Region IV-A

Delivery Information Form

Mass Production, and Supply and Delivery of 49,623 Science and Mathematics Equipment for Grades 1 to 3 (Teachers Kit) to 38,689 Pub

Name of School: Division:

School ID no: School Address:

QTY UNIT
PACKAGE ITEM DATE OF DELIVERED UNDELIVERED
DESCRIPTION per of SUPPLIER
NO. NO. DELIVERY QUANTITY QUANTITY
KIT ISSUE

A. Mass Production Items

5 Storage Cabinets

1 Storage Cabinet (for Science), steel 1 unit Multifocus Corp.

2 Storage Cabinet (for Math), steel 1 unit Multifocus Corp.

B. Market Items

11 Science Equipment

Double-pan Balance, 500-gram Scientific Product

1 2 unit
capacity Company

Connecting Wires with bulb & socket

2
assembly

250mm long Connecting Wire w/ Philab Industries,

2.1 2 pc
crocodile clips Inc.

//cgaltea Page 1 of 14
 Region IV-A
Delivery Information Form

Mass Production, and Supply and Delivery of 49,623 Science and Mathematics Equipment for Grades 1 to 3 (Teachers Kit) to 38,689 Pub

Name of School: Division:

School ID no: School Address:

QTY UNIT
PACKAGE ITEM DATE OF DELIVERED UNDELIVERED
DESCRIPTION per of SUPPLIER
NO. NO. DELIVERY QUANTITY QUANTITY
KIT ISSUE

Philab Industries,
2.2 Bulb and Socket assembly 1 set
Inc.

Dry Cell Holder, 1 chamber, for size D Scientific Product

3 2 pc
dry cell Company

4 Toy Car, non-friction, non-battery 2 pc Nikka Trading

Eduresources
5 Hand Magnifying Lens, 5x 2 pc
Publishing, Inc.

Philab Industries,
6 Pair of Bar Magnets 2 pair
Inc.

7 Weighing Scale, bathroom-type 1 unit Nikka Trading

Philab Industries,
8 Beral Pipette, 5 mL 4 pc
Inc.

//cgaltea Page 2 of 14
 Region IV-A
Delivery Information Form

Mass Production, and Supply and Delivery of 49,623 Science and Mathematics Equipment for Grades 1 to 3 (Teachers Kit) to 38,689 Pub

Name of School: Division:

School ID no: School Address:

QTY UNIT
PACKAGE ITEM DATE OF DELIVERED UNDELIVERED
DESCRIPTION per of SUPPLIER
NO. NO. DELIVERY QUANTITY QUANTITY
KIT ISSUE

Eduresources
9 Flashlight with incandescent bulb 1 pc
Publishing, Inc.

14 Science Equipment Models

Philab Industries,
1 Human Ear Model 1 pc
Inc.

Philab Industries,
2 Human Nose Model 1 pc
Inc.

Eduresources
3 Model of Invertebrates 3 pc
Publishing, Inc.

Eduresources
4 Model of Vertebrates 3 pc
Publishing, Inc.

Eduresources
5 Human Torso Model (miniature-type) 1 pc
Publishing, Inc.

16 Plastic Wares

//cgaltea Page 3 of 14
 Region IV-A
Delivery Information Form

Mass Production, and Supply and Delivery of 49,623 Science and Mathematics Equipment for Grades 1 to 3 (Teachers Kit) to 38,689 Pub

Name of School: Division:

School ID no: School Address:

QTY UNIT
PACKAGE ITEM DATE OF DELIVERED UNDELIVERED
DESCRIPTION per of SUPPLIER
NO. NO. DELIVERY QUANTITY QUANTITY
KIT ISSUE

1 Plastic Thermometer, Celsius Scale 1 pc Nikka Trading

2 Set of Measuring Cups and Spoons 2 set Nikka Trading

4 Plastic Ruler, 12 inches or 30 cm 5 pc Nikka Trading

18 Mathematics Equipment

1 Digital Clock, tabletop 1 unit Nikka Trading

2 Beads, 16mm 50 pc Nikka Trading

Eduresources
3 Weighing Scale, analog, 5 kg. capacity 1 unit
Publishing, Inc.

Eduresources
5 Square Tiles, 10cm x 10cm, plastic 10 pc
Publishing, Inc.

//cgaltea Page 4 of 14
 Region IV-A
Delivery Information Form

Mass Production, and Supply and Delivery of 49,623 Science and Mathematics Equipment for Grades 1 to 3 (Teachers Kit) to 38,689 Pub

Name of School: Division:

School ID no: School Address:

QTY UNIT
PACKAGE ITEM DATE OF DELIVERED UNDELIVERED
DESCRIPTION per of SUPPLIER
NO. NO. DELIVERY QUANTITY QUANTITY
KIT ISSUE

Eduresources
6 Square Tiles, 2.54 x 2.54cm, plastic 100 pc
Publishing, Inc.

Eduresources
7 Pattern Blocks, 250 pcs/set 2 set
Publishing, Inc.

Cuisenaire Rods/Number Sticks, 250 Scientific Product

8 1 set
pcs/set Company

Scientific Product
9 Plastic Ruler, 12 inches or 30 cm 5 pc
Company

//cgaltea Page 5 of 14
 Region IV-A
Delivery Information Form

Mass Production, and Supply and Delivery of 49,623 Science and Mathematics Equipment for Grades 1 to 3 (Teachers Kit) to 38,689 Pub

Name of School: Division:

School ID no: School Address:

QTY UNIT
PACKAGE ITEM DATE OF DELIVERED UNDELIVERED
DESCRIPTION per of SUPPLIER
NO. NO. DELIVERY QUANTITY QUANTITY
KIT ISSUE

Eduresources
10 Demonstration Clock 1 pc
Publishing, Inc.

Measuring Cup, 250 mL capacity, w/ Scientific Product

11 5 pc
graduations Company

Eduresources
12 Liter Volume Set 5 set
Publishing, Inc.

Double-pan Balance, 500-gram Scientific Product

13 2 unit
capacity Company

Eduresources
14 Basic 3-Dimensional Models 1 set
Publishing, Inc.

NOTE: Deliveries of these items are expected until December 2016.

and/or and/or
Accomplished by: [Signature over Printed name] [Signature over Printed [Signature over Printed
Math Teacher Science Teacher School Property Custo

//cgaltea Page 6 of 14
 Region IV-A
Delivery Information Form

Mass Production, and Supply and Delivery of 49,623 Science and Mathematics Equipment for Grades 1 to 3 (Teachers Kit) to 38,689 Pub

Name of School: Division:

School ID no: School Address:

QTY UNIT
PACKAGE ITEM DATE OF DELIVERED UNDELIVERED
DESCRIPTION per of SUPPLIER
NO. NO. DELIVERY QUANTITY QUANTITY
KIT ISSUE

Submitted to DepEd Central Office (CMD) by: [Signature over Printed

Principal/ School He

Principal/School Head's Telephone number/s, and/or

Cellular phone number/s:

Date:

//cgaltea Page 7 of 14
(Teachers Kit) to 38,689 Public Elementary Schools

OTHER REMARKS/OBSERVATIONS
(Good condition/ Defective/ Short
Delivery/ Others)
Use additional sheet if
necessary

//cgaltea Page 8 of 14
(Teachers Kit) to 38,689 Public Elementary Schools

OTHER REMARKS/OBSERVATIONS
(Good condition/ Defective/ Short
Delivery/ Others)
Use additional sheet if
necessary

//cgaltea Page 9 of 14
(Teachers Kit) to 38,689 Public Elementary Schools

OTHER REMARKS/OBSERVATIONS
(Good condition/ Defective/ Short
Delivery/ Others)
Use additional sheet if
necessary

//cgaltea Page 10 of 14
(Teachers Kit) to 38,689 Public Elementary Schools

OTHER REMARKS/OBSERVATIONS
(Good condition/ Defective/ Short
Delivery/ Others)
Use additional sheet if
necessary

//cgaltea Page 11 of 14
(Teachers Kit) to 38,689 Public Elementary Schools

OTHER REMARKS/OBSERVATIONS
(Good condition/ Defective/ Short
Delivery/ Others)
Use additional sheet if
necessary

//cgaltea Page 12 of 14
(Teachers Kit) to 38,689 Public Elementary Schools

OTHER REMARKS/OBSERVATIONS
(Good condition/ Defective/ Short
Delivery/ Others)
Use additional sheet if
necessary

[Signature over Printed name]

School Property Custodian

//cgaltea Page 13 of 14
(Teachers Kit) to 38,689 Public Elementary Schools

OTHER REMARKS/OBSERVATIONS
(Good condition/ Defective/ Short
Delivery/ Others)
Use additional sheet if
necessary

[Signature over Printed name]

Principal/ School Head

//cgaltea Page 14 of 14