Local Purchase Order



Serial No…………………

Vendors Name & Address

__________________________________ Delivery Date  ______________


__________________________________ Terms of Payment  __________


__________________________________ Delivery Point  ___________


PR REF: _________________ ___________ Order Date  ____________


This document constitutes an agreement between the vendor and the buyer. See terms and conditions of this purchase listed on the reverse side

Item No.




Unit Price

Total Value



























































Total Value


Amount in Words : _________________________________________Currency___________________


Sign: _________________________ Date____________

            Supplier Acceptance/Stamp Prepared by: ____Date______ _


Approval A/C Code: _____________________

Sign: ________________________ Date____________ Financial Review: _________

Procurement Manager  



Sign: ______________________ Date____________ Country Director: _________

Program Manager/Director/Head of Dept ( Approval for Capital Items )

White – Supplier

Green – First to Stores/then to accounts with attached to a Goods Received Note

Pink – Purchasing

Yellow – Book Copy