Purchased Request (PR) (Repaired)

Appendix 34PURCHASE REQUESTBukidnonLGU

Department BENRO/MMT P.R. No. ___________________ Date ________________________ SAI No. _______________________Date___________Section ________________________ ALOBS No. ____________________ Date_________

Item No.QuantityUnitOf IssueItem DescriptionEstimated Unit CostEstimated Cost

1.

2.

3.4.

5. 6.7.

8.9.10.11.12. 13.14.15.

16.17.18.19.20.

21.23.24.25.26.27.

28.29.30.31.32.33.34.35.36.37.38.39.40.

41.42.

44.45.46.

7

24411141313

111010106

110612

2

11212

7411 1 111 1 11

50 2

122

reams

reams

pcspcs

pcsboxpcs

eacheacheacheachpadboxboxpcs

setpcspcsboxpcs

box

boxpackunitbottledozenpcs

piecepiecepieceboxpiecepiecerollrollrollrollrollboxpiece

sheetsheet

piecepiece pieceCOMMON OFFICE SUPPLIES:

Paper,multicopy, legal size, 216mm x 330mm (8-1/2" x 13") - 80gsm, bookpaper, for laser/ink-jet printers,high-speed copier Paper, multicopy, A-4 size, for laser ink-jet printers, high speed copiers 2012mmx297mm, 80gsm bookpaperTape Dispenser, heavy duty, for 24mm(1") Envelope, expanding, plastic, 0.50mm, min platic thickness with plastic strap,380mm x 260mm, min size, 30mm, min expansion, assorted colors Sign pen, liquid gel ink, 0.5mm needle tip color black Pencil, lead with eraser, 12 pcs/box Notebook, stenographer, spiral, 40 leaves, ruled both sides 55 gsm, GSP bond Ring Binder , 24mm x 1.2M (1"x44") plastic Ring Binder , 19mm x 1.2M (3/4"x44") plastic Ring Binder, (1/2" x 44") plasticRing Binder, (1/4" x 44") plastic Note pad (3"x4"),75mm x 102mm Paper clip, gem type, small, 33mm, 100s/box Paper Clip, gem type,jumbo, 50mm,100s/boxFile Organizer, expanding, plastic, legal, with 12 inside pockets with index tab, for legal size paper/document, with elastic strap, snap, etc. for closing or binding the organizer, assorted Marker, flourescent, 3 colors per setFolder, - Expanding w/index tab-green(long, coated)Folder, transparent sliding white, long size Data File Box, double with closed ends and finger ring Correction Tape,disposable, usable length of 6 meters(min), 5mm width, 0.02mm(min) thickness, white opaque, with protective cap Fastener,plastic, 25mm, 50 sets/box

Time Card, for Amano Calculator 12 digits HL Casio Alcohol, 70% ethyl, 250ml Bathroom tissue, 2 ply, 12rolls/pack DVD Rewritable, 4x speed, 4.7GB capacity, 120 min recording time, individually pack in non breakable slim plastic case

II. NON-COMMON OFFICE SUPPLIES:

Folder, transparent sliding white, long size Folder, expanding w/ inde tab-green (long coated) Correction, pen tube, 9 ml Pen, ballpen, B4-45 black, 50 pcs/box Stapler HD 50/50 max with remover Scissor, stainless steel, 8 1/4" heavy dutyTape, Magic Tape Tape, Double adhesive tape " Tape, adhesive, transparent, 72mm (3") Tape, transparent (3") 72mm Tape , double adhesive mounting tape , 1" 5M Paper, Photopaper, glossy, 100's Record Book, 500 pages, white bond, non-blot, smythe sewn, 55 gsm., pre-numbered, with printing of " Official Record Book" Form, Provincial Payroll, Form No. 38 (A) Forms daily time record (DTR), regular, 500's

COMPUTER SUPPLIES (NON PS-DBM)

Flash Drive, 16 GB capacity, USB, Computer Ink Cartridge, HP 704, black for deskjet printer Computer Ink Cartridge, HP 704, colored for deskjet printer

Charged to : Monitoring Re-Environmental Protection (MRP) 1st Qtr.

271.00

266.00

95.6046.80

43.14 20.5315.00

40.0039.7517.5011.0038.509.0022.0076.32

41.0814.007.00205.0013.00

44.00

82.68429.0039.0073.0083.00

7.00 14.00 26.00 261.00 280.00 65.00 305.00 42.00 76.00 76.00 143.00 980.00520.00

5.00 87.00

1096.00 799.00 919.00

P 1,900.50

1,066.00

95.00

43.1420.53105.00

40.0039.7517.0011.0038.0018.0044.0076.32

164.3228.0042.00205.0026.00

88.00

82.68429.0078.0073.00166.00

P 4,990.84

49.0056.00 261.00 280.00 65.00 305.00 42.00 76.00 76.00 143.00 980.00

250.00 174.00P 2,757.00

1,096.00 1,598.00 1,838.00P 4,532.00

Purpose: For Multi-Partite Monitoring Team (MMT).

Signature Printed NameDesignationRequested byCash availabilityApproved by:

ALFEO U. BAGUIOMMT Chairman & SP ChairpersonCommittee on Environment VIOLETA B. CRUZ Acting Provincial TreasurerALEX P. CALINGASAN Provincial Governor

PURCHASE REQUESTBukidnonLGU

Department BENRO/MMT P.R. No. ___________________ Date ________________________ SAI No. _______________________Date___________Section ________________________ ALOBS No. ____________________ Date_________

Item No.QuantityUnitOf IssueItem DescriptionEstimated Unit CostEstimated Cost

1.

2.

2525

2525

pax pax

pax DAY 1

MealsSnacks

DAY 2

MealsSnacks

Charged to: Monitoring Re-Environmental Protection (MRP) 1st Quarter

150.0050.00

150.00 50.00

P 3,750.00 1,250.00P 5,000.00

P 3,750.00 1, 250.00P 5,000.00




Appendix 34

PURCHASE REQUESTBukidnonLGU

Department BENRO/MMT P.R. No. ___________________ Date ____________ SAI No. ____________ Date___________Section ________________________ ALOBS No. ____________________ Date_________

Item No.Acct. CodeBACCodeQuantityUnitOf IssueItem DescriptionEstimated Unit CostEstimated Cost

1.

liters

Fuel/Gasoline

Charged to: Monitoring Re-Environmental Protection(MRP) 1st Quarter

25,000.00

25, 000.00







1.

2.

3.4.5. 6.7.89.10.

11.

12.

13.14.

755

755

755755755755755755755755

755

755

755755

COS-0130

COS-0142

COS-0141COS-0181HKS-0003HKS-0005COS-0097COS-0191COS-0261COS-0266

CMS-0131

COS-0004

CMS-0040CMS-0041

6

3

124210711

2

3

21

pc

pc

pcboxbtlpckpcspcsrollroll

pcs

pck

pcspc DBM

Common Office Supplies:

Notebook, stenographer, spiral, 40 leaves, ruled both sides 55 gsm, GSP bondPaper, mimeo, whitewove, 216mmx339mm(8-11/2"x13) legal size, subs 20Paper, mimeo, ground wood, 210mmx297mm A4 sizePencil, lead with eraser, 12pcs/boxAlcohol, 70% isoprophyl, 500mlBathroom tissue, 2ply, industrial pack of 48Folder, tagboard, legal size (ordinary brown color)Pen, sign pen, high tech,0.5mm ball,fine color blackTape, masking, 24mmTape, transparent, 24mm

Common Computer Supplies/Consumables:

Flash drive 4 GIG

Common Electrical Supplies: Battery dry cel, size AA,1.5volts,alkaline 2pcs/pack

Computer Supplies:

Computer Ink Cartridge, HP 703, BlackComputer Ink Cartridge, HP 703, Colored

Charged to : BENRO/MMT (ISF Project)(3rd Quarter)

15.00

190.00120.0060.0080.00513.004.0540.0028.5028.50

500.00

48.00

660.00760.00

90.00

570.00120.00120.00320.001,026.0040.50280.0028.5028.502,623.50228.50

1,000.00

144.00

1,320.00760.002,080.00

P 5,847.50







125

pcs

Photocopy (Clear copy)

Charged to : BENRO/MMT (ISF Project) (3rd Quarter)

2.00

250.00

P 250.00




Documents

Purchased Request (PR) (Repaired)