PURCHASE ORDER
SK of Barangay: City/Municipality:
Tel. No.: Province:
Supplier: ______________________ PO No.: _________
Address: Date: ____________
Tel. No.: ___________________ TIN: _________________ Mode of Procurement: ____________________
Gentlemen: Please deliver to this office the following articles subject to the terms and conditions contained herein:
Place of Delivery: _______________________________________ Delivery Team: ___________________________________
Date of Delivery: ________________________________________ Payment Team: ___________________________________
Item No. Unit Description Qty Unit Cost Amount
In case of failure to make 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 on the undelivered item/s.
Conforme: Very truly yours,
__________________________________ __________________________________
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 SK Secretary/Budget Monitoring Officer Date: _______________________