Local Purchase Clearance Request and Approval Form, ROASD-1067, Revision-5

PAGE NO. Page 1 of 2 LOCAL PURCHASE CLEARANCE REQUEST AND FORM NO. ROASD-1067 APPROVAL FORM REVISION NO. 5 EFFECTIVITY August 4, 2026 Use this form to request clearance from PAGCOR on local purchase of equipment and/or paraphernalia necessary for the data streaming operations. Only requests with correct and complete information and complete documentary requirements will be processed. Failure to provide correct and complete information could result in rejection of processing this request. PLEASE ALLOW THREE (3) BUSINESS DAYS FOR ROASD TO PROCESS YOUR REQUEST Name of Data Streaming Provider (DSP): __________________________________________________________ Address: ______________________________________________________________________________________ SECTION A: LOCAL PURCHASE CLEARANCE REQUEST (TO BE FILLED OUT BY ACCREDITED DSP) ITEMS DESCRIPTION QUANTITY PURPOSE/USE * use another sheet if necessary. Name of Supplier/Broker: _______________________________________________________ Address: ____________________________________________________________________ Purchase Documents Attached: Commercial Invoice No. (Put an [X] mark on any of the following) Pro-forma Invoice No. SECTION B: TERMS AND CONDITIONS • A supplier of gaming equipment and paraphernalia, surveillance equipment, I.T. equipment and all other equipment and paraphernalia to be used for the Live Studio, must be accredited by PAGCOR. A local purchase clearance request from a supplier not accredited by PAGCOR shall be rejected by ROASD. • If approval is granted by ROASD on the local purchase request, DSP shall ensure that all items purchased shall be strictly within the quantities and description indicated in the PAGCOR approved purchasing documents. Items which are found to be in excess of those or are not indicated in the PAGCOR-approved purchasing documents shall subject the DSP to sanctions and penalties. • A representative from Compliance Monitoring and Enforcement Department (CMED) shall conduct an inspection and inventory of the shipped items. • Any subsequent movement of said items shall require written approval of PAGCOR prior to implementation. • Local Purchases must only be placed in the address stated in the Permit to Possess. This is to certify that the aforementioned are true, correct, complete and consistent with the attached purchasing documents. In addition, we hereby agree to abide by the terms and conditions under Section B above. Name of Requestor : Signature : Position Title : Date : SECTION C: ACTION TAKEN (TO BE FILLED OUT BY ROASD) A. RETURNED / HELD Reason: _________________________________________________________________ B. RECEIVED FOR PROCESSING with assigned Reference No. ________________ Printed By: Name: Signature Position Title: Date:

PAGE NO. Page 2 of 2 LOCAL PURCHASE CLEARANCE REQUEST AND FORM NO. ROASD-1067 APPROVAL FORM REVISION NO. 5 EFFECTIVITY August 4, 2026 C. RECOMMENDED FOR APPROVAL Printed By: Name: Signature: Position Title: Date: Approved by: ___________________________ Assistant Vice President, ROASD For endorsement to the following department/s: SECTION D: INSPECTION AND INVENTORY OF LOCALLY PURCHASED ITEM/S T O: THE ASSISTANT VICE PRESIDENT, CMED Request for the following: 1. A representative from CMED, together with the accredited DSP, shall conduct a joint inspection and inventory of the Subject Item(s) to verify that item(s) to be locally purchased is/are within ROASD’s approval. 2. Submission of an Inspection and Inventory Report to ROASD after the conduct of said activity. 3. CMED ensures that item(s) purchased locally is/are used according to the intended purpose.