Local Purchase Order Page 3

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L
P
O
OCAL
URCHASE
RDER
(continued)
Procurement Number
Procuring Entity
Department/Project
Sequence Number
Bid/RFQ/RFP No
Contract/PO No
Financial Year
S
R
/A
S
CHEDULE OF
EQUIREMENTS
CTIVITY
CHEDULE
Item
Description
Unit of
Quantity Unit Price
Total Price
No
Measure
(Currency)
(Currency)
(Attach additional specification if necessary)
Total Order Price
Receipt of Order by the Supplier :
Signature:………………………………………Name:………………………………………
Position:………………………………………………………………………………………..
On behalf of: ……………………………………..…. Date: ….……………….
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