ABCDEFGHIJKLMNOPQRSTUVWXYZ
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PURCHASE REQUEST
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Entity Name:
Fund Cluster: __________________
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TSSD LRLSPR No.:Date: March 6, 2024
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Responsibility Center Code : _________
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Stock/ Property No.Unit Item DescriptionQuantityUnit CostTotal Cost
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Purchase of Spare Tires
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12pcHeavy Duty 3 in 1 Printer1212,000144,000
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10pcProjector with Widescreen set1045,000450,000
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*** Nothing Follows***
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 ---------------
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 TOTAL 594,000.00
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Purpose: For use of service vehicle (Toyota Innova SJS976)
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Requested by:Approved by:
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Signature: ________________________________________________________________p
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Printed Name : ENGR. JOSEPH P. Atty. MARION S. SEVILLA, LL.M
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Designation : OIC-Chief, IMSD Assistant Regional Director
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FM-IM-011
Revision: 2
Effective 2018-04-01
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