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WORK AND FINANCIAL PLAN

SCHOOL-BASED FEEDING PROGRAM (SBFP)


SY 2019-2020
Region: X
Division: MISAMIS ORIENTAL
District: NAAWAN
Name of School: NAAWAN CENTRAL SCHOOL
BEIS School ID: 127935

Objectives: To rehabilitate at least 70% of the beneficiaries to normal nutritional status


Ensure 85-100% attendance among target beneficiaries
To improve the children's health and nutrition values and behavior

Target Beneficiaries SY 2018 - 2019 Financial Requirements for SY 2018- 2019


CY 2019 CY 2020 RESPONSI
PROGRAM/ACTIVITY/PROJECT Grade 1 3rd - 4th SOURCE REMARKS
Performance 1st Qtr. TOTAL Cost BILITY OF FUND
Indicator / Kinder to Qtr. of 2016 TARGET Assumption
JUL AUG SEP OCT NOV DEC JAN FEB TOTAL (days) CENTER
Unit of Grade6 2015
Measure 2 19 21 17 20 15 20 6 120
GAS/STO/Project
1. Procurement of
Food Commodities for School-Based no. of SBFP Number of - Naawan Deped
Feeding Beneficiaries beneficiaries beneficiaries CS ROX-
XP16.00X120
fed days Sub-ARO

(See attached lists of commodities


estimated amount and Cycle Menu)
beneficiaries beneficiaries beneficiaries

Kinder 19 19 19 19 36,480.00 608.00 5,776.00 6,384.00 5,168.00 6,080.00 4,560.00 6,080.00 1,824.00 36,480.00
Grade 1 7 7 7 7 13,440.00 224.00 2,128.00 2,352.00 1,904.00 2,240.00 1,680.00 2,240.00 672.00 13,440.00
Grade 2 14 14 14 14 26,880.00 448.00 4,256.00 4,704.00 3,808.00 4,480.00 3,360.00 4,480.00 1,344.00 26,880.00
Grade 3 21 21 21 21 40,320.00 672.00 6,384.00 7,056.00 5,712.00 6,720.00 5,040.00 6,720.00 2,016.00 40,320.00
Grade 4 4 4 4 4 7,680.00 128.00 1,216.00 1,344.00 1,088.00 1,280.00 960.00 1,280.00 384.00 7,680.00
Grade 5 29 29 29 29 55,680.00 928.00 8,816.00 9,744.00 7,888.00 9,280.00 6,960.00 9,280.00 2,784.00 55,680.00
Grade 6 16 16 16 16 30,720.00 512.00 4,864.00 5,376.00 4,352.00 5,120.00 3,840.00 5,120.00 1,536.00 30,720.00
Total No. of Beneficiaries 0 19 91 110 110 110 Sub - total 3,520.00 33,440.00 36,960.00 29,920.00 35,200.00 26,400.00 35,200.00 10,560.00 211,200.00

Number of
beneficiaries
XP2.00X120 days
II. Operational Expenses
Target Beneficiaries SY 2018 - 2019 Financial Requirements for SY 2018- 2019
CY 2019 CY 2020 RESPONSI
PROGRAM/ACTIVITY/PROJECT Grade 1 3rd - 4th BILITY SOURCE REMARKS
Performance 1st Qtr. TOTAL Cost OF FUND
Indicator / Kinder to Qtr. of
2016 TARGET Assumption
JUL AUG SEP OCT NOV DEC JAN FEB TOTAL (days) CENTER
Unit of Grade6 2015
Measure 2 19 21 17 20 15 20 6 120
Maintenance and Operating Expenses
(See attached lists of supplies and
materials with estimated cost )
1. Orientation of stakeholders
2. Supplies & materials related to
feeding program 0.9
(Gasul, kerosene, fuel, charcoal, water, 0.3 LPG & LPG &
etc.) other other
Cooking Cooking
Materials Materials
7,920.00 1,254.00 1,386.00 1,122.00 1,320.00 990.00 1,320.00 396.00 7,788.00
0.1 contains contains
gallons / gallons /
containers) containers)
of of mineral /
mineral / purified
purified water
water
2,640.00 418.00 462.00 374.00 440.00 330.00 440.00 132.00 2,596.00

set of set of
related related
feeding feeding
0.5 utensils utensils 13,200.00 2,090.00 2,310.00 1,870.00 2,200.00 1,650.00 2,200.00 660.00 12,980.00
3. Management Program Operation 0.1
(minimal transportation expenses, xerox,
and other priority related expenses)

0.1 photocopyi photocopyi


ng & other ng & other
supplies supplies for
for
documenta documen
tation
tion 2,640.00 418.00 462.00 374.00 440.00 330.00 440.00 132.00 2,596.00

Sub-Total 4,180.00 4,620.00 3,740.00 4,400.00 3,300.00 4,400.00 1,320.00 25,960.00 - - -

TOTAL ESTIMATED COST GRAND TOTAL 37,620.00 41,580.00 33,660.00 39,600.00 29,700.00 39,600.00 11,880.00 237,160.00

Prepared by: Noted by: Funds Available: Approved by:

MARJORIE ROSE ANGELITA S. RANALAN,


JAGONIA ELCRIS E. CAÑO CPA RANDOLPH
Schools B. TORTOLA
Division
Feeding Coordinator ES Principal II Accountant III Superintendent
ANNUAL PROCUREMENT PLAN FOR 2019
For School Feeding 2019 - 2020

Department/Bureau/Office: DEPARTMENT OF EDUCATION Contact Person: AURA O. VILLASTIQUE


Region: X Position: ES PRINCIPAL II
Address: NAAWAN, MISAMIS ORIENTAL E-mail : auravillastique@yahoo.com
Telephone/Mobile Nos: 639177019744

Quantity Requirement
Unit of TOTAL
Item & Specifications Measure Unit Price AMOUNT
Jan Feb Mar Q1 2020 April May June Q2 2019 July Aug Sept Q3 2019 Oct Nov Dec Q4 2019 Total

A. Food Commodities for School-Based Feeding Beneficiaries

Ampalaya, bunga grams 1768.8 1768.8 0 3537.6 106.128 0 0 0 0 0 0 1768.8 1768.8 3537.6 106.128 1768.8 1769 1769 5306.4 159.19 12382 30.00 371.45

Arina (All Purpose Flour) grams 9262 4092 0 13354 400.62 0 0 2728 6534 11990 21252 637.56 6534 9262 9262 25058 751.74 59664 30.00 1,789.92
Bagoong dilis grams 660 660 0 1320 132 0 0 0 0 0 0 660 660 1320 132 660 660 660 1980 198.00 4620 100.00 462.00
Bagoong hipon grams 308 0 0 308 30.8 0 0 0 308 308 616 61.6 308 308 308 924 92.40 1848 100.00 184.80
Baguio beans grams 6094 3344 0 9438 283.14 0 0 0 0 0 2200 6094 6094 14388 431.64 3894 6094 6094 16082 482.46 39908 30.00 1,197.24

Banana Heart grams 8795.6 0 0 8795.6 131.934 0 0 0 8795.6 8795.6 17591.2 263.868 4228.4 8796 4228 17252.4 258.79 43639 15.00 654.59

Banana saba grams 20068 20068 0 40136.8 602.052 0 0 0 0 0 0 20068 20068.4 40136.8 602.052 20068 ### ### 60205.2 903.08 ### 15.00 2,107.18

Black Pepper grams 35.2 35.2 0 70.4 19.36 0 0 35.2 0 70.4 105.6 29.04 0 35.2 35.2 70.4 19.36 246 275.00 67.76
Bread crumbs grams 7282 2090 0 9372 562.32 0 0 0 0 0 0 7282 7282 14564 873.84 7282 7282 5610 20174 1210.44 44110 60.00 2,646.60
Bread Toasted grams 3850 0 0 3850 173.25 0 0 0 3850 3850 7700 346.5 3850 3850 2090 9790 440.55 21340 45.00 960.30
Cabbage grams 6516.4 0 0 6516.4 260.656 0 0 0 0 0 0 6516.4 6516.4 13032.8 521.312 6516.4 6516 6516 19549.2 781.97 39098 40.00 1,563.94

Calamansi juice grams 1271.6 1271.6 0 2543.2 114.444 0 0 0 1271.6 1271.6 2543.2 114.444 1271.6 1271.6 1271.6 3814.8 171.67 8901 45.00 400.55
Carrots grams 8791.2 3432 0 12223.2 366.696 0 0 0 0 0 2574 7933.2 9649.2 20156.4 604.692 6217.2 8791 7933 22941.6 688.25 55321 30.00 1,659.64
Chicken grams 7229.2 0 0 7229.2 939.796 0 0 0 7229.2 7229.2 14458.4 1879.592 7229.2 7229 7071 21529.2 2798.80 43217 130.00 5,618.18

Chicken cubes each 4 0 0 4 28 0 0 0 0 0 0 4 4 8 56 4 4 0 8 56.00 20 7.00 140.00


Chicken Wings grams 9350 9350 0 18700 2992 0 0 0 9350 9350 18700 2992 9350 9350 9350 28050 4488.00 65450 160.00 10,472.00

Coconut meat, grated grams 12372.8 0 0 12372.8 247.456 0 0 0 0 0 0 12372.8 12372.8 24745.6 494.912 12372.8 1E+04 1E+04 37118.4 742.37 74237 20.00 1,484.74
Coconut milk grams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00 0 675.00 -
Cornstarch grams 880 0 0 880 4840 0 0 0 0 0 0 880 880 1760 9680 880 880 880 2640 14520 5280 5.50 29.04
Dilis grams 616 0 0 616 107.8 0 0 0 616 616 1232 215.6 616 616 0 1232 215.6 3080 175.00 539.00
Egg,chicken,whole tray 4 4 0 8 1400 0 0 0 0 0 4 6 6 16 2800 6 6 6 18 3150 42 175.00 7,350.00

Eggplant grams 1518 651.2 0 2169.2 43.384 0 0 0 1518 1518 3036 60.72 1518 1518 1518 4554 91.08 9759 20.00 195.18
Fresh corn grated grams 6160 0 0 6160 431.2 0 0 0 0 0 0 6160 6160 12320 862.4 6160 6160 0 12320 862.4 30800 70.00 2,156.00

Fried Galunggong, flaked grams 15083.2 0 0 15083.2 1508.32 0 0 0 15083.2 15083.2 30166.4 3016.64 15083.2 ### ### 45249.6 4524.96 90499 100.00 9,049.92
Gabi leaves, whole grams 2596 0 0 2596 25.96 0 0 0 0 0 0 2596 2596 5192 51.92 2596 2596 2596 7788 77.88 15576 10.00 155.76
Gabi, raw grams 2054.8 0 0 2054.8 61.644 0 0 0 2054.8 2054.8 4109.6 123.288 2054.8 2055 0 4109.6 123.288 10274 30.00 308.22

Garlic, minced grams 8703.2 853.6 0 9556.8 1146.816 0 0 0 0 0 356.4 8654.8 8751.6 17762.8 2131.536 8166.4 8703 6921 23790.8 2854.896 51110 120.00 6,133.25

Ginger sliced grams 413.6 118.8 0 532.4 31.944 0 0 0 413.6 413.6 827.2 49.632 413.6 413.6 413.6 1240.8 74.448 2600 60.00 156.02

Green onions grams 281.6 281.6 0 563.2 101.376 0 0 0 0 0 0 281.6 281.6 563.2 101.376 281.6 281.6 281.6 844.8 152.064 1971 180.00 354.82
Green Peas grams 2200 0 0 2200 132 0 0 0 2200 2200 4400 264 2200 2200 2200 6600 396 13200 60.00 792.00

Ground beef grams 7770.4 0 0 7770.4 1709.488 0 0 0 0 0 0 7770.4 7770.4 15540.8 3418.976 7770.4 7770 7770 23311.2 5128.464 46622 220.00 10,256.93
Quantity Requirement
Item & Specifications Unit of Unit Price TOTAL
Measure AMOUNT
Jan Feb Mar Q1 2020 April May June Q2 2019 July Aug Sept Q3 2019 Oct Nov Dec Q4 2019 Total

KInchay grams 862.4 343.2 0 1205.6 72.336 0 0 343.2 519.2 1205.6 2068 124.08 519.2 862.4 862.4 2244 134.64 5518 60.00 331.06

Lumpia Wrapper grams 4840 0 0 4840 338.8 0 0 0 0 0 0 4840 4840 9680 677.6 4840 4840 4840 14520 1016.4 29040 70.00 2,032.80
Malunggay leaves grams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
Malunggay powder grams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00 -

Margarine grams 550 0 0 550 33 0 0 0 550 550 1100 66 550 550 550 1650 99 3300 60.00 198.00
Milk, evaporated cans 8 8 0 16 512 0 0 8 0 8 16 512 0 8 8 16 512 48 32.00 1,536.00
Munggo, green grams 2970 0 0 2970 267.3 0 0 0 0 0 0 2970 2970 5940 534.6 2970 2970 0 5940 534.6 14850 90.00 1,336.50
Mungo sprouted grams 3960 1544.4 0 5504.4 330.264 0 0 1544 3960 3960 9464.4 567.864 2415.6 3960 3960 10335.6 620.136 25304 60.00 1,518.26

Oil grams 10991.2 3014 0 14005.2 980.364 0 0 0 0 0 792 10991.2 10991.2 22774.4 1594.208 9275.2 1E+04 8536 28802.4 2016.168 65582 70.00 4,590.74

Oil, Coconut grams 2750 550 0 3300 165 0 0 550 2200 3300 6050 302.5 2200 2750 2200 7150 357.5 16500 50.00 825.00

Okra grams 880 880 0 1760 52.8 0 0 0 0 0 0 880 880 1760 52.8 880 880 880 2640 79.2 6160 30.00 184.80
Onion, chopped grams 13296.8 2147.2 0 15444 1081.08 0 0 1109 12469.6 14124 27702.4 1939.168 12025.2 1E+04 8672 33994.4 2379.608 77141 70.00 5,399.86
Pancit Canton grams 2750 0 0 2750 385 0 0 0 0 0 0 2750 2750 5500 770 2750 2750 2750 8250 1155 16500 140.00 2,310.00
Patis bot 1 1 0 2 36 0 0 1 1 1 3 54 0 1 1 2 36 7 18.00 126.00

Pepper , ground grams 514.8 140.8 0 655.6 295.02 0 0 0 0 0 74.8 440 589.6 1104.4 496.98 440 514.8 514.8 1469.6 661.32 3230 450.00 1,453.32
Pimiento grams 1034 0 0 1034 62.04 0 0 0 1034 1034 2068 124.08 1034 1034 1034 3102 186.12 6204 60.00 372.24
Pork boston butt, lean grams 5676 5676 0 11352 2497.44 0 0 0 0 0 0 5676 5676 11352 2497.44 5676 5676 5676 17028 3746.16 39732 220.00 8,741.04

Pork liempo, cut into cube grams 10392.8 7092.8 0 17485.6 3846.832 0 0 0 10392.8 10392.8 20785.6 4572.832 10392.8 1E+04 1E+04 31178.4 6859.248 69450 220.00 15,278.91
Pork, cubed grams 19232.4 4730 0 23962.4 5032.104 0 0 0 0 0 4730 19232.4 19232.4 43194.8 9070.908 14502.4 ### ### 51154.4 10742.424 118312 210.00 24,845.44

Quail eggs grams 2499.2 0 0 2499.2 199.936 0 0 0 2499.2 2499.2 4998.4 399.872 2499.2 2499 0 4998.4 399.872 12496 80.00 999.68
Raisins grams 1320 0 0 1320 264 0 0 0 0 0 0 1320 1320 2640 528 1320 1320 1320 3960 792 7920 200.00 1,584.00
Salt grams 924 264 0 1188 17.82 0 0 264 660 1188 2112 31.68 660 924 726 2310 34.65 5610 15.00 84.15
Salt, iodized grams 1716 528 0 2244 1402.5 0 0 0 0 0 44 1716 1716 3476 2172.5 1606 1716 1122 4444 2777.5 424 15.00 6,352.50
Shrimp, freshwater (small) grams 4576 4576 0 9152 2196.48 0 0 4576 0 9152 13728 3294.72 0 4576 4576 9152 2196.48 32032 240.00 7,687.68

Shrimp, tagunton, peeled, chopped grams 15840 0 0 15840 3801.6 0 0 0 0 0 0 15840 15840 31680 7603.2 13464 ### 11088 40392 9694.08 87912 240.00 21,098.88
Sili haba grams 158.4 0 0 158.4 9.504 0 0 0 158.4 158.4 316.8 19.008 158.4 158.4 158.4 475.2 28.512 950 60.00 57.02

Sitaw, bunga, berde grams 2552 2552 0 5104 306.24 0 0 0 0 0 0 2552 2552 5104 306.24 2552 2552 2552 7656 459.36 17864 60.00 1,071.84
Soy Sauce grams 1298 0 0 1298 103.84 0 0 0 1298 1298 2596 207.68 1298 1298 1298 3894 311.52 7788 80.00 623.04
Spring onion grams 396 0 0 396 11.88 0 0 0 0 0 0 396 396 792 23.76 396 396 167.2 959.2 28.776 2147 30.00 64.42

Spring Roll grams 4840 0 0 4840 338.8 0 0 0 4840 4840 9680 677.6 0 4840 0 4840 338.8 19360 70.00 1,355.20
Squash grams 35411.2 17349.2 0 52760.4 791.406 0 0 0 0 0 12144 23267.2 47555.2 82966.4 1244.496 21036.4 ### ### 84858.4 1272.876 ### 15.00 3,308.78

Sweet Corn, young grams 6600 0 0 6600 396 0 0 0 6600 6600 13200 792 6600 6600 0 13200 792 33000 60.00 1,980.00
Sweet potato, yellow grams 16249.2 10991.2 0 27240.4 817.212 0 0 0 0 0 3146 13103.2 19395.2 35644.4 1069.332 11303.6 ### 1E+04 42002.4 1260.072 ### 30.00 3,146.62

Tokwa grams 4237.2 3080 0 7317.2 146.344 0 0 3080 4237.2 4237.2 11554.4 231.088 1157.2 4237 3080 8474.4 169.488 27346 20.00 546.92

Tomato Sauce grams 1377.2 0 0 1377.2 82.632 0 0 0 0 0 0 1377.2 1377.2 2754.4 165.264 1377.2 1377 1377 4131.6 247.896 8263 60.00 495.79

Tomato, sliced grams 13345.2 3797.2 0 17142.4 514.272 0 0 0 13345.2 13345.2 26690.4 800.712 13345.2 1E+04 1E+04 38882.8 1166.484 82716 30.00 2,481.47
Tuna Flakes grams 6600 6600 0 13200 2640 0 0 0 0 0 0 6600 6600 13200 2640 6600 6600 6600 19800 3960 46200 200.00 9,240.00
Quantity Requirement
Item & Specifications Unit of Unit Price TOTAL
Measure AMOUNT
Jan Feb Mar Q1 2020 April May June Q2 2019 July Aug Sept Q3 2019 Oct Nov Dec Q4 2019 Total

Tuna Yellow-fin flakes grams 12029.6 0 0 12029.6 2405.92 0 0 0 12029.6 12029.6 24059.2 4811.84 12029.6 1E+04 1E+04 35384.8 7076.96 71474 200.00 14,294.72

Vinegar, coconut grams 1830.4 1830.4 0 3660.8 219.648 0 0 0 0 0 1830 0 3660.8 5491.2 329.472 0 1830 1830 3660.8 219.648 12813 60.00 768.77

B. OPERATIONAL EXPENSE

ORIENTATION OF STAKEHOLDERS
1. 0 0 0 0 0 0 0 0 0 -

2. 0 0 0 0 0 0 0 0 0 -
3. 0 0 0 0 0 0 0 0 0 -
4. 0 0 0 0 0 0 0 0 0 -
5. 0 0 0 0 0 0 0 0 0 -
SUPPLIES & MATERIALS RELATED TO FEEDING PROGRAM

1. Gasul tank 1 1 897.75 0 0 1 1 1 3 2693.25 1 1 897.75 5 897.75 4,488.75


2. Water container 16 6 22 550 0 0 4 16 16 36 900 16 16 10 42 1050 100 25.00 2,500.00

3. Set of Spoons and Fork doz 0 0 0 0 20 20 2580 0 0 20 129.00 2,580.00


4.Frying Pans set 0 0 0 0 1 1 2 2598 0 0 2 1,299.00 2,598.00
5. Drinking Glasses each 110 50 160 4000 160 25.00 4,000.00

Stainless Mixing Bowl each 0 0 0 0 2 2 970 0 0 2 485.00 970.00


MANAGEMENT PROGRAM OPERATION
1. Photocopy 190 90 280 280 0 0 200 200 400 400 190 190 140 520 520 1200 1.00 1,200.00
2. Transportation 20 6 26 364 0 0 2 20 21 43 602 16 20 16 52 728 121 14.00 1,694.00

3. 0 0 0 0 0 0 0 0 0 -

4. 0 0 0 0 0 0 0 0 0 -

5. 0 0 0 0 0 0 0 0 0 -

C. TOTAL (A + B): 237,609.21

D. MONTHLY CASH REQUIREMENTS (In Pesos) ###


D.1 Available at Procurement of Food Commodities
for School-Based Feeding Beneficiaries 51583.998 0 84228.8 ### 246,589.42

D.2 Other Items for Operational Expense 2091.75 0 14743.25 3195.75 20,030.75

TOTAL MONTHLY CASH REQUIREMENTS 53675.748 0 98972 ### 266,620.17

We hereby warrant that the total amount reflected in this Annual Procurement Plan for School Feeding to procure the listed supplies has been included in or is within our approved budget for the year.

Prepared by: Noted By: Approved by:

AURA O. VILLASTIQUE ANGELITA S. RANALAN, CPA RANDOLPH B. TORTOLA


ES Principal II Accountant III Schools Division Superintendent
PURCHASE REQUEST
Entity Name: DEP ED - DIVISION OF BATAAN Fund Cluster: 101
Office/Section : PR No.: Date:
Responsibility Center Code : ______________

Stock/ Property No. Unit Item Description Quantity Unit Cost Total Cost

-
-

~nothing follows~
TOTAL: -

Purpose:
_________________
_________________
_________________
_________________
_________________
____________
_________________
____________ Requested by: Approved by:
Signature :

Printed Name : MARJORIE ROSE JAGONIA 0


Designation : Feeding Coordinator 0
PURCHASE REQUEST
Entity Name: DEP ED - DIVISION OF BATAAN Fund Cluster: 101
Office/Section : PR No.: Date:
Responsibility Center Code : ______________

Stock/ Property No. Unit Item Description Quantity Unit Cost Total Cost

-
-

~nothing follows~
TOTAL: -

Purpose:
_________________
_________________
_________________
_________________
_________________
____________
_________________
____________ Requested by: Approved by:
Signature :

Printed Name : MARJORIE ROSE JAGONIA 0


Designation : Feeding Coordinator 0
Republic of the Philippines
Department of Education
Region III
SCHOOLS DIVISION OFFICE OF BATAAN
Balanga City

LIQUIDATION OF CASH ADVANCE


SUPPLIES FOR FEEDING

√ 1 copy/s Approved School Feeding Plan

√ 1 copy/s Approved Purchase Request

√ 1 copy/s Official Receipt from Supplier

√ 1 copy/s Original Sales Invoice from Supplier

√ 1 copy/s Request for Quotation from 3 Suppliers

√ 1 copy/s Summary of Canvass

√ 1 copy/s Purchase Order

√ 1 copy/s Inspection and Acceptance

√ 1 copy/s RER for Vegetables / Fish

DETAILED List of vegetables / fish with Vendor's


√ 1 copy/s
Signature and information of supplier

√ 1 copy/s Daily Attendance

Delivery Receipt FROM SUPPLIER (ALL ITEMS


√ 1 copy/s
PURCHASED) / Acknowledgement Receipt
Republic of the Philippines
Department of Education
Region III
SCHOOLS DIVISION OFFICE OF BATAAN
Balanga City

SCHOOL FEEDING
GRANTING OF CASH ADVANCE: Remarks

√ 1 copy/s Approved Purchase Request

√ 1 copy/s Photocopy of Sales Invoice from Supplier

√ 1 copy/s RER (IF EVER)

√ 1 copy/s Approved Work and Financial Plan

√ 1 copy/s List of Recipients

√ 1 copy/s Daily Menu FOR THE MONTH

Prepared by:

JOY G. TRINIDAD
REIMBURSEMENT EXPENSE RECEIPT

Entity Name:
Date :

RECEIVED from ______________________________________


(Name)

_________________________________________________ the amount


(Official Designation)

of __________________________________________ (P__________)
(In Words) (in Figures)

in payment for _______________________________________________


(Payments for subsistence, services,

_________________________________________________________
rental or transportation should show inclusive dates,

_________________________________________________________
purpose, distance, inclusive points of travel, etc.)
PAYEE
Name/Signature __________________________________________
Address ________________________________________________

WITNESS
Name/Signature __________________________________________
Address ________________________________________________
Appendix 46

NSE RECEIPT

Fund Cluster : ________________


RER No. : ___________________

Name)

services,

w inclusive dates,

s of travel, etc.)
ACKNOWLEDGEMENT RECEIPT
TO:

NAME OF SCHOOL HEAD:

SCHOOL NAME:

ADDRESS:

CONTACT NUMBER:

P.O. #:

INVOICE NUMBER:

QUANTITY DESCRIPTION UNIT PRICE TOTAL

FROM:

SUPPLIER AUTHORIZED REPRESENTATIVE:

COMPANY NAME:

ADDRESS:

CONTACT NUMBER:

TIN #:

Received from: Received by:

(PRINTED NAME AND SIGNATURE OF SUPPLIER'S (PRINTED NAME AND SIGNATURE OF FEEDING COORDINATOR)
AUTHORIZED REPRESENTATIVE)

Date Delivered: Date Received: 12.30.99

Noted by:

0
(PRINTED NAME AND SIGNATURE OF SCHOOL HEAD)
Date Received: 12.30.99
DETAILED LIST OF VEGETABLES or FISH

School Name:
School Address:
Date Coverage:

DESCRIPTION UNIT QUANTITY UNIT PRICE AMOUNT


1 -
2 -
3 -
4 -
5 -
6 -
7 -
8 -
9 -
10 -
11 -
12 -
13 -
14 -
15 -
16 -
17 -
18 -
19 -
20 -
TOTAL -

Received by: Noted by:

Feeding Coordinator School Head

Delivered by:

Printed Name and Signature of Vendor:


Store Address:
Stall Number:
Contact Number:

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