DISBURSEMENT VOUCHER

SK of Barangay: Veteranos DV No.:

City/Municipality: Alangalang Date:
Province: Leyte
Payee: Blessy Enterprises
Address: Alangalang, Leyte
TIN:
Particulars Amount
TO: Purchase for the Payment of School Supplies , as per supporting papers
here to attached in the amount of ……. ₱ 10,000.00
- 400.00

10,000.00*3%= 300
10,000.00*1%= 100
400

₱9, 600.00
Total
A. Certified as to availability of B. Certified as to availability of C. Certified as to necessity, validity,
the budget or funds received for cash, and completeness and propriety, and legality of claim; and
specific purpose propriety of supporting documents Approved for payment:

________________________ _________________________
(Signature Over Printed Name) (Signature Over Printed Name) (Signature Over Printed Name)
Budget Monitoring Officer SK Treasurer SK Chairperson

Date: Date: Date:

D. Received Paymet: Check No.:

Date:
BLESSY ENTERPRISES
Signature Over Printed Name of Payee/ Bank Name:
Authorized Representative
Bank Branch:
Date OR No.:
Date:
 PURCHASE REQUEST

SK of Barangay: Veteranos PR No.:

City/Municipality: Alangalang Date:
Province: Leyte
Item No. Qty. Unit of Item Description Estimated Unit Estimated
Measurement Cost Amount

1 2 Box Bond paper long 1,500.00 3,000.00

2 1 Box Bond paper short 1,500.00 1,500.00

3 1 Box Ballpen 120.00 120.00

4 12 Pcs Colored paper 15.00 180.00

5 1 box Pencil 125.00 125.00

6 4 Pcs Glue 35.00 140.00

7 3 Pcs Masking tape 35.00 105.00

8 2 Ream Folder long 500.00 1,000.00

9 1 Ream Folder short 500.00 500.00

10 13 Pcs Plastic folder 85.00 1,105.00

11 12 Pcs Brown envelope 45.00 1,540.00

12 12 Pcs Record book 120.00 1,440.00

13 1 Box Paper fastener 65.00 65.00

14 1 Box Sharpener 45.00 45.00

15 3 Pcs Scissor 45.00 135.00

Total Estimated Amount: 9,600.00

Purpose:
Requested by: Approved by:

_______________________
Signature over Printed Name Signature over Printed Name
SK Requesting Official SK Chairperson

Date Date

Republic of the Philippines

 OFFICE OF THE SK TREASURER
-0o0-
Barangay Veteranos
Alangalang, Leyte
(Municipality) (Province)

No.
Date:

CANVASS

Maam/Sir:
Please quote your unit prices for the articles described below with the request
That the desired condition and/or requirements herein be complied with:
ITEM QTY. UNIT ARTICLES BRAND UNIT TOTAL
NO. NAME COST
1 2 Box Bond paper long
2 1 Box Bond paper short

3 1 Box Ballpen
4 12 Pcs Colored paper

5 1 box Pencil

6 4 Pcs Glue

7 3 Pcs Masking tape

8 2 Ream Folder long

9 1 Ream Folder short

10 13 Pcs Plastic folder

11 12 Pcs Brown envelope

12 12 Pcs Record book

13 1 Box Paper fastener

14 1 Box Sharpener

15 3 Pcs Scissor

CONDITION AND/OR PRE-REQUISTES FOR BIDDER TO COMPLY WITH:

1. To specify the brand or trademark and other pertinent data of your product article.
2. To quote the price for the articles actually verified and found in your store.
3. To deliver the articles to the Office of the SK Treasurer within ________ days from the date of
receipt of the Purchase order.
4. To return the canvass paper to the Office of the SK Treasurer on or before the opening of the
canvass at __________________________ 0n __________________ 2024.
5. To accept the flag law (foreigner only).
6. To participate as a bona fide dealer.
7. That this business is duly licensed and with business permit by the government agency concern.
The government reserve the right to accept or reject any bids or depending upon compliance or non-compliance with the above-
mentioned requirement and other lawful reasons most advantageous government.
Very truly yours,

SK Treasurer
To: SK Treasurer

I accept condition and/or requirements in this canvass. Failure on my part to comply with the requirements in this canvass is enough
reason to disqualify me from participating any future bidding canvass

(Dealer’s Signature)

Republic of the Philippines

OFFICE OF THE SK TREASURER
 Barangay Veteranos
Municipality of Alangalang
Province of Leyte

Date:
ABSTRACT OF CANVASS & AWARDS

NAME OF SUPPLIER
QTY UNIT DESCRIPTION OF
ARTCILES

BLESSY ENTERPRISES ABBY OFFICE SUPPLIES DUCIEL ENTERPRISES

AND EQUIPMENT AWARDED TO
TRADING

UNIT TOTAL UNIT PRICE TOTAL UNIT PRICE TOTAL BLESSY

PRICE ENTERPRISES

2 Box Bond paper long 1,500.00 3,000.00 1,550.00 3,100.00 1,600.00 3,200.00
1 Box Bond paper short 1,500.00 1,500.00 1,550.00 1,500.00 1,600.00 1,600.00

1 Box Ballpen 120.00 120.00 130.00 130.00 135.00 135.00

12 Pcs Colored paper 15.00 180.00 20.00 240.00 25.00 300.00

1 box Pencil 125.00 125.00 130.00 130.00 135.00 135.00
4 Pcs Glue 35.00 140.00 37.00 148.00 39.00 156.00
3 Pcs Masking tape 35.00 105.00 40.00 120.00 45.00 135.00
2 Ream Folder long 500.00 1,000.00 510.00 1,020.00 515.00 1,030.00
1 Ream Folder short 500.00 500.00 510.00 510.00 515.00 515.00
13 Pcs Plastic folder 85.00 1,105.00 88.00 1,144.00 90.00 1,170.00

12 Pcs Brown envelope 45.00 540.00 49.00 588.00 53.00 636.00

12 Pcs Record book 120.00 1,440.00 130.00 1,560.00 140.00 1,680.00
1 Box Paper fastener 65.00 65.00 70.00 70.00 75.00 75.00
1 Box Sharpener 45.00 45.00 50.00 50.00 55.00 55.00
3 Pcs Scissor 45.00 135.00 50.00 150.00 55.00 165.00
We certify the foregoing is the abstract of the price quotations of the Canvass of the Prices opened
________________ 2024 and that Award is hereby made to Supplier/Suppliers named in the last column above.

CERTIFICATION OF ABSTRACT

We the Bids ad Awards committee (BAC) do hereby certify of Official Oath that the prices herein quoted is the lowest in
the locality after a Canvass of prices quoted is true and correct. Award is hereby given to BLESSY ENTERPRISES.

BAC member BAC member BAC member

_______________________
BAC Vice-Chairman BAC Chairman SK Treasurer

Recommended for Approval:

Appropriation Committee Member

__________________________
SK Chairman
PURCHASE ORDER
SK of Barangay: Veteranos City/Municipal: Alangalang
Tel. No. Province: Leyte
Supplier: Blessy Enterprises PO No.:
Address: Alangalang Leyte Date:

Tel. No. TIN: Mode of Procedure:

Gentlemen: Please deliver to this office the following articles subject to the terms and conditions contained herein:

Place of Delivery: ______________________ Delivery Term: ___________________________

Date of Delivery: Payment Term:

Item No. Quantity Unit of Item Description Unit Cost Amount

Measurement
1 2 Box Bond paper long 1,500.00 3,000.00

2 1 Box Bond paper short 1,500.00 1,500.00

3 1 Box Ballpen 120.00 120.00

4 12 Pcs Colored paper 15.00 180.00

5 1 box Pencil 125.00 125.00

6 4 Pcs Glue 35.00 140.00

7 3 Pcs Masking tape 35.00 105.00

8 2 Ream Folder long 500.00 1,000.00

9 1 Ream Folder short 500.00 500.00

10 13 Pcs Plastic folder 85.00 1,105.00

11 12 Pcs Brown envelope 45.00 1,540.00

12 12 Pcs Record book 120.00 1,440.00

13 1 Box Paper fastener 65.00 65.00

14 1 Box Sharpener 45.00 45.00

15 3 Pcs Scissor 45.00 135.00

(Total Amount in words) NINE THOUSAND SIX HUNDRED PESOS ONLY.

In case of failure to make full delivery within the time specified above, a penalty of one-tenth (1/10) of one percent
for evert day of delay shall be imposed on the undelivered item/s.
Conforme: Very truly yours,

BLESSY ENTERPRISES _________________________

Signature over Printed Name of Supplier Signature over Printed Name of SK Chairperson

Date Date

Availability of the budget or funds received for specific purpose:

_________________________________________
Signature over Printed Name of Budget Monitoring Officer

INSPECTION AND ACCEPTANCE REPORT

SK of Barangay: Veteranos IAR No.

City/Municipality: Alangalang Date:

Province: Leyte
Supplier: Blessy Enterprises Invoice No.
PO No. Date: Date:
Requesting SK Officials:
Item No. Item Description Unit of Measurement Quantity

1 Bond paper long Box 2

2 Bond paper short Box 1

3 Ballpen Box 1

4 Colored paper Pcs 12

5 Pencil box 1

6 Glue Pcs 4

7 Masking tape Pcs 3

8 Folder long Ream 2

9 Folder short Ream 1

10 Plastic folder Pcs 13

11 Brown envelope Pcs 12

12 Record book Pcs 12

13 Paper fastener Box 1

14 Sharpener Box 1

15 Scissor Pcs 3

Date Inspected: _______________ Date Received: _______________

Inspected, verified as to quantity and

specifications Complete

Partial (Pls. specify quantity Received

___________________________
Signature over Printed Name Signature Over Printed Name
Head, Inspection and Appraisal Committee SK treasurer