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Appendix 61
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PURCHASE ORDER
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______________________
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Entity Name
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Supplier : _____________________________________________
P.O. No. : ____________________________
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Address : _____________________________________________
Date : _______________________________
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TIN : ________________________________________________Mode of Procurement : _________________
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 Gentlemen:
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 Please furnish this Office the following articles subject to the terms and conditions contained herein:
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Place of Delivery : ___________________________________
Delivery Term : ________________________
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Date of Delivery : ____________________________________
Payment Term : ________________________
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Stock/ Property No.UnitDescriptionQuantityUnit CostAmount
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(Total Amount in Words)
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 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.
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 Conforme:Very truly yours,
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__________________________________________________________
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Signature over Printed Name of SupplierSignature over Printed Name of Authorized Official
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 ________________________________________________________
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DateDesignation
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Fund Cluster : ___________________________________
ORS/BURS No. : ______________________
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Funds Available : _________________________________
Date of the ORS/BURS: _______________
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________________________________________
Amount : ____________________________
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Signature over Printed Name of Chief Accountant/Head of Accounting Division/Unit
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