ABSTRACT OF PERSONAL CANVASS/ BIDS FOR THE SUPPLY AND DELIVERY

PR No.
ABSTRACT OF BIDS OPENED ON: ,2018. TIME: AM/PM
IN THE BAC OFFICE, TAMPILISAN, ZAMBOANGA DEL NORTE.
Article/ Services Requisitioned DEALERS FURNISHED
JTHREE ENTERPRISES RK Enterprises Henrose Enterprises
Q U AN T I T Y
ITEM NO. DESCRIPTION Poblacion,Tampilisan Fatima Liloy, Z.N. Ipi, Zambo. Sibugay
No. Unit of Issue Unit Price Total Amount Unit Price Total Amount Unit Price Total Amount
1 30 pcs. Tarpaulin 2x3 190.00 5,700.00 195.00 5,850.00 235.00 7,050.00
2 10 pcs. Tarpaulin plywood size 750.00 7,500.00 845.00 8,450.00 850.00 8,500.00
3 2 pcs. Tarpaulin 4x16 ft 1,400.00 2,800.00 1,450.00 2,900.00 1,355.00 2,710.00

THIS IS TO CERTIFY that the requirements of R.A. No. 9184 otherwise known Total 16,000.00 Total 17,200.00 Total 18,260.00
as the Government Procurement Reform Act ( Rule XVI - Sec.52 ) had been complied with. WE HEREBY CERTIFY to the correctness and authenticity of the above Abstract
of Bids to the best of our knowledge.

CARMEL MATHILDA B. LADEZA ADELBERTO G. SAMUYA

BIDS AND AWARDS COMMITTEE: Municipal Health Officer Municipal Civil Registrar
(Requesting Officer) ( Member )

VIGILUS D. CREDO GRACE A. GUMANSING GODFREY B. GIMON RENE R. MANAIT

Municipal Engineer Municipal Budget Officer Municipal Assessor MPDC
(Chairman) ( Vice Chairman ) ( Member ) ( Member )
16,000.00 17,200.00 18,260.00
 ABSTRACT OF PERSONAL CANVASS/ BIDS FOR THE SUPPLY AND DELIVERY
PR No.
ABSTRACT OF BIDS OPENED ON: ,2018. TIME: AM/PM
IN THE BAC OFFICE, TAMPILISAN, ZAMBOANGA DEL NORTE.
Article/ Services Requisitioned DEALERS FURNISHED
RIE ENTERPRISES TAMPILISAN CONS. Subing Subing
Q U AN T I T Y
ITEM NO. DESCRIPTION Poblacion,Tampilisan Poblacion,Tampilisan Poblacion,Tampilisan
No. Unit of Issue Unit Price Total Amount Unit Price Total Amount Unit Price Total Amount
1 6 length GI Pipe S-40 1 1/2"X 6m 881.92 5,291.52 - 770.00 4,620.00
2 9 length 9mm square bar x6 m 98.58 887.22 - 160.00 1,440.00
3 8 length 10mm deformed steel bar 169.60 1,356.80 180.83 1,446.64 165.00 1,320.00
4 6 bags Portland cement/Premium 268.18 1,609.08 262.15 1,572.90 250.00 1,500.00
5 5 cum mixed sand 850.00 4,250.00 - 1,300.00 6,500.00
6 2 liters metal primer 132.50 265.00 159.43 318.86 160.00 320.00
7 6 sheets plain sheet 219.42 1,316.52 187.25 1,123.50 270.00 1,620.00
8 20 pcs. 4'x8'x1/4' ordinary plywood 375.00 7,500.00 - 300.00 6,000.00
9 166.67 bd. Ft 1"x2"x8 good lumber 31.00 5,166.77 - - -
10 1 kl. welding rod 74.20 74.20 85.60 85.60 80.00 80.00
11 3 kls cw.nails 58.30 174.90 58.85 176.55 60.00 180.00
12 1 liter paint thinner 37.10 37.10 58.85 58.85 60.00 60.00
13 2 kls. tie wire 77.38 154.76 - - 80.00 160.00

THIS IS TO CERTIFY that the requirements of R.A. No. 9184 otherwise known Total 28,083.87 Total 4,782.90 Total 23,800.00
as the Government Procurement Reform Act ( Rule XVI - Sec.52 ) had been complied with. WE HEREBY CERTIFY to the correctness and authenticity of the above Abstract
of Bids to the best of our knowledge.

CARMEL MATHILDA B. LADEZA ADELBERTO G. SAMUYA

BIDS AND AWARDS COMMITTEE: Municipal Health Officer Municipal Civil Registrar
(Requesting Officer) ( Member )

VIGILUS D. CREDO GRACE A. GUMANSING GODFREY B. GIMON RENE R. MANAIT

Municipal Engineer Municipal Budget Officer Municipal Assessor MPDC
(Chairman) ( Vice Chairman ) ( Member ) ( Member )
28,083.87 4,782.90 23,800.00
 PURCHASE ORDER
Tampilisan, Zamboanga del Norte
LGU
Supplier JTHREE ENTERPRISES P.O. No.
Address Pob. Tampilisan, Z.N. Date
Mode of Procurement:
Gentlemen:
Please furnish this office the following articles subject to the terms and conditions contained herein:

Place of Delivery: RHU Delivery Term:

Date of Delivery: Immediately Payment Term:

Item No. Unit Quantity Item Description Unit Cost Amount

1 pcs. 30 Tarpaulin 2x3 190.00 5,700.00
2 pcs. 10 Tarpaulin plywood size 750.00 7,500.00
3 pcs. 2 Tarpaulin 4x16 ft 1,400.00 2,800.00

(Total Amount in Words) 16,000.00

In case of failure to make the full delivery within the time specified above, a penalty of one-tenth (1/10)
of one percent for every day of delay shall be imposed.
Very truly yours,
Conforme:
ANGELES R. CARLOTO II
JTHREE ENTERPRISES Municipal Mayor
(Signature Over Printed Name) (Authorized Official)

Date
(In case of Negotiated Purchase pursuant toSection 369 (a) of RA 7160, this portion must
be accomplished).

Approved to be purchased thru negotiated

purchase per Sanggunian Res. No. ______.

Certified Correct:

Secretary to the Sanggunian Date:

 0

0
0

16,000.00
 PURCHASE ORDER
Tampilisan, Zamboanga del Norte
LGU
Supplier RIO ENTERPRISES P.O. No.
Address Pob. Tampilisan, Z.N. Date
Mode of Procurement:
Gentlemen:
Please furnish this office the following articles subject to the terms and conditions contained herein:

Place of Delivery: Dep Ed Delivery Term:

Date of Delivery: Immediately Payment Term:

Item No. Unit Quantity Item Description Unit Cost Amount

1 length 6 GI Pipe S-40 1 1/2"X 6m 881.92 5,291.52
2 length 9 9mm square bar x6 m 98.58 887.22
3 length 8 10mm deformed steel bar 169.60 1,356.80
4 bags 6 Portland cement/Premium 268.18 1,609.08
5 cum 5 mixed sand 850.00 4,250.00
6 liters 2 metal primer 132.50 265.00
7 sheets 6 plain sheet 219.42 1,316.52
8 pcs. 20 4'x8'x1/4' ordinary plywood 375.00 7,500.00
9 bd. Ft 166.67 1"x2"x8 good lumber 31.00 5,166.77
10 kl. 1 welding rod 74.20 74.20
11 kls 3 cw.nails 58.30 174.90
12 liter 1 paint thinner 37.10 37.10
13 kls. 2 tie wire 77.38 154.76

(Total Amount in Words) 28,083.87

In case of failure to make the full delivery within the time specified above, a penalty of one-tenth (1/10)
of one percent for every day of delay shall be imposed.
Very truly yours,
Conforme:
ANGELES R. CARLOTO II
RIO ENTERPRISES Municipal Mayor
(Signature Over Printed Name) (Authorized Official)

Date
(In case of Negotiated Purchase pursuant toSection 369 (a) of RA 7160, this portion must
be accomplished).

Approved to be purchased thru negotiated

purchase per Sanggunian Res. No. ______.

Certified Correct:

Secretary to the Sanggunian Date:

 0

0
0

28,083.87
 ABSTRACT OF PERSONAL CANVASS/ BIDS FOR THE SUPPLY AND DELIVERY
PR No.
ABSTRACT OF BIDS OPENED ON: ,2018. TIME: AM/PM
IN THE BAC OFFICE, TAMPILISAN, ZAMBOANGA DEL NORTE.
Article/ Services Requisitioned DEALERS FURNISHED
NORJUN ENTERPRISES DESOY ENTERPRISES RIO ENTERPRISES
Q U AN T I T Y
ITEM NO. Poblacion,Tampilisan Poblacion,Tampilisan Poblacion,Tampilisan
No. Unit of Issue Unit Price Total Amount Unit Price Total Amount Unit Price Total Amount
1 8 gal Latex gloss 740.00 5,920.00 745.00 5,960.00 750.00 6,000.00
2 7 bags Cement 280.00 1,960.00 285.00 1,995.00 290.00 2,030.00
3 3 pcs. Roller Paint Brush #4 75.00 225.00 75.00 225.00 75.00 225.00
4 1 pcs. Paint Thinner 570.00 570.00 570.00 570.00 570.00 570.00
5 3 pcs. Paint Brush #2 50.00 150.00 50.00 150.00 50.00 150.00
6 4 can Tinting color red 80.00 320.00 80.00 320.00 80.00 320.00
7 4 can Tinting color blue 80.00 320.00 80.00 320.00 80.00 320.00
8 4 can Tinting color hanza yellow 80.00 320.00 80.00 320.00 80.00 320.00
9 4 can Tinting color rosena 80.00 320.00 80.00 320.00 80.00 320.00
10 5 can Tinting color black 80.00 400.00 80.00 400.00 80.00 400.00
11 4 can Tinting color yellow 80.00 320.00 80.00 320.00 80.00 320.00
12 1 meter sand paper butterfly 420.00 420.00 420.00 420.00 420.00 420.00
13 3 pcs. electrical tape 60.00 180.00 60.00 180.00 60.00 180.00
14 2 can solvent 1/4 Dye tax 140.00 280.00 140.00 280.00 140.00 280.00
15 4 gal Roof paint baguio green 770.00 3,080.00 780.00 3,120.00 770.00 3,080.00
16 10 pcs. 50watts Bulb Led 230.00 2,300.00 230.00 2,300.00 230.00 2,300.00

THIS IS TO CERTIFY that the requirements of R.A. No. 9184 otherwise known Total 17,085.00 Total 17,200.00 Total 17,235.00
as the Government Procurement Reform Act ( Rule XVI - Sec.52 ) had been complied with. WE HEREBY CERTIFY to the correctness and authenticity of the above Abstract
of Bids to the best of our knowledge.

ANGELES R. CARLOTO II ADELBERTO G. SAMUYA

BIDS AND AWARDS COMMITTEE: Municipal Mayor Municipal Civil Registrar
(Requesting Officer) ( Member )

VIGILUS D. CREDO GRACE A. GUMANSING GODFREY B. GIMON RENE R. MANAIT

Municipal Engineer Municipal Budget Officer Municipal Assessor MPDC
(Chairman) ( Vice Chairman ) ( Member ) ( Member )
17,085.00 17,200.00 17,235.00
 ABSTRACT OF PERSONAL CANVASS/ BIDS FOR THE SUPPLY AND DELIVERY
PR No.
ABSTRACT OF BIDS OPENED ON: ,2017. TIME: AM/PM
IN THE BAC OFFICE, TAMPILISAN, ZAMBOANGA DEL NORTE.
Article/ Services Requisitioned DEALERS FURNISHED
Tamp. Cons. Supply & Hauling Norjun Enterprises RIO ENTERPRISES
Q U AN T I T Y
ITEM NO. DESCRIPTION Poblacion,Tampilisan Poblacion,Tampilisan Poblacion,Tampilisan
No. Unit of Issue Unit Price Total Amount Unit Price Total Amount Unit Price Total Amount
1 15 mtrs. PDX Wire #12 62.00 930.00 63.00 945.00 64.00 960.00
2 1 box Staple Wire#1 69.00 69.00 71.00 71.00 72.00 72.00
3 1 roll Armak Electrical tape 39.00 39.00 39.00 39.00 41.00 41.00

THIS IS TO CERTIFY that the requirements of R.A. No. 9184 otherwise known Total 1,038.00 Total 1,055.00 Total 1,073.00
as the Government Procurement Reform Act ( Rule XVI - Sec.52 ) had been complied with. WE HEREBY CERTIFY to the correctness and authenticity of the above Abstract
of Bids to the best of our knowledge.

ANNGELES R. CARLOTO II ADELBERTO G. SAMUYA

BIDS AND AWARDS COMMITTEE: Municipal Mayor Municipal Civil Registrar
(Requesting Officer) ( Member )

VIGILUS D. CREDO GRACE A. GUMANSING GODFREY B. GIMON RENE R. MANAIT

Municipal Engineer Municipal Budget Officer Municipal Assessor MPDC
(Chairman) ( Vice Chairman ) ( Member ) ( Member )
1,038.00 1,055.00 1,073.00
 ABSTRACT OF PERSONAL CANVASS/ BIDS FOR THE SUPPLY AND DELIVERY
PR No.
ABSTRACT OF BIDS OPENED ON: ,2016. TIME: AM/PM
IN THE BAC OFFICE, TAMPILISAN, ZAMBOANGA DEL NORTE.

Article/ Services Requisitioned DEALERS FURNISHED

Remlits Enterprises Jeroline Canoy Enterprises Mengie Store
Q U AN T I T Y
ITEM NO. DESCRIPTION Pob. Tampilisan, Z.N. Pob. Tampilisan, Z.N. Pob. Tampilisan,Z.N.
No. Unit of Issue Unit Price Total Amount Unit Price Total Amount Unit Price Total Amount
1 3 sacks Potash Fertilizer 1,200.00 3,600.00 1,200.00 3,600.00 1,200.00 3,600.00
2 3 sacks Urea Fertilizer 1,050.00 3,150.00 1,075.00 3,225.00 1,050.00 3,150.00
3 3 sacks 14-14-14 Fertilizer 1,100.00 3,300.00 1,100.00 3,300.00 1,150.00 3,450.00
4 3 sacks Ammunium Fertilizer 800.00 2,400.00 800.00 2,400.00 800.00 2,400.00
5 5 packs Foliar (Grow More) 260.00 1,300.00 250.00 1,250.00 260.00 1,300.00
6 10 packs Kamatis 50.00 500.00 50.00 500.00 50.00 500.00
7 10 packs Choy FI 50.00 500.00 50.00 500.00 50.00 500.00
8 10 packs Mestisa FI 50.00 500.00 50.00 500.00 50.00 500.00
9 10 packs Kangkong (tsina) 50.00 500.00 50.00 500.00 50.00 500.00
10 10 packs Pantastiko 50.00 500.00 50.00 500.00 50.00 500.00
11 10 packs Patola 50.00 500.00 50.00 500.00 50.00 500.00
12 10 packs Yellow Squash 50.00 500.00 50.00 500.00 50.00 500.00
13 10 packs Eggplant 50.00 500.00 50.00 500.00 50.00 500.00
14 10 packs Okra 50.00 500.00 50.00 500.00 50.00 500.00
15 10 packs Sibuyas(green onion) 30.00 300.00 30.00 300.00 30.00 300.00
16 10 packs Luy-a 80.00 800.00 80.00 800.00 80.00 800.00
17 1 Lit. Cymbush 1,200.00 1,200.00 1,200.00 1,200.00 1,200.00 1,200.00
18 1 Lit. Fungicide 800.00 800.00 800.00 800.00 800.00 800.00
19 10 kilos Strawless 70.00 700.00 75.00 750.00 70.00 700.00
20 10 kilos Nylon 200.00 2,000.00 200.00 2,000.00 200.00 2,000.00
21 1 pc. Weighing Scale 800.00 800.00 800.00 800.00 800.00 800.00

THIS IS TO CERTIFY that the requirements of R.A. No. 9184 otherwise known Total 24,850.00 Total 24,925.00 Total 25,000.00
as the Government Procurement Reform Act ( Rule XVI - Sec.52 ) had been complied with. WE HEREBY CERTIFY to the correctness and authenticity of the above Abstract
of Bids to the best of our knowledge.

ANTONIO S. GUMELA,EM.D. GRACE A. GUMANSING

BIDS AND AWARDS COMMITTEE: Public School District Supervisor Municipal Budget Officer
(Requesting Officer) ( Member )

VIGILUS D. CREDO ADELBERTO G. SAMUYA OLIVIA G. EBORDE RENE R. MANAIT

Municipal Engineer Municipal Civil Registrar Municipal Treasurer MPDC
(Chairman) ( Vice Chairman ) ( Member ) ( Member )
24,850.00 24,925.00 25,000.00
LGU - TAMPILISAN Purchase Request No.
Bids And Awards Committee Office of the: RHU
Tampilisan, Zambo. Norte
REQUEST FOR QUOTATION
Date: ____________________
Quotation No.______________

Please quote your lowest price on the item/s listed below, subject to the General Condition on the
Philippine Bidding Documents on Goods, stating the shortest time of delivery and submit your quotation duly
signed by your representative not later than ________________________.

VIGILUS D. CREDO
NOTE: BAC Chairman
1. ALL ENTRIES MUST BE TYPEWRITTEN
2. DELIVERY PERIOD WITHIN SEVEN (7) CALENDAR DAYS
3. WARRANTY SHALL BE FOR A PERIOD OF THREE (3) 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 THIRTY (30) CALENDAR DAYS
5. G-EPS REGISTRATION CERTIFICATE SHALL BE ATTACHED UPON SUBMISSION OF THE QUOTATION, IF AVAILABLE.
6. BIDDERS SHALL SUBMIT ORIGINAL BROCHURES SHOWING CERTIFICATIONS OF THE PRODUCT BEING OFFERED.
ITEM
ITEM & DESCRIPTION QTY. Unit Unit Price TOTAL
NO.
1 Anesthesia Dental 40 box
2 Dental needle 15 box
3 Clean gloves 15 box
4 Face mask 12 box
5 cotton roll 5
6 lysol gal 1
7 rubbing alcohol 9 pcs.

Brand and Model

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.

Date
1 CART Epson t6641 black 500 500.00
5 Cactus Long 198 990.00
5 Cactus Short 178 890.00
2,380.00
 PURCHASE REQUEST
Tampilisan, Zamboanga del Norte
LGU
PR No.: Date:
Department: Dep Ed SAI No.: Date:
Section: OR No. Date:

Item Unit of Estimated Estimated

Quantity Item Description
No. Issue Unit Cost Cost
1 15 bags Portland cement 290.00 4,350.00
2 500 pcs. 4" CHB 15.00 7,500.00
3 20 pcs. 1/4 Marine Plywood 550.00 11,000.00
4 10 L DSB 10 mm 180.00 1,800.00
5 15 L DSB 8 mm 170.00 2,550.00
6 4 kls. cw nails #1 90.00 360.00
7 2 kls. cw nails #2 90.00 180.00
8 3 kls. cw nails #3 90.00 270.00
9 3 kls. cw nails #4 90.00 270.00
10 2 kls. #16 Tie wire 100.00 200.00
11 5 cu.m. mixed sand 900.00 4,500.00
12 3 cu.m. fine aggregates 850.00 2,550.00
13 2 gal. latex paint 650.00 1,300.00
14 2 gal. gloss latex paint 700.00 1,400.00
15 2 gal. enamel paint 700.00 1,400.00

39,630.00

Purpose: Repair of School Classrooms of Central Ementary School

Requested by: Cash Availability: Approved by:

Signature:
Printed Name: ANTONIO S. GUMELA,EM.D. PRAXIDES C. ARCINO ANGELES R. CARLOTO II
Designation: Public School District Supervisor OIC-Municipal Treasurer Municipal Mayor
 1963.42

32.757

(19,630.00)
982.71

35.10

39,630.00 35.0967857

1965.42

982.71
 PURCHASE ORDER
Tampilisan, Zamboanga del Norte
LGU
Supplier NORJUN ENTERPRISES P.O. No.
Address Pob. Tampilisan, Z.N. Date
Mode of Procurement:
Gentlemen:
Please furnish this office the following articles subject to the terms and conditions contained herein:

Place of Delivery: Dep Ed Delivery Term:

Date of Delivery: Immediately Payment Term:

Item No. Unit Quantity Item Description Unit Cost Amount

1 gal 8 Latex gloss 740.00 5,920.00
2 bags 7 Cement 280.00 1,960.00
3 pcs. 3 Roller Paint Brush #4 75.00 225.00
4 pcs. 1 Paint Thinner 570.00 570.00
5 pcs. 3 Paint Brush #2 50.00 150.00
6 can 4 Tinting color red 80.00 320.00
7 can 4 Tinting color blue 80.00 320.00
8 can 4 Tinting color hanza yellow 80.00 320.00
9 can 4 Tinting color rosena 80.00 320.00
10 can 5 Tinting color black 80.00 400.00
11 can 4 Tinting color yellow 80.00 320.00
12 meter 1 sand paper butterfly 420.00 420.00
13 pcs. 3 electrical tape 60.00 180.00
14 can 2 solvent 1/4 Dye tax 140.00 280.00
15 gal 4 Roof paint baguio green 770.00 3,080.00
16 pcs. 10 50watts Bulb Led 230.00 2,300.00

(Total Amount in Words) 17,085.00

In case of failure to make the full delivery within the time specified above, a penalty of one-tenth (1/10)
of one percent for every day of delay shall be imposed.
Very truly yours,
Conforme:
ANGELES R. CARLOTO II
NORJUN ENTERPRISES Municipal Mayor
(Signature Over Printed Name) (Authorized Official)

Date
(In case of Negotiated Purchase pursuant toSection 369 (a) of RA 7160, this portion must
be accomplished).

Approved to be purchased thru negotiated

purchase per Sanggunian Res. No. ______.

Certified Correct:

Secretary to the Sanggunian Date:

17,085.00
 Republic of the Philippines
PROVINCE OF ZAMBOANGA DEL NORTE
MUNICIPALITY OF TAMPILISAN

No.:
OBLIGATION REQUEST
PAYEE LLOYD P. GONZALES
OFFICE
ADDRESS MALILA Tampilisan, Z.N.

Responsibilit ACCOUNT
PARTICULARS F.P.P AMOUNT
y Center CODE
Php 23,750.00

Labor for Singage (No Smoking)

TOTAL Php 23,750.00

A. CERTIFIED: B. CERTIFIED:
X Charges to appropriation/allotment necessary,
lawful and under my direct supervision Existence of available appropriation
Supporting documents valid, proper and legal

Signature Over Signature Over

Printed Name CARMEL MATHILDA B. LADEZA Printed Name GRACE A. GUMANSING
Position Municipal Health Officer Position Municipal Budget Officer
Date Date

Republic of the Philippines

PROVINCE OF ZAMBOANGA DEL NORTE
MUNICIPALITY OF TAMPILISAN

No.:
OBLIGATION REQUEST
PAYEE LLOYD P. GONZALES
OFFICE
ADDRESS MALILA Tampilisan, Z.N.

Responsibilit ACCOUNT
PARTICULARS F.P.P AMOUNT
y Center CODE
Php 23,750.00

Labor for Singage (No Smoking)

TOTAL Php 23,750.00

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

Signature Over Signature Over

Printed Name CARMEL MATHILDA B. LADEZA Printed Name GRACE A. GUMANSING
Position Municipal Health Officer Position Municipal Budget Officer
Date Date
 Republic of the Philippines
PROVINCE OF ZAMBOANGA DEL NORTE
MUNICIPALITY OF TAMPILISAN

DISBURSEMENT VOUCHER No.

MODE OF Check Cash Other

PAYMENT

PAYEE NORJUN ENTERPRISES TIN/Employee No.: Obligation Request No.

RESPONSIBILITY CENTER
ADDRESSPob. Tampilisan, Z.N.
Office/Unit/Project: Code:
EXPLANATION AMOUNT
To payment of supplies for minor repair /improvement of Situbo National High
School ,Tampilisan,
Tampilisan ZamboangaZamobanga del
del Norte Norte
per per supporting
supporting papersattached
papers,hereto hereto attached
in the
in the amount
total amount …..of…….
Php 17,085.00

Less: 17,085.00 x 4% 683.40

Total Amount due this Voucher . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Php 16,401.60

A CERTIFIED: B CERTIFIED:

Funds Available
Supporting documents complete and paper

Signature Signature
Printed Date: Printed Date:
SHERRY LOU P. DAPROSA CYNTHIA D.A BIL
Name Name
Municipal Accountant Acting Municipal Treasurer
Position Position
(Head,Accounting Unit/Authorized Representative) (Head,Treasury Unit/Authorized Representative)
APPROVED FOR PAYMENT: RECEIVED PAYMENT:
C D
Signature Check No.: Bank Name: Date:
Printed Date: Signature
ANGELES R. CARLOTO II
Name Printed Nam NORJUN ENTERPRISES Date:
Municipal Mayor OR. No./Other Documents JEV No. Date:
Position
(Local Chief Executive/Authorized Representative)

FOR ACCOUNTING/PRE-AUDIT PERSONNEL USE ONLY:

CHECKLIST: MANDATORY MINIMUM SUPPORTING DOCUMENTS FOR COMMON TRANSACTIONS
(Maintenance & Other Operating Expenses/Capital Outlay)
I. TRAVELS 2 ALTERNATIVE MODE OF PROCUREMENT
Travel Order or Memorandum by the LCE authorizing the travel 2.a
Approved Itinerary (Appendix A) Purchase Request
Tickets (Original) for Plane, Bus, Ships Fare or equivalent Purchase Order/Letter Order/Contract,duly received
Certificate of Travel Completed (Appendix B) by bidder/supplier
Certificate of Appearance (Appendix C), or its equivalent Certificate of Acceptance
Liquidation Report-in case of cash advance Inspection Report/Waiver of Inspection
Receipts, in case of actual travel claims Result of Test Analysis (if subject to test)
Original Invoice:
Accomplishment Report -Charge Invoice/Sales Invoice
RER (optional)-For reimb. Of expenses above P 75.00 (COA Cir. 96-005 -Delivery Receipt
II. PURCHASES Canvass sheet/price quotation
1 COMPETITIVE BIDDING: Abstract/summary of canvass
Purchase Request (PR)/RIS-Original Certificate of emergency purchase-in the absence of
Purchase Order (PO)/Letter Order (LO)/Contract, duly received by canvass if amount is below 1,000.00
bidder 2.b NEGOTIATED PROCUREMENT/NEGOTIATED CONTRACT
Inspection and Acceptance Report/Waiver of Inspection Negotiated Procurement:
Original Invoice: Purchase Request
Delivery Receipt Purchase Order/Letter Order/Contract(contract)
Sales Invoice/Charge Invoice duly received by bidder/supplier
Stock Position Sheet Certificate of Authority to negotiate/enter into negotiated
Result of test analysis by proper government, if subject to test contract.
Copy of Advertisement/Invitation to bid Delivery Receipt
Bidder's Bond Sales Invoice/Original Invoice
Notice/Letter of Award Certificate of Acceptance & Inspection Report
Performance Bond Result of Test Analysis (if subject to test)
Abstract of Bids supported by: Certificate of failure of bidding for the second time from BAC
Bid tenders of other participants Canvass sheet/price quotation
Acceptance of bid/proposal Abstract/summary of canvass
BAC recommendation-Award of the LCRB/HRRB to the LCE Negotiated Contract: (in addition to the above)
TWG recommendation Notice to commence to work
VE MODE OF PROCUREMENT

hority to negotiate/enter into negotiated

ure of bidding for the second time from BAC

***Computation***
Php #REF!
 ABSTRACT OF PERSONAL CANVASS/ BIDS FOR THE SUPPLY AND DELIVERY
PR No.
ABSTRACT OF BIDS OPENED ON: ,2018. TIME: AM/PM
IN THE BAC OFFICE, TAMPILISAN, ZAMBOANGA DEL NORTE.
Article/ Services Requisitioned DEALERS FURNISHED
RIE ENTERPRISES TAMPILISAN CONS. Subing Subing
Q U AN T I T Y
ITEM NO. DESCRIPTION Poblacion,Tampilisan Poblacion,Tampilisan Poblacion,Tampilisan
No. Unit of Issue Unit Price Total Amount Unit Price Total Amount Unit Price Total Amount
1 6 length GI Pipe S-40 1 1/2"X 6m 881.92 5,291.52 - 770.00 4,620.00
2 9 length 9mm square bar x6 m 98.58 887.22 - 160.00 1,440.00
3 8 length 10mm deformed steel bar 169.60 1,356.80 180.83 1,446.64 165.00 1,320.00
4 6 bags Portland cement/Premium 268.18 1,609.08 262.15 1,572.90 250.00 1,500.00
5 5 cum mixed sand 850.00 4,250.00 - 1,300.00 6,500.00
6 2 liters metal primer 132.50 265.00 159.43 318.86 160.00 320.00
7 6 sheets plain sheet 219.42 1,316.52 187.25 1,123.50 270.00 1,620.00
8 20 pcs. 4'x8'x1/4' ordinary plywood 375.00 7,500.00 - 300.00 6,000.00
9 166.67 bd. Ft 1"x2"x8 good lumber 31.00 5,166.77 - - -
10 1 kl. welding rod 74.20 74.20 85.60 85.60 80.00 80.00
11 3 kls cw.nails 58.30 174.90 58.85 176.55 60.00 180.00
12 1 liter paint thinner 37.10 37.10 58.85 58.85 60.00 60.00
13 2 kls. tie wire 77.38 154.76 - - 80.00 160.00

THIS IS TO CERTIFY that the requirements of R.A. No. 9184 otherwise known Total 28,083.87 Total 4,782.90 Total 23,800.00
as the Government Procurement Reform Act ( Rule XVI - Sec.52 ) had been complied with. WE HEREBY CERTIFY to the correctness and authenticity of the above Abstract
of Bids to the best of our knowledge.

CARMEL MATHILDA B. LADEZA ADELBERTO G. SAMUYA

BIDS AND AWARDS COMMITTEE: Municipal Health Officer Municipal Civil Registrar
(Requesting Officer) ( Member )

VIGILUS D. CREDO GRACE A. GUMANSING GODFREY B. GIMON RENE R. MANAIT

Municipal Engineer Municipal Budget Officer Municipal Assessor MPDC
(Chairman) ( Vice Chairman ) ( Member ) ( Member )
28,083.87 4,782.90 23,800.00
 INSPECTION & ACCEPTANCE REPORT
Tampilisan,Zamboanga del Norte
LGU
Supplier JTHREE ENT. O.R. No.
PO No. Date Invoice No. Date
Requesitioning Office/Dept. RHU

Item No. Unit Description of Supplies Quantity Unit Cost Total

1 pcs. Tarpaulin 2x3 30 190.00 5,700.00
2 pcs. Tarpaulin plywood size 10 750.00 7,500.00
3 pcs. Tarpaulin 4x16 ft 2 1,400.00 2,800.00

16,000.00
INSPECTION ACCEPTANCE
Date Received:
Inspected, verified and found OK X Complete
as to quantity and specifications. Partial

ALBERTO L. ACAS
Assessment Clerk II
X
MILLER B. MAGHANOY
CYNTHIA D. ABIL Admin. Aide VI/ GSO Designate
RCO II

LOLITA B. DELLABA CARMEL MATHILDA B. LADEZA,MD

Bookeeper II Head Teacher III