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Appendix 49
PURCHASE ORDER
LGU
Supplier :P.O. No. :
Address :Date :
TIN :Mode of Procurement :
PR No/s. :Budget Ref No. :
Gentlemen:
Please furnish this Office the following articles subject to the terms and conditions contained herein:
Place of Delivery :Delivery Term :
Date of Delivery :Payment Term :
Stock/ Property No.UnitDescriptionQuantityUnit CostAmount
110.000.00
TOTAL0.00
(Total Amount in Words)
P 0.00
In case of failure to make the 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:
Signature over Printed Name of Supplier
Date
Very truly yours,
Date
(In case of Negotiated Purchase pursuant to Section 369 (a) of RA 7160, this portion must be accomplished.)
Approved per Sangguniang Resolution No.:
Certified Correct:
Secretary to the Sangguniang
Date