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JUSTICE JOSE ABAD SANTOS GENERAL HOSPITAL

UPM-INSTITUTE OF HUMAN GENETICS

Newborn Screening Center, Bldg. H, UP Ayala Land


Techno Hub Complex, Commonwealth Avenue, Quezon City 4421-4

Payment of procurement of 3085 Expanded Newborn Screening Test Kits


delivered to Justice Jose Abad Santos General Hospital as per BAC Res. No.
2019-608 dated Nov. 22, 2019, PO No. 0693 dated Nov. 25, 2019, PR No. 90, 5,250,000.00
SI No. dated June 26, 2019 in the amount of FIVE MILLION TWO
HUNDRED FIFTY THOUSAND PESOS ONLY ........

This is to certify that this disbursement was incurred under my direct control and
supervision guaranteeing that the provision of RA 3019 AGL has not been violated.
This is to certify that signatures of the officials contained in the herein
attached documents are their true and genuine signatures.

MERLE SACDALAN-FAUSTINO, MD, MPH, MHSA


OIC-Hospital Director

MARIA LOURDES R. MANLULU MA. JAZMIN M. TALEGON


City Accountant Asst. City Treasurer

HON. FRANCISCO "ISKO MORENO" DOMAGOSO


City Mayor
UPM-INSTITUTE OF HUMAN GENETICS

4421-4 Philhealth Trust Fund-Hospital Charge 2-02-01-050-307 HC 5,250,000.00

Cash in Bank, LCCA 1-01-02-010

Payment of procurement of 3000 Expanded Newborn Screening


Test Kits delivered to Abad Santos General Hospital as per BAC Res
No. 2019-608 dated Nov. 22, 2019, PO No. 0693 dated Nov. 25.
2019, PR No. 90.
(UPM-INSTITUTE OF HUMAN GENETICS)

5,250,000.00

ANNABEL A. ALANO JONATHAN R. GALORIO MARIA LOURDES R. MANLULU


Admin. Asst. II Division Chief City Accountant
Financial Operations Division
5,250,000.00

5,250,000.00

RDES R. MANLULU
Accountant
60 1,300.50 78,030.00 78,030.00 -
24 3,880.50 93,132.00 93,132.00 -
24 11,040.00 264,960.00 264,960.00 -
6 10,792.30 64,753.80 64,753.80 -
20000 6.30 126,000.00 126,000.00 -
64 1,536.00 98,304.00 98,304.00 -
63 1,536.00 96,768.00 96,768.00 -
18 13,248.00 238,464.00 238,464.00 -
10 50,342.40 503,424.00 503,424.00 -
8 24,835.20 198,681.60 198,681.60 -
8 21,638.40 173,107.20 173,107.20 -
8 22,532.00 180,256.00 180,256.00 -
3 53,788.80 161,366.40 161,366.40 -
6 16,646.40 99,878.40 99,878.40 -
10 30,816.00 308,160.00 308,160.00 -
3 47,692.80 143,078.40 143,078.40 -
1000 13.00 13,000.00 13,000.00 -
500 59.50 29,750.00 29,750.00 -
8 545.20 4,361.60 4,361.60 -
2 828.40 1,656.80 1,656.80 -
24 27,014.40 648,345.60 648,345.60 -
24 8,064.00 193,536.00 193,536.00 -
60 994.00 59,640.00 59,640.00 -
50 994.00 49,700.00 49,700.00 -
50 176.60 8,830.00 3,837,183.80 8,830.00 -
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