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NO.:Department of EducationDivision Office, Baguio CityAGENCY PROCUREMENT REQUESTTo:THE PROCUREMENT SERVICERegional Depot - CAR Baguio CityRPLEASE CHECK ( / ) APPROPRIATE BOX ON ACTION REQUESTED ON THE ITEM/S LISTED BELOWa[ ] Please issue common-use supplies/materials per Price List No. ________ dated ______________o Mode of delivery: [ ] Pick-up (Fast Lane) [ ] Pick-up (Schedule) [ ] Delivery (door-to-door)J[ ] Please purchase for our agency non-common items. Attached herewith: [ ] Complete Specifications [ ] Obligation equest (ObR) [ ] Others, pls. specify _________________ [ ] Certificate of Budget Allocation (CBA) [ ] Payment _________________________________ITEMUNIT UNIT PRICEAMOUNTQTY. AGENCY ACCT. CODE:AGENCY CONTROL NO.: PS APR No.:(Date Prepared) In case fund is not sufficient: [ ] Reduce Quantity [ ] Bill Us [ ] Charge to Unutilized Deposit, APR No.: _______Date:______________pjn442-78190NOTE ; ALL SIGNATURES MUST BE OVER PRINTED NAME=STOCKS REQUESTED ARE CERTIFIED TO BE WITHIN APPROVED PROGRAM:FUNDS CERTIFIED AVAILABLE: APPROVED:SOFIA G. BERMUDEZ*Administrative Officer IV - Supply OfficerAgency Accountant Agency Head# [ ] Funs Deposited with PS [ ] ________ Check No. Bank/in the amount of ______________________________b___________________________________________________________________(P__________________) enclosed."downloadable at www.dbm.gov.ph/CARTOTAL***N othing Follows*** PURPOSE: LILIBETH G. DEGSI, CPA$FEDERICO P. MARTIN, EdD,CEdD, CESO V:< `=@{@ABBCccB ZO :#S}[a  dMbP?_*+%&?'?(?)?M Canon MP280 series Printer ߁ odLegal BJDM VT,`Oȇ,`OȇVT,v`Oȇ,v,v`Oȇ,,DRAFTSample 1'dVT$mVT$m@ ? 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