GAAM Vol. II Appendex 18 GAAM Vol. II Appendex 18Revised January 1992 Revised January 1992

REIMBURSEMENT EXPENSES RECEIPT REIMBURSEMENT EXPENSES RECEIPT

Date __________________ No. _____________________ Date __________________ No. _____________________

Received from ______________________________________________ Received from ______________________________________________ (Name) (Name)

_____________________________________________________ the amount _____________________________________________________ the amount

of _____________________________________________ (Php____________) of _____________________________________________ (Php____________)

in payment for ___________________________________________________ in payment for ___________________________________________________

rental or transportation should show inclusive dates, rental or transportation should show inclusive dates,

purpose, distance, inclusive points or travel, etc.) purpose, distance, inclusive points or travel, etc.)

PAYEE PAYEE

Name/Signature: _________________________________________________ Name/Signature: _________________________________________________

Address: ________________________________________________________ Address: ________________________________________________________

Residence Cert. No.: ______________________________________________ Residence Cert. No.: ______________________________________________

Date of Issue: ____________________________________________________ Date of Issue: ____________________________________________________

Place of Issue: ________________ Place of Issue: ___________________________________________________

WITNESS WITNESS

Name/Signature: _________________________________________________ Name/Signature: _________________________________________________

Address: ________________________________________________________ Address: ________________________________________________________

Residence Cert. No.: ______________________________________________ Residence Cert. No.: ______________________________________________

Date of Issue: ____________________________________________________ Date of Issue: ____________________________________________________

Place of Issue: ___________________________________________________ Place of Issue: ___________________________________________________

(Payment for subsistence, services, (Payment for subsistence, services,

of _____________________________________________ (Php____________)

135

Summary of Expenses

Program / Activity Description Payee Date Amount

ROD MYPA Meals (Snacks) Greenwich 10225 07/03/15 1,001.00

Meals (Lunch) Penongs Lanang 01010343 07/03/15 1,326.00

Taxi Fare Davtransco Taxi 011390 07/03/15 50.50

Fare & Softdrinks RER 07/03/15 62.00

Taxi Fare Voiture Taxi 17689 06/25/15 82.00

Taxi Fare Arlyn Mea Taxi 2318 06/25/15 92.50

Taxi Fare Lago Grande 164 06/25/15 103.00

Taxi Fare RGSM Taxi 25405 06/26/15 92.50

Taxi Fare Mabuhay Taxi 2201 06/08/15 61.00

Taxi Fare Maro Taxi 14107 06/26/15 131.00

Taxi Fare Datts Taxi 6658 06/22/15 274.50

Taxi Fare Visa Cab 11135 06/22/15 274.50

GRAND TOTAL 3,550.50

Prepared by:

WENA C.TINIO

TESDS II

Receipt No./Docketed

No.

Conduct of Compliance Audit (Assessment)

Summary of Expenses

Program / Activity Description Payee Receipt No. Date Amount

Meals Uloy's Ihaw-ihaw 31444 08/28/15 600.00

Pinakbet Edong's Lechon Manok 017193 08/28/15 280.00

Meals 11003 08/28/15 360.00

Meals 11006 08/28/15 643.00

Softdrinks & Rice RER 08/28/15 99.00

Jeepney Fare RER 08/28/15 32.00

GRAND TOTAL 2,014.00

Prepared by:

JEAN C. GONZALES

SR. TESDS

RE-ECHO ON ENHANCE CURRICULUM

Freemont Foods Corporation

Freemont Foods Corporation

TESDA

Standard Form Number: SF-GOODE-59 Project Reference Number: N/ARevised On: May 24, 2004 Name of Project: N/A

Location of the Project: N/A

PURCHASE REQUESTTechnical Education and Skills Development Authority, Davao City

616 Interior 2, Rimas St., Aquino Subd., JP Laurel Avenue, Davao CityRegional Office XI

(Agency)

Department: ROD PR No : Date : 06-Aug-15Section SAI N o : Date :

Stock No. Unit Item Description Quantity Unit Cost Total Cost

unit Computer Monitor 19" 2 6,000.00 12,000.00

12,000.00 Purpose: For MoNet and Scholarship use

REQUESTED BY : APPROVED BY :

SignaturePrinted Name ARLYN S. BANDONG GASPAR S. GAYONA, Ph.D., CESO IIIDesignation Chief, ROD Regional Director

Standard Form Title: Purchase Request

TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY Project Reference Number: N/A 616 Interior 2, Rimas St., Aquino Subd., JP Laurel Avenue, Davao City Name of the Project: N/ATelephone Nos. 221-8778/222-2294 Location of the Project: N/A

Standard Form Number: SF-GOOD-60 Date: Aug. 6, 2015Revise on: May 24, 2004 Quotation No.:

Company Name: ______________________________________________________________________________Address: ____________________________________________________________________________________

Please quote your lowest price on the item/s listed below,subject to the General Conditions on the last page, stating the shortest time of delivery and submit your quotation duly signed by your representative not later than _________________ in the return envelop attached herewith.

WILMA G. UDALVENOTE: Procurement Officer

1. ALL ENTRIES MUST BE TYPEWRITTEN.2. DELIVERY PERIOD WITHIIN __________ CALENDAR DAYS3. WARRANTY SHALL BE FOR A PERIOD OF SIX (6) MONTHS FOR SUPPLIES &MATERIALS, ONE YEAR FOR EQUIPMENT, FROM THE DATE OF ACCEPTANCE OF THE PROCURING ENTITY.4. PRICE VALIDITY SHALL BE FOR A PERIOD OF ___________ CALENDAR DAYS.5. G-EPS REGISTRATION CERTIFICATE SHALL BE ATTACHED UPON SUBMISSION OF THE QUOTATION.6. BIDDERS SHALL SUBMIT ORIGINAL BROCHURES SHOWING CERTIFICATIONSOF THE PRODUCT BEING OFFERED.

ITEM & DESCRIPTION QTY UNIT PRICE

1 Computer Monitor 19" 2 units

For MoNet and Scholarship use

Brand & Model: __________________________Delivery Period: __________________________

Warranty: __________________________Price Validity: __________________________

After having carefully read and accepted your General Conditions, I/ We quote you on the item at prices

noted above.Printed Name & Signature_____________________Tel. No./ Cellphone #e-mail address_______________________Date

Standard Form Title : Request for Quotation

ITEM NO.

Republic of the PhilippinesTECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY XI

Regional Office, 616 Interior 2, Rimas St., Aquino Subd., JP Laurel Avenue, Davao CityTelephone Nos. 221-8778, 222-2294,

Date: 6-Aug-15 NOTICE TO BIDDERS:

Sealed bids subject to the conditions consigned herein will be received at the Technical Education

publicly opened for the furnishing POB, TESDA Office XI of the following: TO BE DELIVERED WITHIN_________ WORKING DAYS AFTER RECEIPTS OF AWARD

No. Qty. Unit NAMES AND DESCRIPTION OF ARTICLES Unit Price Total Price

1 1 unit Router P_____________ P____________

TERESITA Y. RODA GASPAR S. GAYONA, Ph.D., CESO IIICanvasser Regional Director

The above are our quoted for items called for and I/We hereby certify that the above articles are our bonafide stock. In case of failure on our part to furnish the above materials and or equipment within____working days from the date of receipt of the order we agree to pay the penalty imposed one tenth (1/10) of the percent per day of delay the diferent in price should there be any other expenses that the government may incure in securing articles from the dealers and therefore authorizing the TESDA Disbursing Officer to deduct the value of the penalty imposed from any money due or which may become due us.

Name of Establishment________________________________________ Business/Trade Name_________________________________________ Principal Place of Business____________________________________ Vat No. or Non Vat Taxpayer Reg. No___________________________ TIN _________________________________________________________

and Skills Development Authority Office XI, Davao City on or before 10:00 Am dated on , ________2014

TESDA

Standard Form Number: SF-GOODE-58 Project Reference Number:Revised On: May 24, 2004 Name of Project:

Location of the Project:

PURCHASE ORDERTechnical Education and Skills Development Authority, Davao City

616 Interior 2, Rimas St., Aquino Subd., JP Laurel Avenue, Davao CityName of Procuring Entity

Supplier JEAN C. GONZALES P. O.

Address Date

Email Address

Telephone No.

TINGentlement

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 No. Unit Description Quantity Unit Cost

units Computer Monitor 19" 2 5,590.00 11,180.00

unit Optical Mini Mouse 1 680.00 680.00

(Total Amount in Words) Eleven thousand eight hundred sixty pesos only 2,014.00

In case of failure to make the full delivery the time specified above, a penalty .

of one-tenth (1/10) of one percent for every day of delay shall be imposed.

JEAN C. GONZALES GASPAR S. GAYONA, Ph.D., CESO III

(Signature Over Printed Name) Regional Director

(Authorized Officials)

(Date)

Date

Funds Available: OR No.:

Amount: 2,014.00

Source of Fund:

MIREY LOVE C. CAGUIAT Name of End User:

Accountant IV Check No.:

Standard Form Title: Purchase Order

Mode of Procurement

Appendix 64

INSPECTION & ACCEPTANCE REPORT

Technical Education and Skills Development Authority, Davao City(Agency)

Supplier: JEAN C. GONZALES IAR No :

PO No. Invoice No.0140 Date : 12/31/14Requisitioning Office/Dept.

Stock No. Unit Description Qty. Unit Total

page Publication of 2014 Compendium of 2 10,000.00 20,000.00

Registered Programs and Accredited

Assessment Centers

20,000.00 Inspected, verified and found OK Partial (pls. specify quantity)as to quantity and specifications

JOEL A. ATABLANCO WILMA G. UDALVE Inspection Officer Supply Officer

For Property Officer Use

Republic of the Philippines Technical Education and Skills Development Authority XI

ABSTRACT OF BIDS

Tel. Nos. 221-8778 and 222-2294July 18, 2014

NO. QTY. Unit Description Chippens Yellow Fin Seafood Restaurant

1 5 pax Meals - Dinner 2,111.20 2,200.00 2,325.00

Item no. 1 is Nanay Bebeng Culinary Enterprises, Inc. due to lower costs

MELBA A. RAÑON ADONIS F. CULAS JEAN C. GONZALES DORLITA B. LAUREL ARLYN S. BANDONG

Provisional Member Provisional Member Reg. Member Vice-Chair Chairman

Nanay Bebeng Culinary Enterprises, Inc.

Appendix 50TESDA

Standard Form Number SF-GOOD-61 Revised on: May 24, 2004Standard Form Title: Requisition and Issuance Slip

REQUISITION AND ISSUANCE SLIP

Technical Education and Skills Development Authority, XI616 Interior 2, Rimas Street, Aquino Subdivision, JP Laurel Avenue, Davao City

Regional Office XI, Tel. No. 221-8778

DIVISION: ROD RIS No.OFFICE: TESDA XI - Regional Office SAI No.

R e q u I s I t I o n

Stock No. Unit Description Quantity Unit Remarks

page Publication of 2014 Compendium of 2 10,000.00 20,000.00

Registered Programs and Accredited

Assessment Centers

Purpose: 20,000.00 Requested By : Approved By : Issued By : Received By :

JEAN C. GONZALES WILMA G. UDALVE MALANGKA S. JUMDANA JEAN C. GONZALESSr. TESDS Supply Officer V Adm. Asst. III Sr. TESDS

Annex A1Republic of the Philippines

TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY616 Interior 2, Rimas St., Aquino Subd., JP Laurel Avenue, Davao City

Regional Office XI

No.

OBLIGATION REQUEST

Payee JEAN C. GONZALES

Office

Address Davao City

Responsibility AccountCenter P.P.A Code Amount

To reimbursement of expenses spent during re-echo on 2,014.00 enhanced curriculum as per supporting papers hereto attached in the amount of…

Total 2,014.00

Certified Certified

Charges to appropriation/allotment necessary, lawful Allotment available and obligated for the Purpose and under my direct supervision as indicated above

Supporting documents valid, proper and legal

Signature Signature

PrintedARLYN S. BANDONG

Printed YOLANDA S. VILLAFLORName Name

Position Chief, ROD Position Administrative Officer V

Head, Requesting Officer/Authorized Representative Head, Budget Unit/Authorized Representative

Date Date

A.

B.

A.

B.

A. B.

A.

Annex BRepublic of the Philippines

TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY616 Interior 2, Rimas St., Aquino Subd., JP Laurel Avenue, Davao City

Regional Office XI

DISBURSEMENT VOUCHER No.

MODE OF PAYMENT MDS Check Commercial Check ADA Others

TIN/Employee No. OR/BUR No.Payee JEAN C. GONZALES

Office/Unit/Project Code

Address Davao City

EXPLANATION AMOUNT

To reimbursement of expenses spent during re-echo on 2,014.00 enhanced curriculum as per supporting papers hereto attached in the amount of…

0

0

2,014.00 Certified: Approved for Payment: Cash Available

Supporting documents complete and proper

Subject to ADA (where available)

Signature Signature

Printed MIREY LOVE C. CAGUIAT

Printed GASPAR S. GAYONA, Ph.D., CESO III Name Name

Position Accountant IV Position Regional DirectorHead, Accounting Unit/Authorized Representative Agency Head/Authorized Representative

Date Date Received Payment: JEV NO. Check/ Date Bank Name ADA No.

Date Printed Name Date:Signature

Official Receipt/Other Documents

A B

D

B

D

C

TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITYRegion XI, Davao City

TRAVEL ORDERNo. _________

Name : ADONIS F. CULAS

Station : TESDA XI - RO, Davao City

You are hereby directed to travel on official business via Cebu Pacific, land transport,and/or sea transport.

Place : Davao del SurDuration: Dcember 10, 2014Purpose: Attendance to the Local Poverty Reduction Action Team Orientation

It is understood that a report shall be submitted upon completion of this travel.

GASPAR S. GAYONA, Ph.D., CESO III Regional Director

Authorized Representative

TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITYRegion XI, Davao City

TRAVEL ORDERNo. _________

Name : ADONIS F. CULAS

Station : TESDA XI - RO, Davao City

You are hereby directed to travel on official business via Cebu Pacific, land transport,and/or sea transport.

Place : Davao del SurDuration: Dcember 10, 2014Purpose: Attendance to the Local Poverty Reduction Action Team Orientation

It is understood that a report shall be submitted upon completion of this travel.

GASPAR S. GAYONA, Ph.D., CESO III Regional Director

Authorized Representative

Appendix 46

ITINERARY OF TRAVEL

TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY 616 Interior 2, Rimas St., Aquino Subd., JP Laurel Avenue, Davao City

Region XI

No.

Name: ADONIS F. CULAS

Purpose of Travel: Attendance to the LPRAT Orientation

TIME Expenses

Date Places to be Visited Means of FARE ALLOW Total

Depart. Arrival Transpo.

10-Dec-14 Davao City - Davao del Sur 6:30 AM 9:00 AM RP Vehicle - 320.00 320.00

10-Dec-14 Davao del Sur - Davao City 6:30 PM 9:00 AM RP Vehicle

TOTAL 0.00 320.00 320.00 Prepared by:

I certify that : (1) I have reviewed theforegoing itinerary , (2) the travel isnecessary to the service, (3) the periodforegoing itinerary , (2) the travel is ADONIS F. CULAScovered is reasonable and (4) the Official/Employeeexpenses claimed are proper. Approved by:

ARLYN S. BANDONGSupervisor GASPAR S. GAYONA, Ph.D., CESO III

Regional Director

TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITYAgency

CERTIFICATE OF TRAVEL COMPLETED

GASPAR S. GAYONA, Ph.D., CESO III TESDA Regl. Office XIAgency Head Station

Regional Director 10-Dec-14Position DATE

I CERTIFY THAT I have completed the travel authorized in Itinerary of Travel No. dated December 26, 2012 under conditions indicated below:

x Strictly in accordance in the approved itinerary.Cut short as explained below; payment in the amount of P ________, was refundedunder O. R. No. _________, dated ______________.Extended as explained below; additional itinerary was submitted.Other deviations as explained below:

Explanation or justification:

Evidence of Travel:x Appendix B

Plane Ticket/Busx Certificate of Appearance

Others:

Respectfully Submitted:

ADONIS F. CULASSr. TESDS

On evidence and information of which I have knowledge, the travel was actually undertaken.

ARLYN S. BANDONGSupervisor

Appendix 58

LIQUIDATION REPORT No.Date: 8-Oct-12

TECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY Responsibility Center(Agency) Code:

ALBERT N. MANINGO

PARTICULARS AMOUNT

Liquidation of cash advance granted for traveling expenses during the ROD Team ###at Surigao del Sur on October 4-6, 2012

TOTAL AMOUNT SPENT 2,400.00AMOUNT OF CASH ADVANCE PER DV NO. 12-08-900 Dtd. 2,400.00AMOUNT REFUNDED PER OR NO. _____________DTD_________

AMOUNT TO BE REIMBURSE

Certified: Correctness of the Certified: Purpose of travel/cash Certified: Supporting documents

above date advance duly accomplished complete and proper

ALBERT N. MANINGO ARLYN S. BANDONG MIREY LOVE C. CAGUIAT

Immediate Supervisor Accountant IV

Claimant JEV. No.

AA

B C

Republic of the PhilippinesTECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY

Rimas St., Aquino Village, J.P. Laurel Avenue, Davao City

PAYMENT OF SALARYDecember 2013

Gross Total

350 4 1400.00 0 43.75 32 1,400.00

Each Official whose name appears above has been paidthe amount indicated opposite his/her name. Certified by:

EVANGELINE C. PEDARIOS MIREY LOVE C. CAGUIATCashier Accountant IV

Noted by:

ARLYN S. BANDONGChief TESD Specialist, ROD

NAME OF PERSONNEL

Rate per Day

No. of Working

days

Minutes Late

Rate per hour

Undertime hours

Total Number of Hours

JESSIELO C. GUBALANI

Republic of the PhilippinesTECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY

616 Int. 2, Rimas St., Aquino Village, J.P. Laurel Avenue, Davao City

PAYMENT OF SALARYDecember 16-31, 2014

Gross Total

620 13 8060.00 0 77.50 0 8 8,680.00

Each Official whose name appears above has been paidthe amount indicated opposite his/her name. Certified by:

KRISTI DONNA N. PAREDES MIREY LOVE C. CAGUIATHRMO Accountant IV

Noted by:

ARLYN S. BANDONGChief TESD Specialist, ROD

NAME OF PERSONNEL

Rate per Day

No. of Working

days

Minutes Late

Rate per hour

Undertime

Overtime (in hours)

ALBERT N. MANINGO

Republic of the PhilippinesTECHNICAL EDUCATION AND SKILLS DEVELOPMENT AUTHORITY616 Interior 2, Rimas St., Aquino Subd., JP Laurel Avenue, Davao City

PAYROLL

NAME OF PERSONNEL DESIGNATION AMOUNT SIGNATURE

ARLYN S. BANDONG CHIEF ROD 1,840.00

THELMA M. REQUILLO TESDS II 1,040.00

ARNULFO L. PELAYO DRIVER 1,040.00

ALBERT N. MANINGO JOB ORDER 1,040.00

TOTAL 4,960.00

Each Official whose name appears above has been paidthe amount indicated opposite his/her name.

Prepared by:

EVANGELINE C. PEDARIOSCashier

PANTAWID PAMILYA BENEFICIARIES

AS OF MAY 20, 2014

PANTAWID PAMILYA BENEFICIARIES

AS OF MAY 20, 2014

PANTAWID PAMILYA BENEFICIARIES

AS OF MAY 20, 2014

PANTAWID PAMILYA BENEFICIARIES

AS OF MAY 20, 2014