Republic of the Philippines
Province of Zamboanga del Sur
Municipality of Vincenzo Sagun
Barangay _____________
-oOo-
CERTIFICATION
To whom it may concern:
This is to certify that my Sari-sari Store & has no Official
Receipt to be issued to all my customers who will purchase any
items from my store, therefore I will prefer to sign a
Reimbursement Expense Receipt (R.E.R.).
In witness hereof, I will affixed my signature below this
____day of ______________ 2022 to validate this certification.
Golden Daughter Enterprises
Proprietor
(NGAS) Barangay Form
Revised 2007 Appendix 7
INSPECTION AND ACCEPTANCE REPORT
Barangay: Ambulon City/Municipality: Vincenzo Sagun
Tel. No.: Province: Zamboanga del Sur
Supplier: Golden Daughter Enterprises Invoice No.:______IAR No.: ___________ RIS No.:___________
PO No.:_________ Date:_____________________Date:___________ Date: _____________ Date:_____________
Unit Particulars Quantity
pcs ring binder 10
set photo paper A4 1
rm acetate 1
pcs stapler 2
pcs blood pressure 1
pcs puncher 1
rm bond paper long 10
rm bond paper A4 6
set computer ink 1
pcs weighing scale 1
INSPECTION ACCEPTANCE
Date Inspected: Date Received: _______________
Inspected, Verified as to quantity and specifications. Complete
Partial (Pls. specify quantity received)
SILVANO AMBO, JR. DENNIS FLORES
Signature Over Printed Name Signature Over Printed Name
Authorized Inspector Barangay Treasurer
(NGAS) Barangay Form
Revised 2007 Appendix 3
PURCHASE ORDER
Barangay: Ambulon City/Municipality: Vincenzo Sagun
Tel No.: ______________________ Province: Zamboanga del Sur
P.O. No.: _______________
Supplier: Golden Daughter Enterprises
Date: _____________________
Address: Pagadian City
Mode of Procurement:
TIN: ____________________________
Bidding Negotiated x Over the Counter
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: _______________________________
Unit Particulars Qty Unit Cost Amount
pcs ring binder 10 7.80 78.00
set photo paper A4 1 160.00 160.00
rm acetate 1 1,350.00 1,350.00
pcs stapler 2 290.00 580.00
pcs blood pressure 1 1,900.00 1,900.00
pcs puncher 1 285.00 285.00
rm bond paper long 10 320.00 3,200.00
rm bond paper A4 6 300.00 1,800.00
set computer ink 1 1,800.00 1,800.00
pcs weighing scale 1 1,200.00 1,200.00
(TOTAL Amount in words): Ҏ 12,353.00
In case of failure to make full delivery within the time specified above, a penlty of one-ten (1/10) of one percent for
everyday of delay shall be imposed.
Very truly yours,
Pablito Pansib, Jr. ______________
Signature Over Printed Name Date
Punong Barangay
Conforme:
Existence of Available Appropriation of ______________
Golden Daughter Enterprises _________________________________________________
Signature Over Printed Name
Supplier
Rosito Tois _____________
Signature Over Printed Name Date
Date Chairman, Committee on Apropriations
Republic of the Philippines
Province of Zamboanga del Sur
OFFICE OF THE PUNONG BARANGAY
Municipality of Vincenzo Sagun
Barangay Ambulon Date: _______________________
Time of Opening:
ABSTRACT OF QUOTATION
Golden Daughter Enterprises
Quantity Unit Articles
Unit Price TOTAL Unit Price TOTAL Unit Price TOTAL Unit Price TOTAL Unit Price TOTAL
10 pcs ring binder 7.80 78.00
1 set photo paper A4 160.00 160.00
1 rm acetate 1,350.00 1,350.00
2 pcs stapler 290.00 580.00
1 pcs blood pressure 1,900.00 1,900.00
1 pcs puncher 285.00 285.00
10.00 rm bond paper long 320.00 3,200.00
6.00 rm bond paper A4 300.00 1,800.00
1.00 set computer ink 1,800.00 1,800.00
1.00 pcs weighing scale 1,200.00 1,200.00
Action of the Committee on Award:
Approved the award as reccomended.
Requesitioner
Dennis Flores _____ Dennis Flores Pablito Pansib, Jr.
Punong Barangay Barangay Treasurer Barangay Treasurer Punong Barangay
Remarks if recommended for recanvass.
Municipal Accountant ____________________________________________________________________________
Barngay Council
2
Revised May 2004
REQUEST FOR PRICE QUOTATION
______________________________________
Project Reference No.____________________
Name of Project:________________________
Location of Project:______________________
Date:___________________
Quotation No.___________
Please quote your lowest price on the item/s listed below, subject to the General Conditions on the
last page, starting the shortest time of delivery and submit your quotation duly signed by your representative
not later than , 201 in the return envelope attached herewith.
SK Treasurer
Item No. Item/ Description Qty. Unit Price Amount
TOTAL > > > > > > > > > -
PEGASUS
After having carefully read and accepted your General Conditions, I / We quoted you on the item/s at
prices noted above.
Delivery Period:___________________________
Warranty:____________________________
Price Validity:____________________________
_______________________________
Name of Company/ Stablishment Printed Name
Adress Signature
_____________________________________
Tel. No. / Cellphone No. Date
Standard Form No. SF-GOOD- 06
Revised May 2004
REQUEST FOR PRICE QUOTATION
______________________________________
Project Reference No.____________________
Golden Daughter Enterprises Name of Project:________________________
Pagadian City Location of Project:______________________
Date:__________________
Quotation No.___________________
Please quote your lowest price on the item/s listed below, subject to the General Conditions on the last
page, starting the shortest time of delivery and submit your quotation duly signed by your representative not
later than ______________________ in the return envelope attached herewith.
Dennis Flores
Barangay Treasurer
Item No. Item/ Description Qty. Unit Price Amount
1 ring binder 10
2 photo paper A4 1
3 acetate 1
4 stapler 2
5 blood pressure 1
6 puncher 1
bond paper long 10.00
bond paper A4 6.00
computer ink 1.00
weighing scale 1.00
TOTAL > > > > > > > > >
PEGASUS
After having carefully read and accepted your General Conditions, I / We quoted you on the item/s at
prices noted above.
Delivery Period:___________________________
Warranty:____________________________
Price Validity:____________________________
Golden Daughter Enterprises Golden Daughter Enterprises
Name of Company/ Stablishment Printed Name
Pagadian City
Address Signature
_____________________________________
Tel. No. / Cellphone No. Date
Appendix 4
PURCHASE REQUEST
Barangay: Ambulon PR No.:______________
City/Municipality: Vincenzo Sagun Date: __________________
REQUISITION
Item Unit of Estimated Estimated
Qty Item Description
Number Measurement Unit Cost Amount
Ҏ
Purpose:
Requested by: Approved:
______________________ Mary Mae P. Del Rosario
Signature Over Printed Name Signature Over Printed Name
Requisitioner
______________________________ ________________________
Date Date
Project Reference Number:____________________________
Name of Procuring Entity Name of the Project:_________________________________
Location of the Project:_______________________________
Standard Form Number: SF-GOOD-42
Revised on May, 2004
ABSTRACT OF BIDS AS CALCULATED
Name of Project:__________________________________________________________ Sheet :
Location of the Project:_____________________________________________________ Date :
Implenting Office:_________________________________________________________ Time :
Approved Budget for the Contract:____________________________________________
Time and Place of Bid Opening:______________________________________________
NAME OF BIDDERS BIDDER 1 BIDDER 2 BIDDER 3 BIDDER 4
______________________________________ _________________ __________________ __________________ __________________
BAC Chairman BAC Vice-Chairman BAC Member BAC Member BAC Member
____________________ ___________________ ___________________ ___________________
PMO / End-User Unit Head, BAC-TWG Representative Representative
rice 10 50.00 500.00 5,000.00 rice 10
pork 7 160.00 1,120.00 pork 7
softdrinks 5 240.00 1,200.00 fish 5
juice 3 95.00 285.00 union 1
behon 3 30.00 90.00 garlic 0.5
fish 5 120.00 600.00 sili bells 0.5
union 1 80.00 80.00 carrots 1
garlic 0.5 86.00 43.00 cabbage 1
sili bells 0.5 80.00 40.00 toyo 2
carrots 1 60.00 60.00 edible 0.5
cabbage 1.5 40.00 60.00 paminta 11
toyo 0.5 130.00 65.00 betsin 2
edible 0.5 180.00 90.00 magic sarap 3
paminta 2 10.00 20.00 behon 2
betsin 2 5.00 10.00 juice 4
magic sarap 5 7.00 35.00
slice bread 10 45.00 450.00
monggo 3 50.00 150.00
pansit 3 30.00 90.00
salt 1 12.00 12.00
-
-
50.00 500.00 3,049.00 rice 4 50.00 200.00 1,100.00
160.00 1,120.00 pork 3 160.00 480.00
120.00 600.00 Juice 2 90.00 180.00
80.00 80.00 fish 2 120.00 240.00
86.00 43.00 -
80.00 40.00 -
60.00 60.00 -
40.00 40.00 -
7.00 14.00 -
180.00 90.00 -
1.00 11.00 -
5.00 10.00 -
7.00 21.00 -
30.00 60.00 -
90.00 360.00 -
- -
-
-
-
-
-
-
rice 4 50.00 200.00 2,109.00 - rice
pork 3 160.00 480.00 fish
fish 3 120.00 360.00 soft drinks
soft drinks 3 240.00 720.00 pork
behon 2 30.00 60.00 spicies
slice bread 4 45.00 180.00 behon
spicies 1 109.00 109.00 bread
-
-
rice 4 50.00 200.00 1,500.00
fish 3.5 120.00 420.00
soft drinks 1.5 240.00 360.00
spicies 1 65.00 65.00
pork 2 160.00 320.00
bread 3 45.00 135.00
-
-
-
-
-
-
-
3 50.00 150.00 1,383.00 -
4 120.00 480.00
1 240.00 240.00
2 160.00 320.00
1 73.00
1 30.00 30.00
2 45.00 90.00
-
-
-
-
-
-
-
-
Standard Form No. SF-GOOD- 06
Revised May 2004
REQUEST FOR PRICE QUOTATION
______________________________________
Project Reference No.____________________
____________________________ Name of Project:________________________
____________________________ Location of Project:______________________
____________________________
Date:___________________
Quotation No.___________
Please quote your lowest price on the item/s listed below, subject to the General Conditions on the last
page, starting the shortest time of delivery and submit your quotation duly signed by your representative not
later than , 2015 in the return envelope attached herewith.
Leonilo R. Guiting
Barangay Treasurer
Item No. Item/ Description Qty. Unit Price Amount
0 0 0 - -
#NAME? #NAME? #NAME? #NAME? #NAME?
0 0 0 20.00 -
#NAME? #NAME? #NAME? #NAME? #NAME?
0 0 0 - -
0 0 0 98.00 -
0 0 0 - -
#NAME? #NAME? #NAME? 60.00 #NAME?
#NAME? #NAME? #NAME? #NAME? #NAME?
#NAME? #NAME? #NAME? 47.00 #NAME?
#NAME? #NAME? #NAME? #NAME? #NAME?
#NAME? #NAME? #NAME? 7,040.00 #NAME?
TOTAL > > > > > > > > > #NAME?
PEGASUS
After having carefully read and accepted your General Conditions, I / We quoted you on the item/s at
prices noted above.
Delivery Period:___________________________
Warranty:____________________________
Price Validity:____________________________
GOLDEN DAUGHTER
MANHATTAN ENT. ENT. JACQUELINE C. DELOS REYES
Name of Company/ Stablishment Printed Name
Pagadian City
Adress Signature
_____________________________________
Tel. No. / Cellphone No. Date
Standard Form No. SF-GOOD- 06
Revised May 2004
REQUEST FOR PRICE QUOTATION
______________________________________
Project Reference No.____________________
____________________________ Name of Project:________________________
____________________________ Location of Project:______________________
____________________________
Date:___________________
Quotation No.___________
Please quote your lowest price on the item/s listed below, subject to the General Conditions on the last
page, starting the shortest time of delivery and submit your quotation duly signed by your representative not
later than , 2015 in the return envelope attached herewith.
Leonilo R. Guiting
Barangay Treasurer
Item No. Item/ Description Qty. Unit Price Amount
0 0 0 3.00 -
#NAME? #NAME? #NAME? #NAME? #NAME?
0 0 0 - -
#NAME? #NAME? #NAME? 75.00 #NAME?
0 0 0 6.50 -
0 0 0 97.00 -
0 0 0 - -
#NAME? #NAME? #NAME? 59.00 #NAME?
#NAME? #NAME? #NAME? #NAME? #NAME?
#NAME? #NAME? #NAME? #NAME? #NAME?
#NAME? #NAME? #NAME? 71.00 #NAME?
#NAME? #NAME? #NAME? 7,050.00 #NAME?
TOTAL > > > > > > > > > #NAME?
PEGASUS
After having carefully read and accepted your General Conditions, I / We quoted you on the item/s at
prices noted above.
Delivery Period:___________________________
Warranty:____________________________
Price Validity:____________________________
GOLDEN
D' BEAM DAUGHTER ENT. JACQUELINE C. DELOS REYES
Name of Company/ Stablishment Printed Name
Pagadian City
Adress Signature
_____________________________________
Tel. No. / Cellphone No. Date
