Purchase Order: Unit Description Qty. Unit Cost Amount
Purchase Order: Unit Description Qty. Unit Cost Amount
Supplier:
Address: Iligan City
TIN:
Negotiated
Gentlemen:
Please deliver to this Office the following articles to terms and conditions herein:
Place of Delivery : Brgy. Dulag
Delivery Term: 10 days
Date of Delivery : _____________
Payment Term: Check
:
:
UNIT
Box
Bottle
Bottle
Box
Bottle
Bottle
Box
Box.
Bottle
Box
Bottle
Box
Box
DESCRIPTION
Paracetamol Tablet 500mg
Paracetamol Syrup 250mg/5ml 60ml
Paracetamol Drops 15ml
Amoxicillin Capsule 500mg
Amoxicillin Susp. 250mg/5ml-60ml
Amoxicillin Drops 15ml
Cotrimoxazole Capsule 400 mg/80mg
Cotrimoxazole Capsule 800 mg/160mg
Cotrimoxazole Susp. 200 mg/40mg
Carbocisteine Capsule 500mg
Carbocisteine Syrup 60ml
Mefenamic Acid Capsule 500 mg
Loperamide Capsule 2mg
QTY.
UNIT COST
AMOUNT
130
750
297
100
510
200
60
90
398
81
400
32
30
115.00
38.00
30.00
390.00
40.00
35.00
390.00
390.00
42.00
320.00
32.00
372.00
180.00
14,950.00
28,500.00
8,910.00
39,000.00
20,400.00
7,000.00
23,400.00
35,100.00
16,716.00
25,920.00
12,800.00
11,904.00
5,400.00
TOTAL AMOUNT
P
250,000.00
In case of failure to make the 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.
Very truly yours,
CESARVE C. SIACOR
ABC PRESIDENT
Conformed:
Date: __________________