ABCDEFGHIJKLMNOPQRSTUVWXYZ
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PURCHASE ORDER
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SK of Barangay:City/Municipality:
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Tel. No.:Province:
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Supplier: ___________________________________________PO No.: ____________________________
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Address: __________________________________________Date: ______________________________
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Tel. No.:____________________TIN: ___________________Mode of Procurement: _________________
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Gentlemen: Please deliver to 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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Item No.Unit of MeasurementItem DescriptionQuantityUnit CostAmount
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(Total Amount in words)
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 In case of failure to make 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 SK Chairperson
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______________________________________
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DateDate
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Availability of the budget or funds received for specific purpose:
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_________________________________________________________ ____________________
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 Signature over Printed Name of Budget Monitoring Officer Date
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