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Fund Cluster :

Privatization and Management Office


Date :
DISBURSEMENT VOUCHER DV No. :

Mode of MDS Check Commercial Check ADA Others (Please specify)


Payment
_________________
TIN/Employee No.: ORS/BURS No.:
Payee ALEXIS SECURITY AGENCY PROVIDER PHILS. CO., INC.

Address
# 28A First St., Las Pias Village, Las Pias City
Responsibility
Particulars MFO/PAP Amount
Center
Representing payment for the security services rendered by Alexis
Security Agency for NCR for the period covered October 1-31,2015 662,982.89
in the amount of ..

Attachments:
1. Memo to DPO in charge - Grace Valentine A. Merino dated January 8, 2016
2. Summary of Billings
3. Statement of Account
4. Summary Sheets
5. Guard's Daily Time Record (DTR's)
6. Payroll for the period covered October 1-31,2015
7. Payroll Report
8. Pay Slips for the period covered October 1-31, 2015
9. Semi Monthly Reports
10. Guard Details
11. Posting Pull Out Certificate
12. Affidavit of Payment stating that the agency has paid its security guards.
13. SSS,Philhealth and Pag-ibig Contributions and Listings
14. Retirement Fund Benefit Certificate & Official Receipt 662,982.89
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

GRACE VALENTINE A. MERINO


Printed Name, Designation and Signature of Supervisor

B. Accounting Entry:
Account Title UACS Code Debit Credit

- -
C. Certified: D. Approved for Payment
Cash available
Subject to Authority to Debit Account (when applicable)
Sup
proper

Signature Signature

Printed
FERNANDO C. SABADO Printed Name GRACE VALENTINE A. MERINO
Name
Chief Accountant Deputy Privatization Officer
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
E. Receipt of Payment JEV No.
Check/ Date : Bank Name & Account Number:
ADA No. :
Date : Printed Name: Date
Signature :
Official Receipt No. & Date/Other Documents
Fund Cluster :
Privatization and Management Office
Date :
DISBURSEMENT VOUCHER DV No. :

Mode of MDS Check Commercial Check ADA Others (Please specify)


Payment
_________________
TIN/Employee No.: ORS/BURS No.:
Payee ALEXIS SECURITY AGENCY PROVIDER PHILS. CO., INC.

Address
# 28A First St., Las Pias Village, Las Pias City
Responsibility
Particulars MFO/PAP Amount
Center
Representing payment for the security services rendered by Alexis
Security Agency for NCR -Supervisor for the period covered 21,614.44
October 1-31, 2015 in the amount of ..

Attachments:
1. Memo to DPO in charge - Grace Valentine A. Merino dated January 8, 2016
2. Summary of Billings
3. Statement of Account
4. Summary Sheets
5. Guard's Daily Time Record (DTR's)
6. Payroll for the period covered October 1-31,2015
7. Payroll Report
8. Pay Slips for the period covered October 1-31, 2015
9. Semi Monthly Reports
10. Guard Details
11. Posting Pull Out Certificate
12. Affidavit of Payment stating that the agency has paid its security guards.
13. SSS,Philhealth and Pag-ibig Contributions and Listings
14. Retirement Fund Benefit Certificate & Official Receipt 21,614.44
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

GRACE VALENTINE A. MERINO


Printed Name, Designation and Signature of Supervisor

B. Accounting Entry:
Account Title UACS Code Debit Credit

- -
C. Certified: D. Approved for Payment
Cash available
Subject to Authority to Debit Account (when applicable)
Sup
proper

Signature Signature

Printed
FERNANDO C. SABADO Printed Name GRACE VALENTINE A. MERINO
Name
Chief Accountant Deputy Privatization Officer
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
E. Receipt of Payment JEV No.
Check/ Date : Bank Name & Account Number:
ADA No. :
Date : Printed Name: Date
Signature :
Official Receipt No. & Date/Other Documents
Fund Cluster :
Privatization and Management Office
Date :
DISBURSEMENT VOUCHER DV No. :

Mode of MDS Check Commercial Check ADA Others (Please specify)


Payment
_________________
TIN/Employee No.: ORS/BURS No.:
Payee John Robert Bautista

Address
PMO Makati
Responsibility
Particulars MFO/PAP Amount
Center

1,031.00

Reimbursement to secure certified true copy of


TCT RT- 13673- 96 (PIONEER GLASS MANUFACTRNG, CORP)

Attachment:
1. BUR
2. Itenerary of Travel
3. Certificate of Appearance
4. O fficial Receipts, etc.
5. Certificate of Travel Completed

1,031.00
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

MA. LIRIO A. ZABALA


Printed Name, Designation and Signature of Supervisor

B. Accounting Entry:
Account Title UACS Code Debit Credit

- -
C. Certified: D. Approved for Payment
Cash available
Subject to Authority to Debit Account (when applicable)
Sup
proper

Signature Signature

Printed
RHODORA B. TORRALBA Printed Name ELLEN H. RONDAEL
Name
Chief Accountant Deputy Privatization Officer
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
E. Receipt of Payment JEV No.
Check/ Date : Bank Name & Account Number:
ADA No. :
Date : Printed Name: Date
Signature :
Official Receipt No. & Date/Other Documents