Republic of the Philippines

MUNICIPAL GOVERNMENT OF BAYAMBANG

Bayambang, Pangasinan
DISBURSEMENT VOUCHER No.

Mode of
Payment Check Cash X Others
TIN/Employee No. Obligation Request No.
Payee
Responsibility Center
Address Office/Unit/Project Code

EXPLANATION AMOUNT

To payment for the meals / snacks served during the inauguration ceremony of P 100,000.00
Newly constructed Rural Health Unit I, building as per attached supporting papers

A. Certified B. Certified
Allotment obligated for the purpose as indicated above Funds Available
Supporting documents complete

Signature Signature
Printed Date Printed Date
Name Name

Position MUNICIPAL ACCOUNTANT Position MUNICIPAL TREASURER

Head, Accounting Unit/Authorized Representative Treasurer/Authorized Representative
C. Approved for Payment D. Received Payment
Check No. Bank Name Date
Signature
Printed Date Signature
Name Printed Date
Name
Position OR/Other Documents JEV No. Date
MUNICIPAL MAYOR
Agency Head/Authorized Representative

Agency Head/Authorized Representative

 PURCHASE ORDER
BAYAMBANG
LGU
Supplier: P.O No.___________________
Date:_____________________
Mode of Procurement
Gentlemen:
Please furnish this office the following articles subject to the terms and condition
Contained herein

Place of Delivery:_____________________________________ Delivery Term:_____________

Date of Delivery:_____________________________________ Payment Term:_____________
Item
No. Unit Quantity Description Unit Cost Amount

1 pack 800 Meals with snacks 125.00 100,000.00

(Total Amount in Words) P 100,000.00

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 everyday of delay shall be imposed.
Conforme: Very truly yours,
( Signature over printed name)

______________________ (Authorized Official)

(Date)
(in case of Negotiated Purchase pursuant Requisitioning Office/Dep Funds Available:
to Section 369(a) or RA 7160, this portion
must be accomplished. Amount:
R.O. No.
Approved to be purchased thru negotiated
purchase per Sangunian Res. No.____

Certified Correct:__________________
Secretary to Sangunian (Authorized Official) (Chief Accountant)
 PURCHASE REQUEST
BAYAMBANG
LGU

Department: PR. No.__________Date:_________

Section:________________________ SAI. No._________ Date:_________
ALOBS. No._______Date:_________

Stock Estimated Estimated

Quantity Unit Item Description No. Unit Cost Cost
Issue

800 pack Meals with snacks 1

PURPOSE:
Requested by: Approved by:

Municipal Mayor
 INSPECTION & ACCEPTANCE REPORT
MUNICIPALITY OF BAYAMBANG
LGU
Supplier________ AR No. ________________
PO No. ________________ Date____________ Invoice No.___________ Date _______
Requisitioning Office/Dept. _________________________________________________

Item No. Unit Description Quantity

1 pack Meals with snacks 800

INSPECTION ACCEPTED
Date Inspected:_______________________ Date Received:___________________

Inspected, verified and found OK Complete

As to quantity ans specifications Partial

____________________
Inspection Officers Property Officer
 Republic of the Philippines
MUNICIPALITY OF BAYAMBANG
Province of Pangasinan

OFFICE OF THE TREASURER

NOTICE OF CANVASSING
(Address)

SIR:
PLEASE QUOTE YOUR PRICES ON THE FOLLOWING

QUANTITY UNIT TOTAL

COST

Please put you quotations in a sealed envelope and submit to this Office on……………………
to be opened at …………………………..am/p.m. in the presence of an interested bidders and to
be delivered immediately to the lowest bidders at the …………………………….
Pangasinan
ATTESTED: Very truly yours,

Municipaol Mayor
SIr:
My price for the above mentioned articles are as indicated above: