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Republic of the Philippines

DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

DISBURSEMENT VOUCHER
Mode of
Payment

ADA

Commercial Check

MDS Check

RIVERDALE APPLIANCE SERVICE CENTER

Payee

Address

TUGUEGARAO CITY
EXPLANATION

To obligate payment of labor and materials for the installation of 2 units split type ai
as per supporting papers hereto attached in the amount of ..
Attachments:
1. Canvass
2. PR
3. ORS
4. Abstract of Canvass

Certified

Approv

Cash Available
Subject to Authority to Debit Account (when applicable)
Supporting documents complete

Signature

Signature

Printed Name

Printed Name

Position

Head, Accounting Unit/Authorized Representative

Date
C

Position
Date

Received Payment

Check/
ADA No.

Date

Signature

Date

Official Receipt/Other Documents

Bank Name
Printed Name

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

DISBURSEMENT VOUCHER
Mode of
Payment

MDS Check

ADA

Commercial Check

Payee

Address

EXPLANATION

Signature

Certified
Cash Available
Subject to Authority to Debit Account (when applicable)
Supporting documents complete

Signature

Approv

Printed Name

Printed Name

Position

Head, Accounting Unit/Authorized Representative

Date
C
Check/

Position
Date

Received Payment

ADA No.

Date

Signature

Date

Bank Name
Printed Name

Official Receipt/Other Documents

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

DISBURSEMENT VOUCHER
Mode of
Payment
Payee

MDS Check

Commercial Check

ADA

GINA M. CONSIGNA
Tuguegarao City, Cagayan

Address

EXPLANATION

To Cash Advance payment of airfare and per diems


as per supporting papers hereto attach in the amount of
Attachments:

1.
2.
3.
4.

Itinerary of Travel
Approved TO
DV
ORS

CERTIFICATION:

Thi is certify that Ms. Gina M. Consigna has no pending unliquidated cas
this date.

Certified

Approv

Cash Available
Subject to Authority to Debit Account (when applicable)
Supporting documents complete

Signature

Signature

Printed Name
Position

BONIFACIO M. TUGADE, Jr.


Head, Accounting Unit/Authorized Representative

Date

Printed Name
Position
Date

Received Payment
C
Check/
ADA No.

Signature
Official Receipt/Other Documents

Bank Name
Date

Printed Name
Date

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

DISBURSEMENT VOUCHER
Mode of
Payment

MDS Check

ADA

Commercial Check

MARICEL F. CAMAPANO

Payee

Tuguegarao City, Cagayan


Address

EXPLANATION

To payment of honorarium under PCAARRD funded project titled S&T on slaughter G


for the perioud January to June 2015 amounting to ..

Certified

Cash Available
Subject to Authority to Debit Account (when applicable)
Supporting documents complete

Approv

Signature

Signature

Printed Name

Printed Name

Position

Head, Accounting Unit/Authorized Representative

Date
C

Position
Date

Received Payment

Check/
ADA No.

Date

Signature

Date

Bank Name
Printed Name

Official Receipt/Other Documents

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

DISBURSEMENT VOUCHER
Mode of
Payment
Payee

MDS Check

Commercial Check

ADA

BRYAN S. SIBAYAN
Tuguegarao City, Cagayan

Address

EXPLANATION

To payment of honorarium under PCAARRD funded project titled S&T on slaughter G


for the perioud January to June 2015 amounting to ..

Certified

Cash Available
Subject to Authority to Debit Account (when applicable)
Supporting documents complete

Approv

Signature

Signature

Printed Name

Printed Name

Position

Head, Accounting Unit/Authorized Representative

Date
C

Position
Date

Received Payment

Check/
ADA No.

Date

Signature

Date

Bank Name
Printed Name

Official Receipt/Other Documents

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

DISBURSEMENT VOUCHER
Mode of
Payment
Payee

MDS Check

Commercial Check

CARELAB
Tuguegarao City, Cagayan

Address

EXPLANATION

ADA

To obligate payment of Cellphone amounting to ..

Certified

Cash Available
Subject to Authority to Debit Account (when applicable)
Supporting documents complete

Approv

Signature

Signature

Printed Name

Printed Name

Position

Head, Accounting Unit/Authorized Representative

Date
C
Check/

Position
Date

Received Payment

ADA No.

Date

Signature

Date

Official Receipt/Other Documents

Bank Name
Printed Name

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

DISBURSEMENT VOUCHER
Mode of
Payment

ADA

Commercial Check

MDS Check

JOMAR REUBEN A. RUECO

Payee

Tuguegarao City, Cagayan


Address

EXPLANATION

Payment of contractual services for the month of July 2015 as per supporting paper
attach in the amount of .
Attachments

1.
2.
3.
4.

Bill of collection
ORS
Output and timeframe
Certificate of acceptance

Certified

Cash Available
Subject to Authority to Debit Account (when applicable)
Supporting documents complete

Approv

Signature

Signature

Printed Name

Printed Name

Position

Head, Accounting Unit/Authorized Representative

Date
C
Check/

Position
Date

Received Payment

ADA No.

Date

Signature

Date

Official Receipt/Other Documents

Bank Name
Printed Name

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

DISBURSEMENT VOUCHER
Mode of
Payment

MDS Check

Commercial Check

Payee

Address

EXPLANATION

ADA

Certified

Cash Available
Subject to Authority to Debit Account (when applicable)
Supporting documents complete

Approv

Signature

Signature

Printed Name

Printed Name

Position

Head, Accounting Unit/Authorized Representative

Date
C

Position
Date

Received Payment

Check/
ADA No.

Date

Signature

Date

Bank Name
Printed Name

Official Receipt/Other Documents

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

DISBURSEMENT VOUCHER
Mode of
Payment
Payee

MDS Check

Commercial Check

ADA

HOTEL ROMA
Tuguegarao City, Cagayan

Address

EXPLANATION

Payment of lodging accommodation of participants during the Geo-Tagging training


as per supporting papers hereto attach in the amount of .

Attachments:

1. PR
2. Canvass
3. Abstract of Canvass

Certified

Cash Available
Subject to Authority to Debit Account (when applicable)
Supporting documents complete

Approv

Signature

Signature

Printed Name

Printed Name

Position

Head, Accounting Unit/Authorized Representative

Date
C

Position
Date

Received Payment

Check/
ADA No.

Date

Signature

Date

Official Receipt/Other Documents

Bank Name
Printed Name

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

DISBURSEMENT VOUCHER
Mode of
Payment

ADA

Commercial Check

MDS Check

HOTEL ROMA

Payee

Tuguegarao City, Cagayan


Address

EXPLANATION

Payment of lodging accommodation of participants during the Geo-Tagging training


as per supporting papers hereto attach in the amount of .
Attachments:

1. PR
2. Canvass
3. Abstract of Canvass

Certified

Cash Available
Subject to Authority to Debit Account (when applicable)
Supporting documents complete

Approv

Signature

Signature

Printed Name

Printed Name

Position

Head, Accounting Unit/Authorized Representative

Date
C

Position
Date

Received Payment

Check/
ADA No.

Date

Signature

Date

Official Receipt/Other Documents

Bank Name
Printed Name

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

DISBURSEMENT VOUCHER
Mode of
Payment
Payee

MDS Check

ADA

Commercial Check

NVES, TAPAYA, Nueva Vizcaya


Tapaya, Nueva Vizcaya

Address

EXPLANATION

To fund transfer for payment of 2 laborer from August 2 to October 6, 2015 for ga
and feeding of imported goat at Sta Fe in the amount of . . .
Attachments:

1. PR
2. Canvass
3. Abstract of Canvass

Certified
Cash Available
Subject to Authority to Debit Account (when applicable)

Approv

Supporting documents complete

Signature

Signature

Printed Name

Printed Name

Position

Head, Accounting Unit/Authorized Representative

Date
C

Position
Date

Received Payment

Check/
ADA No.

Date

Signature

Date

Bank Name
Printed Name

Official Receipt/Other Documents

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

DISBURSEMENT VOUCHER
Mode of
Payment
Payee

MDS Check

Commercial Check

Address

EXPLANATION

ADA

Certified

Cash Available
Subject to Authority to Debit Account (when applicable)
Supporting documents complete

Approv

Signature

Signature

Printed Name

Printed Name

Position

Head, Accounting Unit/Authorized Representative

Date
C

Position
Date

Received Payment

Check/
ADA No.

Date

Signature

Date

Official Receipt/Other Documents

Bank Name
Printed Name

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

DISBURSEMENT VOUCHER
Mode of
Payment
Payee

MDS Check

Commercial Check

CHRISTIAN NICKEL CARUNGI


Tuguegarao City

Address

EXPLANATION
TO payment of of contract services for the month of November 2015
in the amount of . . . . . .

Attachment:
1. ORS
2. Contract of Manpower Services
3. Manpower Deployment
4. Certificate of Acceptance
5. Bill of Colllection

ADA

Certified

Approv

Cash Available
Subject to Authority to Debit Account (when applicable)
Supporting documents complete

Signature

Signature

Printed Name

Printed Name

Position

Head, Accounting Unit/Authorized Representative

Date
C

Position
Date

Received Payment

Check/
ADA No.
Signature
Official Receipt/Other Documents

Date

Bank Name

Date

Printed Name

Annex B

pines

ULTURE

o. 02

No.
ADA

Others

TIN/Employee No.

OR/BUR No.
Responsibility Center

Office/Unit Project

AMOUNT

split type aircon

me

Code

P12,800.00

Approved for Payment

Agency Head/Authorized Representative

JEV No.
Date:

Annex B

pines
ULTURE

o. 02

No.
ADA

Others

TIN/Employee No.

Office/Unit Project

OR/BUR No.
Responsibility Center
Code

AMOUNT

Approved for Payment

Agency Head/Authorized Representative

me

JEV No.
Date:

Annex B

pines
ULTURE

o. 02

No.
ADA

Others

TIN/Employee No.

Office/Unit Project

OR/BUR No.
Responsibility Center
Code

..

dated cash advance as of

AMOUNT

Php

23,589.00

me

Approved for Payment

Agency Head/Authorized Representative

JEV No.
Date:

Annex B

pines
ULTURE

o. 02

No.
ADA

Others

TIN/Employee No.

Office/Unit Project

OR/BUR No.
Responsibility Center
Code

AMOUNT

slaughter Goat program

Php

Approved for Payment

Agency Head/Authorized Representative

36,000.00

me

JEV No.
Date:

Annex B

pines
ULTURE

o. 02

No.
ADA

TIN/Employee No.
Office/Unit Project

slaughter Goat program

Others

OR/BUR No.
Responsibility Center
Code

AMOUNT

Php

28,800.00

Approved for Payment

Agency Head/Authorized Representative

me

JEV No.
Date:

Annex B

pines
ULTURE

o. 02

No.
ADA

TIN/Employee No.

Office/Unit Project

Others

OR/BUR No.
Responsibility Center
Code

AMOUNT

me

Php

Approved for Payment

Agency Head/Authorized Representative

JEV No.
Date:

9,999.00

Annex B

pines
ULTURE

o. 02

No.
ADA

Others

TIN/Employee No.

Office/Unit Project

OR/BUR No.
Responsibility Center
Code

AMOUNT

rting papers hereto

me

Php

Approved for Payment

Agency Head/Authorized Representative

JEV No.
Date:

14,931.00

Annex B

pines
ULTURE

o. 02

No.
ADA

TIN/Employee No.

Office/Unit Project

Others

OR/BUR No.
Responsibility Center
Code

AMOUNT

Approved for Payment

Agency Head/Authorized Representative

me

JEV No.
Date:

Annex B

pines
ULTURE

o. 02

No.
ADA

Others

TIN/Employee No.

Office/Unit Project

OR/BUR No.
Responsibility Center
Code

AMOUNT

ng training on July 22-24, 2015


Php

20,320.00

me

Approved for Payment

Agency Head/Authorized Representative

JEV No.
Date:

Annex B

pines
ULTURE

o. 02

No.
ADA

Others

TIN/Employee No.

Office/Unit Project

OR/BUR No.
Responsibility Center
Code

AMOUNT

ng training on July 22-24, 2015

me

Php

Approved for Payment

Agency Head/Authorized Representative

JEV No.
Date:

5,080.00

Annex B

pines
ULTURE

o. 02

No.
ADA

TIN/Employee No.
Office/Unit Project

Others

OR/BUR No.
Responsibility Center
Code

AMOUNT

2015 for gathering


Php

Approved for Payment

32,000.00

Agency Head/Authorized Representative

me

JEV No.
Date:

Annex B

pines
ULTURE

o. 02

No.
ADA

TIN/Employee No.
Office/Unit Project

Others

OR/BUR No.
Responsibility Center
Code

AMOUNT

me

Approved for Payment

Agency Head/Authorized Representative

JEV No.
Date:

Annex B

pines
ULTURE

o. 02

No.
ADA

TIN/Employee No.
Office/Unit Project

Others

OR/BUR No.
Responsibility Center
Code

AMOUNT

Php

13,890.00

me

Approved for Payment

Agency Head/Authorized Representative

JEV No.
Date:

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

OBLIGATION REQUEST AND STATUS (ORS)


Payee

RIVERDALE APPLIANCE SERVICE CENTER

Office
Address

Tuguegarao City

Responsibility
Center

Particulars

To obligate payment of Labor and materials


for the installation of 2 unit split type aircon at the
DA-RADDL amounting to

TOTAL
A.

Certified: Charges to appropriation / allotment


necessary, lawful, and under my direct supervision, and
supporting documents valid, proper, and legal

Signature:
Printed Name:
Position:

GERONIMA G. LUDAN, DVM


Head, Requesting Office / Authorized Representative

Date:

STATUS OF OBLIGATIO

C.
Reference
Date

Particulars

ORS / JEV / RCI / RADAI


No.

Totals

Obligation

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

OBLIGATION REQUEST AND STATUS (ORS)


Payee

ML FROST

Office
Address

Tuguegarao City, Cagayan

Responsibility
Center

Particulars
To obligate payment of labor and materials for the
installation of 2 units split type and 1 unit window type
aircon.

TOTAL
A.

Certified: Charges to appropriation / allotment


necessary, lawful, and under my direct supervision, and
supporting documents valid, proper, and legal

Signature:
Printed Name:
Position:
Date:

Head, Requesting Office / Authorized Representative

C.

STATUS OF OBLIGATIO
Reference
Date

Particulars

ORS / JEV / RCI / RADAI


No.

Totals

Obligation

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

OBLIGATION REQUEST AND STATUS (ORS)


Payee

GINA M. CONSIGNA

Office
Address

Tuguegarao City, Cagayan

Responsibility
Center

Particulars
To CASH ADVANCDE payment of airfare & per diems
amounting to.

TOTAL
A.

Certified: Charges to appropriation / allotment


necessary, lawful, and under my direct supervision, and
supporting documents valid, proper, and legal

Signature:
Printed Name:
Position:
Date:

GERONIMA G. LUDAN, DVM


Chief, Agriculturist

C.

STATUS OF OBLIGATIO
Reference
Date

Particulars

ORS / JEV / RCI / RADAI


No.

Totals

Obligation

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

OBLIGATION REQUEST AND STATUS (ORS)


Payee

GERONIMA G. LUDAN

Office
Address

Tuguegarao City, Cagayan

Responsibility
Center

Particulars
To CASH ADVANCDE payment of airfare & per diems
amounting to.

TOTAL
A.

Certified: Charges to appropriation / allotment


necessary, lawful, and under my direct supervision, and
supporting documents valid, proper, and legal

Signature:
Printed Name:
Position:
Date:

GERONIMA G. LUDAN, DVM


Chief, Agriculturist

C.

STATUS OF OBLIGATIO
Reference
Date

Particulars

ORS / JEV / RCI / RADAI


No.

Obligation

Totals

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

OBLIGATION REQUEST AND STATUS (ORS)


Payee

JOMAR REUBEN A. RUECO

et.al.

Office
Address

Tuguegarao City, Cagayan

Responsibility
Center

Particulars
To obligate payment of contractual services
for the month of July - December 2015 amounting to ..

TOTAL
A.

Certified: Charges to appropriation / allotment


necessary, lawful, and under my direct supervision, and
supporting documents valid, proper, and legal

Signature:
Printed Name:
Position:
Date:

GERONIMA G. LUDAN, DVM


Chief, Agriculturist

C.

STATUS OF OBLIGATIO
Reference
Date

Particulars

ORS / JEV / RCI / RADAI


No.

Totals

Obligation

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

OBLIGATION REQUEST AND STATUS (ORS)


Payee

Anthony Cordova

Office

DA-RFO

Address

Tuguegarao City

Responsibility
Center

Particulars
Payment of TEV for the period of July 13-17
2015 as per supporting papers hereto attached
in the amount of . . . . . . . . . . .

TOTAL
A.

Certified: Charges to appropriation / allotment


necessary, lawful, and under my direct supervision, and
supporting documents valid, proper, and legal

Signature:
Printed Name:
Position:
Date:

GERONIMA G. LUDAN, DVM


Chief Agriculturist

C.

STATUS OF OBLIGATIO
Reference
Date

Particulars

ORS / JEV / RCI / RADAI


No.

Obligation

Totals

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

OBLIGATION REQUEST AND STATUS (ORS)


Payee

NVES, TAPAYA, Nueva Vizcaya

Office
Address
Responsibility
Center

Tapaya, Nueva Vizcaya


Particulars
To fund transfer for payment of 2 laborer
from August 2 to October 6, 2015 for gathering
and feeding of imported goat at Sta Fe
in the amount of . . .

TOTAL
A.

Signature:
Printed Name:
Position:
Date:

Certified: Charges to appropriation / allotment


necessary, lawful, and under my direct supervision, and
supporting documents valid, proper, and legal

GERONIMA G. LUDAN, DVM


Chief Agriculturist

C.

STATUS OF OBLIGATIO
Reference
Date

Particulars

ORS / JEV / RCI / RADAI


No.

Obligation

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

OBLIGATION REQUEST AND STATUS (ORS)


Payee

GREGORIO SORIANO

Office
Address
Responsibility
Center

Tuguegarao City
Particulars
To obligate payment of labor and materials
for the fabrication and installation of one (1) screen
door od the Liquid Nitrogen Plant Building

TOTAL
A.

Certified: Charges to appropriation / allotment


necessary, lawful, and under my direct supervision, and
supporting documents valid, proper, and legal

Signature:
Printed Name:
Position:
Date:

GERONIMA G. LUDAN, DVM


Chief Agriculturist

C.

STATUS OF OBLIGATIO
Reference
Date

Particulars

ORS / JEV / RCI / RADAI


No.

Obligation

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

OBLIGATION REQUEST AND STATUS (ORS)


Payee

GERONIMA G. LUDAN, DVM

Office
Address

Tuguegarao City

Responsibility
Center

Particulars
To payment of Advanced Cash

TOTAL
A.

Certified: Charges to appropriation / allotment


necessary, lawful, and under my direct supervision, and
supporting documents valid, proper, and legal

Signature:
Printed Name:
Position:
Date:

GERONIMA G. LUDAN, DVM


Chief Agriculturist

C.

STATUS OF OBLIGATIO
Reference
Date

Particulars

ORS / JEV / RCI / RADAI


No.

Obligation

epublic of the Philippines


RTMENT OF AGRICULTURE
ional Field Office No. 02
Tuguegarao City
COA Circular 2015 -002: Annex F

ATUS (ORS)

MFO / PAP

No.

Date
Fund

:
:

UACS Code /
Expenditure

Amount

Php

B.

12,800.00

Certified: Allotment available and obligated


for the purpose / adjustment necessary as
indicated above

Signature:
Printed Name:

MACARIO B. ANDAL

Position:

Chief, Budget Section

Date:
STATUS OF OBLIGATION
Amount
Payment

Not Yet Due

Due and Demandable

epublic of the Philippines


RTMENT OF AGRICULTURE
ional Field Office No. 02
Tuguegarao City
COA Circular 2015 -002: Annex F
No.
Date
Fund

ATUS (ORS)

MFO / PAP

:
:
:

UACS Code /
Expenditure

Amount
P 22,000.00

B.

Certified: Allotment available and obligated


for the purpose / adjustment necessary as
indicated above

Signature:
Printed Name:
Position:
Date:

MACARIO B. ANDAL
Chief, Budget Section

STATUS OF OBLIGATION
Amount
Payment

Not Yet Due

Due and Demandable

epublic of the Philippines


RTMENT OF AGRICULTURE
ional Field Office No. 02
Tuguegarao City
COA Circular 2015 -002: Annex F
No.
Date
Fund

ATUS (ORS)

MFO / PAP

:
:
:

UACS Code /
Expenditure

Amount

f airfare & per diems


Php

23,589.00

23,589.00
Certified: Allotment available and obligated
for the purpose / adjustment necessary as
indicated above

B.

Signature:
Printed Name:
Position:
Date:

MACARIO B. ANDAL
Chief, Budget Section

STATUS OF OBLIGATION
Amount
Payment

Not Yet Due

Due and Demandable

epublic of the Philippines


RTMENT OF AGRICULTURE
ional Field Office No. 02
Tuguegarao City
COA Circular 2015 -002: Annex F
No.
Date
Fund

ATUS (ORS)

MFO / PAP

:
:
:

UACS Code /
Expenditure

Amount

f airfare & per diems


Php

20,989.00

20,989.00
Certified: Allotment available and obligated
for the purpose / adjustment necessary as
indicated above

B.

Signature:
Printed Name:
Position:
Date:

MACARIO B. ANDAL
Chief, Budget Section

STATUS OF OBLIGATION
Amount
Payment

Not Yet Due

Due and Demandable

epublic of the Philippines


RTMENT OF AGRICULTURE
ional Field Office No. 02
Tuguegarao City

COA Circular 2015 -002: Annex F


No.
Date
Fund

ATUS (ORS)

MFO / PAP

:
:
:

UACS Code /
Expenditure

Amount

Php

172,926.00

172,926.00
Certified: Allotment available and obligated
for the purpose / adjustment necessary as
indicated above

B.

Signature:
Printed Name:
Position:
Date:

MACARIO B. ANDAL
Chief, Budget Section

STATUS OF OBLIGATION
Amount
Payment

Not Yet Due

Due and Demandable

epublic of the Philippines


RTMENT OF AGRICULTURE
ional Field Office No. 02
Tuguegarao City
COA Circular 2015 -002: Annex F
No.
Date
Fund

ATUS (ORS)

MFO / PAP

:
:
:

UACS Code /
Expenditure

Amount

Php

3,360.00

3,360.00
Certified: Allotment available and obligated
for the purpose / adjustment necessary as
indicated above

B.

Signature:
Printed Name:
Position:
Date:

MACARIO B. ANDAL
Chief, Budget Section

STATUS OF OBLIGATION
Amount
Payment

Not Yet Due

Due and Demandable

epublic of the Philippines


RTMENT OF AGRICULTURE
ional Field Office No. 02
Tuguegarao City
COA Circular 2015 -002: Annex F
No.
Date
Fund

ATUS (ORS)

MFO / PAP

:
:
:

UACS Code /
Expenditure

Amount

Php

B.

Signature:
Printed Name:
Position:
Date:

32,000.00

32,000.00
Certified: Allotment available and obligated
for the purpose / adjustment necessary as
indicated above

MACARIO B. ANDAL
Chief, Budget Section

STATUS OF OBLIGATION
Amount
Payment

Not Yet Due

Due and Demandable

epublic of the Philippines


RTMENT OF AGRICULTURE
ional Field Office No. 02
Tuguegarao City
COA Circular 2015 -002: Annex F
No.
Date
Fund

ATUS (ORS)

MFO / PAP

:
:
:

UACS Code /
Expenditure

Amount

Php

4,500.00

4,500.00
Certified: Allotment available and obligated
for the purpose / adjustment necessary as
indicated above

B.

Signature:
Printed Name:
Position:
Date:

MACARIO B. ANDAL
Chief, Budget Section

STATUS OF OBLIGATION
Amount
Payment

Not Yet Due

Due and Demandable

epublic of the Philippines


RTMENT OF AGRICULTURE
ional Field Office No. 02
Tuguegarao City

ATUS (ORS)

COA Circular 2015 -002: Annex F


No.
Date
Fund

:
:
:

MFO / PAP

UACS Code /
Expenditure

Amount

0.00
Certified: Allotment available and obligated
for the purpose / adjustment necessary as
indicated above

B.

Signature:
Printed Name:
Position:
Date:

MACARIO B. ANDAL
Chief, Budget Section

STATUS OF OBLIGATION
Amount
Payment

Not Yet Due

Due and Demandable

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

BUDGET UTILIZATION REQUEST AND STATUS (BURS)


Payee

HOTEL ROMA

Office
Address

Tuguegarao City

Responsibility
Center

Particulars

Payment of lodging accommodation of


participants during the Geo-Tagging training on July 22-24, 2015

TOTAL
A.

Certified:

Charges to budget necessary, lawful

and under my direct supervision, and supporting


documents valid, proper, and legal
Signature:
Printed Name:
Position:

Head, Requesting Office / Authorized Representative

Date:

STATUS OF UTILIZATION

C.
Reference
Date

Particulars

BURS / JEV / RCI etc.

Totals

Utilization

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

BUDGET UTILIZATION REQUEST AND STATUS (BURS)


Payee

GERONIMA G. LUDAN, DVM

Office

DA-RFO 02

Address

Tuguegarao City

Responsibility
Center

Particulars
To obligate payment for Travelling Expenses incured
while on official travel to PRDP-Subprojects sites
covering the period rofm July 23-25, Month of August
and Sept. 1-4, 2015 as per supporting papers
hereto attached in the amount . . . . . .

TOTAL
A.

Signature:
Printed Name:
Position:
Date:

Certified: Charges to budget necessary, lawful


and under my direct supervision, and supporting
documents valid, proper, and legal

Head, Requesting Office / Authorized Representative

C.

STATUS OF UTILIZATION
Reference

Date

Particulars

BURS / JEV / RCI etc.

Utilization

Totals

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

BUDGET UTILIZATION REQUEST AND STATUS (BURS)


Payee

GERONIMA G. LUDAN, DVM

Office

DA-RFO 02

Address

Tuguegarao City

Responsibility
Center

Particulars
To obligate payment for Travelling Expenses incured
while on official travel to PRDP-Subprojects sites
covering the period rofm July 23-25, Month of August
and Sept. 1-4, 2015 as per supporting papers
hereto attached in the amount . . . . . .

TOTAL
A.

Certified: Charges to budget necessary, lawful


and under my direct supervision, and supporting
documents valid, proper, and legal

Signature:
Printed Name:
Position:
Date:

Head, Requesting Office / Authorized Representative

C.

STATUS OF UTILIZATION
Reference
Date

Particulars

BURS / JEV / RCI etc.

Utilization

Totals

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

BUDGET UTILIZATION REQUEST AND STATUS (BURS)


Payee

GOLDEN BAT (FAR EAST) INC.

Office
Address
Responsibility
Center

53 Sct. O.M Alcaraz Cor., D. Tuazon St., Q.C


Particulars
To obligate payment of Laboratory
supplies of DA-RADDL amounting to . . . .

TOTAL
A.

Certified: Charges to budget necessary, lawful


and under my direct supervision, and supporting
documents valid, proper, and legal

Signature:
Printed Name:
Position:
Date:

Head, Requesting Office / Authorized Representative

C.

STATUS OF UTILIZATION
Reference
Date

Particulars

BURS / JEV / RCI etc.

Utilization

Totals

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

BUDGET UTILIZATION REQUEST AND STATUS (BURS)

Payee

MT ZION SCIENTIFIC INC.

Office
Address

# 42 Sampaguita Ave. Mapaya Vill. 2 Brgy. Holy Spirit , Quezon City

Responsibility
Center

Particulars
To obligate payment of Laboratory
supplies of DA-RADDL amounting to . . . .

TOTAL
A.

Certified: Charges to budget necessary, lawful


and under my direct supervision, and supporting
documents valid, proper, and legal

Signature:
Printed Name:
Position:
Date:

Head, Requesting Office / Authorized Representative

C.

STATUS OF UTILIZATION
Reference
Date

Particulars

BURS / JEV / RCI etc.

Totals

Utilization

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

BUDGET UTILIZATION REQUEST AND STATUS (BURS)


Payee

BUSANIA ENTERPRISES

Office
Address

Maddela, Quirino

Responsibility
Center

Particulars
To obligate payment of training kit and tokens used
in the training of setting up of Grievances Redress Mechanism
Provinces of Isabela and Quirino (GRM) in the
on August 25-27, 2015 in the amount of . . . .

TOTAL
A.

Certified: Charges to budget necessary, lawful


and under my direct supervision, and supporting
documents valid, proper, and legal

Signature:
Printed Name:
Position:
Date:

GERONIMA G. LUDAN, DVM


Chief Agriculturist

C.

STATUS OF UTILIZATION
Reference
Date

Particulars

BURS / JEV / RCI etc.

Utilization

Totals

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

BUDGET UTILIZATION REQUEST AND STATUS (BURS)


Payee

BUSANIA ENTERPRISES

Office
Address

Maddela, Quirino

Responsibility
Center

Particulars
To obligate payment of training kit and tokens used
in the training of setting up of Grievances Redress Mechanism

(RGM) in the Provinces of Isabela and Quirino


on August 25-27, 2015 in the amount of . . . .

TOTAL
A.

Certified: Charges to budget necessary, lawful


and under my direct supervision, and supporting
documents valid, proper, and legal

Signature:
Printed Name:
Position:
Date:

GERONIMA G. LUDAN, DVM


Chief Agriculturist

C.

STATUS OF UTILIZATION
Reference
Date

Particulars

BURS / JEV / RCI etc.

Utilization

Totals

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

BUDGET UTILIZATION REQUEST AND STATUS (BURS)


Payee

QDA EMPC

Office
Address
Responsibility
Center

Maddela, Quirino
Particulars
To obligate payment of catering services served during
the training of setting up of Grievances Redress Mechanism

(RGM) in the Provinces of Isabela and Quirino


on August 25-27, 2015 in the amount of . . . .

TOTAL

A.

Certified: Charges to budget necessary, lawful


and under my direct supervision, and supporting
documents valid, proper, and legal

Signature:
Printed Name:
Position:
Date:

GERONIMA G. LUDAN, DVM


Chief Agriculturist

C.

STATUS OF UTILIZATION
Reference
Date

Particulars

BURS / JEV / RCI etc.

Utilization

Totals

Republic of the Philippines


DEPARTMENT OF AGRICULTURE
Regional Field Office No. 02
Tuguegarao City

BUDGET UTILIZATION REQUEST AND STATUS (BURS)


Payee

QDA EMPC

Office
Address
Responsibility
Center

Maddela, Quirino
Particulars
To obligate payment of catering services served during
the training of setting up of Grievances Redress Mechanism

(RGM) in the Provinces of Isabela and Quirino


on August 25-27, 2015 in the amount of . . . .

TOTAL
A.

Certified: Charges to budget necessary, lawful


and under my direct supervision, and supporting
documents valid, proper, and legal

Signature:
Printed Name:
Position:
Date:

GERONIMA G. LUDAN, DVM


Chief Agriculturist

C.

STATUS OF UTILIZATION
Reference
Date

Particulars

BURS / JEV / RCI etc.

Totals

Utilization

hilippines
GRICULTURE
ffice No. 02
City
COA Circular 2015 -002: Annex G

BURS)

MFO / PAP

No.

Date
Fund

:
:

UACS Code /
Expenditure

Amount

20,320.00

B.

Certified: Budget available and utilized


for the purpose / adjustment necessary as
indicated above

Signature:
Printed Name:

MACARIO B. ANDAL

Position:

Chief, Budget Section

Date:
OF UTILIZATION
Amount
Payment

Not Yet Due

Due and Demandable

hilippines
GRICULTURE
ffice No. 02
City
COA Circular 2015 -002: Annex G
No.
Date
Fund

BURS)

MFO / PAP

:
:
:

UACS Code /
Expenditure

Amount

7,296.00

B.

7,296.00
Certified: Budget available and utilized
for the purpose / adjustment necessary as
indicated above

Signature:
Printed Name:
Position:
Date:

MACARIO B. ANDAL
Chief, Budget Section

OF UTILIZATION
Amount

Payment

Not Yet Due

Due and Demandable

hilippines
GRICULTURE
ffice No. 02
City
COA Circular 2015 -002: Annex G
No.
Date
Fund

BURS)

MFO / PAP

:
:
:

UACS Code /
Expenditure

Amount

1,824.00

1,824.00
Certified: Budget available and utilized
for the purpose / adjustment necessary as
indicated above

B.

Signature:
Printed Name:
Position:
Date:

MACARIO B. ANDAL
Chief, Budget Section

OF UTILIZATION
Amount
Payment

Not Yet Due

Due and Demandable

hilippines
GRICULTURE
ffice No. 02
City
COA Circular 2015 -002: Annex G
No.
Date
Fund

BURS)

MFO / PAP

:
:
:

UACS Code /
Expenditure

Amount

9,535.00

9,535.00
Certified: Budget available and utilized
for the purpose / adjustment necessary as
indicated above

B.

Signature:
Printed Name:
Position:
Date:

MACARIO B. ANDAL
Chief, Budget Section

OF UTILIZATION
Amount
Payment

Not Yet Due

Due and Demandable

hilippines
GRICULTURE
ffice No. 02
City

BURS)

COA Circular 2015 -002: Annex G


No.
Date
Fund

:
:
:

rit , Quezon City


MFO / PAP

UACS Code /
Expenditure

Amount

15,584.00

15,584.00
Certified: Budget available and utilized
for the purpose / adjustment necessary as
indicated above

B.

Signature:
Printed Name:
Position:
Date:

MACARIO B. ANDAL
Chief, Budget Section

OF UTILIZATION
Amount
Payment

Not Yet Due

Due and Demandable

hilippines
GRICULTURE
ffice No. 02
City
COA Circular 2015 -002: Annex G
No.
Date
Fund

BURS)

MFO / PAP

:
:
:

UACS Code /
Expenditure

Amount

1,600.00

8,000.00
Certified: Budget available and utilized
for the purpose / adjustment necessary as
indicated above

B.

Signature:
Printed Name:
Position:
Date:

MACARIO B. ANDAL
Chief, Budget Section

OF UTILIZATION
Amount
Payment

Not Yet Due

Due and Demandable

20

8000
1600

80

6400

hilippines
GRICULTURE
ffice No. 02
City
COA Circular 2015 -002: Annex G
No.
Date
Fund

BURS)

MFO / PAP

:
:
:

UACS Code /
Expenditure

Amount
6,400.00

8,000.00
Certified: Budget available and utilized
for the purpose / adjustment necessary as
indicated above

B.

Signature:
Printed Name:
Position:
Date:

MACARIO B. ANDAL
Chief, Budget Section

OF UTILIZATION
Amount
Payment

Not Yet Due

Due and Demandable

hilippines
GRICULTURE
ffice No. 02
City
COA Circular 2015 -002: Annex G
No.
Date
Fund

BURS)

:
:
:

20
80
MFO / PAP

UACS Code /
Expenditure

Amount

23,400.00

138,600.00

117000
23400
93600

B.

Certified: Budget available and utilized


for the purpose / adjustment necessary as
indicated above

Signature:
Printed Name:
Position:
Date:

MACARIO B. ANDAL
Chief, Budget Section

OF UTILIZATION
Amount
Payment

Not Yet Due

Due and Demandable

hilippines
GRICULTURE
ffice No. 02
City
COA Circular 2015 -002: Annex G
No.
Date
Fund

BURS)

MFO / PAP

:
:
:

UACS Code /
Expenditure

Amount

93,600.00

138,600.00
Certified: Budget available and utilized
for the purpose / adjustment necessary as
indicated above

B.

Signature:
Printed Name:
Position:
Date:

MACARIO B. ANDAL
Chief, Budget Section

OF UTILIZATION
Amount
Payment

Not Yet Due

Due and Demandable

OBLIGATION REQUEST AND STATUS (ORS)

OBLIGATION REQUEST AND STATUS (ORS)

OBLIGATION REQUEST AND STATUS (ORS)

OBLIGATION REQUEST AND STATUS (ORS)

OBLIGATION REQUEST AND STATUS (ORS)

OBLIGATION REQUEST AND STATUS (ORS)

OBLIGATION REQUEST AND STATUS (ORS)

OBLIGATION REQUEST AND STATUS (ORS)

OBLIGATION REQUEST AND STATUS (ORS)

OBLIGATION REQUEST AND STATUS (ORS)

OBLIGATION REQUEST AND STATUS (ORS)

OBLIGATION REQUEST AND STATUS (ORS)

OBLIGATION REQUEST AND STATUS (ORS)

OBLIGATION REQUEST AND STATUS (ORS)

OBLIGATION REQUEST AND STATUS (ORS)

OBLIGATION REQUEST AND STATUS (ORS)

OBLIGATION REQUEST AND STATUS (ORS)

OBLIGATION REQUEST AND STATUS (ORS)

OBLIGATION REQUEST AND STATUS (ORS)

OBLIGATION REQUEST AND STATUS (ORS)

OBLIGATION REQUEST AND STATUS (ORS)

OBLIGATION REQUEST AND STATUS (ORS)

OBLIGATION REQUEST AND STATUS (ORS)

OBLIGATION REQUEST AND STATUS (ORS)

OBLIGATION REQUEST AND STATUS (ORS)

OBLIGATION REQUEST AND STATUS (ORS)