Checklist of Supporting Documents 04.25.16 3

LAGONOY NORTH CENTRAL SCHOOL
CHECKLIST OF SUPPORTING DOCUMENTS

PAYMENT for MATERIALS
(with amount of less than 1k)
Payee: RONALD P. SAVILLA

Purpose: Repainting of some rooms
Amount: P475.00
Check No. 1695613
No. Required Documents Date REMARKS

Disbursement Voucher
1 photo copy of check
2 Approved Purchase Request 4/11/2016
3 Official Receipt 4/15/2016
4 Inspection and Acceptance Report
Submitted by: Verified by:
RONALD P. SAVILLA
(School Head) (Bookkeeper)
LAGONOYNORTH CENTRAL SCHOOL

PAYMENT for SUPPLIES & PRINTING
(with amount of less than 1k)

School Acvitity:
Amount: P475.00
Check No.

2 Approved Purchase Request 3/1/2016
3 Official Receipt 3/4/2016
RONALD P. SAVILLA

PROCUREMENT OF GOODS-ALTERNATIVE MODE ADOPTED
Supplier:
Items/Goods Purchased:
Program/Activity/Purpose:
Duration:
Amount:
Check No:
No. Documents Date REMARKS

1 Photo copy of the check
2 Certification that the items/goods are included in the
approved APP-certified by the Supply Officer
and verified by the BAC Sec.
3 Approved Purchase Request
-date, number, other required data indicated
- duly stamped received by the BAC Secretariat
4 Activity Proposal-if applicable
-date of preparation indicated
-duly certified by the end-user/coordinator
-duly stamped received by the BAC Secretariat
5 Agency Procurement Request -
stamped " no stock available" or "not included in
price list"
6 BAC Resolution No.:____________
-recommending the approval of the adoption of the
alternative mode of procurement
7 Three Requests for Quotations (RfQ)-
7.a 1. RfQ of :_______________________
7.b 2. RfQ of:_______________________
7.c 3. RfQ of:_______________________
8 Abstract of Quotations and Award
- duly dated
-duly certified by the BAC
- declaration of the supplier with the lowest
quotation, indicated
9 Approved Purchase Order
-duly stamped received by COA
- date, number, delivery terms, etc. indicated
-duly stamped received by the supplier
10 Delivery Receipt
-dated
-with itemized listings of the goods
- with printed name and signature of the Dep ED
official who received the items
-date, number, etc. -indicated
-with itemized listing of the goods
12 Official receipt/sale invoices No:__________
13 Requisition & Issue Slip (RIS)
14 BIR Withholding Tax Form-from Sources
ADDITIONAL REQUIREMENTS
FOR T SHIRTS -
Specifications of the t shirts showing the color, design
kind of letterings and other specifications
(this should be indicated in the PR)
15 Distribution list of the t shirts showing the names,

position, number of t shirts received and the dates
of receipts.
FOR MEDICINES
16 License to Operate of the Drug Distributor

17 Certificates of Product Registrations of the medicines
FOR SMALL VALUE EQUIPMENT

(costing 15,000.00 and below)
18 Inventory Custodian Slip
RONALD P. SAVILLA

PROCUREMENT OF GOODS FROM PS-DBM
Supplier:
Program/Activity/Purpose:
Duration:
Amount:
Check No:

3 Agency Procurement Request -
-duly stamped received by the supplier
5 Delivery Receipt
-dated
-with itemized listings of the goods
- with printed name and signature of the Dep ED
official who received the items
-with itemized listing of the goods
7 Official receipt No:__________
8 Requisition & Issue Slip (RIS)
9 Inventory Custodian Slip (ICS) for non-consumable
supplies or small equipment

REPAIRS AND MAINTENANCE OF BUILDINGS

(materials only)
Supplier:
Type of building repaired/maintained;
Check No:
Amount:

approved APP- certified by the Supply Officer
and verified by the BAC Secretariat
4 Approved Program of Work
Three Requests for Quotations (RfQ)-
6.a 1. RfQ of :_______________________
6.b 2. RfQ of:_______________________
6.c 3. RfQ of:_______________________
-duly dated
-declaration of the supplier with the lowest quotation
specifically indicated
-duly atamped received by the supplier
9 Delivery Receipts DR NO:________
-dated
-printed name and signature of the official who
received the items indicated
-with itemized listing of the procured goods
-with the itemized listing of the goods
11 official receipt/sales invoices of supplier No:_____
12 BIR Withholding Tax Form-from Sources (2306 and 2307)
13 Report of Waste Materials
-specific action as to disposal of the waste materials
duly indicated
RONALD P. SAVILLA

LABOR-REPAIRS AND MAINTENANCE OF SCHOOL BUILDINGS & FACILITIES
Payee:
Duration of labor worked:
Type of Building/Facility repaired/maintained:
Check No:
Amount:

IF THE AMOUNT IS ABOVE 3K
2 Certification - as to inclusion in the approved APP
3 Copy of the approved Program of Work (POW)
5 BAC Resolution -recommending the adoption of
Three Requests for Quotations (RfQ)
6.a RfQ 1 ______________________
6.b RfQ 2 ______________________
6.c RfQ 3_______________________
-duly dated
-with the declaration of the laborer with the
lowest quotation
8 Purchase Order/Pakyaw Contract
9 Labor Payroll ( for 2 or more laborers)
10 Pre and Post Inspection Report-Division PFU Coordinator
11 Certificate of Acceptance of the School Head
12 Pictures taken before, during and after
(taken in the same position/angle)
IF THE AMOUNT IS BELOW 3K (petty repairs)

Same requirement as above except:
- POW no longer required
- pre and post inspection report - School Facilities in-charge
Submtted by: Verified by:
RONALD P. SAVILLA

REPAIR/MAINTENANCE-EQUIPMENT
Supplier:
Equipment repaired/maintained:
Check No:
Amount:

3 Copy of the Inventory Custodian Slip
4 Certification from the Property Custodian/Supply
Officer of the cause/s of the damages that will
warrant repair/maintenance
6.a 1. RfQ of :_______________________
6.b 2. RfQ of:_______________________
6.c 3. RfQ of:_______________________
-duly dated
9 Officia receipt/sales invoice of the supplier
11 Report of Waste Materials
-specific action as to disposal of the waste materials
duly indicated
12 Pre and Post Inspection Report
13 Warranty

BOCOGAN ELEMENTARY SCHOOL

REIMBURSEMENT OF TRAVELING/TRAINING EXPENSES
Payee:
Position/Designation:
Purpose of Travel:
Duration of Travel:
Amount:
Check No:

1 duplicate copy of check
2 Original copy of the letter of invitation
of host/sponsoring agency/organization
3 Memorandum from SDS (if applicable)
4 Travel Order
5 Approved Itinerary of Travel
6 Certificate of Travel Completed
7 Original copy of Certificate of Appearance
with original initial of the activity coordinator
8 Official receipt for the registration fee
9 Office receipt for the hotel accomodation
if lodging cost exceeds P400.00
10 certification from the School Head as to
the absolute necessity of the cost of the
hotel accommodation if the lodging cost
exceeded the 400.00 cost per day
11 Passenger copies of the bus/van tickets
12 paper/electronic plane tickets
13 boarding pass
14 terminal fee tickets
15 RER for taxi fare, motorboat, habal-habal
Affidavit of loss shall not be considered as appropriate replacement.

EDITA O. PANUNCIO MA. SUSANA S. CORRE

PAYMENT OF ELECTRIC BILL
Payee: EDITA O. PANUNCIO

Consumption Period/Billed Period:
Amount:
Check No:

2 Statement of Account
3 Official Receipt
(2306 and 2307)

(Name of School)

PAYMENT OF WATER CONSUMPTION BILL
Payee:
Amount:
Check No:

3 Official Receipt
4 BIR Withholding Tax Form-from Sources (2306 and 2307)

DEP ED CAMARINES SUR DIVISION

PAYMENT OF POSTPAID INTERNET/ MOBILE PHONE

Consumption Period/Billed Period: Apr-16
Amount: P 500.00
Check No: Cash

3 official receipt
RONALD P. SAVILLA
DEP ED CAMARINES SUR DIVISION

PAYMENT OF PREPAID INTERNET/ MOBILE PHONE
Payee: EDITA O. PANUNCIO

Amount:
Check No:

2 official receipt
3 actual used card


PAYMENT OF JANITORIAL/SECURITY SERVICES

Pay Period: May-16
Amount: 1,000.00
Check No: Cash
No. Required Documents Date Remarks

For janitorial/ security services-

2 Job Order contract
3 Accomplishment report prepared and
signed by the laborer and verified by
the School Head - specifying the area
and rooms cleaned, and the dates
4 DTR
5 RER
For General Services -

(procured on some cases only, such as
cutting of tree branches after typhoon,
removal of debris after typhoon, etc.)
1 Disbursement Voucher
3 Purchase Request
4 Accomplishment Report
5 RER
RONALD P. SAVILLA
(Name of School)

PAYMENT OF TELEPHONE BILLS
Payee:
Billed period;
Amount:
Check No:

3 official receipt of telephone company
4 Certification by the Head Agency that all
National Direct Dial (NDD), natural
operator assisted calls and international
assisted calls are offcials calls
RONALD P. SAVILLA
(Name of School)

PAYMENT - TARPAULIN
Payee:
School Acvitity:
Amount:
Check No.

If the amount is below 1K
2 Approved Purchase Request indicating
the school activity where the tarpaulin
will be used.
3 Official Receipt
4 Picture of the tarpaulin
If the amount is 1K or above:

Will follow the same procedure on regular
procurement process

(Name of School)

FUEL/GRASS CUTTING
Payee:
Amount:
Check No:
No. Date REMARKS

2 Approved Pruchase Request
approved APP- certified by the Supply Officer
and BAC Sec.
5 Official receipts of the gasoline station

(Name of School)

LABOR/GRASS CUTTING
Payee:
Amount:
Check No:
No. Date REMARKS

3 Pre and Post Inspection Report
4 Pictures taken before, during and after the grass
cutting were made (taken same position/angle/place
5 Accomplishment report of the laborer
- signed by the laborer
-certified by the School Head
-specific date/s and areas where the grass cutting
were made, duly indicated
Dates Areas No. of Liters Used
6 RER

(Name of School)

HAULING EXPENSES
Payee:
Goods/items hauled
Amount:
Check No:
No. Date REMARKS

If the amount is 1K or above:
4.a 1. RfQ of :_______________________
4.b 2. RfQ of:_______________________
4.c 3. RfQ of:_______________________
-duly dated
6 Purchase Order/Contract of Agreement
7 Inspection and Acceptance Reporrt
8 official receipt/sales invoice (if any) OR No:
9 RER
10 Photo copy of the Driver's License
11 Photo copy of the LTO registration
of the vehicle
12 Certified list of the items/goods hauled, showing their
quantities that warranted the hauling thereof
signed by the hired driver
If the amount is below 1K (for short-distance hauling,

upland and/or not passable roads)
2 RER
1 Accomplishment Report
2 Picture of hauled items

(Name of School)

FIDELITY BOND
Payee:
Amount:
Check No:
Effectivity date of the bond:
Risk No.
Amount of the bond:
No. Date REMARKS

2 Confirmation letter (if available)
3 Authority to Accept Payment (ATAP)
4 Validated bank deposit

(Name of School)

REMITTANCE-BIR WITHHOLDING TAXES
Payee:
Amount:
Check No:
No. Date REMARKS

2 Monthly alphalist of payees
3 BIR Form No. 1600
4 BIR Form No. 1601-E
5 BIROfficial Receipt
- or -
Validated Bank Deposit Slip or eFPS confirmation slip

LAGONOY NORTH DISTRICT

NOTARIAL FEES
Payee:
Amount:
Check No:
No. Date REMARKS

3 Official receipt of the notary official/lawyer
4 photo copy of the document notarized
RONALD P. SAVILLA
(Name of School)

REIMBURSEMENT-PHOTO COPYING OF DOCUMENTS
Payee:
Amount:
Check No:
No. DOCUMENTS Date REMARKS

- quantities of test papers per subject duly indicated
- duly dated
-quantities of test papers per subject-indicated
5 Official receipts OR No:_________
IF AMOUNT IS MORE THAN P1,000.00

7.a 1. RfQ of :_______________________
7.b 2. RfQ of:_______________________
7,c 3. RfQ of:_______________________
-duly dated

(Name of School)
SCHOOL BASED FEEDING PROGRAM (SBFP)
Payee:
Amount:
SBFP feeding period:
Check No:
1 Copy of the Work and Financial Plan approved by the

SBFP Core Group
2 Copy of the Project Procurement Management Plan
(PPMP) approved by the SBFP Core Group
3 Cycle Menu for the 120 feeding days, consisting of iron-
fortified rice and viand, approved by the SBFP Core Group
4 Masterlist of Beneficiaries (SBFP From 1), approved by
the School Head
5 SBFP Form 2, approved by the School Head
(for SBFP SY 2014-2015 only)
SBFP Form 3-SBFP Summary of Beneficiaries and Start
of Feeding
6 Certification from the SBFP Core Group that the GPP
was the source of vegetabels used in the feeding
7 Disbursement Voucher
10 BAC Resoultion - recommending the adoption of
11 Three Requests For Quotations (RFQ)
11.a 1. RFQ of ___________________
11.b 2. RFQ of ___________________
11.c 3. RFQ of ___________________
14 Daily inspection and acceptance report, showing in one
column- the menu for the day based on the Cycle Menu;
another column- the actual menu prepared/cooked; and
last column, the reasons for the change of menu
15 Official receipts/sales invoices of suppliers/stores
16 Pictures taken before, during and after feeding and the
goods procured
16 SBFP Form 4 (daily attendance and monitoring of

nutritional status of the children/beneficiaries
ADDITIONAL REQUIREMENTS-END OF FEEDING
17 SBFP Accomplishment(School) Physical and Financial

Report approved by the SBFP Core Group
18 Program Terminal Report (PTR)
19 SBFP Monitoring Tool (School)

(Name of School)

GULAYAN SA PAARALAN 2015-2016
Payee:
Amount:
Check No:
2 School Profile and Work and Financial Plan, received
by the SDO (GPP Form 1)
4 BAC Resolution recommending adoption of alternative
mode of procurement
Three Requests For Quotations (RFQ)
5.a 1. RFQ of __________________
5.b 2. RFQ of __________________
5.c 3. RFQ of __________________
9 Official receipt/sales invoices of supplier
10 Pictures taken, before, during and after
(taken same position/angle)
11 GPP Terminal Report (GPP Form 2) received by the
SDO

(Name of School)

GULAYAN SA PAARALAN SY 2014-2015
Payee:
Amount:
Check No:
2 GPP Project Proposal
3 School Work Plan for Elementary
5 BAC Resolution recommending adoption of alternative
mode of procurement
Three Requests For Quotations (RFQ)
6.a 1. RFQ of __________________
6.b 2. RFQ of __________________
6.c 3. RFQ of __________________
10 Official receipt/sales invoices of supplier
11 Pictures taken, before, during and after
(taken same position/angle)
12 GPP Terminal Report certified by School NGP
Coordinator and approved by School Head

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LAGONOY NORTH CENTRAL SCHOOL

CHECKLIST OF SUPPORTING DOCUMENTS

Payee: RONALD P. SAVILLA

No. Required Documents Date REMARKS

Submitted by: Verified by:

CHECKLIST OF SUPPORTING DOCUMENTS

Payee: RONALD P. SAVILLA

No. Required Documents Date REMARKS

Submitted by: Verified by:

CHECKLIST OF SUPPORTING DOCUMENTS

No. Documents Date REMARKS

15 Distribution list of the t shirts showing the names,

16 License to Operate of the Drug Distributor

FOR SMALL VALUE EQUIPMENT

18 Inventory Custodian Slip

Submitted by: Verified by:

CHECKLIST OF SUPPORTING DOCUMENTS

No. Documents Date REMARKS

Submitted by: Verified by:

(School Head) (Bookkeeper)

REPAIRS AND MAINTENANCE OF BUILDINGS

No. Documents Date REMARKS

Submitted by: Verified by:

CHECKLIST OF SUPPORTING DOCUMENTS

No. Documents Date REMARKS

IF THE AMOUNT IS BELOW 3K (petty repairs)

CHECKLIST OF SUPPORTING DOCUMENTS

No. Documents Date REMARKS

(School Head) (Bookkeeper)

CHECKLIST OF SUPPORTING DOCUMENTS

No. Required Documents Date REMARKS

Affidavit of loss shall not be considered as appropriate replacement.

Submitted by: Verified by:

CHECKLIST OF SUPPORTING DOCUMENTS

Payee: EDITA O. PANUNCIO

No. Required Documents Date REMARKS

Submitted by: Verified by:

EDITA O. PANUNCIO MA. SUSANA S. CORRE

CHECKLIST OF SUPPORTING DOCUMENTS

No. Required Documents Date REMARKS

Submitted by: Verified by:

(School Head) (Bookkeeper)

LAGONOY NORTH CENTRAL SCHOOL

CHECKLIST OF SUPPORTING DOCUMENTS

Payee: RONALD P. SAVILLA

No. Required Documents Date REMARKS

Submitted by: Verified by:

BOCOGAN ELEMENTARY SCHOOL

CHECKLIST OF SUPPORTING DOCUMENTS

Payee: EDITA O. PANUNCIO

No. Required Documents Date REMARKS

Submitted by: Verified by:

EDITA O. PANUNCIO MA. SUSANA S. CORRE

CHECKLIST OF SUPPORTING DOCUMENTS

Payee: RONALD P. SAVILLA

No. Required Documents Date Remarks

For janitorial/ security services-

For General Services -

Submitted by: Verified by:

CHECKLIST OF SUPPORTING DOCUMENTS

No. Required Documents Date REMARKS

Submitted by: Verified by:

CHECKLIST OF SUPPORTING DOCUMENTS

No. Required Documents Date REMARKS