup 250 mg. 60 ml 2,475
2 bots Paracetamol drop 100 mg. 15 ml 576
3 boxes Parcetamol tab 500 mg. 100's BP 130
4 bots Amoxicillin susp. 250 mg. 60 ml. 2,300
5 bots Amoxicillin drop 100 mg. 10 ml. 428
8 bots Cefalexin susp. 250 mg. 60 ml. 1,340
9 boxes Cefalexin cap 500 mg. 100's BP 140
10 boxes Lagundi 600 mg. Cp 60's 150
11 bots Lagundi 300 mg. syrup 60 ml 1,095
12 bots Cetirizine drop 2.5 mg. 60 ml. 356
13 boxes Cetirizine tab 10 mg. 100's BP 21
14 bots Cetirizine syrup 5mg. 10 ml. 356
15 boxes Cotrimoxazole 800 mg. 100'BP 90
16 bots Cotrimoxazole susp 200mg. 60 ml 1714
17 nebule Salbotamol nebule 1 mg. 2.5 ml 495
18 bots Salbotamol + Guarafeneson 60 ml. 50
19 boxes Cimefidine 400 mg. tab. 100's BP 25
20 boxes Mefenamic acid cap 500 mg. 100'sBP 92
21 bots Mefenamic acid syrup 50 mg. 60 ml. 500
22 boxes Multivitamin cap 100's BP w/iron 750
23 boxes Tranexamic acid 500 mg. caps 100's BP 10
24 boxes Dicycloverine 10 mg. Tab. 100's 250
25 bots Dicycloverine 10 mg. syrup 60 ml. 500
26 bots Multivitamin syrup + iron 60 ml. 2500
27 boxes Ascrobic acid 500 mg. tab. 100' BP 50
28 boxes Diclofenac tab. 50 mg. 10's Bp 15
29 boxes Vitamin B-complex tabs 100's BP 1000
30 boxes Aluminum magnesium tab 200mg. 100's BP 50
31 boxes Ferrous sulfate tabs. w/folic acid 300mg./250mg 1500
32 boxes Nifedipine 5 mg. tab. 100's BP 12.5
33 boxes Norfloxacine 400 mg. caps 100's BP 12.5
34 boxes Salbotamol 2 mg. 100's BP 90
35 boxes Cefuroxime BP 10's 25
36 boxes Hyoscine Butylbromide 10 mg. 100's BP 25
37 boxes Amlodipine 10 mg. tabs 100' BP 50
38 bots Metronidazole susp. 125 mg. 60 ml. 50
39 boxes ORS sachet 24's 100
40 boxes Ranitidine 150 mg. tab. 100's BP 5
41 boxes Cinarizine tab 100's BP 12.5
42 boxes Ibruprofen 200 mg. tab. 100's BP 17.5
43 boxes Metronidazole 500 mg. 100's BP. 12.5
44 boxes Losartan 50 mg. tab. 100's BP 50
45 boxes Metropolol 50 mg. Tab. 1--'s BP 12.5
46 boxes Dexycycline 100 mg. cap 100's BP 12.5
47 boxes Ciprofloxacin 40 mg. tab. 100's BP 25
48 boxes Famotidine 40 mg. 100's BP 5
49 boxes Simvastatine 20 mg. tab. 100's Bp 10
50 boxes Sambong 600 mg. caps. 100's BP 10
51 boxes Cloxacillin 500 mg. tabs. 100's BP 10
53 bots Zinc Sulfate drop 50
54 bots Zinc Sulfate syrup 60 ml. 50
55 boxes Omeprazole 29 mg. 100's BP 12.5
56 boxes Erythromycin 500 mg. tabs 100's\ 12.5
57 bots Erythromycin 250 mg. 60 ml. 50
58 nebule Budesonide nebules 500
Date 59 boxes Betahistine tab. 100's BP 12.5
60 bots Metoclopramide 5 mg. syrup 60 ml. 50
X 61 boxes Metoclopramide tab. 5 mg. 100's BP 12.5
62 bots Salbutamol syrup 60 ml. 25
MAN 63 bots Lagundi susp. 300 mg. 120 ml. 50
Insp 64 boxes Lagundi 300 mg. 100's BP 45
65 pcs Hydrite Granujles 50
66 box Retanol Palmitate 25,000 IU 100's BP 1
67 boxes Vitamin A cap 200,000 IU 100's 15
BERNABETH B. ISRAEL
MAO Representative
Date Received

Partial
MMO Representative
Property Officer
ARLENE B. JAGAPE
MPDO Representative
Supplier AR No. _________________ Supplier
Requisitioning Office/Dept. MEO Requisitioning Offic

2 cu.m Screened Sand 4.5
3 cu.m Gravel ¾ 5
4 length 12mm RSB 20
6 bd.ft 2x2x8 G-melina Lumber 80
7 pcs ½" Ordinary Plywood 7
8 kg. Tie Wire #16 4
9 kgs. Common Wire Nails no.4" 3
10 kgs. Common Wire Nails no. 2½" 3
12 lin.m. Plastic Screened ⅛" opening 1
13 rolls Cyclone Wire 4'x6m. 2
14 pcs Gl Nipple 4" x 14" dia. 6
15 pcs Gl Elbow 4" dia. 1
16 pcs Gl End Cap 4" dia. 2
17 pc. Gl Elbow 3" dia. 1
18 pc. Gl ?Nipple 3" x 10' dia. 1
19 pcs 4" dia. Sleeve Type Coupling 3
20 length 2½" Ø Gl PIPE Sch. 40 1
21 ltr Red Oxide Primer 1
22 pcs Gate Valve 4" dia. Mechanical Joint 1
23 set Air Vent 2" dia. GIP 2
24 pcs 4"Ø uPVC Pipe (class 150) Fittings 80
25 pcs 4"dia. C.l. Sleeve Type Coupling 4
specifications.
X Complete
Inspection Officer
JOEL SALONOY ARTEMIO APOSTOL

MMO Representative MEO Representative
Property Officer
NESTOR W. ABALDE LOREPIDO RATUNIL
MPDO Representative MCSU Representative
Date Inspected
X
MAN
JOEL SALONO
MMO Represent
NESTOR W. ABA
MPDO Represen
ANNEX G-7

Supplier AR No. _________________
PO No. TF - 83 Date Invoice No_______Date ____________

Inspection Officer
MMO Representative
Property Officer
Supplier ISRAEL HARDWARE & ELECTRICAL SUPPLY, GENERAL MERCHANDISE AR No. _________________

3 cu.m. ¾ Gravel 46
4 length 16mm x 6m rebars 174
7 kls. Gl Tie Wire # 16 158
9 cu.m. Fine Sand 18
11 pcs. 4" CHB 945
14 length 1.2mm x 50mm x 150mm x 6m C-Purlins 45
16 length 3mm x 25mm x 25mm x 6m Angle Bar 62
17 length 3mm x 50mm x 6m Flat Bar 30
18 length 50mm φ x 6m Stainless Pipe 43
19 sheets 6mm x 1.20 x 2.40 Steel Matting 15
20 sheets .4mm x 1040mm x 7.20m Durarib 60
21 pcs .4mm Ridge Cap 40
22 pcs .4mm Valley Gutter 14
23 boxes Welding Rod (20kls./box) 3
24 kls. Stainless Welding Rod 15
25 pcs Tek Screw 1,000
26 liters Vulce Seal 3
27 gal. Red oxide Primer 6
28 gal. Paint Thinner 4
29 box 3/16 x ⅜ Blind Rivets 1
30 set Roll up Door (for canteen)2m x 2.50m including Installation 1
31 sheets ¼ x 4 x 8 Plywood 174
32 bd.ft 596-2 x 2 x 10 - lumber 1,986.66
33 bd.ft 350- 2 x 3x 10 - lumber 1,750
34 keg CW Nails # 4 (25kls.) 3
35 keg CW Nails #2½ (25 kls.) 1
36 kls. CW Nails # 1 12
37 sheets 6mm x 1.20 x 2.40 Hardiflex 8
38 pcs 4" Wood Moulding 92
39 kls. Finishing Nails # 2½ 5
40 pcs .40 x .40 Floor Tiles 2,969
42 cu.m Fine Sand 21.5
43 packs Tile Grout 20
44 length 3mm x 50mm x 2.40m Bronze Stair Nosing 8
45 gal. Flatwall Enamel 41
46 gal. Patastolux Putty 16
47 gal. Bodyfiller w/ Hardener 10
48 gal. Concrete Putty 20
49 gal. Latex Gloss Ivory 48
50 gal. Latex Flat White 24
51 gal. Latex Choco Brown 10
52 gal. QDE White 10
54 pcs Sand Paper # 120 24
55 gal. Roofguard Green 26
56 gal. Roof Paint - Pacific Blue 8
57 gal. Roof Paint - Spanish Red 8
58 gal. Red Oxide Primer 4
59 pail Latex Gloss Ivory 12
60 pail Epoxy Concrete Floor Paint w/ Catalyts- Sky blue 12
61 gal. Epoxy Reducer 8
62 gal. Cleansing Solution #1 8
64 gal. Latex Gloss Choco Brown 20
65 sets Flourescent Lamp w/stainless casing louver type double 40w 24
66 pcs ESL Bulb 9w 17

67 pcs 4"φ Pin Light 17
69 pcs. Receptacle 4" x 4" 17
70 sets Wall Lamp (indoor type) 2 bulb up & down 7
71 pcs. ESL Bulb 3w Genie Warm White 14
72 pcs. Convenience Outlet flush type 2 gang 12
73 sets Floor Mounted Outlet 3
74 sets Switch Flush Type 3 gang 4
76 pcs. Utility Box 30
77 pcs. Junction Box 50
78 pcs. Pole Box 4 x 6 x 6 5
79 pcs. Panel Board 2 branches 2
80 pcs. Circuit Breaker 60 amp 2
82 pcs. ¾ Entrance cap 2
83 pcs. ¾ EMT Adaptor 4
84 pcs. ¾ EMT Long Elbow 4
85 pcs. ¾ EMT Coupling 10
86 length ¾ EMT Pipe 4
87 pcs ¾ PVC Clamp 36
88 meters THHN Wire #14 36
89 box THHN Wire 3.5mm 1
90 length ½ PVC Pipe Orange 90
91 pcs ½ PVC Long Elbow 20
92 rolls Electrical Tape Big 6
specifications.
X Complete
Inspection Officer
JOEL SALONOY ARTEMIO APOSTOL

MMO Representative MEO Representative
Property Officer
NESTOR W. ABALDE LOREPIDO RATUNIL
MPDO Representative MCSU Representative
REQUISITION AND ISSUE SLIP

Division/Branch/Unit MMO Responsibility Center RIS No.

Office Code: SAI No.
REQUISITION ISSUANCE
STOCK NO. UNIT DESCRIPTION QTY REMARKS
1 54 Panels Partition with Glass and Strip, 1
1200 Meters High, Laminate Partition with
17 Panels Table Top, Melamine Board
Finish, 25mm with PVC Edging
Finish with Drawers
with Chrome Legs
Board Finish
Finish
6 Units Sofa Bench with Cushion
Purpose: for office partition of personal staff and public affairs information assistant division (PAIAD)
Requested by: Approved by: Issued by: Received by:

Signature:
Printed Name: ELGIE P. BATERNA GREGORIO LLOREN GUE
Designation: Private Secretary II Municipal Mayor
Date:

Division/Branch/Unit Municipal Health Center Responsibility Center RIS No.

REQUISITION ISSUANCE STOCK NO

1 unit Vehicle (Ambulance) 1
Purpose:

Signature:
Printed Name: GREGORIO LLOREN GUE
Designation: Municipal Mayor
Date:

Division/Branch/Unit Budget Office Responsibility Center RIS No.

1 unit Laptop IN5567 1 52,500.00
Intel Core i7
8 GB RAM
1 TB Hard Disk Drive
Radeon Graphics
15.6 HD Display STOCK NO
Purpose: For Office use

Signature:
Printed Name: ROGER D. LACUBTAN GREGORIO LLOREN GUE
Designation: Municipal Budget Officer Municipal Mayor
Date:

Division/Branch/Unit MHO Responsibility Center RIS No.

1 unit Laptop x 455 L - Asus X 441VA - Wx168T 33
Processor: Intel Core i3 - i3600 60
2gb DDr3 RAM - 4GB
500 gb HDD SATA - 1 TB
14 inch screen
Windows 10 Operating System
4 cell up to 8 hours
HD Webcam 720p
USB Type mouse
With complete Accessories
Purpose: for Philhealth Iclinicsystem use to all midwives

Signature:
Printed Name: KARLA MAE I. CAMARINTA, MD GREGORIO LLOREN GUE
Designation: MGADH I/MHO Municipal Mayor
Date:

Division/Branch/Unit MEO Responsibility Center RIS No.

1 sets TIRE - MRF Super Lug 10 x 20 10

2 sets TIRE - MRF Miller 700 x 16 6
Purpose: For the replacement of worn out parts -Dumptrucks & Lifter

Signature:
Printed Name: MANUEL L. REMOROZA, CE GREGORIO LLOREN GUE
Designation: Assistant Municipal Engineer Municipal Mayor
Date:



unit VIBRATORY COMPACTOR (A-1 Surplus) dynapac 1

Steering
Capacity (W): 4600
Purpose: For the implementation of Barangay Roads Maintenance

Signature:
Date:



units 10W DUMPTRUCKS (A1-Surplus ) Supergreat 4

Engine Power: 336hp
Gear Box: HW15710
Steering: ZF 8098
OR ITS EQUIVALENT

Signature:
Date:



unit GARBAGE COMPACTOR (A-1 Surplus) 1

6W, 4T, GIGA,
Diesel Fueled
8.0m3, Push type
OR ITS EQUIVALENT

Signature:
Date:



unit BULLDOZER (A-1 Surplus) Catterpillar D6R 1

OR ITS EQUIVALENT
with tools

Signature:
Date:


Division/Branch/Unit MPDO Responsibility Center RIS No.

1 unit SM-T116 Samsung Galaxy Tab 3V 3G: 93

Tablet Bag
16gb SD Card
Power Bank 5000Mah
2 unit Desktop Computer w/ 1

Motherboard Asus
4GB DDP3 Memory
500 GB HDD
DVD Writer
w/ 24" Monitor
Purpose: For CBMS USE

Signature:
Printed Name: JOSE I. ILAR, CE. GE GREGORIO LLOREN GUE
Designation: MPDC Municipal Mayor
Date:



2 bots. Amoxicillin tab. 250 mg. 60 ml. 5
3 bots. Amoxicillin susp. 5 ml 60 ml. 144
4 bots. Amoxicillin drop 100 mg. 1 ml. 10 ml. 54
5 bots. Cefalexin cap. 500 mg. 100's BP 10
6 bots. Cefalexin susp. 250 mg. 60 ml. 144
7 bots. Cefalexin drop. 100 mg. 1 ml. 108
9 bots. Cotrimoxazole cap. 800 mg. 100's BP 10
10 bots. Cotrimoxazole tab. 400 mg. 100 BP 10
11 bots. Cotrimoxazole susp. 200 mg. 5 ml. 60 ml. 108
14 bots. Cloxacillin 250 mg. susp. 60 ml. 27
16 bots. Ery thromycin 250 mg. 5 ml. bot 18
17 boxes Erythromycin 500 mg. cap 100's BP 2
18 boxes Norfloxacine 400 mg. caps 100's BP 5
19 boxes Cefexime 200 mg. cap 20's 2
20 boxes Cefuroxime 200 mg. tab 100's 2
21 boxes Paracetamol 500 mg. tab 100's BP 20
22 bots. Paracetamol susp. 250 mg. 25 ml. 60 ml. 144
23 bots. Paracetamol drop 100 mg. 1 ml. 10 ml. 108
24 boxes Diclofenac tab. 50 mg. 10's BP 10
Purpose: for out patent

Signature:
Printed Name: DR. LEONORA D. BOH GREGORIO LLOREN GUE
Designation: Municipal Health Officer-oic Municipal Mayor
Date:



25 boxes Mefenamic acid tab. 500 mg. 100's 15
26 boxes Mefinamic acid 250 mg. tab 100's 5
27 bots. Mefinamic acid 50mg/5ml. 60 ml.bot 57
29 bots. Lagundi 300 mg. 120 ml bots. 15
30 boxes Lagundi 300 mg. tab. 100's 15
31 bots. Lagundi 300 mg. /5 ml. 60 bots 54
32 boxes Salbutamol 2 mg. tab. 100's 20
33 bots. Salbutamol 2 mg/5 ml. 60 ml.bot 90
34 nebule Salbutamol Nebule 1 mg/1 ml 150
35 boxes Ranitidine 150 mg. tabs. 100's 3
36 boxes Cimitidine 400 mg. tabs 100's 3
38 boxes Metopolol 50 mg. tab 100's 5
39 boxes Metronidazole 500m.tab 100's 5
40 boxes Metronidazole 125 mg/5ml. 60ml bot. 27
41 boxes Hyoscine 10mg. Tab 100's 5
42 boxes Dicycloverine 10mg. Tab 100's 2
43 bots. Dicycloverine 10mg./5ml.60ml. 27
44 bots. Phenyl drop 6.25 mg/1ml. 27
45 bots. Phenyl susp. 4 mg/5 ml 60ml. 27
46 boxes Cetirizine tab10 mg. 100's BP 5
47 bots. Cetirizine drop 2.5 mg/ 1 ml.60ml. 42
48 bots. Cetirizine syrup 5 mg./5ml. 60ml. 42

Signature:
Date:


49 bots. Chlorphenamine 2.5 mg. 60 ml. bot. 54
50 bots. Ascorbic acid 100 mg./5 ml. 60 ml. bot. 54
51 boxes Ascorbic acid tab 500 mg. 100's BP 10
52 boxes Multivitamins + iron 500 mg. cap 100's BP 15
53 bots. Multivitamins syrup 60 ml. 72
55 drop Zinc sulfate drop 27
56 bots. Zinc sulfate syrup 60 ml. 27
57 boxes Ferrous sulfate w/ folic acid 300mg./ 250 mg. 100's 10
58 boxes Metoclopramide tab. 10 mg. 100's 2
59 bots. Metoclopramide bot 5 mg./5 ml. 60 ml. 5
60 bots. Prednisone 10 mg./ 5 ml. 30 ml. 15
61 boxes Prednisone tab. 20 mg 100's 2
63 boxes Aluminum Hydroxide manesium 20
64 sachet Sambong tab 250 mg. 100's BP 10
65 boxes Sambong tab 500 mg. 100's BP 4
66 boxes Salbutamol inhaler 100 mcg. 28
68 boxes Simvastatin tab. 20 mg. 100's 3

Signature:
Date:


2 cu.m Screened Sand 4.5
3 cu.m Gravel ¾ 5
6 bd.ft 2x2x8 G-melina Lumber 80
7 pcs ½" Ordinary Plywood 7
8 kg. Tie Wire #16 4
9 kgs. Common Wire Nails no.4" 3
12 lin.m. Plastic Screened ⅛" opening 1
13 rolls Cyclone Wire 4'x6m. 2
14 pcs Gl Nipple 4" x 14" dia. 6
15 pcs Gl Elbow 4" dia. 1
16 pcs Gl End Cap 4" dia. 2
17 pc. Gl Elbow 3" dia. 1
18 pc. Gl ?Nipple 3" x 10' dia. 1
19 pcs 4" dia. Sleeve Type Coupling 3
20 length 2½" Ø Gl PIPE Sch. 40 1
21 ltr Red Oxide Primer 1
22 pcs Gate Valve 4" dia. Mechanical Joint 1
23 set Air Vent 2" dia. GIP 2
24 pcs 4"Ø uPVC Pipe (class 150) Fittings 80
25 pcs 4"dia. C.l. Sleeve Type Coupling 4
Purpose: LGU-Quezon Water Supply Project under the SALINTUBIG Program
Completion (additional Spring Source)

Signature:
Printed Name: BENJUN T. BAGUIO, CE GREGORIO LLOREN GUE
Designation: Const. & Maint. Foreman / MEO -oic Municipal Mayor
Date:


26 roll Teflon Tape ½" x 6 m. 60
28 pcs G.I. Elbow ¾" 60
29 pcs G.I. Tee ¾" 80
30 pcs PE End Cap 50mm. 4
31 pcs Brass Faucet 50
Purpose: For Rehabilitation of Water System ( Additional Work Item)

Signature:
Designation: Municipal Engineer - OIC Municipal Mayor
Date:



1 bots Paracetamol syrup 250 mg. 60 ml 2,475
2 bots Paracetamol drop 100 mg. 15 ml 576
3 boxes Parcetamol tab 500 mg. 100's BP 130
4 bots Amoxicillin susp. 250 mg. 60 ml. 2,300
5 bots Amoxicillin drop 100 mg. 10 ml. 428
8 bots Cefalexin susp. 250 mg. 60 ml. 1,340
9 boxes Cefalexin cap 500 mg. 100's BP 140
10 boxes Lagundi 600 mg. Cp 60's 150
11 bots Lagundi 300 mg. syrup 60 ml 1,095
12 bots Cetirizine drop 2.5 mg. 60 ml. 356
13 boxes Cetirizine tab 10 mg. 100's BP 21
14 bots Cetirizine syrup 5mg. 10 ml. 356
15 boxes Cotrimoxazole 800 mg. 100'BP 90
16 bots Cotrimoxazole susp 200mg. 60 ml 1714
17 nebule Salbotamol nebule 1 mg. 2.5 ml 495
18 bots Salbotamol + Guarafeneson 60 ml. 50
19 boxes Cimefidine 400 mg. tab. 100's BP 25
20 boxes Mefenamic acid cap 500 mg. 100'sBP 92
21 bots Mefenamic acid syrup 50 mg. 60 ml. 500
22 boxes Multivitamin cap 100's BP w/iron 750
23 boxes Tranexamic acid 500 mg. caps 100's BP 10
24 boxes Dicycloverine 10 mg. Tab. 100's 250
25 bots Dicycloverine 10 mg. syrup 60 ml. 500
26 bots Multivitamin syrup + iron 60 ml. 2500
27 boxes Ascrobic acid 500 mg. tab. 100' BP 50
28 boxes Diclofenac tab. 50 mg. 10's Bp 15
29 boxes Vitamin B-complex tabs 100's BP 1000
30 boxes Aluminum magnesium tab 200mg. 100's BP 50
31 boxes Ferrous sulfate tabs. w/folic acid 300mg./250mg 1500
32 boxes Nifedipine 5 mg. tab. 100's BP 12.5
33 boxes Norfloxacine 400 mg. caps 100's BP 12.5
34 boxes Salbotamol 2 mg. 100's BP 90
35 boxes Cefuroxime BP 10's 25
36 boxes Hyoscine Butylbromide 10 mg. 100's BP 25
37 boxes Amlodipine 10 mg. tabs 100' BP 50
38 bots Metronidazole susp. 125 mg. 60 ml. 50
39 boxes ORS sachet 24's 100
40 boxes Ranitidine 150 mg. tab. 100's BP 5
41 boxes Cinarizine tab 100's BP 12.5
42 boxes Ibruprofen 200 mg. tab. 100's BP 17.5
43 boxes Metronidazole 500 mg. 100's BP. 12.5
44 boxes Losartan 50 mg. tab. 100's BP 50
45 boxes Metropolol 50 mg. Tab. 1--'s BP 12.5
46 boxes Dexycycline 100 mg. cap 100's BP 12.5
47 boxes Ciprofloxacin 40 mg. tab. 100's BP 25
48 boxes Famotidine 40 mg. 100's BP 5
49 boxes Simvastatine 20 mg. tab. 100's Bp 10
50 boxes Sambong 600 mg. caps. 100's BP 10
51 boxes Cloxacillin 500 mg. tabs. 100's BP 10
53 bots Zinc Sulfate drop 50
54 bots Zinc Sulfate syrup 60 ml. 50
55 boxes Omeprazole 29 mg. 100's BP 12.5
56 boxes Erythromycin 500 mg. tabs 100's\ 12.5
57 bots Erythromycin 250 mg. 60 ml. 50
58 nebule Budesonide nebules 500
59 boxes Betahistine tab. 100's BP 12.5
60 bots Metoclopramide 5 mg. syrup 60 ml. 50
61 boxes Metoclopramide tab. 5 mg. 100's BP 12.5
62 bots Salbutamol syrup 60 ml. 25
63 bots Lagundi susp. 300 mg. 120 ml. 50
64 boxes Lagundi 300 mg. 100's BP 45
65 pcs Hydrite Granujles 50
66 box Retanol Palmitate 25,000 IU 100's BP 1
67 boxes Vitamin A cap 200,000 IU 100's 15
Purpose: for Out patient

Signature:
Date:
Lot # 1


1 bot. Paracetamol syr. 250mg/5ml 2880
2 bot. Paracetamol drops 100mg 15ml 2880
3 tab. Paracetamol 500mg tab 100,000
4 bot. Amoxicillin 250/5ml susp 1440
6 cap. Amoxicillin 500mg cap 30,000
7 bot. Cefalexin drops 100mg 10ml 720
8 bot. Cefalexin susp. 250mg 60ml 720
9 cap. Cefalexin cap 500mg 20,000
10 bot. Lagundi 300mg 60ml 1852
11 tab. Cetirizine tab 10mg 30,000
12 bot. Cetirizine syr. 547
13 cap. Multivitamins w/iron cap 100's 288
14 cap. Amoxicillin 250mg cap 1000
15 cap. Cefalexin 250mg cap 1000
16 tab. Ascorbic 500mg tab 20,000
17 tab. Diclofenac 50mg tab 1,000
18 tab. Vitamin B complex tab 10,000
19 tab. Aluminum magnesium tab 20,000
20 tab. Ferrous Sulfate w/ folic acid 5,000
21 cap. Nifedipine 5mg cap 1,000
22 tab. Salbutamol 2mg tab 5,000
23 tab. Amlodipine 10mg tab 2,000
24 bot. Metronidazole 500mg tab 144
Purpose: for Philhealth Members

Signature:
Date:

Lot # 1


25 tab. Cinnarizine tab 1,000
26 tab. Ibuprofen 200mg tab 1,500
27 tab. Metronidazole 500mg tab 1,000
28 tab. Lozartan 50mg tab 7,000
29 tab. Metoprolol 50mg tab 5,000
30 cap. Doxycycline 100mg cap 3,000
31 tab. Ciprofloxacin 400mg tab 3,000
32 tab. Simvastatin 20mg tab 5,000
34 cap. Cloxacillin 500mg cap 1,000
35 bot. Cloxacillin 500mg cap 144
36 bot. Zinc sulfate drop 100
37 bot. Zinc sulfate syr. 100
38 cap. Omeprazole 20mg cap 5,000
39 bot. Salbutamol syr. 60ml 1,954
Purpose: for Philhealth Members

Signature:
Date:


GF -738
3 cu.m. ¾ Gravel 46
7 kls. Gl Tie Wire # 16 158
11 pcs. 4" CHB 945
16 length 3mm x 25mm x 25mm x 6m Angle Bar 62
17 length 3mm x 50mm x 6m Flat Bar 30
18 length 50mm φ x 6m Stainless Pipe 43
19 sheets 6mm x 1.20 x 2.40 Steel Matting 15
20 sheets .4mm x 1040mm x 7.20m Durarib 60
21 pcs .4mm Ridge Cap 40
22 pcs .4mm Valley Gutter 14
23 boxes Welding Rod (20kls./box) 3
24 kls. Stainless Welding Rod 15
25 pcs Tek Screw 1,000
26 liters Vulce Seal 3
27 gal. Red oxide Primer 6
29 box 3/16 x ⅜ Blind Rivets 1
30 set Roll up Door (for canteen)2m x 2.50m including Installation 1
31 sheets ¼ x 4 x 8 Plywood 174
32 bd.ft 596-2 x 2 x 10 - lumber 1,986.66
33 bd.ft 350- 2 x 3x 10 - lumber 1,750
34 keg CW Nails # 4 (25kls.) 3
35 keg CW Nails #2½ (25 kls.) 1
36 kls. CW Nails # 1 12
37 sheets 6mm x 1.20 x 2.40 Hardiflex 8
38 pcs 4" Wood Moulding 92
39 kls. Finishing Nails # 2½ 5
40 pcs .40 x .40 Floor Tiles 2,969
42 cu.m Fine Sand 21.5
43 packs Tile Grout 20
44 length 3mm x 50mm x 2.40m Bronze Stair Nosing 8
45 gal. Flatwall Enamel 41
46 gal. Patastolux Putty 16
47 gal. Bodyfiller w/ Hardener 10
48 gal. Concrete Putty 20
49 gal. Latex Gloss Ivory 48
50 gal. Latex Flat White 24
51 gal. Latex Choco Brown 10
52 gal. QDE White 10
54 pcs Sand Paper # 120 24
55 gal. Roofguard Green 26
56 gal. Roof Paint - Pacific Blue 8
57 gal. Roof Paint - Spanish Red 8
58 gal. Red Oxide Primer 4
59 pail Latex Gloss Ivory 12
60 pail Epoxy Concrete Floor Paint w/ Catalyts- Sky blue 12
61 gal. Epoxy Reducer 8
64 gal. Latex Gloss Choco Brown 20
65 sets Flourescent Lamp w/stainless casing louver type double 40w 24

67 pcs 4"φ Pin Light 17
69 pcs. Receptacle 4" x 4" 17
70 sets Wall Lamp (indoor type) 2 bulb up & down 7
71 pcs. ESL Bulb 3w Genie Warm White 14
72 pcs. Convenience Outlet flush type 2 gang 12
73 sets Floor Mounted Outlet 3
76 pcs. Utility Box 30
77 pcs. Junction Box 50
78 pcs. Pole Box 4 x 6 x 6 5
79 pcs. Panel Board 2 branches 2
82 pcs. ¾ Entrance cap 2
83 pcs. ¾ EMT Adaptor 4
84 pcs. ¾ EMT Long Elbow 4
85 pcs. ¾ EMT Coupling 10
86 length ¾ EMT Pipe 4
87 pcs ¾ PVC Clamp 36
88 meters THHN Wire #14 36
89 box THHN Wire 3.5mm 1
90 length ½ PVC Pipe Orange 90
91 pcs ½ PVC Long Elbow 20
92 rolls Electrical Tape Big 6
Purpose: Construction Materials for Renovation of Function Hall

Signature:
Printed Name: BENJUN T. BAGUIO, CE GREGORIO LLOREN GUE
Designation: Const. & Maint. Foreman / MEO -oic Municipal Mayor
Date:
Lot # 2


1 cap Amoxicillin 500mg cap 1,250
2 cap Amoxicillin 250mg cap 375
3 bot. Amoxicillin 250mg/5ml susp. 180
5 cap Cefalexin 500mg cap 1,250
6 bot. Cefalexin 250mg/5ml susp. 180
7 bot. Cefalexin drops 180
8 tab. Ciprofloxacin 500mg 250
9 cap Cloxacillin 500mg cap 750
10 bot. Cloxacillin 250mg/5ml susp 25
11 cap Doxycycline 100mg cap 75
12 cap Cefexime 200mg cap 250
13 tab. Paracetamol 500mg 10,000
14 bot. Paracetamol 250mg/5ml susp. 360
15 bot. Paracetamol drops 360
16 tab. Celecoxib cap 50
17 tab. Diclofenac 50mg 250
18 cap. Mefenamic 250mg 1,250
19 bot. Mefenamic 50mg/5ml susp. 36
20 tab. Ibuprofen 200mg 75
22 bot. Lagundi 300mg/5ml syr. 266.75
23 tab. Salbutamol 2mg tab 750
24 bot. salbutamol 2mg/5ml 72
Purpose: for Non Philhealth Members

Signature:
Date:

Lot # 2


25 tab. Omeprazole 20mg 1,250
26 tab. Losartan 50mg 1,250
27 cap. Nifedipine 5mg 125
28 tab. Metoprolol 50mg 250
29 tab. Amlodipine 10mg 750
30 tab. Metronidazole 500mg 250
31 bot. Metronidazole 125mg/5ml 36
32 tab. Levofloxacin 500mg 250
33 tab. Cetirizine 10mg 2,500
34 bot. Cetirizine drops 36
35 bot. Cetirizine syrup 72
36 bot. Ascorbic 100mg/5ml 60ml 72
37 tab. Ascorbic 500mg 2,500
38 cap. Multivitamins + iron 500mg 2,500
39 bot. Multivitamins syr 60ml 180
40 tab. Vitamin B-Complex 5,000
41 bot. Zinc Sulfate drops 10
42 bot. Zinc Sulfate syr 10
43 cap. Ferrous Sulfate w/folic acid 60mg+400mg 495
44 tab. Prednisone tab 125
45 tab. Aluminum Hydroxide Magnesium 1,250
47 tab. Chlorphenamine 4mg tab 1,250
48 inh. Salbutamol inhaler 100mgx200doses 25
49 tab. Simvastatin 20mg 748.75
Purpose: for Non Philhealth Members

Signature:
Date:
No.
OBLIGATION REQUEST
Payee SMART COMMUNICATIONS, INC.
Office
Address
Responsibility Account
Particulars F.P.P Amount
Center Code
Internet services 2,472.34
Total 2,472.34
A Certified B Certified
Charges to appropriation/allotment necessary, lawful
and under my direct supervision Existence of available appropriation
Supporting documents valid, proper and legal
Printed Printed
Name
GREGORIO LLOREN GUE Name
ROGER D. LACUBTAN
Municipal Mayor Municipal Budget Officer
Position: Position:
Head, Budget Units/Authorized Representative
Date: Date:
Annex A
No.
OBLIGATION REQUEST
Payee Neil Mar Q. Apita
Office
Address
Center Code
2,500.00
Total
Printed Printed
Name
EVELYN J. BAGUIO
Municipal Mayor Municipal Budget Officer III - OIC
Position: Position:
Date: Date:
Head Requesting Office/Authorized Representative Head, Budget Units/Authorized Representative
Date: Date:
No.
OBLIGATION REQUEST
Payee Jose I. Ilar, CE, GE
Office
Address
Center Code
BAC Honorarium 109,712.25
Total 109,712.25
Printed Printed
Name
ROGER D. LACUBTAN
Municipal Mayor Municipal Budget Officer
Position: Position:
Date: Date:
Head Requesting Office/Authorized Representative Head, Budget Units/Authorized Representative
Date: Date:
Annex 34
ACKNOWLEDGEMENT RECEIPT FOR EQUIPMENT

Quezon, Bukidnon
LGU
No.
Quantity Unit Description Amount Property No.
93 unit SM-T116 Samsung Galaxy Tab 3V 3G: 727,260.00

Tablet Bag
16gb SD Card
Power Bank 5000Mah
1 unit Desktop Computer w/ 33,793.75

Motherboard Asus
4GB DDP3 Memory
500 GB HDD
DVD Writer
w/ 24" Monitor
Received from: Received by:
MYRNA M. GARCIANO SUSAN D. PABAYO

Name Name
Adm. Officer I/Record Officer I Statistian Aide
Position Position
Date Date
Annex 34

Quezon, Bukidnon
LGU
No.
1 unit GARBAGE COMPACTOR (A-1 Surplus) 1,840,000.00

6W, 4T, GIGA,
Diesel Fueled
8.0m3, Push type
OR ITS EQUIVALENT
6HLI-308979
FRR35G4-7000456
white
2005
ACO-3896
MV Files: 0301-00000211205
Name Name
Position Position
Date Date
Annex 34

Quezon, Bukidnon
LGU
No.
1 unit 10W DUMPTRUCKS (A1-Surplus ) Supergreat 2,742,000.00

Engine Power: 336hp
Gear Box: HW15710
Steering: ZF 8098
OR ITS EQUIVALENT
8DC11-522989
F5509MY-710011
Gray 2005
aco-2361
Name Name
Position Position
Date Date
Annex 34

Quezon, Bukidnon
LGU
No.

Engine Power: 336hp
Gear Box: HW15710
Steering: ZF 8098
OR ITS EQUIVALENT
8DC11-511348
FV5195X-500960
BLUE
CAN-9366
MV FILES: 0301-000082727
Name Name
Position Position
Date Date
Annex 34

Quezon, Bukidnon
LGU
No.

Engine Power: 336hp
Gear Box: HW15710
Steering: ZF 8098
OR ITS EQUIVALENT
8DC9-519100
FV5195X-500975
BLUE
2005
ACO-2363
0301-00000197944
Name Name
Position Position
Date Date
Annex 34

Quezon, Bukidnon
LGU
No.

Engine Power: 336hp
Gear Box: HW15710
Steering: ZF 8098
OR ITS EQUIVALENT
8DC11-525241
FV5195X-510554
BLACK
2005
ACO 3097
MV FILES: 0301-000082727
Name Name
Position Position
Date Date
Annex 34

Quezon, Bukidnon
LGU
No.
1 unit VIBRATORY COMPACTOR (A-1 Surplus) dynapac 3,438,000.00

Steering
Capacity (W): 4600
Name Name
Position Position
Date Date
Annex 34
Quezon, Bukidnon
LGU
No.
1 unit Vehicle (Ambulance) 988,900.00

Name Name
Position Position
Date Date
Annex 34
Quezon, Bukidnon
LGU
No.
1 unit Laptop IN5567 52,500.00

Intel Core i7
8 GB RAM
1 TB Hard Disk Drive
Radeon Graphics
15.6 HD Display

MYRNA M. GARCIANO
Name Name
Adm. Officer I/Rec. Officer I
Position Position
Date Date
NAME AND ADDRESS AGENCY MMO

OF REQUESTING ACCT. CODE
AGENCY MMO / PERSONAL STAFF AGENCY CONTROL No
AGENCY PROCUREMENT REQUEST PS APR. No.
DBM RO X
Zone 1, Bulua Highway
Cagayan de Oro City January 22, 2015
(Date Prepared)
ACTION REQUESTED ON THE ITEM LISTED BELOW
[ ] Please furnish us with the Price Estimate ( for office equipment/furniture & Supplementary items)
[ ] Please purchase for our agency the equipment/furniture/supplementary items per your Price Estimate
(PS RAD No. ______________________attached) dated ______________________,____________
[ ] Please issue common-use supplies/materials per price list as of ___________________, ___________
[ ] Please issue certificate or Price Reasonableness
[ ] Please furnish us with your latest/updated Price List
[ ] Others (Specify) _____________________________________________________________________
IMPORTANT !! PLEASE SEE THE INSTRUCTION/CONDITIONS AT THE BACK OF THE ORIGINAL COPY
ITEM UNIT
ITEM AND DESCRIPTION SPECIFICATIONS/STOCK No. QUANTITY UNIT AMOUNT
NO. PRICE
1 Alcohol 500ml 15 pcs. 70.00 1,050.00
2 Ball pen 50 pcs. 15.00 750.00
3 Book paper , Long 10 reams 320.00 3,200.00
4 Book paper , short 10 reams 210.00 2,100.00
5 Carbon paper, long black 2 packs 450.00 900.00
6 Correction Tape 20 pcs. 25.00 500.00
7 DTR "Form 48 10 pads 15.00 150.00
8 Envelope 10x15" 500 pcs/box 1 box 814.00 814.00
9 Envelope Expanding legal size 100pcs./ box 2 boxes 574.00 1,148.00
10 Eraser, Rubber 10 pcs. 5.00 50.00
11 Mineral Water 120 gals 50.00 6,000.00
12 Paper Clip, Jumbo Plastic 9 boxes 17.00 153.00
13 Paper fastener, Plastic 2 boxes 90.00 180.00
14 Record Book 300 pages 10 pcs. 70.00 700.00
16 Sign Pen, black 10 pcs. 50.00 500.00
17 Sign Pen, blue 10 pcs. 50.00 500.00
18 Stam Pad Ink, Violet 50 ml 5 bottles 30.00 150.00
19 Staple Wire Standard # 35 5 boxes 30.00 150.00
20 Trash Bag. Plastic, Black 10pcs /roll 2 rolls 115.00 230.00
21 CD - R 700 MB 5 pcs. 25.00 125.00
22 DVD - R 4.7 GB 10 pcs. 35.00 350.00
23 DVD - R 4.7 GB Rewritable 2 pcs. 100.00 200.00
24 DVD - R Double Layer 5 pcs. 100.00 500.00
Total AMOUNT P 21,300.00
STOCK REQUESTED ARE CERTIFIED TO B FUNDS CERTIFIED AVAILABLE: APPROVED:

WITHIN APPROVED PROGRAM:
GLENDAMARIE A. LAMBONAO MIRAFLOR I. DIVINASFLORES GREGORIO LLOREN GUE

GENCY PROPERTY SUPPLY OFFICER AGENCY CHIEF ACCOUNTANT AGENCY HEAD/AUTHORIZE
SIGNATURE
[ ] FUND DEPOSIT WITH PS [ ] ___________ CHECK No. ____________________

IN THE AMOUNT OF : _________________________________________________ (P ) ENCLOSED

NCY PROCUREMENT REQUEST PS APR. No.
DBM RO X
(Date Prepared)
[ ] Others (Specify) _____________________________________________________________________
ITEM UNIT
NO. PRICE
1 Alcohol 500ml 15 pcs. 70.00 1,050.00
2 Ball pen 50 pcs. 15.00 750.00
3 Book paper , Long 10 reams 320.00 3,200.00
4 Book paper , short 10 reams 210.00 2,100.00
5 Carbon paper, long black 2 packs 450.00 900.00
6 Correction Tape 20 pcs. 25.00 500.00
7 DTR "Form 48 10 pads 15.00 150.00
8 Envelope 10x15" 500 pcs/box 1 box 814.00 814.00
9 Envelope Expanding legal size 100pcs./ box 2 boxes 574.00 1,148.00
10 Eraser, Rubber 10 pcs. 5.00 50.00
11 Mineral Water 120 gals 50.00 6,000.00
12 Paper Clip, Jumbo Plastic 9 boxes 17.00 153.00
13 Paper fastener, Plastic 2 boxes 90.00 180.00
16 Sign Pen, black 10 pcs. 50.00 500.00
17 Sign Pen, blue 10 pcs. 50.00 500.00
18 Stam Pad Ink, Violet 50 ml 5 bottles 30.00 150.00
19 Staple Wire Standard # 35 5 boxes 30.00 150.00
20 Trash Bag. Plastic, Black 10pcs /roll 2 rolls 115.00 230.00
21 CD - R 700 MB 5 pcs. 25.00 125.00
22 DVD - R 4.7 GB 10 pcs. 35.00 350.00
23 DVD - R 4.7 GB Rewritable 2 pcs. 100.00 200.00
24 DVD - R Double Layer 5 pcs. 100.00 500.00


SIGNATURE


DBM RO X
(Date Prepared)
[ ] Others (Specify) _____________________________________________________________________
ITEM UNIT
NO. PRICE
25 DVE - Rewritable Double Layer 2 pcs 150.00 300.00
26 Ink # 685 Black 10 crtrd 700.00 7,000.00
27 Ink # 685 Cvan 10 crtrd 700.00 7,000.00
28 Ink # 685 Magenta 10 crtrd 700.00 7,000.00
29 Ink # 685 Yellow 10 crtrd 700.00 7,000.00
30 Ink # 704 Black 22 crtrd 700.00 15,400.00
31 Ink # 704 colored 22 crtrd 700.00 15,400.00
32 Toner MP 1500 5 tubes 2,900.00 14,500.00
33 Universal Ink Cvan 5 bottles 130.00 650.00
34 Universal Ink Magenta 5 bottles 130.00 650.00
35 Universal Ink Yellow 5 bottles 130.00 650.00
36 Universal Ink black 5 bottles 130.00 650.00
76,200.00
21,300.00
97,500.00
Total AMOUNT P


SIGNATURE
NAME AND ADDRESS AGENCY MMO/PAIAD

AGENCY MMO / PAIAD AGENCY CONTROL No
DBM RO X
(Date Prepared)
[ ] Others (Specify) _____________________________________________________________________
ITEM UNIT
NO. PRICE
1 Printer (Epson L210) 1 unit 10,000.00 10,000.00
2 Cart. HP Ink 704 (blk) @ 500 5 cart. 500.00 2,500.00
3 Cart. HP Ink 704 (Color) @ 500 5 cart. 500.00 2,500.00
-


SIGNATURE
NAME AND ADDRESS AGENCY MASSO

AGENCY MASSO AGENCY CONTROL No
DBM RO X
(Date Prepared)
[ ] Others (Specify) _____________________________________________________________________
1st quarter
ITEM UNIT
NO. PRICE
1 PC Printer Toner ( 35A) 1 pcs 3,400.00 3,400.00
2 Detergent Bar 1 bars 30.00 30.00
3 Detergent Powder 2 pouchs 10.00 20.00
4 Disinfectant Spray (big) 1 can 200.00 200.00
5 PC Printer Toner ( 85A) 1 pcs 3,500.00 3,500.00
6 PC Printer Ink # 60 1 pc 790.00 790.00
7 PC Printer Ink # 61(color) 1 pc 850.00 850.00
8 Correction Fluid 2 bot 75.00 150.00
9 Paper Clip, jumbo 50mm 1 box 50.00 50.00
10 Air Freshener, CR (big) 1 tin 180.00 180.00
11 Bond Paper subs. 20 (long) 5 ream 250.00 1,250.00
12 Bond Paper subs. 20 (A4) 3 ream 240.00 720.00
13 Bond Paper subs. 20 (short) 1 ream 240.00 240.00
14 Musking tape 1" 2 rolls 150.00 300.00
15 Transparent tape 1" 1 rolls 80.00 80.00
16 Toilet bowl cleanser 1 bot 200.00 200.00
17 Wall Clock (big) 1 pc 3,000.00 3,000.00
18 Photo Paper 20 pcs 15.00 300.00
19 Paper, multicopy 11" x 17" 1 ream 500.00 500.00
20 Paper Copier Toner (Dsm618/Dsm618d) 1 pc 3,000.00 3,000.00
21 Alcologn (big) 2 bot 125.00 250.00
22 Cardboard Paper (long) 40 pcs 5.00 200.00
23 Ballpoint Pen, black (ordinary) 10 pcs 25.00 250.00
24 Ballpoint Pen, blue (ordinary) 10 pcs 25.00 250.00
25 Blank DVD-R 10 pcs 25.00 250.00


SIGNATURE

NAME AND ADDRESS AGENCY MTC

AGENCY Municipal Trial Court AGENCY CONTROL No
DBM RO X
(Date Prepared)
[ ] Others (Specify) _____________________________________________________________________
IMPORTANT !! PLEASE SEE THE INSTRUCTION/CONDITIONS AT THE BACK OF THE ORIGINAL COPY 1st quarter
ITEM UNIT
NO. PRICE
1 Sign Pen - 4 black high tech pen 9 pcs 65.00 585.00
2 Daily Time Record (DTR) 500 pcs 0.35 175.00
3 Ribbon Crtridge, Epson - black # 8750 12 pcs 130.00 1,560.00
4 Ribbon Crtridge, Taily DASCOM- black 6 pcs 250.00 1,500.00
5 Toilet Bowl Cleaner 500ml 3 bots 72.00 216.00
6 Detergent Powder -Tawas 500gms/pack 4 packs 61.00 244.00
7 Air Freshener - 280 ml. Orange Scent 2 bots 230.00 460.00
8 Battery - Small (AA) - black 15 pcs 15.00 225.00
9 Floorwax, Paste - Red 900gms/can 3 cans 240.00 720.00
10 Correction tape - 8 mts 15 pcs 52.00 780.00
11 Dishwashing Cream - Orange, 400gms 6 jars 65.00 390.00
12 Masking Tape, 1" - 48 mts 2 rolls 45.00 90.00
13 Packaging Tape, 2" - 48 mts 2 rolls 50.00 100.00
14 Transparent Tape, 1" - 48 mts 2 rolls 45.00 90.00
15 Yellow Ruled Pad 15 pads 45.00 675.00
16 Bond Paper - White, substance 20 - long 6 reams 140.00 840.00
17 Computer Speaker 2 sets 400.00 800.00
18 Magic Foam (floor mcp) 2 pcs 250.00 500.00
19 Toilet Bowl Brush 2 pcs 50.00 100.00
20 Spoon 1 doz 100.00 100.00
21 Forks 1 doz 100.00 100.00
22 Rugs (floor) 6 pcs 50.00 300.00
23 Sosa (declogging zinc) 3 bots 150.00 450.00


AGENCY PROPERTY SUPPLY OFFICER AGENCY CHIEF ACCOUNTANT AGENCY HEAD/AUTHORIZE
SIGNATURE

NAME AND ADDRESS AGENCY MCR

AGENCY Municipal Civil Registrar Office AGENCY CONTROL No
DBM RO X
Cagayan de Oro City February 3, 2015
(Date Prepared)
[ ] Others (Specify) _____________________________________________________________________
ITEM UNIT
NO. PRICE
1 Ballpoint pen, 12pcs./box black 5 boxes 100.00 500.00
2 Pencil 5 dozen 145.00 725.00
3 Eraser 10 pcs 10.00 100.00
4 Sign pen, black 5 boxes 150.00 750.00
5 Bond paper (Legal size) 10 reams 215.00 2,150.00
6 Bond paper (A4 size) 10 reams 210.00 2,100.00
7 Correction Pen 10 pcs 75.00 750.00
8 Correction Tape Applicator 10 pcs 75.00 750.00
9 Long Brown Envelope 20 pcs 20.00 400.00
10 Detergent Bar 6 bar 40.00 240.00
11 Masking Tape 1" 5 rolls 75.00 375.00
12 Air Freshener 5 cans 135.00 675.00
13 Fabric Conditioner 50 ml. 3 pcs 85.00 255.00
14 Dish washing liquid 400 ml. 5 bots 60.00 300.00
15 Mailing Envelope 2 boxes 250.00 500.00
16 L110 Printer Ink black 18 bots 160.00 2,880.00
17 L110 Printer Ink colored 20 bots 160.00 3,200.00
18 Drinking Glass 2 dozen 250.00 500.00
19 Plates 3 dozen 300.00 900.00
20 Spoon & Fork 2 dozen 200.00 400.00
21 Cup & Saucer 2 dozen 150.00 300.00
-
-


SIGNATURE


DBM RO X
(Date Prepared)
[ ] Others (Specify) _____________________________________________________________________
ITEM UNIT
NO. PRICE
1 9 pcs 65.00 585.00
2 500 pcs 0.35 175.00
3 12 pcs 130.00 1,560.00
4 6 pcs 250.00 1,500.00
5 3 bots 72.00 216.00
6 4 packs 61.00 244.00
7 2 bots 230.00 460.00
8 15 pcs 15.00 225.00
9 3 cans 240.00 720.00
10 15 pcs 52.00 780.00
11 6 jars 65.00 390.00
12 2 rolls 45.00 90.00
13 2 rolls 50.00 100.00
14 2 rolls 45.00 90.00
15 15 pads 45.00 675.00
16 6 reams 140.00 840.00
17 2 sets 400.00 800.00
18 2 pcs 250.00 500.00
19 2 pcs 50.00 100.00
20 1 doz 100.00 100.00
21 1 doz 100.00 100.00
22 6 pcs 50.00 300.00
23 3 bots 150.00 450.00


SIGNATURE


DBM RO X
(Date Prepared)
[ ] Others (Specify) _____________________________________________________________________
ITEM UNIT
NO. PRICE
1 9 pcs 65.00 585.00
2 500 pcs 0.35 175.00
3 12 pcs 130.00 1,560.00
4 6 pcs 250.00 1,500.00
5 3 bots 72.00 216.00
6 4 packs 61.00 244.00
7 2 bots 230.00 460.00
8 15 pcs 15.00 225.00
9 3 cans 240.00 720.00
10 15 pcs 52.00 780.00
11 6 jars 65.00 390.00
12 2 rolls 45.00 90.00
13 2 rolls 50.00 100.00
14 2 rolls 45.00 90.00
15 15 pads 45.00 675.00
16 6 reams 140.00 840.00
17 2 sets 400.00 800.00
18 2 pcs 250.00 500.00
19 2 pcs 50.00 100.00
20 1 doz 100.00 100.00
21 1 doz 100.00 100.00
22 6 pcs 50.00 300.00
23 3 bots 150.00 450.00


SIGNATURE


DBM RO X
(Date Prepared)
[ ] Others (Specify) _____________________________________________________________________
ITEM UNIT
NO. PRICE
1 9 pcs 65.00 585.00
2 500 pcs 0.35 175.00
3 12 pcs 130.00 1,560.00
4 6 pcs 250.00 1,500.00
5 3 bots 72.00 216.00
6 4 packs 61.00 244.00
7 2 bots 230.00 460.00
8 15 pcs 15.00 225.00
9 3 cans 240.00 720.00
10 15 pcs 52.00 780.00
11 6 jars 65.00 390.00
12 2 rolls 45.00 90.00
13 2 rolls 50.00 100.00
14 2 rolls 45.00 90.00
15 15 pads 45.00 675.00
16 6 reams 140.00 840.00
17 2 sets 400.00 800.00
18 2 pcs 250.00 500.00
19 2 pcs 50.00 100.00
20 1 doz 100.00 100.00
21 1 doz 100.00 100.00
22 6 pcs 50.00 300.00
23 3 bots 150.00 450.00


SIGNATURE


DBM RO X
(Date Prepared)
[ ] Others (Specify) _____________________________________________________________________
ITEM UNIT
NO. PRICE
1 9 pcs 65.00 585.00
2 500 pcs 0.35 175.00
3 12 pcs 130.00 1,560.00
4 6 pcs 250.00 1,500.00
5 3 bots 72.00 216.00
6 4 packs 61.00 244.00
7 2 bots 230.00 460.00
8 15 pcs 15.00 225.00
9 3 cans 240.00 720.00
10 15 pcs 52.00 780.00
11 6 jars 65.00 390.00
12 2 rolls 45.00 90.00
13 2 rolls 50.00 100.00
14 2 rolls 45.00 90.00
15 15 pads 45.00 675.00
16 6 reams 140.00 840.00
17 2 sets 400.00 800.00
18 2 pcs 250.00 500.00
19 2 pcs 50.00 100.00
20 1 doz 100.00 100.00
21 1 doz 100.00 100.00
22 6 pcs 50.00 300.00
23 3 bots 150.00 450.00


SIGNATURE


DBM RO X
(Date Prepared)
[ ] Others (Specify) _____________________________________________________________________
ITEM UNIT
NO. PRICE
1 9 pcs 65.00 585.00
2 500 pcs 0.35 175.00
3 12 pcs 130.00 1,560.00
4 6 pcs 250.00 1,500.00
5 3 bots 72.00 216.00
6 4 packs 61.00 244.00
7 2 bots 230.00 460.00
8 15 pcs 15.00 225.00
9 3 cans 240.00 720.00
10 15 pcs 52.00 780.00
11 6 jars 65.00 390.00
12 2 rolls 45.00 90.00
13 2 rolls 50.00 100.00
14 2 rolls 45.00 90.00
15 15 pads 45.00 675.00
16 6 reams 140.00 840.00
17 2 sets 400.00 800.00
18 2 pcs 250.00 500.00
19 2 pcs 50.00 100.00
20 1 doz 100.00 100.00
21 1 doz 100.00 100.00
22 6 pcs 50.00 300.00
23 3 bots 150.00 450.00


SIGNATURE


DBM RO X
(Date Prepared)
[ ] Others (Specify) _____________________________________________________________________
ITEM UNIT
NO. PRICE
1 9 pcs 65.00 585.00
2 500 pcs 0.35 175.00
3 12 pcs 130.00 1,560.00
4 6 pcs 250.00 1,500.00
5 3 bots 72.00 216.00
6 4 packs 61.00 244.00
7 2 bots 230.00 460.00
8 15 pcs 15.00 225.00
9 3 cans 240.00 720.00
10 15 pcs 52.00 780.00
11 6 jars 65.00 390.00
12 2 rolls 45.00 90.00
13 2 rolls 50.00 100.00
14 2 rolls 45.00 90.00
15 15 pads 45.00 675.00
16 6 reams 140.00 840.00
17 2 sets 400.00 800.00
18 2 pcs 250.00 500.00
19 2 pcs 50.00 100.00
20 1 doz 100.00 100.00
21 1 doz 100.00 100.00
22 6 pcs 50.00 300.00
23 3 bots 150.00 450.00


SIGNATURE

11,380.00
7,830.00
750.00

DBM RO X
Cagayan de Oro City
(Date Prepared)
[ ] Others (Specify) _____________________________________________________________________
IMPORTANT !! PLEASE SEE THE INSTRUCTION/CONDITIONS AT THE BACK OF THE ORIGINAL COPY 2nd quarter
ITEM UNIT
NO. PRICE
1 Pilot Ink black 4 bots 100.00 400.00
2 Eraser 10 pcs 10.00 100.00
3 Paste 10 pcs 35.00 350.00
4 Cartridge Ink Color black 4 pcs 700.00 2,800.00
5 Cartridge Ink Colored 4 pcs 700.00 2,800.00
8 Stamp Pad 5 pcs 40.00 200.00
9 Stamp Pad Ink (black) 10 pcs 35.00 350.00
10 Typewriter Ribbon 25 spool 25.00 625.00
11 Rubbing Alcohol 10 bots 75.00 750.00
12 Paper Fashener 10 boxes 60.00 600.00
13 Detergent Bar 6 bar 40.00 240.00
14 Furniture Cleaner 5 cans 135.00 675.00
15 DTR (Daily Time Record) 500 pcs 1.00 500.00
16 Sponge 15 pcs 45.00 675.00
17 Fabric Conditioner 50ml 2 pcs 85.00 170.00
18 Pentel Pen Broad black 3 dozen 45.00 135.00
19 Detergent Powder 5 dozen 150.00 750.00
20 Bleach Detergent Big 2 gals 200.00 400.00
21 Carbon Paper 15 boxes 100.00 1,500.00
22 Scissor 6 pcs 150.00 900.00
-


SIGNATURE


DBM RO X
Cagayan de Oro City
(Date Prepared)
[ ] Others (Specify) _____________________________________________________________________
IMPORTANT !! PLEASE SEE THE INSTRUCTION/CONDITIONS AT THE BACK OF THE ORIGINAL COPY 3rd quarter
ITEM UNIT
NO. PRICE
1 Ballpoint pen, 12pcs./box black 5 bots 100.00 500.00
2 Pencil 5 dozen 145.00 725.00
3 Sign pen, black 10 boxes 150.00 1,500.00
4 Staple Wire # 35 15 boxes 80.00 1,200.00
7 Stapler # 35 10 pcs 120.00 1,200.00
8 Correction Pen 25 pcs 75.00 1,875.00
9 Correction Tape Applicator 25 pcs 75.00 1,875.00
10 Long , Brown Envelope 85 pcs 20.00 1,700.00
11 Folder 30 pcs 35.00 1,050.00
12 Tape Transparent (1") 8 roll 55.00 440.00
13 DTR (Daily Time Record) 500 pcs 1.00 500.00
14 Soft Broom 10 pcs 50.00 500.00
15 Fabric Conditioner 50ml 2 pcs 85.00 170.00
16 Mop 5 pcs 100.00 500.00
17 Mailing Envelope 1 box 250.00 250.00
-


SIGNATURE


DBM RO X
Cagayan de Oro City
(Date Prepared)
[ ] Others (Specify) _____________________________________________________________________
IMPORTANT !! PLEASE SEE THE INSTRUCTION/CONDITIONS AT THE BACK OF THE ORIGINAL COPY Fourt quarter
ITEM UNIT
NO. PRICE
1 Tape Transparent (1") 2 roll 55.00 110.00
2 Pentel Pen Broad black 2 pcs 45.00 90.00
3 Disd washing liquid 400ml 5 bots 60.00 300.00
4 Mailing Envelope 1 box 250.00 250.00
5 Book binder with extended volts 10 set 1,300.00 13,000.00
6 Assorted Christmas Décor 10 pcs 500.00 5,000.00
-


SIGNATURE

NAME AND ADDRESS PERSONAL STAFF AGENCY

OF REQUESTING MMO ACCT. CODE
AGENCY LGU - QUEZON AGENCY CONTROL No
DBM RO X
Cagayan de Oro City 22-Jan-15
(Date Prepared)
[ ] Others (Specify) _____________________________________________________________________
ITEM UNIT
NO. PRICE
1 Alcohol 500ml
2 BallPen
3 Book Paper long
4 Blook Paper short
5 Carbon Paper long black
6 Voreection Tape DTR Form 48
7 Envelope "10"15" 500pcs / box
8 Envelope , Expanding legal size 100 pex/box
9 Eraser, Rubber
10 Mineral "Water
11 Paper Clip, Jumbo Plastic
12 Paper Fastener, Plastic
13 Record Book 300 pages
14 Record Book 500 pages
15 Sign Pen, Black
16 Sign Pen, Blue
Total AMOUNT P

GLENDA A. LAMBONAO JULIET D. ROLDAN GREGORIO LLOREN GUE

SIGNATURE

NAME AND ADDRESS AGENCY MASSO

AGENCY MASSO AGENCY CONTROL No
DBM RO X
Cagayan de Oro City
(Date Prepared)
[ ] Others (Specify) _____________________________________________________________________
ITEM AND
ITEMDESCRIPTION SPECIFICATIONS/STOCK No. QUANTITY UNIT UNIT AMOUNT
NO. PRICE
1 -
2 -
3 -
4 -
5 -
6 -
7 -
8 -
9 -
10 -
11 -
12 -
13 -
14 -
15 -
16 -
17 -
18 -
19 -
20 -
21 -
22 -
23 -
24 -
25 Blank DVD-R 10 pcs 25 250.00
Total AMOUNT P
IGNATURE MUST BE OVER PRINTED NAME


SIGNATURE

NAME AND ADDRESS AGENCY POPDEV

AGENCY POPDEV AGENCY CONTROL No
DBM RO X
Cagayan de Oro City
(Date Prepared)
[ ] Others (Specify) _____________________________________________________________________
ITEM AND
NO. PRICE
1 HP Ink 703 - black 25 cart 450.00
2 HP Ink 703 - colored 16 cart 450.00
3 Epson LX 300(Ribbon) 15 cart 100.00
4 Magazine File box, medium size 1 pc 50.00
5 Scented board paper long 3 sets 80.00
6 Cartolina 20 pcs 7.00
7 Calculator 4 pcs 200.00
8 Scissor 4 pcs 60.00
9 Wall Clock 1 pc 300.00
10 Soft Broom 2 pcs 80.00
11 Rug Cotton 2 pcs 50.00
12 Alcohol 70% (500 ml) 9 pcs 70.00
Battery,A
13 A 6 pck 20
14 Glue All Purpose,200 grms 5 jars 40.00
15 Paste,200grms 4 jars 25.00
16 Carbon Film,long, blue 5 box 800.00
17 Correction Tape 12 pcs 40.00
18 Folder, long 1 bundle 350
19 File Organizer, long 4 pcs 300.00
20 DTR 2000 pcs 0.25
21 Cellophane Tape 1" 12 pcs 50.00
22 Ballpen, blue & black 2 box 350.00
23 Dishwashing paste 3 pcs 50.00
24 Writing Pad paper(white) 6 pads 30.00
25 Toilet Tissue 2 pack 70.00
26 Dating & Stamping machine(Receive) 1 pc 500.00
27 Paper, for PPC A4 size 10 rms 200.00
28 HP Ink 703 - black 6 cart 450.00
29 HP Ink 703 - colored 5 cart 450.00
Total AMOUNT P

GLENDA A. LAMBONAO
SIGNATURE

NAME AND ADDRESS AGENCY POPDEV

AGENCY POPDEV AGENCY CONTROL No
DBM RO X
Cagayan de Oro City
(Date Prepared)
[ ] Others (Specify) _____________________________________________________________________
ITEM AND
NO. PRICE
30 Stapler No.10 4 pcs 180.00
31 Staple Wire No. 10 5 box 100
32 Computer Monitor 1 unit 9000.00
33 Printer, DOS program 1 unit 9000.00
34 Chair 2 pcs 2000.00
Total AMOUNT P

GLENDA A. LAMBONAO
GENCY PROPERTY SUPPLY OFFICER AGENCY CHIEF ACCOUNTANT AGENCYHEAD/AUTHORIZE
SIGNATURE


NAME AND ADDRESS AGENCY SBO
AGENCYOffice of the Sangguniang Bayan AGENCY CONTROL No
DBM RO X
Cagayan de Oro City
(Date Prepared)
UESTED ON THE ITEM LISTED BELOW
[ ] Others (Specify) _____________________________________________________________________
ITEM AND
NO. PRICE
1 Mailing Envelop (Window- Brown) 2 boxes 200.00
2 Rechargeable Battery 1 dozen 3120.00
3 Flash Disk (8GB) 3 pcs 1000.00
4 Pencils (lead w/eraser) 1 box 70.00
5 CCFL Lighting (24 watts+-) 1 88.00 3,360.00
6 Drinking Glass 2 dozens 300.00
7 Air Freshener (For Aircon) 4 pcs 100.00
8 PC Hard Disk 1 pc 1,800.00
9 Canon #810 5 pcs 1,000.00
10 Canon #811 5 pcs 1,150.00
11 Rubber Doormat 2 pcs 800.00
12 Wi Fi Adaptor 1 pc 1000.00
13 Optical Mouse 3 pcs 400.00
14 Computer Keyboard 3 pcs 400.00
15 Computer Monitor Screen 1 unit 9,000.00
Total AMOUNT P

GLENDA A. LAMBONAO GREGORIO LLOREN GUE

SIGNATURE

NAME AND ADDRESS AGENCY MEO

AGENCY MEO AGENCY CONTROL No
DBM RO X
Cagayan de Oro City
(Date Prepared)
UESTED ON THE ITEM LISTED BELOW
[ ] Others (Specify) _____________________________________________________________________
ITEM AND
NO. PRICE
1 Book Paper long; 80 grms. 10 180.00
2 Book Paper A4; 80 grms. 10 175.00
3 Record Book - 300 pp w/ logo 5 80.00
4 Folder, long; 14 pts. 30 7.50
5 Dishwashing Liquid (200 ml.) 5 50.00
6 Ballpen, best quality, black 25 8.00
7 Sign pen, best quality, black 5 100.00
8 Time Book and Payroll 20 130.00
9 Battery - AA size 6 90.00
10 Cash Register Tape 5 15.00
11 Ink refill for canon iP 1900 series (8-black, 2-
magenta,4-yellow,4- cyan) 4 150.00
12 Marking pens - red, black, blue 3 60.00
13 DTR 500 0.25
14 Stationery Paper, long, cream 5 50.00
15 Furniture Cleaner 3 200.00
16 Detergent soap (bar) 5 30.00
17 HP Ink - 1020 laserjet 3 1,300.00
18 Photo copier Ink - Gestetner 1372 3 4,000.00
19 HP Ink - No. 60 (black) 1 1,000.00
20 HP ink - No. 61 (colored) 1 1,100.00
Total AMOUNT P

GLENDA A. LAMBONAO GREGORIO LLOREN GUE

SIGNATURE

HE BIDS AND AWARDS COMMITTEE
BIDS AND AWARDS
Method is hereby recommended as provided under Sec. 53 par. (a). IRR-A, of R.A. 9184 to directly negotiate the contract to t
Item QTY. Unit DESCRIPTION Estimated Cost Temar

Mangubat Furnt &Maramag
Enterprises Lumberyard REMARKS
Supersales
No. per Item / PR Electrical Supply
NAME
(ABC)
OF CAPABLE SUPPLIER
1 280 bd.ft. 70-2x2x12 lumber 13.00 13.00 15.00 14.00
Mangubat Enterprises
2 35 bd.ft. 5-2 x6x7-lumber 13.00 13.00 15.00 14.00
3 30 bd.ft. 6-2x3x10 lumber 13.00 13.00 15.00 14.00
A negotiated procurement was made directly to the abovementioned capable Supplier in conformity with Sec. 53 (a)
Head of the Procuring Entity ( H.O.P.E.) for approval and the Notice of Execution of Award conformity with Sec. 37.1 and 37.2.
BAC CHAIRMAN BAC Vice Chairman BAC Member BAC Member Requisitioning Officer
APPROVED : Note: Only for the Items
GREGORIO LLOREN GUE
Municipal Mayor

BIDS AND AWARDS
Item QTY. Unit DESCRIPTION Estimated Cost TEMAR'SL.

FURITURE
BALORA LUMBERREMARKS&
No. per Item / PR & LUMBERYARD
Const. Supply
NAME
(ABC)OF CAPABLE SUPPLIER
1 48 bd.ft. 4- 2 x 6 x 12 G-melin 13.00 15.00 13.00 Temars
NONE Furniture & Lumberyard
2 37.33 bd.ft. 4 - 2 x 4 x 14 G-mel 13.00 15.00 13.00 Temars
3 40 bd.ft. 6 - 2 x 4 x 10 G-mel 13.00 15.00 13.00 Temars
16.80Furniture & Lumberyard
5 120 bd.ft. 20 - 2 x 3 x 12 G-me 13.00 15.00 13.00 Temars
6 26.66 bd.ft. 4 - 1 x 8 x 10 G-mel 13.00 15.00 13.00 Temars
8 150 bd.ft. 30 - 2 x 3 10 G-mel 13.00 15.00 13.00 Temars
9 50 bd.ft. 30 - 1 x 2 10 G-mel 13.00 15.00 13.00 Temars
10 35 bd.ft. 5 - 2 x 6 x 7 G-melin 13.00 15.00 13.00 Temars
GREGORIO LLOREN GUE
Municipal Mayor
BIDS AND AWARDS

Item QTY. Unit DESCRIPTION REJ Temar

Estimated Cost Furnt L.
Enterprises & BALORA
Lumberyard REMARKS
LUMBER &
Const. Supply
NAME
(ABC)
OF CAPABLE SUPPLIER
1 32 bd.ft 4 - 1 x 8 x 12 G meli 15.00 15.00 13.00 Temars
2 21.33 bd.ft 4- 1 x 8 x 8 G-meli 15.00 15.00 13.00 Temars
3 32 bd.ft 4- 2 x 4 x 12 G-meli 15.00 15.00 13.00 Temars
4 20 bd.ft 2 - 2 x 6 x 10 G-mel 15.00 15.00 13.00 Temars
8 14 bd.ft 2 - 2 x 6 x 7 G-melin 15.00 15.00 13.00 Temars
9 14 bd.ft 3 - 2 x 4 x 7 G-meli 15.00 15.00 13.00 Temars
10 12 bd.ft 3 - 2 x 4 x 7 G-meli 15.00 15.00 13.00 Temars
GREGORIO LLOREN GUE
Municipal Mayor
BIDS AND AWARDS

Supersales
No. per Item / PRElectrical Supply
NAME
(ABC)
OF CAPABLE SUPPLIER
1 280 bd.ft. 70-2x2x12 lumber 13.00 13.00 15.00 14.00
2 35 bd.ft. 5-2 x6x7-lumber 13.00 13.00 15.00 14.00
3 30 bd.ft. 6-2x3x10 lumber 13.00 13.00 15.00 14.00
GREGORIO LLOREN GUE
Municipal Mayor
BIDS AND AWARDS

Supersales
NAME
(ABC)
OF CAPABLE SUPPLIER
1 280 bd.ft. 70-2x2x12 lumber 13.00 13.00 15.00 14.00
2 35 bd.ft. 5-2 x6x7-lumber 13.00 13.00 15.00 14.00
3 30 bd.ft. 6-2x3x10 lumber 13.00 13.00 15.00 14.00
GREGORIO LLOREN GUE
Municipal Mayor
rectly negotiate the contract to the herein capable suppliers, thus;
REMARKS
gubat Enterprises
gubat Enterprises
gubat Enterprises
er in conformity with Sec. 53 (a) IRR-A, R.A. 9184 and hereby recommend to the
formity with Sec. 37.1 and 37.2.1.,
uisitioning Officer
: Only for the Items
REMARKS
Furniture & Lumberyard

uisitioning Officer
REMARKS

uisitioning Officer
REMARKS
gubat Enterprises
gubat Enterprises
gubat Enterprises
uisitioning Officer
REMARKS
gubat Enterprises
gubat Enterprises
gubat Enterprises
uisitioning Officer
PURCHASE REQUEST
Department: BAC PR No. Date:__________

Section: SAI No. Date:__________

1 reams Book Paper long 10 260.00 2,600.00
2 reams Book Paper short 10 240.00 2,400.00
3 gals. Water refill 38 50.00 1,900.00
Total 6,900.00
Purpose / Remarks Supplies for the 4th quarter.
Requested by: Approved by:

Signature:
Printed Name: ARNIE C. WAGAS GREGORIO LLOREN GUE
Designati BAC Secretary Municipal Mayor
PURCHASE REQUEST

1 units 8 PANELS 1200X1200mm w/glass 1 665,000.00 665,000.00

2 PANELS 1400X1200mm w/glass
1 unit MODULAR CONFERENCE
TABLE 14 SEATERS
2 units WORKING TABLE w/2 drawers
6 units L_SHAPE TABLE FOR
STAFF w/FIX PEDESTAL
3 DRAWERS AND OPEN SHELF,
1200X1500mm OPEN SHELF
Total 665,000.00
Purpose / Remarks For Office of the LSB Secretary, Second Quarter.

Signature:
Designation: BAC Secretary Municipal Mayor
Date:
URCHASE REQUEST PURCHASE REQU

LGU - Quezon, Bukidnon LGU - Quezon, Bukidn
Department:
Section:
STOCK NO. UNIT DESCRIPTION UNIT COST AMOUNT
Brake Rubber Cup 25.00 100.00

Bolt 1'' x 5 w/ nut 115.00 230.00
1" Plain Washer 5.00 20.00
Door Lock Yale 235.00 705.00
Safety Hask 15.00 60.00
Bolt 3/8 x 1 1/2 w/ nut 6.00 12.00
Bolt 15 mm x 65 mm 60.00 600.00
L. Fitting Big 12.00 125.00
Straight Fitting Big 10.00 100.00
1" Plain Washer 5.00 40.00
14 mm x 3" 50.00 200.00
Hub Bolt Hyundai 200.00 400.00
Nut # 5/8 15.00 15.00
Bolt 3/4 x 2 1/2 w/ nut 70.00 140.00
Bolt 10 mm x 2 w/ DW L Washer 20.00 40.00
Bolt 3/4 x 7 w/ DW nut 192.00 192.00
Bolt 7/8 x 7 w/ DW nut 130.00 130.00
Devcon 90.00 90.00
Ignition Switch 800.00 800.00
Horn Relay 24V 200.00 200.00
Fan Belt A-38 100.00 100.00
Bolt 5/16 x 1 3.00 24.00
5/16 Plain Washer 1.00 16.00
Nut 25.00 25.00
Triangular Pile 200.00 200.00
Button Switch 50.00 100.00
Flasher Relay 150.00 150.00
Stock No. in circle (O) are not available in Procurement
Service-DBM, Cagayan de Oro City.
(Please refer to price quotations and stock availbility
certification, dated ___________ APR Ref.No. __________ 4,814.00
Purpose / Remarks For Municipal Equipments/vehicles/motorpool.

Requested by:
Signature:
Printed Name: DOUGLAS B. ABUL,CE
Designation: Municipal Engineer
Date:


Department:
Section:
STOCK NO. UNIT DESCRIPTION UNIT COST AMOUNT
150.00 1,500.00
Stock No. in circle (O) are not available in Procurement

Service-DBM, Cagayan de Oro City.
(Please refer to price quotations and stock availbility
certification, dated ___________ APR Ref.No. __________
Purpose / Remarks
Requested by:
Signature:
Printed Name:
Designation:
Date:


Department:
Section:
STOCK NO. DESCRIPTION UNIT COST AMOUNT

Purpose / Remarks
Requested by:
Signature:
Printed Name:
Designation:
Date:


Department:
Section:

Purpose / Remarks
Requested by:
Signature:
Printed Name:
Designation:
Date:


Department:
Section:

Purpose / Remarks
Requested by:
Signature:
Printed Name:
Designation:
Date:
PURCHASE REQUEST
Department: LSB PR No. Date:__________


1 packs Coffee 3n1 13 175.00 2,275.00
2 jars Water Refill 37 50.00 1,850.00
3 crt Ink (704)Colored 2 700.00 1,400.00
4 crt Ink (704) black 2 700.00 1,400.00
5 tubes Toner (MP 2501) 1 3,500.00 3,500.00
6 box
1,300.00
1,200.00
350.00
300.00
2,000.00
2,000.00
1,000.00
400.00
225.00
Total 19,200.00
Purpose / Remarks For Office of the LSB Sectretary.

Signature:
Designati LSB Secretary Municipal Mayor
PURCHASE REQUEST


1 tubes Toner (MP2501) 3 3,500.00 10,500.00
2 tubes Toner (HP 12A) 2 4,500.00 10,500.00
3 cart. Print Cartridge 900 (black) 5 400.00 10,500.00
4 cart. Print Cartridge 900 (colored) 5 400.00 10,500.00
5 cart. Print Cartridge 704 (black) 5 700.00 10,500.00
6 cart. Print Cartridge 704 (colored) 5 700.00 10,500.00
7 10,500.00
8
9
10
Total 63,000.00
Purpose / Remarks BAC meeting for the 1st Quarter.

Signature:
Designation: BAC Secretary Municipal Mayor
Date:
URCHASE REQUEST
Department:
Section:
STOCK NO. UNIT DESCRIPTION
2,160.00
Purpose / Remarks
Requested by:
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Printed Name:
Designation:
Date:

URCHASE REQUEST
Department:
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Purpose / Remarks
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Signature:
Printed Name:
Designation:
Date:

URCHASE REQUEST
Department:
Section:

Purpose / Remarks
Requested by:
Signature:
Printed Name:
Designation:
Date:

URCHASE REQUEST
Department:
Section:

Purpose / Remarks
Requested by:
Signature:
Printed Name:
Designation:
Date:

URCHASE REQUEST
Department:
Section:

Purpose / Remarks
Requested by:
Signature:
Printed Name:
Designation:
Date:
_________
_________
PURCHASE ORDER
Supplier CLARENZON MARKETING P.O. No.
Address Cagayan de Oro City Date
TIN
lo t 5
Gentlemen:
contained herein:
1 boxes Amoxicillin cap 500 mg. 100BP 20 170.00 3,400.00
2 bots Amoxicillin tab 250 mg. 60 ml. 5 152.00 760.00
3 bots Amoxicillin susp. 5 ml 60 ml 144 24.00 3,456.00
4 bots Amoxicillin drop 100 mg. 1 ml. 10 ml. 54 20.00 1,080.00
5 bots Cefalexin cap. 500 mg. 100's BP 10 348.00 3,480.00
6 bots Cefalexin susp. 250 mg. 60 ml. 144 30.00 4,320.00
7 bots Cefalexin drop 100 mg. 1 ml. 108 25.00 2,700.00
8 boxes Ceprofloxacin 500 mg. tab 100's BP 10 192.00 1,920.00
9 bots Cotrimoxazole cap. 800 mg. 100's BP 10 160.00 1,600.00
10 bots Cotrimoxazole tab. 400 mg. 100's BP 10 105.00 1,050.00
11 bots Cotrimoxazole susp 200 mg. 5 ml. 60 ml. 108 20.00 2,160.00
12 boxes Cloxacillin 500 mg. cap 100's BP 3 352.00 1,056.00
13 boxes Cloxacillin 250 mg. tab 100's 5 300.00 1,500.00
14 bots Cloxacillin 250 mg. susp. 60 ml. 27 34.00 918.00
15 boxes Doxycyline 100 mg. cap 100's BP 8 144.00 1,152.00
16 boxes Norfloxacine 400mg. Caps 100's BP 5 500.00 2,500.00
17 bots Celecoxib tab 200 mg. 100's 1 1,280.00 1,280.00
18 boxes Diclofena tab 50 mg. 10's BP 5 150.00 750.00
19 boxes Mefenamic acid tab 500 mg. 100's 15 98.00 1,470.00
20 bots Mefenamic acid 50 mg/5ml. 60 ml bot 57 20.00 1,140.00
21 boxes Ibuprofen 200 mg. tab 100's 10 92.00 920.00
22 bots Lagundi 300 mg. /5 ml.60 ml. 54 75.00 4,050.00
23 bots Salbutamol 2 mg./5ml 60 ml. bot 90 18.00 1,620.00
24 nebule Salbutamol nebule 1 mg./1 ml. 150 9.00 1,350.00
25 boxes Losartan 50 mg. tab 100's 3 200.00 600.00
26 boxes Metropolol 50 mg. tab 100's 5 150.00 750.00
27 boxes Amlodipine 10 mg. 100's 5 250.00 1,250.00
28 boxes Metronidazole 500 mg. tab 100's 5 107.00 535.00
29 boxes Metronidazole 125 mg./5ml 60 ml. tab 100's 27 19.00 513.00
30 bots Phenyl drop 6.25 mg./1ml. 27 28.00 756.00
31 bots Phenyl susp. 4 mg./5ml 60 ml.. 27 25.60 691.20
32 boxes Cetirizine tab 10 mg. 100's 5 140.00 700.00
33 bots Cetirizine drop 2.5 mg/1 ml 60 ml. 42 56.00 2,352.00
34 bots Cetirizine syrup 5 mg/5 ml. 60 ml 42 56.00 2,352.00
35 boxes Tranexamic cap. 500 mg.100' BP 1 1,100.00 1,100.00
36 boxes Multivitamin + iron 500 mg. cap 100's BP 15 180.00 2,700.00
37 bots Multivitamin syrup 60 ml. 72 32.00 2,304.00
38 boxes Vitamin B-complex 20 90.00 1,800.00
39 bots Zinc suldate syrup 60 ml. 27 78.00 2,106.00
40 boxes Metoclopramide tab 10 mg. 100's 2 352.00 704.00
41 bots Metoclopramide bot 5 mg./5ml. 60 m l. 5 25.00 125.00
42 boxes Prednisone tab. 20 mg. 100's 2 400.00 800.00
43 boxes Dextrometorphan 10 mg. tab 100's 10 150.00 1,500.00
44 boxes Aluminum Hydroxide magnesium 10 128.00 1,280.00
45 boxes Salbutamol inhaler 100 mg. 15 250.00 3,750.00
46 sachet Oresol sachet 25's 6 190.00 1,140.00
-
P 75,440.20
(Total Amount in words) Seventy Five Thousand Four Hundred Forty Pesos & 20/100
Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor
CLARENZON MARKETING
Date
PURCHASE ORDER
Supplier JB PHARMA AND TRADE CENTER P.O. No.
TIN
Lot 4
Gentlemen:
contained herein:
1 bots Paracetamol syrup 250 mg. 60 ml 2,475 28.00 69,300.00
2 bots Paracetamol drop 100 mg. 15 ml 576 20.00 11,520.00
3 boxes Parcetamol tab 500 mg. 100's BP 130 38.00 4,940.00
4 bots Amoxicillin susp. 250 mg. 60 ml. 2,300 36.00 82,800.00
5 bots Amoxicillin drop 100 mg. 10 ml. 428 19.00 8,132.00
6 boxes Amoxicillin cap 500 mg. 100 BP 150 220.00 33,000.00
7 bots Cefalexin drop 100 mg. 10 ml. 428 30.00 12,840.00
8 bots Cefalexin susp. 250 mg. 60 ml. 1,340 30.00 40,200.00
9 boxes Cefalexin cap 500 mg. 100's BP 140 438.00 61,320.00
10 boxes Lagundi 600 mg. Cp 60's 150 455.00 68,250.00
11 bots Lagundi 300 mg. syrup 60 ml 1,095 76.00 83,220.00
12 bots Cetirizine drop 2.5 mg. 60 ml. 356 63.00 22,428.00
13 boxes Cetirizine tab 10 mg. 100's BP 21 160.00 3,360.00
14 bots Cetirizine syrup 5mg. 10 ml. 356 60.00 21,360.00
15 boxes Cotrimoxazole 800 mg. 100'BP 90 295.00 26,550.00
16 bots Cotrimoxazole susp 200mg. 60 ml 1714 25.00 42,850.00
17 nebule Salbotamol nebule 1 mg. 2.5 ml 495 10.00 4,950.00
18 bots Salbotamol + Guarafeneson 60 ml. 50 30.00 1,500.00
19 boxes Cimefidine 400 mg. tab. 100's BP 25 105.00 2,625.00
20 boxes Mefenamic acid cap 500 mg. 100'sBP 92 120.00 11,040.00
21 bots Mefenamic acid syrup 50 mg. 60 ml. 500 20.00 10,000.00
22 boxes Multivitamin cap 100's BP w/iron 750 185.00 138,750.00
23 boxes Tranexamic acid 500 mg. caps 100's BP 10 1,380.00 13,800.00
24 boxes Dicycloverine 10 mg. Tab. 100's 250 32.00 8,000.00
25 bots Dicycloverine 10 mg. syrup 60 ml. 500 13.00 6,500.00
26 bots Multivitamin syrup + iron 60 ml. 2500 35.00 87,500.00
27 boxes Ascrobic acid 500 mg. tab. 100' BP 50 78.00 3,900.00
28 boxes Diclofenac tab. 50 mg. 10's Bp 15 150.00 2,250.00
29 boxes Vitamin B-complex tabs 100's BP 1000 98.00 98,000.00
30 boxes Aluminum magnesium tab 200mg. 100's BP 50 85.00 4,250.00
31 boxes Ferrous sulfate tabs. w/folic acid 300mg./250mg 1500 60.00 90,000.00
32 boxes Nifedipine 5 mg. tab. 100's BP 12.5 310.00 3,875.00
33 boxes Norfloxacine 400 mg. caps 100's BP 12.5 550.00 6,875.00
34 boxes Salbotamol 2 mg. 100's BP 90 74.00 6,660.00
35 boxes Cefuroxime BP 10's 25 880.00 22,000.00
36 boxes Hyoscine Butylbromide 10 mg. 100's BP 25 315.00 7,875.00
37 boxes Amlodipine 10 mg. tabs 100' BP 50 655.00 32,750.00
38 bots Metronidazole susp. 125 mg. 60 ml. 50 20.00 1,000.00
39 boxes ORS sachet 24's 100 190.00 19,000.00
40 boxes Ranitidine 150 mg. tab. 100's BP 5 145.00 725.00
41 boxes Cinarizine tab 100's BP 12.5 140.00 1,750.00
42 boxes Ibruprofen 200 mg. tab. 100's BP 17.5 90.00 1,575.00
43 boxes Metronidazole 500 mg. 100's BP. 12.5 108.00 1,350.00
44 boxes Losartan 50 mg. tab. 100's BP 50 405.00 20,250.00
45 boxes Metropolol 50 mg. Tab. 1--'s BP 12.5 150.00 1,875.00
46 boxes Dexycycline 100 mg. cap 100's BP 12.5 145.00 1,812.50
47 boxes Ciprofloxacin 40 mg. tab. 100's BP 25 190.00 4,750.00
48 boxes Famotidine 40 mg. 100's BP 5 2,850.00 14,250.00
49 boxes Simvastatine 20 mg. tab. 100's Bp 10 800.00 8,000.00
50 boxes Sambong 600 mg. caps. 100's BP 10 780.00 7,800.00
51 boxes Cloxacillin 500 mg. tabs. 100's BP 10 500.00 5,000.00
52 bots Cloxacillin 250 mg. susp. 60 ml. 50 35.00 1,750.00
53 bots Zinc Sulfate drop 50 53.00 2,650.00
54 bots Zinc Sulfate syrup 60 ml. 50 80.00 4,000.00
55 boxes Omeprazole 29 mg. 100's BP 12.5 495.00 6,187.50
56 boxes Erythromycin 500 mg. tabs 100's\ 12.5 465.00 5,812.50
57 bots Erythromycin 250 mg. 60 ml. 50 45.00 2,250.00
58 nebule Budesonide nebules 500 56.00 28,000.00
59 boxes Betahistine tab. 100's BP 12.5 1,630.00 20,375.00
60 bots Metoclopramide 5 mg. syrup 60 ml. 50 30.00 1,500.00
61 boxes Metoclopramide tab. 5 mg. 100's BP 12.5 580.00 7,250.00
62 bots Salbutamol syrup 60 ml. 25 18.00 450.00
63 bots Lagundi susp. 300 mg. 120 ml. 50 98.00 4,900.00
64 boxes Lagundi 300 mg. 100's BP 45 300.00 13,500.00
65 pcs Hydrite Granujles 50 13.00 650.00
66 box Retanol Palmitate 25,000 IU 100's BP 1 1,800.00 1,800.00
67 boxes Vitamin A cap 200,000 IU 100's 15 1,995.00 29,925.00
P 1,375,307.50
(Total Amount in words) One Million three Hundred Seventy Five Thousand Three Hundred Seven Pesos and 50/100
Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor
JB PHARMA AND TRADE CENTER

Date
PURCHASE ORDER
Supplier LR ENTERPRISES P.O. No.
Address Malaybalay City Date
TIN
Gentlemen:
contained herein:
1 boxes Amoxicillin cap 500 mg. 100 BP 20 220.00 4,400.00
2 bots. Amoxicillin tab. 250 mg. 60 ml. 5 180.00 900.00
3 bots. Amoxicillin susp. 5 ml 60 ml. 144 37.00 5,328.00
4 bots. Amoxicillin drop 100 mg. 1 ml. 10 ml. 54 19.00 1,026.00
5 bots. Cefalexin cap. 500 mg. 100's BP 10 438.00 4,380.00
6 bots. Cefalexin susp. 250 mg. 60 ml. 144 30.00 4,320.00
7 bots. Cefalexin drop. 100 mg. 1 ml. 108 30.00 3,240.00
8 boxes Ceprofloxacin 500 mg. tab 100's BP 10 192.00 1,920.00
9 bots. Cotrimoxazole cap. 800 mg. 100's BP 10 300.00 3,000.00
10 bots. Cotrimoxazole tab. 400 mg. 100 BP 10 148.50 1,485.00
11 bots. Cotrimoxazole susp. 200 mg. 5 ml. 60 ml. 108 25.00 2,700.00
12 boxes Cloxacillin 500 mg. cap 100's BP 3 500.00 1,500.00
13 boxes Cloxacillin 250 mg. tab 100's 5 300.00 1,500.00
14 bots. Cloxacillin 250 mg. susp. 60 ml. 27 35.00 945.00
15 boxes Doxycyline 100 mg. cap 100's BP 8 148.00 1,184.00
16 bots. Ery thromycin 250 mg. 5 ml. bot 18 45.00 810.00
17 boxes Erythromycin 500 mg. cap 100's BP 2 460.00 920.00
18 boxes Norfloxacine 400 mg. caps 100's BP 5 555.00 2,775.00
19 boxes Cefexime 200 mg. cap 20's 2 715.00 1,430.00
20 boxes Cefuroxime 200 mg. tab 100's 2 900.00 1,800.00
21 boxes Paracetamol 500 mg. tab 100's BP 20 40.00 800.00
22 bots. Paracetamol susp. 250 mg. 25 ml. 60 ml. 144 20.00 2,880.00
23 bots. Paracetamol drop 100 mg. 1 ml. 10 ml. 108 17.00 1,836.00
24 boxes Diclofenac tab. 50 mg. 10's BP 10 152.00 1,520.00
25 boxes Mefenamic acid tab. 500 mg. 100's 15 125.00 1,875.00
26 boxes Mefinamic acid 250 mg. tab 100's 5 70.00 350.00
27 bots. Mefinamic acid 50mg/5ml. 60 ml.bot 57 21.00 1,197.00
28 boxes Ibuprofen 200 mg. tab 100's 10 92.50 925.00
29 bots. Lagundi 300 mg. 120 ml bots. 15 98.50 1,477.50
30 boxes Lagundi 300 mg. tab. 100's 15 230.00 3,450.00
31 bots. Lagundi 300 mg. /5 ml. 60 bots 54 77.00 4,158.00
32 boxes Salbutamol 2 mg. tab. 100's 20 40.00 800.00
33 bots. Salbutamol 2 mg/5 ml. 60 ml.bot 90 18.50 1,665.00
34 nebule Salbutamol Nebule 1 mg/1 ml 150 10.00 1,500.00
35 boxes Ranitidine 150 mg. tabs. 100's 3 145.00 435.00
36 boxes Cimitidine 400 mg. tabs 100's 3 105.00 315.00
37 boxes Losartan 50 mg. tab 100's 2 405.00 810.00
38 boxes Metopolol 50 mg. tab 100's 5 155.00 775.00
39 boxes Metronidazole 500m.tab 100's 5 110.00 550.00
40 boxes Metronidazole 125 mg/5ml. 60ml bot. 27 20.00 540.00
41 boxes Hyoscine 10mg. Tab 100's 5 316.00 1,580.00
42 boxes Dicycloverine 10mg. Tab 100's 2 32.00 64.00
43 bots. Dicycloverine 10mg./5ml.60ml. 27 12.80 345.60
44 bots. Phenyl drop 6.25 mg/1ml. 27 30.00 810.00
45 bots. Phenyl susp. 4 mg/5 ml 60ml. 27 30.00 810.00
46 boxes Cetirizine tab10 mg. 100's BP 5 165.00 825.00
47 bots. Cetirizine drop 2.5 mg/ 1 ml.60ml. 42 64.00 2,688.00
48 bots. Cetirizine syrup 5 mg./5ml. 60ml. 42 60.00 2,520.00
49 bots. Chlorphenamine 2.5 mg. 60 ml. bot. 54 17.00 918.00
50 bots. Ascorbic acid 100 mg./5 ml. 60 ml. bot. 54 16.00 864.00
51 boxes Ascorbic acid tab 500 mg. 100's BP 10 80.00 800.00
52 boxes Multivitamins + iron 500 mg. cap 100's BP 15 180.00 2,700.00
53 bots. Multivitamins syrup 60 ml. 72 35.00 2,520.00
54 boxes Vitamin B-complex 25 98.50 2,462.50
55 drop Zinc sulfate drop 27 55.00 1,485.00
56 bots. Zinc sulfate syrup 60 ml. 27 85.00 2,295.00
57 boxes Ferrous sulfate w/ folic acid 300mg./ 250 mg. 100's 10 60.00 600.00
58 boxes Metoclopramide tab. 10 mg. 100's 2 600.00 1,200.00
59 bots. Metoclopramide bot 5 mg./5 ml. 60 ml. 5 30.00 150.00
60 bots. Prednisone 10 mg./ 5 ml. 30 ml. 15 105.00 1,575.00
61 boxes Prednisone tab. 20 mg 100's 2 820.00 1,640.00
62 boxes Dextrometorphan 10 mg. tab 100's 10 150.00 1,500.00
63 boxes Aluminum Hydroxide manesium 20 200.00 4,000.00
64 sachet Sambong tab 250 mg. 100's BP 10 235.00 2,350.00
65 boxes Sambong tab 500 mg. 100's BP 4 800.00 3,200.00
66 boxes Salbutamol inhaler 100 mcg. 28 250.00 7,000.00
67 sachet Oresol sachet 25's 6 190.00 1,140.00
68 boxes Simvastatin tab. 20 mg. 100's 3 350.00 1,050.00
P 122,513.60
(Total Amount in words) One Hundred Twenty Two Thousand Five Hundred Thirteen Pesos & 60/100
Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor
LR ENTERPRISES
Date
Lot # 1
PURCHASE ORDER
TIN
Gentlemen:
contained herein:
1 bot. Paracetamol syr. 250mg/5ml 2880 12.75 36,720.00

2 bot. Paracetamol drops 100mg 15ml 2880 12.00 34,560.00
3 tab. Paracetamol 500mg tab 100,000 0.28 28,000.00
4 bot. Amoxicillin 250/5ml susp 1440 16.20 23,328.00
5 bot. Amoxicillin drops 100mg 10ml 1440 28.25 40,680.00
6 cap. Amoxicillin 500mg cap 30,000 1.32 39,600.00
7 bot. Cefalexin drops 100mg 10ml 720 17.25 12,420.00
8 bot. Cefalexin susp. 250mg 60ml 720 23.00 16,560.00
9 cap. Cefalexin cap 500mg 20,000 2.15 43,000.00
10 bot. Lagundi 300mg 60ml 1852 61.75 114,361.00
11 tab. Cetirizine tab 10mg 30,000 0.49 14,700.00
12 bot. Cetirizine syr. 547 76.75 41,982.25
13 cap. Multivitamins w/iron cap 100's 288 19.25 5,544.00
14 cap. Amoxicillin 250mg cap 1000 1.00 1,000.00
15 cap. Cefalexin 250mg cap 1000 1.20 1,200.00
16 tab. Ascorbic 500mg tab 20,000 0.66 13,200.00
17 tab. Diclofenac 50mg tab 1,000 1.00 1,000.00
18 tab. Vitamin B complex tab 10,000 1.28 12,800.00
P 480,655.25
(Total Amount in words) Four Hundred Eighty Thousand Six Hundred Fifty Five Pesos & 25/100
Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor

Date
Lot # 1
PURCHASE ORDER
TIN
Gentlemen:
contained herein:
19 tab. Aluminum magnesium tab 20,000 1.49 29,800.00

20 tab. Ferrous Sulfate w/ folic acid 5,000 0.74 3,700.00
21 cap. Nifedipine 5mg cap 1,000 1.88 1,880.00
22 tab. Salbutamol 2mg tab 5,000 0.22 1,100.00
23 tab. Amlodipine 10mg tab 2,000 3.70 7,400.00
24 bot. Metronidazole 500mg tab 144 15.10 2,174.40
25 tab. Cinnarizine tab 1,000 1.15 1,150.00
26 tab. Ibuprofen 200mg tab 1,500 0.93 1,395.00
27 tab. Metronidazole 500mg tab 1,000 0.98 980.00
28 tab. Lozartan 50mg tab 7,000 0.93 6,510.00
29 tab. Metoprolol 50mg tab 5,000 1.50 7,500.00
30 cap. Doxycycline 100mg cap 3,000 0.98 2,940.00
31 tab. Ciprofloxacin 400mg tab 3,000 1.36 4,080.00
32 tab. Simvastatin 20mg tab 5,000 0.81 4,050.00
33 tab. Sambong 500mg tab 5,000 6.07 30,350.00
34 cap. Cloxacillin 500mg cap 1,000 2.70 2,700.00
35 bot. Cloxacillin 500mg cap 144 36.00 5,184.00
36 bot. Zinc sulfate drop 100 39.00 3,900.00
120,993.40
(Total Amount in words) One Hundred Twenty Thousand Nine Hundred Ninety Three Pesos & 40/100
Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor

Date
Lot # 1
PURCHASE ORDER
TIN
Gentlemen:
contained herein:
37 bot. Zinc sulfate syr. 100 42.00 4,200.00

38 cap. Omeprazole 20mg cap 5,000 1.00 5,000.00
39 bot. Salbutamol syr. 60ml 1,954 11.50 22,471.00
40 tab. Lagundi 300mg tab 40,000 1.95 78,000.00
105,471.00
(Total Amount in words) One Hundred Five Thousand Four Hundred Seventy One Pesos
Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor

Date
Lot # 2
PURCHASE ORDER
TIN
Gentlemen:
contained herein:
1 cap Amoxicillin 500mg cap 1,250 1.32 1,650.00

2 cap Amoxicillin 250mg cap 375 1.00 375.00
3 bot. Amoxicillin 250mg/5ml susp. 180 16.20 2,916.00
4 bot. Amoxicillin drops 100mg 10ml 180 14.25 2,565.00
5 cap Cefalexin 500mg cap 1,250 2.10 2,625.00
6 bot. Cefalexin 250mg/5ml susp. 180 23.00 4,140.00
7 bot. Cefalexin drops 180 16.00 2,880.00
8 tab. Ciprofloxacin 500mg 250 1.36 340.00
9 cap Cloxacillin 500mg cap 750 2.70 2,025.00
10 bot. Cloxacillin 250mg/5ml susp 25 36.00 900.00
11 cap Doxycycline 100mg cap 75 0.98 73.50
12 cap Cefexime 200mg cap 250 14.25 3,562.50
13 tab. Paracetamol 500mg 10,000 0.23 2,300.00
14 bot. Paracetamol 250mg/5ml susp. 360 12.75 4,590.00
15 bot. Paracetamol drops 360 12.00 4,320.00
16 tab. Celecoxib cap 50 6.10 305.00
17 tab. Diclofenac 50mg 250 0.80 200.00
18 cap. Mefenamic 250mg 1,250 0.48 600.00
P 36,367.00
(Total Amount in words) Thirty Six Thousand Three Hundred Sixty Seven Pesos
Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor

Date
Lot # 2
PURCHASE ORDER
TIN
Gentlemen:
contained herein:
19 bot. Mefenamic 50mg/5ml susp. 36 19.25 693.00

20 tab. Ibuprofen 200mg 75 0.93 69.75
21 tab. Lagundi 300mg tab 2,500 1.95 4,875.00
22 bot. Lagundi 300mg/5ml syr. 266.75 61.75 16,471.81
23 tab. Salbutamol 2mg tab 750 0.23 172.50
24 bot. salbutamol 2mg/5ml 72 11.50 828.00
25 tab. Omeprazole 20mg 1,250 1.00 1,250.00
26 tab. Losartan 50mg 1,250 0.93 1,162.50
27 cap. Nifedipine 5mg 125 1.88 235.00
28 tab. Metoprolol 50mg 250 1.50 375.00
29 tab. Amlodipine 10mg 750 3.70 2,775.00
30 tab. Metronidazole 500mg 250 0.98 245.00
31 bot. Metronidazole 125mg/5ml 36 15.00 540.00
32 tab. Levofloxacin 500mg 250 8.15 2,037.50
33 tab. Cetirizine 10mg 2,500 0.49 1,225.00
34 bot. Cetirizine drops 36 128.50 4,626.00
35 bot. Cetirizine syrup 72 77.00 5,544.00
36 bot. Ascorbic 100mg/5ml 60ml 72 14.00 1,008.00
44,133.06
(Total Amount in words) Forty Four Thousand One Hundred Thirty Three Pesos & 06/100
Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor

Date
Lot # 2
PURCHASE ORDER
TIN
Gentlemen:
contained herein:
37 tab. Ascorbic 500mg 2,500 0.66 1,650.00

38 cap. Multivitamins + iron 500mg 2,500 1.00 2,500.00
39 bot. Multivitamins syr 60ml 180 18.50 3,330.00
40 tab. Vitamin B-Complex 5,000 1.28 6,400.00
41 bot. Zinc Sulfate drops 10 39.00 390.00
42 bot. Zinc Sulfate syr 10 42.00 420.00
43 cap. Ferrous Sulfate w/folic acid 60mg+400mg 495 0.74 366.30
44 tab. Prednisone tab 125 2.98 372.50
45 tab. Aluminum Hydroxide Magnesium 1,250 1.48 1,850.00
46 tab. Sambong 250mg tab 1,250 1.82 2,275.00
47 tab. Chlorphenamine 4mg tab 1,250 0.76 950.00
48 inh. Salbutamol inhaler 100mgx200doses 25 97.40 2,435.00
49 tab. Simvastatin 20mg 748.75 0.82 613.97
-
-
-
-
23,552.77
(Total Amount in words) Twenty Three Thousand Five Hundred Fifty Two Pesos & 78/100
Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor

Date
Lot # 2
PURCHASE ORDER
Supplier EXECOM COMPUTER SALES AND SERVICES P.O. No.
Address Maramag, Bukidnon Date
TIN
Gentlemen:
contained herein:
1 unit Communication Equipment 19 15,000.00 285,000.00

Specs.
5,5 inch Full HD TFT display, 401 ppi
2.5 Gorilla Glass 4
1.6 GHz Samsung Exynos 7870 octa-core CPU
Mali- T830 GPU
3GB RAM
32 G Internal storage
Expandable via microSD card, up to 256GB
13 MP autofocus rear camera w/LED flash
8 MP wide-angle front camera
4GB LTE
Wi-fi 802,11 b/g/n
Bluetooth 4.1
GPS w/ A-GPS, Glonass
Fingerprint scanner
3300 mAh battery
Android 6.0.1 Marmallow w/ Touch Wiz
P 285,000.00
(Total Amount in words) Two Hundred Eighty Five Thousand Pesos
Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor
EXECOM COMPUTER SALES AND SERVICES

Date
PURCHASE ORDER
Supplier DAVAO G.H. ENTERPRISES, INC. P.O. No.
Address Davao City Date
TIN
Gentlemen:
contained herein:
1 54 Panels Partition with Glass and Strip, 1 1,358,000.00 1,358,000.00

1200 Meters High, Laminate Partition with
17 Panels Table Top, Melamine Board -
Finish, 25mm with PVC Edging -
Finish with Drawers
with Chrome Legs
Board Finish
Finish
6 Units Sofa Bench with Cushion P 1,358,000.00
(Total Amount in words) One Million Three Hundred Fifty Eight Thousand Pesos
Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor
DAVAO G.H. ENTERPRISES, INC.

Date
Lot # 2
PURCHASE ORDER
Supplier BOSTON HOME INCORPORATED P.O. No.
Address Quezon City Date
TIN
Gentlemen:
contained herein:
1 pcs Hard Hat 27 4,980.00 134,460.00

Specs -
CE ANSI 289 1-2009 -
TYPE 1, CLASS E -
-
2 pcs Head Lamp 30 1,980.00 59,400.00
Specs:
120 LUMENS
Battery Compability
Rechageable NIRIMH litium
CE , 1p x 4 (water resist)
P 193,860.00
(Total Amount in words) One Hundred Ninety Three Thousand Eight Hundred Sixty Pesos
Very truly yours,
GREGORIO LLOREN GUE

Municipal Mayor
BOSTON HOME INCORPORATED

Date
Lot # 2
PURCHASE ORDER
Supplier BOSTON HOME INCORPORATED P.O. No.
Address Quezon City Date
TIN
Gentlemen:
contained herein:
1 pcs First Aid Shoulder Bag 7 25,660.00 179,620.00

* water resistant
* five internal storage compartments -
* double zipper closure -
* adjustable shoulder strap -
2 pair Rescue and Work Chukka Boots 29 6,400.00 185,600.00
* lunar grain water proof cowhide leather -
w/soft leather collar -
* natural suede split leater inside -
* easy lacing eyelet-hook -
* removable insole -
* dual density sole w/ midsole & toecap -
3 pc Rechargeable High Performance Led Lighting System 1 88,648.00 88,648.00
* high performance LED portable worklight -
* rechargeable w/coloured flash lights and -
estension poles -
* working height up to 1.8 m -
* coloured flash lights can be changed from white, -
red, green, and amber. -
4 pc Automated External Defibrillator 1 180,000.00 180,000.00
* samaritan PAD 500P -
5 pair Operator Gloves Rescue 29 6,300.00 182,700.00
* palm made of KEVLAR -
* w/silicon-carbon- coating -
* reinforced w/ pads of blended KEVLAR fabric -
w/ high abrasion level -
6 pcs Rescue Pants 29 2,000.00 58,000.00
7 pcs Handheld Radio w/ Speaker MIC 35 9,980.00 349,300.00
8 pcs Radio Mobile Antenna 10 2,500.00 25,000.00
P 1,248,868.00
(Total Amount in words) One Million Two Hundred Forty Eight Thousand Eight Hundred Sixty Eight Pesos
Very truly yours,

GREGORIO LLOREN GUE
Municipal Mayor
BOSTON HOME INCORPORATED

Date

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MUNICIPAL GOVERNMENT OF QUEZON Project reference Number

Name of the Project

NOTE: 1. ALL ENTRIES MUST BE TYPEWRITTEN

Printed Name / Signature

_________________________ Tel No. / Cellphone No./

Standard Form Number: SF-GOOD-60

JOSE I. ILAR, CE; GE

Cellphone No./ _________________________

MUNICIPAL GOVERNMENT OF QUEZON

Standard Form Number: SF-GOOD-60

NOTE: 1. ALL ENTRIES MUST BE TYPEWRITTEN

JOSE I. ILAR, CE; GE

DESCRIPTION QTY. UNIT PRICE

Printed Name / Signature

_________________________ Tel No. / Cellphone No./

AL GOVERNMENT OF QUEZON Project reference Number

JOSE I. ILAR, CE; GE

DESCRIPTION QTY. UNIT PRICE

Printed Name / Signature

_________________________ Tel No. / Cellphone No./

JOSE I. ILAR, CE; GE

JOSE I. ILAR, CE; GE

ITEM QTY. UNIT PRICE

_________________________ Tel No. / Cellphone No./

JOSE I. ILAR, CE; GE

ITEM QTY. UNIT PRICE

_________________________ Tel No. / Cellphone No./

JOSE I. ILAR, CE; GE

ITEM QTY. UNIT PRICE

Printed Name / Signature

_________________________ Tel No. / Cellphone No./

JOSE I. ILAR, CE; GE

_________________________ Tel No. / Cellphone No./

JOSE I. ILAR, CE; GE

Printed Name / Signature

_________________________ Tel No. / Cellphone No./

1. ALL ENTRIES MUST BE TYPEWRITTEN

Printed Name / Signature

_________________________ Tel No. / Cellphone No./

JOSE I. ILAR, CE; GE

ITEM UNIT QTY. UNIT PRICE

at prices noted above.

Tel No. / Cellphone No./

JOSE I. ILAR, CE; GE

ITEM Unit QTY. UNIT PRICE

at prices noted above.

Tel No. / Cellphone No./

JOSE I. ILAR, CE; GE

ITEM Unit QTY. UNIT PRICE

at prices noted above.

Tel No. / Cellphone No./

JOSE I. ILAR, CE; GE

ITEM Unit QTY. UNIT PRICE

at prices noted above.

Tel No. / Cellphone No./

JOSE I. ILAR, CE; GE

at prices noted above.

Tel No. / Cellphone No./

JOSE I. ILAR, CE; GE

ITEM Unit QTY. UNIT PRICE

at prices noted above.

Tel No. / Cellphone No./

JOSE I. ILAR, CE; GE