Purchase Order: NO. Unit QTY Description Unit Cost Amount

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PURCHASE ORDER

Supplier: PO No.:
Date:
Address: Mode of Procurement: Shopping
PR No.:
Gentlemen:
Please furnish this office the following articles subjects to the terms and conditions contained herein
Place of Delivery: Delivery Term:
Date of Delivery:
Payment Term:
NO. UNIT QTY DESCRIPTION UNIT COST AMOUNT

TOTAL AMOUNT IN WORDS:


NOTE: 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 everyday of delay shall be imposed

Municipal Mayor

Conforme:
Date: _____________

Note: In case of negotiated Purchase pursuant to Section 369 (a) RA No. 7160, this portion must be accomplished.
Approved per Sangguniang Resolution No. ___________________________________________
Certified Correct: ____________________________________ Date: _________________________________

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