BICOL MEDICAL CENTER Naga City PURCHASE REQUEST Department: Section Stock No.

Unit pcs Pcs Box Packs Packs pcs pcs pcs pcs pcs ream roll pcs pcs pcs pcs box copies pcs box pcs pcs pcs roll roll copies Item Description Steno Notes Plastic Envelop Ballpen Certificate paper Specialty paper Token Styro Clearbook - short Clearbook - long Cardboard short size bond paper (substance 20) Double sided tape Photoframe columnar paper - 12 columns columnar paper - 10 columns ID case alcohol prep pad computer printing Inkjet #78 christmas light holograph speaker's snacks foil paper silver Adhesive tape scotch tape photocopies Qty 150 150 5 10 10 5 5 2 2 3 1 2 4 1 1 50 4 150 1 1 1 1 5 5 2 Unit Cost 12 6 80.00 35.00 40.00 350.00 45.00 30.00 40.00 50.00 250.00 45.00 90.00 45.00 40.00 6.00 100.00 20.00 1,800.00 80.00 80.00 100.00 50 8 6.5 100 Total Cost 1,800.00 900.00 400.00 350.00 400.00 1,750.00 225.00 60.00 80.00 150.00 250.00 90.00 360.00 45.00 40.00 300.00 400.00 3,000.00 1,800.00 80.00 80.00 100.00 250.00 40.00 13.00 100.00 NTO PR No. SAL No. Date: Date:

Recommending Approval:
AMELIA V. ENRIQUEZ, RN, MAN CHIEF NURSE

Purpose: Charge to: Request by: Signature: Printed Name: WILHELMINA C. DE CASTRO, RN, MAN RUBEN R. PENAFIEL, MD, MHA Approved By:

Designation

NURSE IV/ TRAINING OFFICER BICOL MEDICAL CENTER Naga City PURCHASE REQUEST

Medical Center Chief I

Department: Section Stock No.

NTO

PR No. SAL No.

Date: Date: Qty 2 1 20 1 5 1 Unit Cost 4 10 6.00 40.00 150.00 2.00 Total Cost 8.00 10.00 120.00 40.00 750.00 2.00 100.00

Unit pcs pcs pcs pcs pcs pcs Paste

Item Description

plastic envelop- long cartolina Glue token safety pin - big

Recommending Approval:
AMELIA V. ENRIQUEZ, RN, MAN CHIEF NURSE

Purpose: Charge to: Request by: Approved By:

Signature: Printed Name: Designation WILHELMINA C. DE CASTRO, RN, MAN NURSE IV/ TRAINING OFFICER RUBEN R. PENAFIEL, MD, MHA Medical Center Chief I

BICOL MEDICAL CENTER Naga City PURCHASE REQUEST

Department: NURSING TRAINING OFFICE PR No. NURSING Section Stock No. Unit Item Description Quality TRAINING OFFICE SAL No.

Date: Date:

Unit Cost

Total Cost

WiFi BWRG1000 Router

Wireless: Data Transfer Rate: Frequency Band: Encryption Algorithm: Networking Standards:

Yes 54 Mbps 2.4 GHz WPA2, WPA-PSK, 128-bit WEP, 64-bit WEP IEEE 802.3, IEEE 802.3u, IEEE 802.11b, IEEE 802.11g VPN passthrough, Wireless Distribution System (WDS) support, DMZ port, DHCP support, NAT support, Virtual server support, DHCP server, NAPT support, BOOTP support, VLAN support, Dynamic DNS server, Intrusion Detection System (IDS) 4-port switch Ethernet Port status, Power, Status External Warranty Information

Networking Features:

Integrated Switch: Switching Protocol: Status Indicators: Form Factor:

Warranty Information: Base Warranty:

1 year warranty 1 year warranty

EFREN SJ. NERVA, MD, FPCP, FPCC, FACC Chief Training Officer

Purpose: Charge to: Request by: Signature: Printed Name: Designation WILHELMINA C. DE CASTRO Training Officer/ Nurse IV RUBEN R. PENAFIEL, MHA OIC, BICOL MEDICAL CENTER Approved By:

BICOL MEDICAL CENTER Naga City PURCHASE REQUEST

Department: NURSING TRAINING OFFICE PR No. NURSING Section Stock No. Unit Item Description IV STANDARDS MANUAL Freight Quantity 100 TRAINING OFFICE SAL No.

Date: Date:

Unit Cost 120.00

Total Cost 12,000.00 800.00 12,800.00

AMELIA V. ENRIQUEZ, RN. MAN Chief Training Officer Purpose: Charge to: Signature: Printed Name: Designation WILHELMINA C. DE CASTRO Nurse Training officer/Nurse IV BICOL MEDICAL CENTER Naga City PURCHASE REQUEST RUBEN R. PENAFIEL, MD, MHA MEDICAL CENTER CHIEF I CATERING FOR IV THERAPY TRAINING OCT 12 - 14, 09 @ BMC AUDITORIUM NTO-SEMINAR FEES Request by: Approved By:

Department: NURSING TRAINING OFFICE PR No. NURSING Section Stock No. Unit Item Description IV STANDARDS MANUAL Freight Quantity 100 TRAINING OFFICE SAL No.

Date: Date:

Unit Cost 120.00

Total Cost 12,000.00 800.00 12,800.00

AMELIA V. ENRIQUEZ, RN. MAN Chief Training Officer Purpose: Charge to: Signature: Printed Name: Designation WILHELMINA C. DE CASTRO Nurse Training officer/Nurse IV RUBEN R. PENAFIEL, MD, MHA MEDICAL CENTER CHIEF I CATERING FOR IV THERAPY TRAINING OCT 12 - 14, 09 @ BMC AUDITORIUM NTO-SEMINAR FEES Request by: Approved By:

BICOL MEDICAL CENTER Naga City PURCHASE REQUEST Department: NURSING Section Stock No. Unit Item Description Quantity Unit Cost Total Cost TRAINING OFFICE PR No. SAL No. Date: Date:

AMELIA V. ENRIQUEZ, RN, MAN CHIEF NURSE

Purpose: Charge to: Request by: Signature: Printed Name: Designation WILHELMINA C. DE CASTRO, RN MAN Training Officer/Nurse IV BICOL MEDICAL CENTER Naga City PURCHASE REQUEST Department: NURSING Section Stock No. Unit Item Description Quantity Unit Cost Total Cost TRAINING OFFICE PR No. SAL No. Date: Date: RUBEN R. PENAFIEL, MHA OIC, BICOL MEDICAL CENTER Approved By:

AMELIA V. ENRIQUEZ, RN, MAN CHIEF NURSE

Purpose: Charge to: Request by: Signature: Printed Name: Designation WILHELMINA C. DE CASTRO, RN MAN Training Officer/Nurse IV RUBEN R. PENAFIEL, MHA OIC, BICOL MEDICAL CENTER Approved By:

BICOL MEDICAL CENTER Naga City PURCHASE REQUEST Department: Section Stock No. Unit Item Description Quality Unit Cost Total Cost PR No. SAL No. Date: Date:

SNACKS

50

30.00

1,500.00

Purpose: Charge to:

Quality Improvement seminar Workshop

Request by: Signature: Printed Name: Designation DIOSDADO UY, MD Medical Specialist / Chairman QI Committee BICOL MEDICAL CENTER Naga City PURCHASE REQUEST Department: Section Stock No. Unit Item Description PR No. SAL No.

Approved By: RUBEN R. PENAFIEL,MD, MHA Medical Center Chief I

Date: Date:

Quality

Unit Cost

Total Cost

Purpose: Charge to:

Quality Improvement (QI)

Request by: Signature: Printed Name: Designation DIOSDADO UY, MD Medical Specialist / Chairman QI Committee

Approved By: RUBEN R. PENAFIEL,MD, MHA MEDICAL CENTER CHIEF I

Department: NURSING Section Stock No. Unit training office

PR No. SAL No.

Date: Date:

Item Description

Quality Unit Cost

Total Cost

External hard drive portable hard drive, 160 GB, 160 Go, Plug play USB 2.0 Memory Card 2GB, microsoft

5,000.00

10,000.00

1,500.00

7,500.00

Ballpen ordinary, black Rechargable battery AA, Ultra High Power, nickel-metal hydride Steno Notebook 50 laeves, Plastic envelope short size, green, yellow, blue, red Pencil ordinary Filing Cabinet Steel, 4 drawers Locker Cabinet stell, 6 openings

500

7.00

3,500.00

1,500.00

7,500.00

500

25.00

12,500.00

500

12.00

6,000.00

500

5.00

2,500.00

10,000.00

50,000.00

20

10,000.00

200,000.00 299,500.00

Recommending Approval:
EFREN SJ. NERVA MD, FPCP, FPCC, FACC Chief Training Officer

Purpose:

for training students affliliates Request by: Approved By: WILHELMINA C. DE CASTRO TRAINING OFFICER/NURSE IV BICOL MEDICAL CENTER Naga City PURCHASE REQUEST RUBEN R. PENAFIEL, MHA OIC, BICOL MEDICAL CENTER

Charge to: affiliation fund Signature: Printed Name: Designation

Department: NURSING Section training office

PR No. SAL No.

Date: Date:

Stock No. Unit Item Description Quality Unit Cost Total Cost

Description:
All steel, fabricated from heavy-duty cold rolled BI steel sheet for body and drawers to it legal (long) size folders with adjustable slide dividers per drawer to protect files from damages. Provided with thumb latches, chrome plated handle and aluminum cardholders. With Acme heavy-duty suspension system which allows drawers to roll
smoothly under full and heavy load utilizing cradle with 8 heavy-duty steel roller bearings 5 6,000.00 30,000.00

mounted on gauge #18 slide rails support drawer glides and cradle system. available in plain enamel Gray or Military Green color and in Wrinkle Brown or Wrinkle Green finish 4-drawers: 52" H x 18-3/4" W x 28-1/2" D
Portable wireless amplifier Speaker - 6.5in, 40 hms, powered by 220v AC,or 12v Dc: 1.2 Ah sealed lead acid typre battery, Inclusive of 12 v 1.2 Ah sealed Acid battery, Transmit with superb clarity from up to 100 m away, talk time in 6 yo 8 hrs, transmitter 160-260m Hz, amlplifier 100Hz16Hz, 35 watts power, comes wuth a VHFhigh band 35mm wireless belt pack transmitter powered by 2AA battery, inclusive of 2AA battery with 1 year warranty, service unit will be provided while on repair. Recommending Approval:
EFREN SJ. NERVA MD, FPCP, FPCC, FACC Chief Training Officer

15,000.00

30,000.00 -

Purpose:

for training students affliliates Request by: Approved By: WILHELMINA C. DE CASTRO TRAINING OFFICER/NURSE IV BICOL MEDICAL CENTER Naga City PURCHASE REQUEST RUBEN R. PENAFIEL, MHA OIC, BICOL MEDICAL CENTER

Charge to: affiliation fund Signature: Printed Name: Designation

Department: NURSING Section Stock No. Unit training office

PR No. SAL No.

Date: Date:

Item Description

Quality Unit Cost

Total Cost

Description:

6-OPENINGS LOCKER Description: All steel, fabricated from heavy-duty

cold rolled BI steel sheet for body, doors and shoe shelf. Double tier with 6-openings (2-openings vertical and 3openings horizontal), each opening provided with hanger rod and shoe shelf. Provided with cardholder and chrome plated handle, ventilation louvers and padlock hasp (padlock not included). Brand new, local manufacture painted with epoxy primer and available in plain enamel Gray or Military Green color,

20

10,000.00

200,000.00

Available in gauge #24, #22 and #20.

Overall dimension: 72" H x 36" W x 18"D Door opening: 31-1/2" H x 10"W
box Gloves Latex free, non sterile, size 7.5, medium Box Mask fall surgical disposable, ordinary, earloop, 50 pcs/ box 185 80.00 14,800.00 125 120.00 15,000.00

Recommending Approval:
EFREN SJ. NERVA MD, FPCP, FPCC, FACC Chief Training Officer

Purpose:

for training students affliliates Request by: Approved By: WILHELMINA C. DE CASTRO TRAINING OFFICER/NURSE IV RUBEN R. PENAFIEL, MHA OIC, BICOL MEDICAL CENTER

Charge to: affiliation fund Signature: Printed Name: Designation

BICOL MEDICAL CENTER Naga City PURCHASE REQUEST

Department: NURSING Section Stock No. Unit unit training office

PR No. SAL No.

Date: Date:

Item Description

Quality Unit Cost 1 114,500.00

Total Cost 114,500.00

RISO KS800 Specification

Processing - Digital scanning thermal screening dupliacting system First prinet speed- Approx. 60 sec. print Speed- 2 selectable print speed (60 and 90/min) Scanning Resolution- 200x300dpi Original Input type-sheets original size-Max273mmx394mm: Min, 182mmx257mm(B5) paper Size-Max: 297mmx420mm(A3), Min:182mmx257mm(B5) Image Area: Max: 249mmx352mm (B4) Paper Capacity: feed 250 sheet(64 g/m2) receivibg: 250sheets (64g/m2) Reduction Parameters: selected reduction (94%, 87%, 82%, 71%)(70-95%) Enlargement parameters: selected enlargement(141%,122%and116%)(110-140%) Features: newspaper mode, scanning contrast adjustment, print position adjustment, print/master count display Power: 220v-240v AC 50/60Hz (1.5A)

Recommending Approval:
EFREN SJ. NERVA MD, FPCP, FPCC, FACC Chief Training Officer

Purpose:

for training students affliliates Request by: Approved By: WILHELMINA C. DE CASTRO TRAINING OFFICER/NURSE IV RUBEN R. PENAFIEL, MHA OIC, BICOL MEDICAL CENTER

Charge to: affiliation fund Signature: Printed Name: Designation