Judy FORMS Travel Galahad Tacloban

APPLICATION FOR LEAVE
CSC Form 6
1. Office/Agency
2. Name (LAST)
ASINAS
MPDO
(FIRST)
(MIDDLE)
TENEDERO
5. Salary (Monthly)
KATHY SALVACION
3. Date of Filing
November 7, 2012
4. Position
PDO
DETAILS OF APPLICATION
6. (A) TYPE OF LEAVE
6. (B) WHERE LEAVE WILL BE SPENT
Vacation
(1) In case of vacation
To seek employment
Within the Philippines
Maternity
Abroad
Sick Leave
(Specify)
Others (specify)
(2) In case of sick leave
In case in hospital (specify)
Out patient
6. ( C ) NUMBER OF WORKING DAYS

APPLIED FOR:
1 day only
Inclusive Date November 6, 2012
6. ( D ) COMMUTATION
Requested
Not requested
SIGNATURE OF APPLICANT
DETAILS OF ACTION ON APPLICATION
7. (A) CERTIFICATION OF LEAVE CREDITS
7. ( B ) RECOMMENDATION
As of
Approval
Vacation
Sick
Total
DAYS
DAYS
DAYS
ESTELITA H. DIAZ
Administrative Officer IV
7. ( C ) APPROVED FOR
DAYS WITH PAY
DAYS WITHOUT PAY
OTHERS (SPECIFY)
Disapproval due to
RIZALINO E. ALARAS
Municipal Planning & Development Coordinator
7. ( D ) DISAPPROVED DUE TO
FREDICANDA TUBELLO- DY
Municipal Mayor
CIVIL SERVICE FORM No. 48
DAILY TIME RECORD

DIANA C. LIGUID-LIGUID
Name
For the month of
January, 2013
Official hours for arrival (Regular days)
departures (Saturdays)
D
a
y
A.M.
DeparArrival
ture
P.M.
DeparArrival
ture
1 Holiday
7:45 12:05 12:53 5:06
2
7:53 12:02 12:48 5:02
3
4 @ DILG No. Samar Prov'l Office
5 Saturday
6 Sunday
7:35 12:01 12:55 5:01
7
7:48 12:05 12:45 5:04
8
7:40 12:02 12:48 5:03
9
7:55 12:01 12:58 5:01
10
7:50 12:02 12:52 5:05
11
12 Saturday
13 Sunday
7:30 12:02 12:50 5:03
14
7:49 12:04 12:48 5:07
15
7:55 12:06 12:53 5:02
16
7:43 12:02 12:57 5:04
17
7:50 12:01 12:45 5:01
18
19 Saturday
20 Sunday
21 Official Travel
22 Reg'l BuB Orientation @ Legazpi
23 Official Travel
7:39 12:03 12:52 5:03
24
7:55 12:02 12:48 5:01
25
26 Saturday
27 Sunday
7:35 12:03 12:50 5:02
28
7:50 12:05 12:45 5:05
29
7:53 12:01 12:47 5:03
30
31 Official Travel
Minutes
City
TOTAL---------------------------I hereby certify on my honor that the above is a true and

correct report of the hours of work performed, record of which
was made daily at the time of arrival and departure from office
Verified as to prescribed office hours.
D
a
y
A.M.
DeparArrival
ture
P.M.
DeparArrival
ture
1 Holiday
7:45 12:05 12:53 5:06
2
7:53 12:02 12:48 5:02
3
5 Saturday
6 Sunday
7:35 12:01 12:55 5:01
7
7:48 12:05 12:45 5:04
8
7:40 12:02 12:48 5:03
9
7:55 12:01 12:58 5:01
10
7:50 12:02 12:52 5:05
11
12 Saturday
13 Sunday
7:30 12:02 12:50 5:03
14
7:49 12:04 12:48 5:07
15
7:55 12:06 12:53 5:02
16
7:43 12:02 12:57 5:04
17
7:50 12:01 12:45 5:01
18
19 Saturday
20 Sunday
21 Official Travel
23 Official Travel
7:39 12:03 12:52 5:03
24
7:55 12:02 12:48 5:01
25
26 Saturday
27 Sunday
7:35 12:03 12:50 5:02
28
7:50 12:05 12:45 5:05
29
7:53 12:01 12:47 5:03
30
31 Official Travel
Minutes
City

DAILY TIME RECORD
Name
For the month of
January, 2013
UNDERTIME
Hours
DAILY TIME RECORD
Name
For the month of
January, 2013
UNDERTIME
Hours
DAILY TIME RECORD
D
a
y
A.M.
DeparArrival
ture
P.M.
DeparArrival
ture
Name
For the month of
January, 2013
UNDERTIME
Hours
1 Holiday
7:45 12:05 12:53 5:06
2
7:53 12:02 12:48 5:02
3
5 Saturday
6 Sunday
7:35 12:01 12:55 5:01
7
7:48 12:05 12:45 5:04
8
7:40 12:02 12:48 5:03
9
7:55 12:01 12:58 5:01
10
7:50 12:02 12:52 5:05
11
12 Saturday
13 Sunday
7:30 12:02 12:50 5:03
14
7:49 12:04 12:48 5:07
15
7:55 12:06 12:53 5:02
16
7:43 12:02 12:57 5:04
17
7:50 12:01 12:45 5:01
18
19 Saturday
20 Sunday
21 Official Travel
23 Official Travel
7:39 12:03 12:52 5:03
24
7:55 12:02 12:48 5:01
25
26 Saturday
27 Sunday
7:35 12:03 12:50 5:02
28
7:50 12:05 12:45 5:05
29
7:53 12:01 12:47 5:03
30
31 Official Travel
Minutes
City

D
a
y
A.M.
DeparArrival
ture
P.M.
DeparArrival
ture
UNDERTIME
Hours
1 Holiday
7:45 12:05 12:53 5:06
2
7:53 12:02 12:48 5:02
3
5 Saturday
6 Sunday
7:35 12:01 12:55 5:01
7
7:48 12:05 12:45 5:04
8
7:40 12:02 12:48 5:03
9
7:55 12:01 12:58 5:01
10
7:50 12:02 12:52 5:05
11
12 Saturday
13 Sunday
7:30 12:02 12:50 5:03
14
7:49 12:04 12:48 5:07
15
7:55 12:06 12:53 5:02
16
7:43 12:02 12:57 5:04
17
7:50 12:01 12:45 5:01
18
19 Saturday
20 Sunday
21 Official Travel
23 Official Travel
7:39 12:03 12:52 5:03
24
7:55 12:02 12:48 5:01
25
26 Saturday
27 Sunday
7:35 12:03 12:50 5:02
28
7:50 12:05 12:45 5:05
29
7:53 12:01 12:47 5:03
30
31 Official Travel
Minutes
City

VALENTE P. BAJET
VALENTE P. BAJET
VALENTE P. BAJET
VALENTE P. BAJET
In Charge
In Charge
In Charge
In Charge
DAILY TIME RECORD

Name
For the month of
D
a
y
A.M.
DeparArrival
ture
P.M.
DeparArrival
ture
DAILY TIME RECORD

Name
For the month of
UNDERTIME
Hours
Minutes
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
D
a
y
A.M.
DeparArrival
ture
P.M.
DeparArrival
ture
I hereby certify on my honor that the above is a true and

In Charge
DAILY TIME RECORD
Name
For the month of
UNDERTIME
Hours
Minutes
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
TOTAL----------------------------
DAILY TIME RECORD
D
a
y
A.M.
DeparArrival
ture
P.M.
DeparArrival
ture
Name
For the month of
UNDERTIME
Hours
Minutes
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31

In Charge
D
a
y
A.M.
DeparArrival
ture
P.M.
DeparArrival
ture
UNDERTIME
Hours Minutes
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31

In Charge

In Charge

CSC Form 6
1. Office/Agency
LGU - Catubig
3. Date of Filing
December 18, 2016
(FIRST)
(MIDDLE)
2. Name (LAST)
BLANDO
BALASE
JUDY
4. Position
5. Salary (Monthly)
FISCAL EXAMINER-1
Vacation
(1) In case of vacation
To seek employment
Maternity
Abroad
Sick Leave
(Specify)
Others (FORCE LEAVE)

Out patient
APPLIED FOR:
Requested
5 days
Inclusive Date 12/22,23,27,28,29/2017
Not requested
7. (A) CERTIFICATION OF LEAVE CREDITS 7. ( B ) RECOMMENDATION
As of
Approval
Vacation
Sick
Total
DAYS
DAYS
DAYS
ESTELITA H. DIAZ
HRMO-111
DAYS WITH PAY

DAYS WITHOUT PAY
OTHERS (SPECIFY)
Disapproval due to
GALAHAD O. VICENCIO
Municipal Mayor
GALAHAD O. VICENCIO
Municipal Mayor
Republic of the Philippines

Province of Northern Samar
MUNICIPALITY OF CATUBIG
TRAVEL ORDER
Travel Order No.:
Date:
TO: ABNER M. ORSOLINO
SOZONTE T. GLORIOSO
TERESITA H. CAPAWING
ESTELITA H. DIAZ
ALLAN T. ORBITA
JUDY B. BLANDO
CATHY SALVACION ASINAS
December 1, 2016
LCR/BAC Member
BAC Chairman
MBO/BAC Member
HRMO/BAC Member
BAC MEMBER
FE/IAS
BAC SECRETARIAT
You are hereby authorized to travel based on the following information:

Inclusive Date
of Travel
Destination
Purpose
12/5-7/2016
Ritz Tower De Leyte, Tacloban City
To attend 3-day training on Government

Procurement Reform Act (GPRA), RA 9184
Your travel is official, subject however to the usual accounting and auditing rules and regulations.
Approved:
GALAHAD O. VICENCIO
Municipal Mayor
Noted:
cc:
File
HRMO
Annex 33
REQUISITION AND ISSUE SLIP

Catubig
LGU
Division: LGU - Catubig
Responsibility Center
RIS No.:
Office:
Code:
SAI No.: _________ Date: _________
MAYORS OFFICE
Date:
Requisition
Issuance
Stock No.
Unit
order
pansit bihon
cups
halo-halo
20
loaves
tasty bread
bottles
softdrinks (1.5 coke)
Purpose:
Description
Quantity Quantity
snacks of COA auditors (exit conference with the head of offices)
Requested by:
Approved by
Signature
Printed Name
Designation
Date
Remarks
ARIEL MEDENILLA
GALAHAD O. VICENCIO
Secretary to the Mayor
Municipal Mayor
Issued by:
Received by:
Purchase Request
Catubig, Northern Samar
PR. No.
Department: Local Government Unit - Catubig
Section: Mayor's Office
SAI No.
Date:
Date
ALOBS No. Date

Unit
Quantity of
Issue
3
order
20
cups
2
loaves
2
bottles
Item Description
Stock No.
pansit bihon
halo-halo
tasty bread
1
2
3
4
Estimated
Cost
150.00
35.00
40.00
65.00
Amount
450.00
700.00
80.00
130.00
1,360.00
Purpose:
snacks of COA Auditors (exit conference with the head of offices)
Requested by:
Signature
Printed Name
Designation
ARIEL A. MEDENILLA
Secretary to the Mayor
Approved by:
GALAHAD O. VICENCIO
Municipal Mayor
PURCHASE ORDER
LGU
SupplieMerlyn Jaro
P.O. No:
Date:
Mode of Procurement:
PR No./s:
AddresCatubig N. Samar
Gentlemen:
Please furnish the following articles subject to the terms and conditions contained herein
Place of DeliveryCatubig, N. Samar

Date of Delivery6/10/2016
Item
Quantity
No.
1
2
3
4
3
20
2
2
Unit
order
cups
loaves
bottles
Delivery Term: ____________________

Payment Term: ____________________
Destription
pansit bihon
halo-halo
tasty bread
Unit
Cost
Amount
150.00
35.00
40.00
65.00
450.00
700.00
80.00
130.00
One thousand three hundred sixty pesos only.

1,360.00
Total Amount in Words:
In case for failure to make the full delivery within the time specified above, a penalty of one-tenth (1/10)
of one percent for every day delay shall be imposed.
Very truly yours,
GALAHAD O. VICENCIO
Conforme:
(Authorized Official)
MERLYN JARO
(Signature over printed name)

Date
(In case of Negotiated Purchase pursuant to Section 369 (a) of RA 7160, this portion must be accomplished)
Certified Correct:
Date:
Secretary to the Sanggunian
ontained herein
ne-tenth (1/10)
INSPECTION & ACCEPTANCE REPORT

LGU
Supplier MERLYN JARO
PO No.
1 Date
Invoice No.
Requisitioning Office/Dept. : mayor's office
Item No.
Unit
1
2
3
4
order
cups
loaves
bottles
AR No.
Date
Description
3
20
2
2
pansit bihon
halo-halo
tasty bread
INSPECTION
Date Inspected
Inspected verified and found OK
as to quantity and specifications
ACCEPTANCE
Date Received
Complete
Partial
MARLON DE ASIS
Inspection Officer
Quantity
ERNESTO TENEDERO
Property Officer

( Date )
CANVASS
Gentlemen:
Please quote your latest price, tax included on the following item/s listed below and submit
CANVASS paper to the General Services Office within (5) Government working days from the date.
Very truly yours,
ERNESTO T. TENEDERO
General Services Officer
QTY
UNIT
3
20
2
2
order
cups
loaves
bottles
DESCRIPTION OF ARTICLES
UNIT
PRICE
TOTAL
PRICE
pansit bihon
halo-halo
tasty bread
General Services Officer

Sir/Madam:
In connection with the above request. I/We submit our quotation indicated above and I/We agree
to furnish or deliver in conformity with specifications any or all said articles described above within Seven (7)
days upon receipts of Purchase Order to this effect.
(Signature of Dealer)
Date:__________________________
TO WHOM IT MAY CONCERN:
I hereby certify that the price/s of articles quoted above and signature of the dealer herein are true
and correct.
ANIANO P. TAGALOG
(Signatur of Canvasser)
NOTE:
This office reserves the right to accept or reject any of the winning bid in the interest of the government.

PROVINCE OF NORTHERN SAMAR
DISBURSEMENT VOUCHER
No.
Mode of
Payment
Check
Cash
Others
Date:
12/02/16
TIN/Employee No.
Payee
Address
OS/BUS No.
REALBO, INC.
TACLOBAN CITY
Date: 12/02/16
Responsibility Center:
Code:
Title:
Travelling Expenses-local
EXPLANATION
Amount
To payment of registration fee for the 3-day full length training on Government
Procurement Reform act (GPRA), RA 9184 at Ritz Tower De Leyte, Tacloban, City
as per supporting papers hereto attached amounting to
42,000.00
Amount Due
A Certified
42,000.00
B
Allotment Obligated for its purpose

as indicated.
Supporting documents is completed
Signature
Position
Funds available
Signature
Printed
Name
Certified:
Date:
MINNIE T. PONTECILLA, CPA
Printed
Name
Municipal Accountant
(Head Accounting Unit/ Authorized Representative)
A Approved for payment
Date
LILIAN R. CELAJES,CPA
Municipal Treasurer
Position
B
(Treasurer/Authorized Representative)
Received Payment
Check No.
Bank Name
Date
Signature
Printed
Name
Position
GALAHAD O. VICENCIO
Date
Municipal Mayor
(Agency Head/Authorized Representative)
Signature
Printed
Name
OR/Other Documents
Date
REALBO, INC.
JEV No.
Date:

OBLIGATION REQUEST
Payee
REALBO, INC.
Office
TACLOBAN CITY
NO.
Address
Responsibility
PARTICULARS
Center
ACCOUNT
CODE
F.F.P.
AMOUNT
To obligate payment of registration fee of participants

for the 3-day full length training on Government
Procurement Reform Act (GPRA), RA 9184
42,000.00
TOTAL
Certified
42,000.00
Certified
Charges to appropriation/allotment necessary,

LAWFUL and under my direct supervision.
Existence of available appropriation.
Supporting documents valid, proper and legal.

Signature
Printed
Name
Position
Date:
Signature
GALAHAD O. VICENCIO
Municipal Mayor
Head Requesting Office/Authorized Representative
Printed
Name
Position
Date
Pursuant to
Date
Municipal Budget Officer
Head, Budget Unit
APPENDIX "A"

Itinerary No.:
Date:
December 3, 2016
ITINERARY OF TRAVEL
Name :
GALAHAD O. VICENCIO
Position :
Municipal Mayor
Official Station: Catubig N. Samar
Purpose of travel : Attend LOAMC forum spearheaded by Greenpeace Philippines Peoples Food Movement
at Hive Hotel, Quezon City.
Date
Place to be
Visited or Travel
12/3/2016
Catubig-Catarman
Airport
Time
Departure
3:30 AM
Catarman-Manila
12/6-7/16
12/12/2016
Arrival
Allowances
Means of Transportation
Per
Fare
Diems
Transportation
4:30 AM special hire

van (VV)
6:55 AM 8:00AM
plane
2,500.00
3,751.00
Still in Manila
Manila-Catarman
5:15AM
6:30 AM
plane
320.00
3,905.00
Amount
Total
2,820.00
3,751.00
1,600.00
1,600.00
240.00
4,145.00
SERVICE FEE(BOOKING OF PLANE TICKETS)

ONE TIME MEMBERSHIP FEE(LEAGUE OF ORGANIC AGRICULTURE MUNICIPALITIES IN THE PHIL.)
400.00
12,000.00
24,716.00
I HEREBY CERTIFY that:

1) I have reviewed the foregoing itinerary.
2) The travel is necessary to the service.
3) The period covered is reasonable.
4) The expenses claimed are proper
Prepared by:
GALAHAD O. VICENCIO
Municipal Mayor
Designation
Approved:
GALAHAD O. VICENCIO
Municipal Mayor
APPENDIX "B"

OFFICE OF THE MUNICIPAL MAYOR
CERTIFICATE OF TRAVEL COMPLETED

Galahad O. Vicencio
(Chief of Office)

(Station)
Municipal Mayor
(Designation)
12-Dec-16
(Date)
I HEREBY CERTIFY that I have completed the travel authorized in the Itinerary of Travel
conditions indicated below;
Strictly in accordance with the approved itinerary.
Cut short as explained below. Excess payment in the amount of P____________was
refunded under O.R. No. _________________ dated _____________________________
Extended to other deviations as explained below:
EXPLANATIONS OR JUSTIFICATIONS:_______________________________________________
EVIDENCE OF TRAVEL ATTACHED HERETO: certificate of appearance, OR , PLANE TICKETS
Respectfully submitted:
GALAHAD O. VICENCIO
Official or Employee
Municipal Mayor
Designation
On evidence and information of which I have knowledge, the travel was actually undertaken.
GALAHAD O. VICENCIO
Municipal Mayor

No.
Mode of
Payment
Check
Cash
Others
Date:
TIN/Employee No.
Payee
Address
OS/BUS No.
GALAHAD O. VICENCIO
Catubig, N. Samar
Date:
Code:
Title:
EXPLANATION
Amount
To LIQUIDATION of Cash Advance for an official travel to Metro Manila to attend

THE LOAMC Forum spearheaded by the Greenpeace Philippines Peoples Food
Movement(see attached letter) as per supporting papers hereto attached amounting to
to.
Cash Advance
Actual expenses
amount to be reimbursed
12,460.00
24,716.00
12,256.00
Amount Due
A Certified
12,256.00
B

as indicated.
Signature
Position
Certified:
Funds available
Signature
Printed
Name
12,256.00
Date:
MINNIE T. PONTECILLA, CPA
Printed
Name
;/
Position
B
Date
Municipal Treasurer
Received Payment
Check No.
Bank Name
Date
Signature
Printed
Name
Position
GALAHAD O. VICENCIO
Date
Municipal Mayor
Signature
Printed
GALAHAD O. VICENCIO
Name
OR/Other Documents
JEV No.
Date
Date:

OBLIGATION REQUEST
Payee
GALAHAD O. VICENCIO
Office
Catubig N. Samar
NO.
Address
Responsibility
PARTICULARS
Center
ACCOUNT
CODE
F.F.P.
AMOUNT
To obligate liquidation of CASH ADVANCE for an

official travel to Manila at Hive Hotel, Q.C. to attend the
LOAMC Forum to be spearheaded by Greenpeace
Philippines Peoples Food Movement in partnership
with LOAMC's Core Group
12,256.00
TOTAL
Certified
12,256.00
Certified


Signature
Printed
Name
Position
Date:
Signature
GALAHAD O. VICENCIO
Municipal Mayor
Printed
Name
Position
Date
Pursuant to
Date
Head, Budget Unit

TRAVEL ORDER
Travel Order No.:
Date:
TO: RIZALEX LLAVE
REMBERTO LUCERO
JOVITO F. SUDIO
12/01/16
SECURITY OFFICER
SECURITY AGENT
SECURITY AGENT

Inclusive Date
of
Travel
12/6-7/2016
Destination
Purpose
Hive Hotel, Quezon City
To accompany the Municipal Mayor for the

purpose of attending the Dialogue with Peoples
Food Movement, and League of Organic Agriculture
Municipalities and Cities in the Philip. (LOAMC Phils)
Your travel is official, subject however to the usual accounting and auditing rules and regulations.
Approved:
GALAHAD O. VICENCIO
Municipal Mayor
Noted:
cc:
File
HRMO
APPENDIX "A"

Itinerary No.:
Date:
December 1, 2016
ITINERARY OF TRAVEL
Name :
JOVITO SUDIO
Position :
Security Agent
Official Station: Catubig N. Samar
Purpose of travel : To accompany the Municipal Mayor to attend the Dialogue with Peoples Food Movement and the
LOAMC Phils. At Hive Hotel, Quezon City on December 6-7, 2016
Date
Place to be
Visited or Travel
12/1/2016
Catubig-Manila
Time
Departure
Arrival
Allowances
Means of Transportation
Per
Fare
Diems
Transportation
6:00 AM
Bus
12/6-7/2016
Still in Manila to accompany the Municipal Mayor
12/13/2016
Manila-Catubig
8:45 AM
1,200.00
320.00
Amount
Total
1,520.00
1,600.00
1,200.00
240.00
1,440.00
4,560.00
I HEREBY CERTIFY that:

1) I have reviewed the foregoing itinerary.
2) The travel is necessary to the service.
3) The period covered is reasonable.
4) The expenses claimed are proper
Prepared by:
JOVITO SUDIO
Security Agent
Designation
Approved:
GALAHAD O. VICENCIO
Municipal Mayor
APPENDIX "B"

OFFICE OF THE MUNICIPAL MAYOR
CERTIFICATE OF TRAVEL COMPLETED

Galahad O. Vicencio
(Chief of Office)

(Station)
Municipal Mayor
(Designation)
19-Dec-16
(Date)
I HEREBY CERTIFY that I have completed the travel authorized in the Itinerary of Travel
conditions indicated below;
Strictly in accordance with the approved itinerary.
Cut short as explained below. Excess payment in the amount of P____________was
refunded under O.R. No. _________________ dated _____________________________
Extended to other deviations as explained below:
EXPLANATIONS OR JUSTIFICATIONS:_______________________________________________
EVIDENCE OF TRAVEL ATTACHED HERETO: Travel order, invitation to attend
Respectfully submitted:
JOVITO SUDIO
Official or Employee
Security Agent
Designation
On evidence and information of which I have knowledge, the travel was actually undertaken.
GALAHAD O. VICENCIO
Municipal Mayor

No.
Mode of
Payment
Check
Cash
Others
Date:
TIN/Employee No.
Payee
Address
OS/BUS No.
JOVITO SUDIO
Catubig, N. Samar
Date:
Code:
Title:
EXPLANATION
Amount
To payment of travelling expenses and per diems while on official travel to Manila
to accompany the Municipal Mayor in attending the Dialogue with Peoples Movement
and the LOAMC Phils. as per supporting papers hereto attached amounting to
4,560.00
Amount Due
A Certified
4,560.00
B

as indicated.
Signature
Position
Funds available
Signature
Printed
Name
Certified:
Date:
MINNIE D. TENEDERO, CPA
Printed
Name
Date
Municipal Treasurer
Position
B
Received Payment
Check No.
Bank Name
Date
Signature
Printed
Name
Position
GALAHAD O. VICENCIO
Date
Municipal Mayor
Signature
Printed
Name
OR/Other Documents
Date
JOVITO SUDIO
JEV No.
Date:

OBLIGATION REQUEST
Payee
JOVITO SUDIO
Office
Catubig N. Samar
NO.
Address
Responsibility
PARTICULARS
Center
ACCOUNT
CODE
F.F.P.
AMOUNT
To obligate payment of travelling expenses and per

diems(To accompany the Municipal Mayor for the
purpose of attending Dialogue with Peoples Movement
and the LOAMC Phils. At Hive Hotel, Q.C.
4,560.00
TOTAL
Certified
4,560.00
Certified


Signature
Printed
Name
Position
Date:
Signature
GALAHAD O. VICENCIO
Municipal Mayor
Printed
Name
Position
Date
Pursuant to
Date
Head, Budget Unit

Barangay Nago-ocan
March 23, 2010
PROGRAM OF WORK BUDGET
Name of Project:
Proposed Street Concreting
Location:
Barangay Nago-ocan, Catubig, N. Samar
Project Cost
Php
Source of Fund:
Provincial Aid to Brgys
85,150.00
Hon. Vice Governor A. Lucero

Cong. Paul Daza
Project Description:
O.10 meter x1.50 meter x 60.00 meters Concrete Pavement
BILL OF MATERIALS
QTY
UNIT
9
4.5
72
8
5
1
cu.m.
cu.m.
bags
pcs
pcs
kg
ITEM
UNIT COST
Gravel
Sand
Portland Cement
2"x 4"x 16' Form Lumber
2"x2"x10' Lumber
Common Wire Nails
AMOUNT
1,620.00
1,080.00
400.00
150.00
50.00
100.00
14,580.00
4,860.00
28,800.00
1,200.00
250.00
100.00
Materials Cost
P
49,790.00
Labor Cost
19,916.00
Transhipment Cost
6,913.13
Contingency
2,298.57
VAT
6,223.75
TOTAL ESTIMATED PROJECT COST
P
85,141.45
---------------------------------------------------- P
85,150.00
BREAKDOWN OF COST ESTIMATES
SAY
Prepared by:
Checked by:
RIZALINO E. ALARAS
MPDC
ALFREDO U. REBADULLA
Municipal Engineer
Approved:
EUSTAQUIO P. DURIN
Punong Barangay

August 1, 2013
PROGRAM OF WORK BUDGET
Name of Project:
CONCRETE CANAL
Location:
Barangay D. Mercader, catubig, Northern Samar
Project Cost
Php
Source of Fund:
SK 10% IRA SHARE
0.40 X 0.075 X 150 LM
63,036.16
BILL OF MATERIALS
QTY
55
4.5
3.75
375
27
2
150
1
UNIT
bags
m3
m3
pcs
pcs
kgs
bdft
kgs
ITEM
UNIT COST
Portland Cement
Gravel
Sand
4"CHB
8mm0 RSB
G.I. Tie Wire
2" x 3" x 10 Form Lumber
CWNails
TOTAL MATERIAL COST
280.00
1,000.00
900.00
15.00
135.00
100.00
22.00
100.00
AMOUNT
15,400.00
4,500.00
3,375.00
6,000.00
3,645.00
200.00
5,500.00
100.00
P38,720.00
BREAKDOWN OF COST ESTIMATES

Materials Cost
Labor Cost
Transp.
Contingency
VAT
Prepared by:
Checked by:
THENEL G. ALIPIO
Eng'ng. Aide
Recommended For Approval:
JUN-JUN C. TENEDERO
SK-Chairman
38,720.00
15,488.00
3,097.60
1,936.00
3,794.56
63,036.16
Municipal Engineer
Approved:
DACIO L. ROBIANO
Punong Barangay

INDIVIDUAL PROGRAM OF WORK
Name/Location of Project:
Appropriation:________________________________
Project Cost
605,530.88
Proposed Barangay Hall

Brgy. Manering, Catubig, N. Samar
Issued Obligated Authority:_____________________

Calendar Days to Complete:___
45
Starting Date:________________________________
see plan
MINIMUM EQUIPMENT REQUIRED

Description
No.
Carpentry & Masonry Tools & Equipments
TECHNICAL PERSONNEL REQUIRED

Description
Const'n Foreman
Carpenter
Mason
Laborer
No.
1
3
2
6
ESTIMATED COST OF PROPOSED WORK

Item No.
I
II
III
IV
V
DESCRIPTION
Concrete & Masonry Works
Carpentry Works
Doors & Windows
Tinsmithry
Painting
UNIT
sq.m.
sq.m.
sq.m.
sq.m.
sq.m.
BREAKDOWN OF ESTIMATED EXPENDITURES

A. Direct Cost:
1. Materials
1.1 Supplies
1.2 Transhipment
1.3 Testing of Materials
2. Labor
3. Equipment Expenses
4. Contingency
QUANTITY UNIT COST AMOUNT % OF TOTAL

47.00
3,061.63 143,896.65
24.59
47.00
5,988.84 281,480.30
48.11
38.22
1,816.27 69,417.88
11.87
121.32
335.96 40,759.16
6.97
521.80
94.86 49,500.00
8.46
% OF TOTAL
AMOUNT
70.17
6.54
424,869.70
39,580.20
17.09
103,505.44
2.82
17,098.65
SUB TOTAL - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Php

B. Government Expenditures
1. Engineering Supv'n & Administrative Overhead
3.38
SUB TOTAL - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Php

TOTAL ESTIMATED COST - - - - - - - - - - - - - - - - - - - - - - - - - -
Prepared by:
585,053.99
100.00
20,476.89
20,476.89
Php
605,530.88
Checked by
RIZALINO E. ALARAS
Municipal Engineer
Approved:
MANUEL L. JARO
Punong Barangay
Page 1 of 3 pages
DETAILED ENGINEERING ESTIMATES

Name of Project:
Location:
Barangay Manering, Catubig, N. Samar
ITEM NO.
DESCRIPTION
I
CONCRETE & MASONRY WORKS
A Materials:
4" thk Concrete Hollow Blks
Portland Cement
Sand
Gravel
10mm x 6.00M RSB
#16 GI Tie Wire
UNIT
SQ.M.
pcs
bags
cu.m.
cu.m.
pcs
kgs
QTY
47
UNIT COST
3,061.63
AMOUNT
143,896.65
1,165
178
11.64
9.28
90
2.5
15.00
260.00
750.00
850.00
175.00
95.00
17,475.00
46,280.00
8,730.00
7,880.00
15,750.00
237.50
96,352.50
24,088.00
19,265.00
4,191.15
143,896.65
47
5,988.94
281,480.30
3,420
30.00
102,600.00
2,673
40.00
106,920.00
13.47
100.00
1,347.20
9.2
2
100.00
3,825.00
920.00
7,650.00
219,437.20
43,887.44
9,957.20
8,198.46
281,480.30
38.22
1,816.27
69,417.88
42
714
4
6
4
14
4
350.00
35.00
1,500.00
75.00
500.00
3,000.00
2,000.00
14,700.00
24,990.00
6,000.00
450.00
2,000.00
42,000.00
8,000.00
48,140.00
14,442.00
4,814.00
2,021.88
69,417.88
B Labor:
C Transhipment
D Contingency
Sub total
II
CARPENTRY WORKS
SQ.M.
A Materials:
Lumber (Toog) delivered to site
BF
18 - 2"x 3"x 16' Purlins
5 - 2"x 3"x 20' Purlins
6 - 2"x 5"x 24' BC
4 - 2"x 5"x 15' BC
6 - 2"x 6"x 14' TC
2 - 2"x 6"x 15' TC
10 - 2"x 6"x 20' WM/CP/KP
389 - 2"x 2"x 10' Nailers/Clg Joist/Studs
186 - 1"x 8"x 10' Wood sidings
Lumber (Yakal) delivered to site
BF
5 - 2"x 8"x 24' Flr Girt
25 - 2"x 6"x 17' Flr Joist
23 - 2"x 6"x 14' Flr Joist/Bridging
18 - 1"x 12"x 24' Flooring
15 - 1"x 12"x 14' Flooring
15 - 2"x 6"x 16' Roof Girt/Wood Blks
8 - 8"x 8"x 24' Wooden Post
3/4"dia.X 11" Mach. Bolts w/ nuts & washers
(32 pcs)
kgs
1/2"dia.x10" Mach. Bolts w/ nuts & washers
(64 pcs)
kgs
Common Wire Nails (assorted)
kegs
B Labor
C Transhipment
D Contingency
Sub total
III
DOORS & WINDOWS

A Materials
Alum. Jal Frame (17 blades)
Glass Jal Blades (4"x20")
0.80Mx1.20M Flush Type Door
4"x4" Loose Pin Hinge
Night Latch
1.50Mx1.50M Window Jambs
0.80Mx2.10M Door Jambs
B Labor
C Transhipment
D Contingency
Sub total
SQ.M.
pairs
pcs
unit
pairs
units
units
units
Page 2 of 3 pages
DETAILED ENGINEERING ESTIMATES
Name of Project:
Location:
Barangay Manering, Catubig, N. Samar
ITEM NO.
IV
DESCRIPTION
TINSMITHRY
A Materials
#26 x 7' Corr. GI Sheet Roofing
#26 Plain GI Sheet Ridge/Gutter/Flashing
Umbrella Nails
Roof Sealant
UNIT
SQ.M.
QTY
UNIT COST
121.32
335.96
shts
shts
kgs
gals
50
27
8
1
390.00
340.00
120.00
800.00
19500.00
9180.00
960.00
800.00
30,440.00
6,088.00
3,044.00
1,187.16
40,759.16
521.8
94.86
49,500.00
30,500.00
15,000.00
2,500.00
1,500.00
49,500.00
B Labor
C Transhipment
D Contingency
Sub total
V
PAINTING
A Material Cost
B Labor Cost
C Transhipment
D Contingency
Sub total
SQ.M.
SUMMARY
Material Cost
Labor Cost
Transhipment Cost
Contingency Cost
Project Mngt. Cost
Prepared by:
424,869.70
103,505.44
39,580.20
17,098.65
20,476.89
605,530.88
Checked by:
RIZALINO E. ALARAS
Approved:
MANUEL L. JARO
Punong Barangay
AMOUNT
40759.16
Municipal Engineer
Page 3 of 3 pages

TRAVEL ORDER
Travel Order No.:
Date:
TO:
ABNER M. ORSOLINO
October 21, 2013

Mun. Gov't. Asst. Dept. Head I

Inclusive Date of Travel
Destination
Purpose
Nov. 5-8, 2013
Caterman, N. Samar
To attend the Supervisory Development

cocurse (SDC) - Track 1
Approved:
GALAHAD O. VICENCIO
Municipal Mayor
cc:
File
HRMO

CSC Form 6
1. Office/Agency
2. Name (LAST)
ORBITA
MPDC
3. Date of Filing
3-Oct-12
(FIRST)
(MIDDLE)
ALLAN
TAFALLA
5. Salary (Monthly)
4. Position
Administrative Assistant II
Vacation
(1)In case of vacation
To seek employment
Maternity
Abroad
x
Sick
(Specify)
Others (specify)
x
APPLIED FOR:
2 days
Inclusive Date October 1 & 2, 2012
Out patient
Requested
Not requested
7. (A) CERTIFICATION OF LEAVE CREDITS
7. ( B ) RECOMMENDATION
As of
Approval
Vacation
Sick
Total
DAYS
DAYS
DAYS
ESTELITA H. DIAZ
Administrative Officer
DAYS WITH PAY
DAYS WITHOUT PAY
OTHERS (SPECIFY)
Disapproval due to
RIZALINO E. ALARAS
MPDC
FREDICANDA TUBELLO- DY
Municipal Mayor
LIQUIDATION REPORT
No.
Date: March 23, 2011
Responsibility Center
LGU
PAR T I C U LAR S
AMOUNT
TO LIQUIDATION of Cash Advance incurred while on official travel to

Manila to attend the training/on-line registration for Procuring Entities (PEs) at
Sta. Cruz, Malate Manila as per supporting papers hereto attached amounting to..
0
vvvvvvvvvvvv
TOTAL AMOUNT SPENT
16,694.00
AMOUNT OF CASH ADVANCE PER DV ___________________DTD __________P 25,440.00

AMOUNT REFUNDED PER O.R. NO. _____________ DTD ______________ P
AMOUNT TO BE REIMBURSED
Submitted by:
8,746.00
Received by:
GALAHAD O. VICENCIO
Municipal Mayor
MINNIE D. TENEDERO, CPA

Date:

Judy FORMS Travel Galahad Tacloban

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APPLICATION FOR LEAVE

6. ( C ) NUMBER OF WORKING DAYS

CIVIL SERVICE FORM No. 48

CIVIL SERVICE FORM No. 48

DAILY TIME RECORD

TOTAL---------------------------I hereby certify on my honor that the above is a true and

Verified as to prescribed office hours.

TOTAL---------------------------I hereby certify on my honor that the above is a true and

Verified as to prescribed office hours.

DAILY TIME RECORD

CIVIL SERVICE FORM No. 48

DAILY TIME RECORD

CIVIL SERVICE FORM No. 48

DAILY TIME RECORD

TOTAL---------------------------I hereby certify on my honor that the above is a true and

Verified as to prescribed office hours.

TOTAL---------------------------I hereby certify on my honor that the above is a true and

Verified as to prescribed office hours.

CIVIL SERVICE FORM No. 48

CIVIL SERVICE FORM No. 48

DAILY TIME RECORD

CIVIL SERVICE FORM No. 48

DAILY TIME RECORD

I hereby certify on my honor that the above is a true and

Verified as to prescribed office hours.

DAILY TIME RECORD

CIVIL SERVICE FORM No. 48

DAILY TIME RECORD

TOTAL---------------------------I hereby certify on my honor that the above is a true and

Verified as to prescribed office hours.

TOTAL---------------------------I hereby certify on my honor that the above is a true and

Verified as to prescribed office hours.

TOTAL---------------------------I hereby certify on my honor that the above is a true and

Verified as to prescribed office hours.

APPLICATION FOR LEAVE

Others (FORCE LEAVE)

DAYS WITH PAY

Republic of the Philippines

You are hereby authorized to travel based on the following information:

Ritz Tower De Leyte, Tacloban City

To attend 3-day training on Government

REQUISITION AND ISSUE SLIP

SAI No.: _________ Date: _________

softdrinks (1.5 coke)

snacks of COA auditors (exit conference with the head of offices)

Secretary to the Mayor

ALOBS No. Date

snacks of COA Auditors (exit conference with the head of offices)

Place of DeliveryCatubig, N. Samar

Delivery Term: ____________________

One thousand three hundred sixty pesos only.

Very truly yours,

(Signature over printed name)

INSPECTION & ACCEPTANCE REPORT

Republic of the Philippines

General Services Officer

Republic of the Philippines

Allotment Obligated for its purpose

MINNIE T. PONTECILLA, CPA

A Approved for payment

Republic of the Philippines

To obligate payment of registration fee of participants

Charges to appropriation/allotment necessary,

SAI No.: _ Date: _