GOCC Letterhead

Performance Measures Description MF# 1 $ [Insert MFO Name] Quantity Quality Timeliness Financial Subtotal of Weights: MF# 2 $ [Insert MFO Name] Quantity Quality Timeliness Financial Subtotal of Weights: T#TA% #F &'()T*$ 100+ Formula eight Data Pro!i"er
if applicable

Interim PES Form 3

Baseline Data
(if available)

2010

2011

2012

CY 2013 Targets

CY 2013 Accomplishment

Rating

Certified Correct:

Head of Planning Approved by:

Date

Head of Finance

Date

Chief E ecutive !fficer

Chairperson" #oard of Directors

Date

GOCC Letterhead

2013 PBB Form 1

B#ARD R&*#%,T'#- -#. $$$$$$$$ AD#PT'-( T)& CY 2013 P&RF#RMA-C&/BA*&D B#-,* *Y*T&M F#R 0-AM& #F T)& (#CC1 '- ACC#RDA-C& 'T) &2&C,T'3& #RD&R -#. 405 *. 2012 A-D (C( M&M#RA-D,M C'RC,%AR -#. 2013/06% )&R&A*" on &' (uly &')&" President #E*+,*! -% AQ.+*! +++ issued E ecutive !rder /E%!%0 *o% 1'" s% &')&" 2hich directed the ,overnance Commission for ,!CCs /,C,0 to issue the necessary guidelines for the Performance3#ased +ncentive/P#+0-ystem of ,!CCs under ,C,4s 5urisdiction6 )&R&A*" ,C, 7emorandum Circular /7%C%0 *o% &')83'9 established the rules and regulations for the +nterim Performance3#ased #onus /P##0 -ystem for Qualified !fficers and Employees of ,!CCs covered by ,C, pursuant to the :GOCC Governance Act of 2011; /<%A% *o% )')=>06 )&R&A*" sub5ect to further evaluation by ,C," ?,!CC Acronym@ has attained a 2eighted3average of $A based on its Performance Agreement for &')8" and has complied 2ith all ,ood ,overnance Conditions" pursuant to ,C, 7C *o% &')83'& and ,C, 7C *o% &')83'96 )&R&A*" based on the guidelines in ,C, 7C *o% &')83'9" ?,!CC Acronym@ is a ?Profitable B Cosing@,!CC6 )&R&A*" E%!% *o% 1' reDuires that the funds for the grant of P## in ,!CCs shall be charged against their respective corporate funds" sub5ect to the approval of their respective governing boards6 and )&R&A*" no other performance3based incentive or its eDuivalent has been granted to the !fficers and Employees for CE &')8% B& 'T 7 R&*#%3&D" the #oard herebyAPPR#3&* the follo2ing: )% Application for authoriFation from ,C, to grant the &')8 P##" 2hich consists of: /a0 Productivity Enhancement +ncentive /PE+0amounting to P9"'''" 2hich shall be granted across3the3board6 and /b0 P## for Qualified !fficers and Employees based on their Percentile <anGing 2ithin their respective levels" and the applicable ?multipleBfi ed rate@% &% Allocation of an amount not e ceeding ? AM#,-T '- #RD* BA*&D #- 2013 PBB F#RM 3@ /P$0" chargeable against corporate funds" for the grant of the CE &')8P## to Dualified!fficers and Employees6 Provided" the grant of the CE &')8P## is sub5ect to the approval andBor ad5ustment by the ,C,%

8% AuthoriFation of the Chairperson of the ,overning #oard" the Chief E ecutive !fficer"Heads of Finance and Planning or their eDuivalent in authority and area of responsibility" Chairperson of the #ids and A2ards Committee and other !fficers concerned" to certify and attest under oath to the veracity of all information disclosed in the submitted documents reDuired in ,C, 7C *o% &')83'9 and such other documents that may be reDuired by ,C,% D#-&5 this $$$ day of ?month@ &')=" in ?city@" Philippines% To be signed by all 7embers of the ,overning #oard

GOCC Letterhead

2013 PBB Form 2

#M-'B,* C&RT'F'CAT'#This is to certify to the follo2ing: )% The ?F,%% -AM& #F (#CC@ achieved a 2eighted3average score of $A on its &')8 Performance -corecard% &% Complied 2ith all ,ood ,overnance Conditions" to 2it: /a0 Transparency -eal6 /b0 Phil,EP- Posting6 /c0 Cash Advance CiDuidation6 /d0 CitiFen4s Charter or its eDuivalent6 /e0 ?select one" delete the other@ -ubmission of statement of compliance 2ith the ,overnment Quality 7anagement -ystem -tandards /,Q7--0 pursuant to E%!% *o% H'9" s% &''I ?!<@-ubmission of concrete and timebound plan and actions taGen to2ards complying 2ith the ,overnment Quality 7anagement -ystem -tandards /,Q7--0 pursuant to E%!% *o% H'9" s% &''I6 /f0 Compliance 2ith the submission and revie2 reDuirements covering -tatement of Assets" Ciabilities and *et2orth /-AC*06 /g0 Paid in full all statutory liabilities" namely: i% All ta es due to the ,overnment6 ii% Declaration and payment of all dividends to the -tate due for CE &')86 iii% Payment of mandatory premiums due for CE &')8 to the ,overnment -ervice +nsurance -ystem /,-+-0" -ocial -ecurity -ystem /---0" Home Development 7utual Fund /Pag3+#+,0" Philippine Health +nsurance Corporation /PhilHealth0 and the Employees Compensation Commission /ECC06 /h0 -ubmission to ,C, and C!A of concrete and time bound action plans for addressing *otices of Disallo2ances and Audit !bservation 7emoranda from the Commission on Audit /C!A0" if any" and the timely e ecution of all such plans that 2ere possible as of the time of the issuance of this Certification% /i0 .ploading of the follo2ing on the official 2ebsite of ?,!CC Acronym@ for unrestricted public access" to 2it: i% Manual of Corporate Governanceapproved by ,C, pursuant to -ection =& of the C#D& #F C#RP#RAT& (#3&R-A-C& F#R (#CC* 0(C( MC -#. 2012/081% ii% Disclosure reDuirements enumerated under -ection =8 of ,C, 7C *o% &')&3'I% iii% No Gift Polic as approved by ,C,pursuant to -ection &> of ,C, 7C *o% &')&3'I%

8% Pursuant to -ection 9/b0 of E%!% 1' and ,C, 7C *o% &')83'9" the funding allocated for the &')8 Performance3#ased #onus /P##0and approved by the ,overning #oard has been sourced from corporate funds" 2hich have not been sourced from any of the follo2ing: /a0 /b0 Coans6 -ubsidy from the *, for the ,!CCJs operations" e cept for subsidy income or subsidy given by D#7 precisely for the payment of the P##6 and -ale of the ,!CCJs asset/s0 for the sole purpose of paying the P## and is other2ise not in the ordinary course of business%

/c0

Furthermore" the allocation of the budget for the P## is in accordance 2ith all other applicable la2s" rules and regulations% =% That ?AM#,-T '- #RD* BA*&D #- 2013 PBB F#RM 3@ /P$0 is available for the grant of the P## for CE &')8" as approved under #oard <esolution *o% $" s% $ and confirmed by ?)ea" of Finance@% This certification is being issued to attest the truth and accuracy of all the information contained herein based on our personal Gno2ledge" available records and information that can be easily verified 2ith ?,!CC Acronym@% D#-&" this $$$$$ day of $$$$$$$$$$$$$ &')= at ?CityB7unicipality" Province@" Philippines%

Chairperson5 Boar" of Directors

Chief &9ecuti!e #fficer

Compliance #fficer : Corporate *ecretar;

)ea" of Finance

)ea" of Bu"get

)ea" of Planning

Chairman5 Bi"s an" A<ar"s Committee

GOCC Letterhead 2013 PBB Form 3 *,MMARY = *C)&D,%& #F T)& RA->'-( #F &%'('B%& #FF'C&R* A-D &MP%#Y&&*
[Notes on the Form: Belo i! an illu!tration of the PBB di!tribution of e"plo#ee!$ %he !ub"i!!ion "u!t co"pl# ith the follo in& for"at provided on thi! Anne'$ %he re(uired infor"ation fro" the GOCC !hall con!i!t of t o table!) (1) A !u""ar# !ho in& the ran* and di!tribution for each per!onnel &roup+ ith corre!pondin& PBB a"ount ba!ed on the percentile ran*, and (2) a !chedule of the actual and applicable PBB di!tribution on a pere"plo#ee ba!i!$ .or profitable GOCC!+ indicate the ba!ic !alar# of the e"plo#ee$/elete note! before printin&$0

M,%T'P%& : F'2&D AM#,-T

D'*TR'B,T'#-

-#. #F P&R*#--&%

PBB AM#,-T0P1

Personnel Grou!: *&-'#R MA-A(&M&-T &%9' B &9"''' )%9' B )9"''' )%'' B I"9'' #elo2 -atisfactory $A $A $A $A

Total$ *enior Management Personnel Grou!: M'DD%& MA-A(&M&-T &%9' B &9"''' )%9' B )9"''' )%'' B I"9'' #elo2 -atisfactory $A $A $A $A

Total$ Mi""le Management Personnel Grou!: PR#F&**'#-A% A-D *,P&R3'*#RY &%9' B &9"''' )%9' B )9"''' )%'' B I"9'' #elo2 -atisfactory $A $A $A $A

Total$ Professional an" *uper!isor; Personnel Grou!: C%&R'CA%:(&-&RA% *TAFF &%9' B &9"''' )%9' B )9"''' $A $A

M,%T'P%& : F'2&D AM#,-T )%'' B I"9'' #elo2 -atisfactory

D'*TR'B,T'#$A $A

-#. #F P&R*#--&%

PBB AM#,-T0P1

Total$ Clerical:(eneral *taff (RA-D T#TA%

*C)&D,%& #F PBB D'*TR'B,T'#- F#R PR#F'TAB%&(#CCs /values indicated are for illustration only0 <anG Employee 7ultiplier code SENIO" M#N#GEMEN$ ) &%9 & &%9 8 &%9 #asic -alary /P0 )9"'''%'' 8'"'''%'' 9'"'''%'' P## Amount /P0 8I"9''%'' I9"'''%'' )&9"'''%'' 2385600.00 &&"9''%'' =9"'''%'' I9"'''%'' 1?25600.00 )9"'''%'' 8'"'''%'' 9'"'''%'' @65000.00 ?865000.00 MI%%&E M#N#GEMEN$ Top 02.601 ) & 8 &%9 &%9 &%9 )9"'''%'' 8'"'''%'' 9'"'''%'' 8I"9''%'' I9"'''%'' )&9"'''%'' 2385600.00 &&"9''%'' =9"'''%'' I9"'''%'' 1?25600.00 )9"'''%'' 8'"'''%'' 9'"'''%'' @65000.00

Top02.601

-ub3total -e9t 01.601 ) & 8 )%9 )%9 )%9 )9"'''%'' 8'"'''%'' 9'"'''%''

-ub3total Remaining 01.001 ) & 8 )%' )%' )%' )9"'''%'' 8'"'''%'' 9'"'''%''

-ub3total Belo< *atisfactor; $A Total$ *enior Management

-ub3total -e9t 01.601 ) & 8 )%9 )%9 )%9 )9"'''%'' 8'"'''%'' 9'"'''%''

-ub3total Remaining 01.001 ) & 8 )%' )%' )%' )9"'''%'' 8'"'''%'' 9'"'''%''

-ub3total Belo< *atisfactor; $A Total$ Mi""le Management PR#F&**'#-A% A-D *,P&R3'*#RY

?865000.00

Top 02.601

) & 8

&%9 &%9 &%9

)9"'''%'' 8'"'''%'' 9'"'''%''

-ub3total -e9t 01.601 ) & 8 )%9 )%9 )%9 )9"'''%'' 8'"'''%'' 9'"'''%''

8I"9''%'' I9"'''%'' )&9"'''%'' 2385600.00 &&"9''%'' =9"'''%'' I9"'''%'' 1?25600.00 )9"'''%'' 8'"'''%'' 9'"'''%'' @65000.00 ?865000.00

-ub3total Remaining 01.001 ) & 8 )%' )%' )%' )9"'''%'' 8'"'''%'' 9'"'''%''

-ub3total Belo< *atisfactor; $A Total$ Professional an" *uper!isor; C%&R'CA%:(&-&RA% *TAFF Top 02.601 ) & 8 &%9 &%9 &%9 )9"'''%'' 8'"'''%'' 9'"'''%''

-ub3total -e9t 01.601 ) & 8 )%9 )%9 )%9 )9"'''%'' 8'"'''%'' 9'"'''%''

8I"9''%'' I9"'''%'' )&9"'''%'' 2385600.00 &&"9''%'' =9"'''%'' I9"'''%'' 1?25600.00 )9"'''%'' 8'"'''%'' 9'"'''%'' @65000.00 ?865000.00 15@005000.00

-ub3total Remaining 01.001 ) & 8 )%' )%' )%' )9"'''%'' 8'"'''%'' 9'"'''%''

-ub3total Belo< *atisfactor; $A Total$ Clerical:(eneral *taff (RA-D T#TA%

*C)&D,%& #F PBB D'*TR'B,T'#- F#R %#*'-((#CCs /values indicated are for illustration only0 <anG *&-'#R MA-A(&M&-T Top ) & 8 &9"'''%'' &9"'''%'' &9"'''%'' 865000.00 )9"'''%'' )9"'''%'' )9"'''%'' ?65000.00 I"9''%'' I"9''%'' I"9''%'' 225600.00 1?25600.00 ) & 8 &9"'''%'' &9"'''%'' &9"'''%'' 865000.00 )9"'''%'' )9"'''%'' )9"'''%'' ?65000.00 I"9''%'' I"9''%'' I"9''%'' 225600.00 1?25600.00 ) & 8 &9"'''%'' &9"'''%'' &9"'''%'' 865000.00 Employee code Amount /P0

-ub3total -e9t ) & 8

-ub3total Remaining ) & 8

-ub3total Belo< *atisfactor; $A Total$ *enior Management M'DD%& MA-A(&M&-T Top

-ub3total -e9t ) & 8

-ub3total Remaining ) & 8

-ub3total Belo< *atisfactor; $A Total$ Mi""le Management PR#F&**'#-A% A-D *,P&R3'*#RY Top

-ub3total

<anG -e9t

Employee code ) & 8

-ub3total Remaining ) & 8

Amount /P0 )9"'''%'' )9"'''%'' )9"'''%'' ?65000.00 I"9''%'' I"9''%'' I"9''%'' 225600.00 1?25600.00

-ub3total Belo< *atisfactor; $A Total$ Professional an" *uper!isor; C%&R'CA%:(&-&RA% *TAFF Top ) & 8

-ub3total -e9t ) & 8

&9"'''%'' &9"'''%'' &9"'''%'' 865000.00 )9"'''%'' )9"'''%'' )9"'''%'' ?65000.00 I"9''%'' I"9''%'' I"9''%'' 225600.00 1?25600.00 6805000.00

-ub3total Remaining ) & 8

-ub3total Belo< *atisfactor; $A Total$ Clerical:(eneral *taff (ran" total