Department of Education Department of Education

Region III Central Luzon Region III Central Luzon

Schools Division of Bulacan Schools Division of Bulacan
SAN MIGUEL NORTH DISTRICT SAN MIGUEL NORTH DISTRICT
Kng. Kabayo Elementary School Kng. Kabayo Elementary School
King Kabayo, San Miguel, Bulacan King Kabayo, San Miguel, Bulacan

PURCHASE REQUEST PURCHASE REQUEST

Department : DEPED - BULACAN PR : 101-2022-10-002 Date: 10/06/2022 Department : DEPED - BULACAN PR : 101-2022-10-001 Date: 10/06/2022
Section : KNG. KABAYO ELEMENTARY SCHOOL SAL NO: _______________ Date:________________ Section : KNG. KABAYO ELEMENTARY SCHOOL SAL NO: _______________ Date:________________
ALOBS NO: ______________ Date:________________ ALOBS NO: ______________ Date:________________
Stock No. Unit of Item Description Quantity Estimated Estimated Stock No. Unit of Item Description Quantity Estimated Estimated
Issue Unit Cost Cost Issue Unit Cost Cost
1 pcs 2x2x0.5 tubular 2 950.00 1900.00 1 packs Worx Paper (A4) 35 38.00 1330.00 Worx Paper (A4) 35 packs 38.00 1,330.00
2 pcs angular bar 1x0.5 2 350.00 700.00 2 reams Form 48 DTR 5 40.00 200.00 Form 48 DTR 5 reams 40.00 200.00
3 L Enamel Paint (Blue) 2 250.00 500.00 3 reams Paper Multi-Purpose 70 gsm (Legal) 40 160.00 6400.00 Paper Multi-Purpose 70 gsm (Legal) 40 reams 160.00 6,400.00
4 L Enamel Paint (Thallo Green) 2 250.00 500.00 4 box Stapler Wire #35 12 50.00 600.00 Stapler Wire #35 12 box 50.00 600.00
5 pcs Paint Brush 1 1/2" 2 30.00 60.00 5 pcs Universal UV Dye Ink (Black) 10 55.00 550.00 Universal UV Dye Ink (Black) 10 pcs 55.00 550.00
6 bottle Paint Thinner 1 37.50 37.50 6 pcs Pilot Ballpen (Black) 12 35.00 420.00 Pilot Ballpen (Black) 12 pcs 35.00 420.00
7 bag Cement 2 220.00 440.00 7 bottle Canon Pixma Ink (Black) 2 250.00 500.00 Canon Pixma Ink (Black) 2 bottle 250.00 500.00
8 box Welding rod 1 450.00 450.00 8
9 pcs flat bar 1 1/2x0.5 1 300.00 300.00 9
10 box cutting disc 1 250.00 250.00
- - - - - - 2 pcs 2x2x0.5 tubular 950.00
2 pcs angular bar 1x0.5 350.00
2 L Enamel Paint (Blue) 250.00
2 L Enamel Paint (Thallo Green) 250.00
2 pcs Paint Brush 1 1/2" 30.00
1 bottle Paint Thinner 37.50
2 bag Cement 220.00
1 box Welding rod 450.00
1 pcs flat bar 1 1/2x0.5 300.00
1 box cutting disc 250.00

TOTAL 5,137.50 TOTAL 10,000.00

Purpose: To compensate the needs in minor repair materials Purpose: To compensate the needs in printing and repoduction of reports and print related materials

Requested by: Approved by: Requested by: Approved by:

Signature Signature
Printed Name JOCELYN B. DELA CRUZ ALMA C. BACUAL Printed Name JOCELYN B. DELA CRUZ ALMA C. BACUAL
Designation Property Custodian Head Teacher III Designation Property Custodian Head Teacher III
NAME AND ADDRESS DepEd - Division of Bulacan AGENCY

OF REQUESTING ACCT. CODE

KNG. KABAYO ELEMENTARY SCHOOL
AGENCY (School) AGENCY CONTROL No.
AGENCY PROCUREMENT REQUEST PS APR No.
To: THE PROCUREMENT SERVICE
DBM - Region III October 24, 2022
Gov't Center, Maimpis (Date Prepared)
San Fernando City, Pampanga

PLEASE CHECK ( / ) APPROPRIATE BOX ON ACTION REQUESTED ON THE ITEM LISTED BELOW

[ ] Please issue common-use supplies/materials per Price List No. __________ dated ____________
Mode of Delivery : [ ] Pick-up (Fast L [ ] Pick-up schedule [ ] Delivery (door-to-door)

In case fund is not sufficient :[ ] Reduce Quantity [ ] Bill Us [ ] Charged to Unutilized Deposit,
APR No. _______ Dated: ________
[ ] Please purchase for our agency non-common items. Attached herewith:
[ ] Complete Specifications [ ] Obligation Request (ObR) [ ] Others, pls. specify __________
[ ] Certificate of Budget Allocation (C [ ] Payment __________

IMPORTANT!! PLEASE SEE THE INSTRUCTIONS/CONDITIONS AT THE BACK OF ORIGINAL COPY

ITEM
ITEM AND DESCRIPTION/SPECIFICATIONS/STOCK NO. QUANTITY UNIT Unit Price AMOUNT
NO.
1 Worx Paper (A4) 35 packs 38.00 1,330.00
2 Form 48 DTR 12 reams 40.00 480.00
3 Paper Multi-Purpose 80 gsm (Legal) 33 reams 195.00 6,435.00
4 box 0.00
5 Universal UV Dye Ink (Black) 22 pcs 55.00 1,210.00
6 Pilot Ballpen (Black) 11 pcs 35.00 385.00
7 Canon Pixma Ink (Black) 2 bottle 250.00 500.00

TOTAL 10,340.00
NOTE : ALL SIGNATURES MUST BE OVER PRINTED NAME
STOCKS REQUESTED ARE CERTIFIED FUNDS CERTIFIED AVAILABLE: APPROVED:
WITHIN APPROVED PROGRAM:

JOCELYN B. DELA CRUZ ADRIAN PAUL ANILLO ALMA C. BACUAL

HEAD TEACHER III

PROPERTY CUSTODIAN ADMIN ASST III AGENCY HEAD/AUTHORIZED SIGNATURE

[ ] FUNDS DEPOSITED WITH PS _________________ CHECK No. ______________

IN THE AMOUNT OF ___________________________________________ (P ______________) ENCLOSED

11
 Republic of the Philippines
DEPARTMENT OF EDUCATION POW=PR
SCHOOL BASED REPAIR AND MAINTENNACE SCHEME

PROGRAM OF WORKS

Name of School: Kng. Kabayo Elementary School District/Municipality: San Miguel North
Estimated Project Cost
No. Description of Work Materials Labor Total
Qty. Unit Article Unit Cost Total Cost Scheme Cost Cost
1 Repalcement of faulty outlet 20 m #10 stranded cable wire 150.00 3,000.00 Straight Contract 1,000.00
inside the classroom 1 pc electrical tape 47.04 47.04 8,637.50
- 4,590.46
-
-
-
- 3,047.04
- 1,000.00
- 4,047.04
-

TOTAL 197.04 3,047.04 1,000.00 4,047.04

Prepared by: Certified true and Correct:

ROBIE P. DE LEON ALMA C. BACUAL

Industrial Arts Teacher Head Teacher III
 Republic of the Philippines
DEPARTMENT OF EDUCATION POW=PR
SCHOOL BASED REPAIR AND MAINTENNACE SCHEME

PROGRAM OF WORKS

Name of School: Kng. Kabayo Elementary School District/Municipality: San Miguel North
Estimated Project Cost
No. Description of Work Materials Labor Total
Qty. Unit Article Unit Cost Total Cost Scheme Cost Cost
1 Repalcement of broken jalousie 50 pcs jalousie glass 40.00 2,000.00 Straight Contract 1,200.00
windows and replacement of broken 12 pcs doorknob 400.00 4,800.00 8,637.50
doorknobs on classrooms - 637.50
-
-
-
- 6,800.00
- 1,200.00
- 8,000.00
-

TOTAL 440.00 6,800.00 1,200.00 8,000.00

Prepared by: Certified true and Correct:

ROBIE P. DE LEON ALMA C. BACUAL

Industrial Arts Teacher Head Teacher III