Appendix 32

DPWH-Sorsogon 1st DEO Fund Cluster :

Entity Name 01 - Regular Agency Fund
Date :
DV No. :
DISBURSEMENT VOUCHER

Mode of MDS Check Commercial Check √ ADA Others (Please specify)

Payment
_________________
TIN/Employee No.: ORS/BURS No.:
Payee AL NIÑO CONSTRUCTION & SUPPLY
146-244-141

Address MANILA

Responsibility
Particulars MFO/PAP Amount
Center

FINAL PAYMENT FOR 100% WORK ACCOMPLISHED OF 17FK0007 -

CONSTRUCTION / MAINTENANCE OF FLOOD MITIGATION
STRUCTURES AND DRAINAGE SYSTEM - CONSTRUCTION OF 34,300,000.00
MILAGROSA RIVER CONTROL, CASTILLA, SORSOGON AS PER
APPROVED CONTRACT IN THE AMOUNT OF P 34,300,000.00

Less: Previous Collection under DV No. __________________ 30,831,647.23

3,468,352.77
Recoupment of Advance Payment --------------------------------------- 494,927.97
Retention ------------------------------------------------------------------------ -
2,973,424.80
Less : 2% EWT ( 2,973,424.80 / 1.12 x 2% ) 53,096.87

5% VAT ( 2,973,424.80 / 1.12 x 5% ) 132,742.18

185,839.05 185,839.05

Amount Due 2,787,585.75

A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

MARIA SUSAN F. EPINO - Chief, Construction Section

Printed Name, Designation and Signature of Supervisor

B. Accounting Entry:
Account Title UACS Code Debit Credit

C. Certified: D. Approved for Payment

Cash available
Subject to Authority to Debit Account (when applicable)
Sup TWO MILLION SEVEN HUNDRED EIGHTY SEVEN THOUSAND FIVE
proper HUNDRED EIGHTY FIVE AND 75/100 PESOS ONLY

Signature Signature

Printed
IVAN MAR D. MANAOIS Printed Name IGNACIO T. ODIAMAN
Name
Accountant III District Engineer
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
E. Receipt of Payment JEV No.
Check/ Date : Bank Name & Account Number:
ADA No. :
Date : Printed Name: Date
Signature :
Official Receipt No. & Date/Other Documents
34300000 32995197.71

5145000 4,949,279.66

1880231.3428 3688698.130598
1808466.79

1303057
1715000
411943
4454351.694
765653.56

4949279.66
494927.97
 Appendix 32

DPWH-Sorsogon 1st DEO Fund Cluster :

Entity Name 01 - Regular Agency Fund
Date :
DV No. :
DISBURSEMENT VOUCHER

Mode of MDS Check Commercial Check √

ADA Others (Please specify)
Payment
TRA
TIN/Employee No.: ORS/BURS No.:
Payee BUREAU OF INTERNAL REVENUE

Address Sorsogon City

Responsibility
Particulars MFO/PAP Amount
Center

REMITTANCE OF 2% (EWT) AND 5% (VAT) CREDITED TOAL NIÑO

CONSTRUCTION AND SUPPLY WITH TAX IDENTIFICATION NO. OF 146-244-
141 IN CONNECTION WITH THE FINAL PAYMENT FOR 100% WORK
ACCOMPLISHED OF 17FK0007 - CONSTRUCTION / MAINTENANCE OF FLOOD 185,839.05
MITIGATION STRUCTURES AND DRAINAGE SYSTEM - CONSTRUCTION OF
MILAGROSA RIVER CONTROL, CASTILLA, SORSOGON AS PER APPROVED
CONTRACT IN THE AMOUNT OF P 34,300,000.00

Less : 2% EWT ( 2,973,424.80 / 1.12 x 2% ) 53,096.87

5% VAT ( 2,973,424.80 / 1.12 x 5% ) 132,742.18

185,839.05

Amount Due 185,839.05

A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

MARIA SUSAN F. EPINO - Chief, Construction Section

Printed Name, Designation and Signature of Supervisor

B. Accounting Entry:
Account Title UACS Code Debit Credit

C. Certified: D. Approved for Payment

Cash available
Subject to Authority to Debit Account (when applicable)
Sup ONE HUNDRED EIGHTY FIVE THOUSAND EIGHT THIRTY NINE AND
proper 5/100 PESOS ONLY

Signature Signature

Printed
IVAN MAR D. MANAOIS Printed Name IGNACIO T. ODIAMAN
Name
Accountant III District Engineer
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
E. Receipt of Payment JEV No.
Check/ Date : Bank Name & Account Number:
ADA No. :
Date : Printed Name: Date
Signature :
Official Receipt No. & Date/Other Documents
 Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS
Sorsogon First District Engineering Office
Guinlajon, Sorsogon City

BACKGROUND INFORMATION

January 10, 2018

Date

FOR : IGNACIO T. ODIAMAN

District Engineer

FROM : PRISCILLA B. JEBULAN

Project Engineer

Contract ID : 17FK0007

CONSTRUCTION / MAINTENANCE OF FLOOD MITIGATION

Project Name : STRUCTURES AND DRAINAGE SYSTEM - CONSTRUCTION OF
MILAGROSA RIVER CONTROL, CASTILLA, SORSOGON

Contractor : AL NIÑO CONSTRUCTION & SUPPLY

Original Contract Amount : 32,995,197.71

Revised Contract Amount : 34,300,000.00
Original Contract Time : 210 CD
Revised Contract Time : 239 CD
Effectivity of Contract Time : May 11,2017
Original Expiry Date : December 7, 2017
Revised Expiry Date : January 4, 2018
Percent, Time Elapsed : 100.00%
Percent, Work Accomplished-Actual : 100.00%
Percent, Work Schedule : 100.00%
Percent, Slippage : 0.00%
Date Project Completed : January 4, 2018
Date Project Accepted :
Kind of Bank Guaranty or Letter of Credit :
Expiry Date of Bank Guarantee or Letter of
:
Credit

REMARKS : Completed (100.00%)

PRISCILLA B. JEBULAN
Project Engineer
 Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS
Sorsogon First District Engineering Office
Guinlajon, Sorsogon City

EXECUTIVE SUMMARY

January 10, 2018

Date

FOR : IGNACIO T. ODIAMAN

District Engineer

CONSTRUCTION / MAINTENANCE OF FLOOD MITIGATION

Subject : STRUCTURES AND DRAINAGE SYSTEM - CONSTRUCTION OF
MILAGROSA RIVER CONTROL, CASTILLA, SORSOGON

Period Covered : DECEMBER 22, 2017 - JANUARY 4, 2018

Action Recommended : FOR PAYMENT
Implementing Office : DPWH-SORSOGON 1ST DEO
Reviewing Office : DPWH-SORSOGON 1ST DEO

Contractor : AL NIÑO CONSTRUCTION & SUPPLY

Contract Data : Original : Revised :

Amount : 32,995,197.71 34,300,000.00
Duration : 210 CD
Starting Date : May 11,2017
Expiration : December 7, 2017
Percent, Time Elapsed : 100.00%
Physical Accomplishment :
Scheduled : 100.00%
Actual : 100.00%
Slippage : 0.00%
Contractor's Performance Bank Guarantee/Letter of Credit in lieu of Retention Money, if needed
Kind :
Amount :
Issued By :
Expiration :
Validated By :
Is Performance Bank Guarantee or Letter of Credit still valid? YES ___X___ NO _______
REMARKS : Completed (100.00%)

:
PRISCILLA B. JEBULAN
Project Engineer
 PLS. CAPITALIZE
X PERIOD COVERED OF BILLING
ALL DETAILS
EXCEPT FOR DATE
(FORMAT)

If there is suspension order or revised contract date put the revised contract end date
 Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS
Sorsogon First District Engineering Office
Guinlajon, Sorsogon City

BILLING SUMMARY

January 10, 2018

Date

Payee : AL NIÑO CONSTRUCTION & SUPPLY

Contract ID : 17FK0007

CONSTRUCTION / MAINTENANCE OF FLOOD MITIGATION STRUCTURES AND

Project Name : DRAINAGE SYSTEM - CONSTRUCTION OF MILAGROSA RIVER CONTROL,
CASTILLA, SORSOGON

Implementing Office : DPWH-SORSOGON 1ST DEO

Nature of Contract :
Contract Amount : 34,300,000.00
Previous Billing : 30,831,647.23
This Billing : 3,468,352.77
Balance : -

PAYMENT BREAKDOWN :
PREVIOUS COST OF THIS
DESCRIPTION CONTRACT COST
BILLING BILLING

CONCRETING OF PANDAN-SACLAYAN FARM TO

MARKET ROAD, CASTILLA, SORSOGON 34,300,000.00 30,831,647.23 3,468,352.77

- - -

34,300,000.00 30,831,647.23 3,468,352.77

PRISCILLA B. JEBULAN
Project Engineer
REMARKS : Completed (100.00%)
 January 10, 2018
Date

ATION STRUCTURES AND

OSA RIVER CONTROL,

BALANCE

if projects in one package is 2 or more, list all projects with corresponding contract
- X
amount per project

-
PLS. CAPITALIZE
ALL DETAILS
EXCEPT FOR DATE
- (FORMAT)

JEBULAN
 Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS
Sorsogon First District Engineering Office
Guinlajon, Sorsogon City

CONTRACT PREVIOUS COST OF THIS

DESCRIPTION BALANCE
COST BILLING BILLING
SUB-TOTAL CARRIED FORWARD 34,300,000.00 30,831,647.23 3,468,352.77 -

34,300,000.00 30,831,647.23 3,468,352.77 -

PRISCILLA B. JEBULAN
Project Engineer

REMARKS : Completed (100.00%)

PLS. CAPITALIZE
ALL DETAILS
EXCEPT FOR DATE
(FORMAT)
 Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS
Sorsogon First District Engineering Office
Guinlajon, Sorsogon City

CONTRACT PREVIOUS COST OF THIS

DESCRIPTION BALANCE
COST BILLING BILLING
SUB-TOTAL CARRIED FORWARD 34,300,000.00 30,831,647.23 3,468,352.77 -

34,300,000.00 30,831,647.23 3,468,352.77 -

PRISCILLA B. JEBULAN
Project Engineer

REMARKS : Completed (100.00%)

PLS. CAPITALIZE
ALL DETAILS
EXCEPT FOR DATE
(FORMAT)
 Republic of the Philippines
Department of Public Works and Highways
OFFICE OF THE DISTRICT ENGINEER
Guinlajon, Sorsogon City

STATEMENT OF TIME ELAPSED AND WORK ACCOMPLISHED

(As of January 4, 2018)

PROJECT ID : 17FK0007

CONSTRUCTION / MAINTENANCE OF FLOOD MITIGATION

PROJECT NAME : STRUCTURES AND DRAINAGE SYSTEM - CONSTRUCTION OF
MILAGROSA RIVER CONTROL, CASTILLA, SORSOGON

CONTRACTOR AL NIÑO CONSTRUCTION & SUPPLY

:

Period Covered : DECEMBER 22, 2017 - JANUARY 4, 2018

Original Contract Time : 210 CD
Date of Effectivity of Contract : May 11,2017
Original Contract Amount : 32,995,197.71
Revised Contract Amount due to Approved
: 34,300,000.00
Change Order/Extra Work Order
Original Expiry Date : December 7, 2017
Approved Time Extension : 29
Shutdown days due to Suspension of Work :
Total Time Extension : 29
Total Calendar Days Elapsed to Date : 239 CD
Contract Time Elapsed (After Extension)
Revised Expiry Date due to Extension : January 4, 2018
Percentage of Time Elapsed : 100.00%
Schedule of Work Accomplished 100.00%
Percentage of Work Accomplished- Actual : 100.00%
Slippage : 0.00%

Certified by:

PRISCILLA B. JEBULAN
Project Engineer

Noted:

IGNACIO T. ODIAMAN
District Engineer
X DATE

X if necessary

X if necessary
X if necessary
X if necessary
X NO. OF DAYS ELAPSED TO DATE

X adjust percentage if there is approved time extensions

 Republic of the Philippines
Department of Public Works and Highways MONTHLY CERTIFICATE OF PAYMENT PAYMENT CERTIFICATE NUMBE
OFFICE OF THE DISTRICT ENGINEER Sheet Number :
Sorsogon City For the Period : DECEMBER 22, 2017 - JANUARY 4, 2018 Date : January 10, 2018

CONSTRUCTION / MAINTENANCE OF FLOOD MITIGATION STRUCTURES

NAME OF PROJECT : AND DRAINAGE SYSTEM - CONSTRUCTION OF MILAGROSA RIVER
CONTROL, CASTILLA, SORSOGON

14. I hereby certify that the attached statement of work accomplished is

correct and does not include items and/or portions thereof for which
NAME OF CONTRACTOR : AL NIÑO CONSTRUCTION & SUPPLY payment has already been received. In regard to items covering advance VERIFIED AND FOUND CORRECT
ORIGINAL CONTRACT AMOUNT P 32,995,197.71 payment for materials, the said materials are on site and properly PAYMENT RECOMMENDED:
protected.
REVISED CONTRACT AMOUNT P 34,300,000.00

1. Total value of work to date P 34,300,000.00

2. Total value of work previously P 30,831,647.23 By:
3. Total value of work this billing P 3,468,352.77
4. Deductions: ALFREDO J. TAN CHECKED AND RECOMMENDED
a) Retention P - Contractor's Representative FOR PAYMENT:
b) 2 % EWT P 53,096.87
c) Recoupment of Cash Advance P 494,927.97 15. I hereby certify that the materials incorporated in monthly certificate of
d) 5% VAT P 132,742.18 payment have been verified and tested in accordance with
TOTAL DEDUCTIONS P 680,767.02 specifications.
5. Amount approved for payments P 2,787,585.75
6. Add: Retention P -
7. Total Amount Due for Payment : P 2,787,585.75 NIDA D. RELLAMA
Foreign Component Materials Engineer APPROVED FOR PAYMENT:
8. Local component approved amount (5-6)
9. Less: Peso cost financing to be paid directly 16. I hereby certify that the quantity of work approved for payment in the
by ADB/ERO/DECF etc. under category attached statement have been accomplished that the quantities including
______________, __________ % of 5 P materials brought to site but not incorporated in the work are correct
10.Less: Local Expenditures and consistent with all previous recommendations for payment and the
Category ________,_________ % of 5 P work quantities and amount are consistent with the requirements of the
contract.
11.Less: Request No._______ for previous
payment of materials on hand P
12.Add: Request No. for materials current
on hand P
13.Net amount due to Contractor P 2,787,585.75 Schedule Physical Progress:
PRISCILLA B. JEBULAN
Whenever applicable; otherwise these items will not be filled up Project Engineer Actual Physical Progress:
or should be revised accordingly to suit lending institution
payment procedure. Contract Expiry Date :

Slippage (+) or (-) :

CERTIFICATE NUMBER : 1
1 of 1
January 10, 2018

ND FOUND CORRECT
ECOMMENDED:

MARIA SUSAN F. EPINO

Chief, Construction Section

ND RECOMMENDED

FELIX M. DIMAANO, JR.

Assistant District Engineer

FOR PAYMENT:

IGNACIO T. ODIAMAN
District Engineer

sical Progress: 100.00%

al Progress: 100.00%

iry Date : January 4, 2018 if there is revised contract date put the revised end date

or (-) : 0.00%
 Republic of the Philippines
Department of Public Works and Highways
Sorsogon First District Engineering Office
Guinaljon, Sorsogon City

January 10, 2018

Date

CERTIFICATION

In connection with the implementation of 17FK0007 -CONSTRUCTION / MAINTENANCE OF FLOOD

MITIGATION STRUCTURES AND DRAINAGE SYSTEM - CONSTRUCTION OF MILAGROSA RIVER CONTROL,
CASTILLA, SORSOGON , this is to certify that AL NIÑO CONSTRUCTION AND SUPPLY has submitted all the
documentary requirements necessary for the processing of its 100.00% FINAL PAYMENT in the amount of
THIRTY FOUR MILLION THREE HUNDRED THOUSAND PESOS ONLY (P43,000,00.00).

This is to certify further that all requirements and supporting papers, pursuant to Department Order NO.
55, series of 1988, have been complied with, reviewed and found to be in order.

MARIA SUSAN F. EPINO

Chief, Construction Section
 AL NIÑO CONSTRUCTION AND SUPPLY
LEGAZPI CITY

January 11, 2018

IGNACIO T. ODIAMAN
DPWH District Engineer
Sorsogon 1st DEO Guinlajon, Sorsogon City

Sir:

In connection with our contract for the implementation of 17FK0007 - CONSTRUCTION /

MAINTENANCE OF FLOOD MITIGATION STRUCTURES AND DRAINAGE SYSTEM -
CONSTRUCTION OF MILAGROSA RIVER CONTROL, CASTILLA, SORSOGON. I have the honor
to request for payment of 100.00% of the above mentioned project.

Very truly yours,

ALFREDO J. TAN
Contractor
 Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS
Sorsogon First District Engineering Office
Guinlajon, Sorsogon City

January 12, 2018

State Auditor III

Commision on Audit
DPWH Compound, Guinlajon
Sorsogon City

Sir:

In connection with the letter request for inspection of 100.00% work accomplished by AL NIÑO
CONSTRUCTION AND SUPPLY , may we request from your good office a representative to
conduct a joint inspection with the Inspectorate Group of this Office in connection with the
implementation of 17FK0007 - CONSTRUCTION / MAINTENANCE OF FLOOD MITIGATION
STRUCTURES AND DRAINAGE SYSTEM - CONSTRUCTION OF MILAGROSA RIVER
CONTROL, CASTILLA, SORSOGON

Very truly yours,

IGNACIO T. ODIAMAN
District Engineer
 AFFIDAVIT

I, ALFREDO J. TAN of legal age, Filipino, and presently residing at LEGAZPI after having duly sworn
to in accordance with the law, depose and say;

That I as the contractor for the implementation of 17FK007 - CONSTRUCTION /

1. MAINTENANCE OF FLOOD MITIGATION STRUCTURES AND DRAINAGE SYSTEM -
CONSTRUCTION OF MILAGROSA RIVER CONTROL, CASTILLA, SORSOGON

2. That I have already paid my employees and laborers of their salaries and wages in connection with
the prosecution of the above named projects;

3. That all the sand and gravel used by us in the prosecution of the aforementioned project was supplied
to us at site by private haulers and concessionaires;

4. That all the taxes due the government in connection with the above mentioned project have been
paid by our firm;

5. That I am executing this affidavit to establish the fact that I am not responsible for the payment of
the said sand and gravel tax required by the Minister of Finance under the local Tax Regulation No.
4-75, dated November 17, 1975 and implemented by the Department of Public Works and Highways
under Memo No. 65, dated November 24, 1975;

6. That I further certify that I did not promise any official or employee of the Department of gift or
money to secure claim for this 100.00 % of work accomplished in the above-mentioned project.

IN WITNESS WHEREOF, I hereunto affix my signature this 10 th day of January at SORSOGON CITY.

ALFREDO J. TAN
Proprietor

SUBSCRIBED AND SWORN TO before me this ________ day of ______________________________

at ____________________________________. The affiant exhibited his/her Residence Certificate NO.
_____________________ issued at _________________________ on ____________________________.

Notary Public

Doc. No.
Page No.
Book No.
Series of 20
X NAME AND ADDRESS

X PROJECT DESCRIPTION

X PERCENTAGE OF ACCOMPLISHMENT

X DATE

X PROPRIETOR

X DATE
 Republic of the Philippines
Department of Public Works and Highways
Sorsogon First District Engineering Office
Guinaljon, Sorsogon City

CERTIFICATION

This is to certify that AL NIÑO CONSTRUCTION AND SUPPLY has submitted final and completed as
staked plans in connection with CONTRACT ID 17FK0007 - CONSTRUCTION / MAINTENANCE OF FLOOD
MITIGATION STRUCTURES AND DRAINAGE SYSTEM - CONSTRUCTION OF MILAGROSA RIVER CONTROL,
CASTILLA, SORSOGON

Issued this 10th day of JANUARY 2018 for payment purposes.

PRISCILLA B. JEBULAN
Project Engineer
 Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS & HIGHWAYS
Sorsogon First District Engineering Office
Guinlajon, Sorsogon City

January 10, 2018

Date

CERTIFICATION OF CLEARANCE FOR LABOR, MATERIALS & EQUIPMENT

CONTRACT ID : 17FK0007

CONSTRUCTION / MAINTENANCE OF FLOOD MITIGATION STRUCTURES AND

NAME OF PROJECT : DRAINAGE SYSTEM - CONSTRUCTION OF MILAGROSA RIVER CONTROL,
CASTILLA, SORSOGON

LIMITS :
LOCATION :

This is to certify that as of January 11, 2018 no written complaints have been filed in this Office on unpaid labor or
unpaid materials and on equipment lease or rental filed against the contractor AL NIÑO CONSTRUCTION AND SUPPLY

This certification is issued to the Contractor as a requirement in connection with their request for final payment of 100%
work accomplished for the implementation of 17FK0007 - CONSTRUCTION / MAINTENANCE OF FLOOD
MITIGATION STRUCTURES AND DRAINAGE SYSTEM - CONSTRUCTION OF MILAGROSA RIVER
CONTROL, CASTILLA, SORSOGON

PRISCILLA B. JEBULAN
Project Engineer
 EQUIPMENT

STRUCTURES AND
VER CONTROL,

X LOCATION

s Office on unpaid labor or X DATE & CONTRACTOR

UCTION AND SUPPLY

for final payment of 100%

TENANCE OF FLOOD
X BILLING & PROJECT DESCRIPTION
F MILAGROSA RIVER

X
 Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS & HIGHWAYS
Sorsogon First District Engineering Office
Guinlajon, Sorsogon City

CERTIFICATION OF CLEARANCE FOR EQUIPMENT RENTAL AND OTHER OBLIGATIONS

TO WHOM IT MAY CONCERN:

This is to certify that AL NIÑO CONSTRUCTION AND SUPPLY did not use/lease/rent any government equipment in
connection with CONTRACT ID 17FK0007 - CONSTRUCTION / MAINTENANCE OF FLOOD MITIGATION
STRUCTURES AND DRAINAGE SYSTEM - CONSTRUCTION OF MILAGROSA RIVER CONTROL, CASTILLA,
SORSOGON and has no financial obligations and the like relative to the above mentioned project.

Issued upon request this 10th day of January, 2018 for the payment of the above-mentioned project.

PRISCILLA B. JEBULAN
Project Engineer
x

X
 Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS & HIGHWAYS
Sorsogon First District Engineering Office
Guinlajon, Sorsogon City

January 10, 2018

Date

COMPLETION INSPECTION REPORT No. 1

CONTRACT ID NO. : 17FK0007

CONSTRUCTION / MAINTENANCE OF FLOOD MITIGATION STRUCTURES

PROJECT NAME AND
: AND DRAINAGE SYSTEM - CONSTRUCTION OF MILAGROSA RIVER
LOCATION
CONTROL, CASTILLA, SORSOGON

CONTRACT PRICE (Original/Revised): 34,300,000.00

CONTRACTOR : AL NIÑO CONSTRUCTION & SUPPLY

IMPLEMENTING OFFICE : DPWH-SORSOGON 1ST DEO

DATE OF INSPECTION :

FINDINGS

Recommendations:

JOSEPH D. DIAZ JOSEPH H. BONIFACIO

Representative Representative
Planning and Design Section Construction Section

ANGELIE D. REMOLACIO NIDA D. RELLAMA

Representative Representative
Maintenance Section Quality Assurance Section
X IF THERE IS REVISED CONTRACT AMOUNT PUT THE REVISED

X DATE OF INSPECTION

PROVIDE HERE A NARRATIVE REPORT OF THE INSPECTORATE TEAM'S

FINDINGS. ATTACH THE TEAM'S PREVIOUS COMPLETION INSPECTION
REPORT, INDICATING DEFECTS/DEFICIENCIES OBSERVED BY THE
INSPECTORATE TEAM AND REPAIR WORKS DONE BY THE CONTRACTOR. IF
X THE FIRST COMPLETION INSPECTION REPORT (NO.1) SHOWS
DEFECTS/DEFICIENCIES, INCLURE HERE THE TEAM'S COMMENDATION FOR
THE CONTRACTOR AND THE DPWH CONSTRUCTION SUPERVISION TEAM
FOR THEIR EXEMPLARY PERFORMANCE

X Recommendations
 Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS & HIGHWAYS
Sorsogon First District Engineering Office
Guinlajon, Sorsogon City

January 10, 2018

Date

FINAL COMPLETION INSPECTION REPORT

CONTRACT ID NO. : 17FK0007

CONSTRUCTION / MAINTENANCE OF FLOOD MITIGATION STRUCTURES

PROJECT NAME AND
: AND DRAINAGE SYSTEM - CONSTRUCTION OF MILAGROSA RIVER
LOCATION
CONTROL, CASTILLA, SORSOGON

CONTRACT PRICE (Original/Revised): 34,300,000.00

CONTRACTOR : AL NIÑO CONSTRUCTION & SUPPLY

IMPLEMENTING OFFICE : DPWH-SORSOGON 1ST DEO

DATE OF INSPECTION :

FINDINGS :

We, the undersigned members of the Inspectorate Team, conducted a joint inspection of the above stated project and found the
same to be satisfactorily completed on March 10, 2019 in accordance with the Plans and Specifications of the Contract.

JOSEPH D. DIAZ JOSEPH H. BONIFACIO

Representative Representative
Planning and Design Section Construction Section

ANGELIE D. REMOLACIO NIDA D. RELLAMA

Representative Representative
Maintenance Section Quality Assurance Section
X IF THERE ARE DEFECTS/DEFICIENCIES NOTED CHANGE THE DATE

X IF THERE IS REVISED CONTRACT AMOUNT PUT THE REVISED

X CHANGE THE DATE IF THERE ARE DEFECTS NOTED IN THE 1ST COMPLETION INSPECTION
PROVIDE HERE A NARRATIVE REPORT OF THE INSPECTORATE TEAM'S
FINDINGS. ATTACH THE TEAM'S PREVIOUS COMPLETION INSPECTION
REPORT, INDICATING DEFECTS/DEFICIENCIES OBSERVED BY THE
INSPECTORATE TEAM AND REPAIR WORKS DONE BY THE CONTRACTOR.
X IF THE FIRST COMPLETION INSPECTION REPORT (NO.1) SHOWS
DEFECTS/DEFICIENCIES, INCLURE HERE THE TEAM'S COMMENDATION
FOR THE CONTRACTOR AND THE DPWH CONSTRUCTION SUPERVISION
TEAM FOR THEIR EXEMPLARY PERFORMANCE

X DATE
 Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS & HIGHWAYS
Sorsogon First District Engineering Office
Guinlajon, Sorsogon City

"Annex B"

January 10, 2018

Date

FINAL INSPECTION REPORT

Project ID : 17FK0007
CONSTRUCTION / MAINTENANCE OF FLOOD MITIGATION
PROJECT NAME: : STRUCTURES AND DRAINAGE SYSTEM - CONSTRUCTION OF
MILAGROSA RIVER CONTROL, CASTILLA, SORSOGON
LOCATION : Castilla, Sorsogon
CONTRACTOR : AL NIÑO CONSTRUCTION & SUPPLY

We, the undersigned members of the Inspectorate Team, conducted a joint inspection of the above stated
project and found the same to be satisfactorily completed on March 10, 2019 in accordance with the Plans
and Specifications of the Contract.

JOSEPH D. DIAZ JOSEPH H. BONIFACIO

Representative Representative
Planning and Design Section Construction Section

ANGELIE D. REMOLACIO NIDA D. RELLAMA

Representative Representative
Maintenance Section Quality Assurance Section
 Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS & HIGHWAYS
Sorsogon First District Engineering Office
Guinlajon, Sorsogon City

January 10, 2018

Date

CERTIFICATION OF COMPLETION

CONTRACT ID NO. : 17FK0007

CONSTRUCTION / MAINTENANCE OF FLOOD MITIGATION STRUCTURES

PROJECT NAME AND
: AND DRAINAGE SYSTEM - CONSTRUCTION OF MILAGROSA RIVER
LOCATION
CONTROL, CASTILLA, SORSOGON

CONTRACT PRICE (Original/Revised): 34,300,000.00

CONTRACTOR : AL NIÑO CONSTRUCTION & SUPPLY

IMPLEMENTING OFFICE : DPWH-SORSOGON 1ST DEO

This is to certify that the above stated project has been satisfactorily completed on March 10, 2019 in accordance
with the Plans and Specifications of the Contract based on the Final Completion Inspection Report of the Inspectorate
Team dated March 19, 2019.

This certification does not relieve the Contractor of his obligations and responsibilities in undertaking repair works
on any defect or failure that may occur in any section of the project during the one-year Defects Liability Period starting
from the date of completion as herein stated. Neither is he relieve of his obligations and responsibilities pursuant to the
provisions of R.A. 9184.

IGNACIO T. ODIAMAN
District Engineer

Conforme:

_______________________
ALFREDO J. TAN
Contractor
 X CHANGE DATE IF THERE IS DEFECTS OR DEFICIENCIES NOTED IN THE 1ST COMPLETION

ATION STRUCTURES
AGROSA RIVER

X IF THERE IS REVISED CONTRACT AMOUNT PUT THE REVISED

10, 2019 in accordance

eport of the Inspectorate X DATE

ndertaking repair works

Liability Period starting
sibilities pursuant to the

X NAME OF CONTRACTOR (FULL NAME)

S NOTED IN THE 1ST COMPLETION INSPEC TION REPORT
 Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS & HIGHWAYS
Sorsogon First District Engineering Office
Guinlajon, Sorsogon City

Reference No.:
Date :

SUPPLY AND PROPERTY CLEARANCE CERTIFICATE ON PROPERTY

ACCOUNTABILITY (FOR CONTRACTORS)

To Whom It May Concern:

This is to certify that as per records of this office, AL NIÑO CONSTRUCTION AND SUPPLY, contractor of
17FK0007 - CONSTRUCTION / MAINTENANCE OF FLOOD MITIGATION STRUCTURES AND DRAINAGE
SYSTEM - CONSTRUCTION OF MILAGROSA RIVER CONTROL, CASTILLA, SORSOGON, has no property
and/or money accountability with the Supply and Property in Administrative Division/Section, in connection with the
above-mentioned contract.

In order to be complete, similar clearance shall be obtained from the DPWH Implementing Office (IO) of the
above-mentioned project and from the Bureau of Equipment and/or Regional Equipment Services (RES) for whatever
accountabilities there might be under their respective jurisdictions.

This certificate is issued for the purpose of final billing.

RICO D. DESPUIG
Supply Officer II

LARRY B. REYES
Administrative Officer V
X CHANGE DATE IF THERE IS DEFECTS OR DEFICIENCIES NOTED IN THE 1ST COMPLETION INSPEC TION R
OMPLETION INSPEC TION REPORT
 Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS & HIGHWAYS
Sorsogon First District Engineering Office
Guinlajon, Sorsogon City

CERTIFICATE OF CLEARANCE FOR EQUIPMENT AND OTHER OBLIGATIONS

Contractor : AL NIÑO CONSTRUCTION & SUPPLY

Contract ID : 17FK0007

CONSTRUCTION / MAINTENANCE OF FLOOD MITIGATION STRUCTURES

Project Name : AND DRAINAGE SYSTEM - CONSTRUCTION OF MILAGROSA RIVER
CONTROL, CASTILLA, SORSOGON

Location : FIRST DISTRICT OF SORSOGON

1. EQUIPMENT RENTALS, SPARE PARTS AND MATERIALS ISSUED, SERVICES RENDERED ETC.
(Attach supporting papers if necessary)

BILL NUMBER PARTICULARS AMOUNT REMARKS

NONE NONE NONE NONE

Note: Equipment Lease Contract dated __________________ and approved by ______________________________

2. OTHER OBLIGATIONS RELATIVE TO EQUIPMENT

(This will include unreturned equipment, attachments and accessories, estimated cost of repairs, etc.)

REMARKS : NO GOVERNMENT EQUIPMENT WAS USED IN THIS PROJECT

(State the present condition of the equipment together with your comment and/or recommendation)

For final payment

Cleared of equipment accountability & other obligations in the Area
Equipment Services

ERLIM JOSEPH B. AZOTEA

OIC-Area Equipment Engineer

Submitted by:

PRISCILLA B. JEBULAN
Project Engineer
x ADD LOCATION
 Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS
Sorsogon First District Engineering Office
Guinlajon, Sorsogon City

CERTIFICATE OF TURN-OVER AND COMPLETION

This is to certify that the construction works as specified below has been completed under direct supervision in
accordance with the plans, specifications and programs of work.

CONCURRED BY:

PRISCILLA B. JEBULAN ALFREDO J. TAN

Project Engineer (Name and Signature w/ Seal)
PTR No. _____________
TIN No.

CONSTRUCTION / MAINTENANCE OF FLOOD MITIGATION STRUCTURES AND DRAINAGE

1. Name/Location of Project: SYSTEM - CONSTRUCTION OF MILAGROSA RIVER CONTROL, CASTILLA, SORSOGON

2. Physical Work Accomplished: 100.00%

3. Appropriation: _________ Appropriation Act: ___________________
4. Work Undertaken By: Contract
5. If By Contract: AL NIÑO CONSTRUCTION & SUPPLY
(Name of Contractor)
34,300,000.00 239 CD
(Contract Amount) (Time Duration)
6. Date Started: May 11,2017
7. Date Completed January 4, 2018
8. Remarks Satisfactorily Completed

Submitted By:

MARIA SUSAN F. EPINO

Chief, Construction Section

ACKNOWLEDGEMENT OF TURN-OVER AND CUSTODY OF COMPLETED PROJECTS

This is to certify that I, has this date acknowledge and receive custody of the above-specified project in view of the
report of the District Inspectorate Team that same is satisfactorily completed in accordance with the plans, specifications and
program of work. I assume the responsibility of the structures for proper maintenance only

WITNESS

PRISCILLA B. JEBULAN
Project Engineer

APPROVED:
IGNACIO T. ODIAMAN
District Engineer
X NAME OF CONTRACTOR
 Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS
Sorsogon First District Engineering Office
Guinlajon, Sorsogon City

What : CERTIFICATION
Re : Turn-over of Laboratory Equipment

CONSTRUCTION / MAINTENANCE OF FLOOD MITIGATION

Project Name : STRUCTURES AND DRAINAGE SYSTEM - CONSTRUCTION OF
MILAGROSA RIVER CONTROL, CASTILLA, SORSOGON

Contract ID : 17FK0007
Contractor : AL NIÑO CONSTRUCTION & SUPPLY

This is to certify that the contract for the said project did not include any provisions for the purchase of
laboratory equipment.

PRISCILLA B. JEBULAN
Project Engineer
ULAN
 Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS
Sorsogon First District Engineering Office
Guinlajon, Sorsogon City

What : CERTIFICATION
Re : Turn-over of Equipment Bought out of Project Funds

CONSTRUCTION / MAINTENANCE OF FLOOD MITIGATION

Project Name : STRUCTURES AND DRAINAGE SYSTEM - CONSTRUCTION OF
MILAGROSA RIVER CONTROL, CASTILLA, SORSOGON

Contract ID : 17FK0007
Contractor : AL NIÑO CONSTRUCTION & SUPPLY

This is to certify that the contract for the said project did not include any provisions for the purchase of
office equipment, furniture, building, surveying instrument and service vehicle.

PRISCILLA B. JEBULAN
Project Engineer
ULAN
 Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS
Sorsogon First District Engineering Office
Guinlajon, Sorsogon City

What : CERTIFICATION
Re : Approved Time Extension / Suspension and Resume Orders

CONSTRUCTION / MAINTENANCE OF FLOOD MITIGATION

Project Name : STRUCTURES AND DRAINAGE SYSTEM - CONSTRUCTION OF
MILAGROSA RIVER CONTROL, CASTILLA, SORSOGON

Contract ID : 17FK0007
Contractor : AL NIÑO CONSTRUCTION & SUPPLY

This is to certify that the contract for the said project did not issue any Approved Time
Extensions/Suspension and Resume Order.

PRISCILLA B. JEBULAN
Project Engineer
ULAN
 Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS
Sorsogon First District Engineering Office
Guinlajon, Sorsogon City

What : CERTIFICATION
Re : As Built Quantity / Final Change Order

CONSTRUCTION / MAINTENANCE OF FLOOD MITIGATION

Project Name : STRUCTURES AND DRAINAGE SYSTEM - CONSTRUCTION OF
MILAGROSA RIVER CONTROL, CASTILLA, SORSOGON

Contract ID : 17FK0007
Contractor : AL NIÑO CONSTRUCTION & SUPPLY

This is to certify that the contract for the said project did not issue any As Built Quantity/Final Change
Order.

PRISCILLA B. JEBULAN
Project Engineer
ULAN
 Republic of the Philippines
Department of Public Works and Highways
Sorsogon First District Engineering Office
Guinaljon, Sorsogon City

January 10, 2018

Date

CERTIFICATION

This is to certify that defects/deficiencies noted in the final inspection of 17FK0007 -

CONSTRUCTION / MAINTENANCE OF FLOOD MITIGATION STRUCTURES AND
DRAINAGE SYSTEM - CONSTRUCTION OF MILAGROSA RIVER CONTROL, CASTILLA,
SORSOGON have already been corrected with pictures.

JOSEPH D. DIAZ JOSEPH H. BONIFACIO

Representative Representative
Planning and Design Section Construction Section

ANGELIE D. REMOLACIO NIDA D. RELLAMA

Representative Representative
Maintenance Section Quality Assurance Section
X NAME OF PROJECT, CONTRACTOR, BILLING AND AMOUNT

ATTACH THIS IF THERE ARE

DEFECTS/DEFICIENCIES NOTED IN THE
COMPLETION INSPECTION REPORT NO. 1 WITH
PICTURES BEFORE DURING AND AFTER OF THE
NOTED DEFECTS AND DEFICIENCIES