17bf0012 Brgy - Disusuan CC 1st

DPWH-Isabela Second District Engineering Office
Roxas, Isabela
CONTRACT PAYMENT CHECKLIST
First Progress Billing
Project (Contract) ID No.: 17BF0012

PCMA ID No. P00140501LZ-CW1
Project Title: Construction of Barangay Disusuan Community Center,
Disusuan, San Mariano,Isabela
Name of Contractor: SMT CONSTRUCTION

Contract Amount: 940,493.13
AMOUNT OF CLAIM: Php ___514,733.28
Attached
DOCUMENTARY REQUIREMENTS Date Y N N/A REMARKS
1 Letter Request of Contractor for Payment
2 Monthly Certificate of Payment
Statement of Work Accomplished
3 Statement of Time Elapsed
4 Contractor's Affidavit- duly notarized
5 Certification of Clearance for Equipment Rentals/ Lease
6 Certificate of Payment of Labor, Materials, and Equipment
7 Pictures of Work Accomplished
8 Back-up Computation
9 Certificate of Material's Quality Test (Material's on Site)
10 Material's Test Report
11 Certificate of Material's Quality Control Assurance
12 Construction Safety and Health Program approved by the DOLE
13 BIR Form No. 2307
14 BIR Form No. 2550 M-Vat declaration
15 Contractor All Risk Insurance duly verified by SAC
16 Copy of Performance Bond duly verified by SAC
17 Copy of Contract and Bill of Quantities
18 Notice to Proceed
19 Copy of Performance Security in the form of letter of Credit
Bank Guarantee or surety bond duly verified by SAC
20 Autority from DBM to purchase vehicles and equipment
21 One Set certified true copy of all documents submitted
for Accounting's copy
I hereby certify that the above supporting documents are complete.
Print Name: SAMUEL M. TORIBIO

Designation : Manager
Attached
DOCUMENTARY REQUIREMENTS Date Y N N/A REMARKS
1 Disbursement Voucher
2 Background Information
3 Executive Summary
4 Billing Summary
5 Property Clearance
6 Request for COA Inspection Report duly received by COA
7 Certification as per DO # 55 of 1988
8 One Set certified true copy of all the documents
submitted for accounting's copy
I hereby certify that the above supporting documents are complete.
Print Name: DANILO R. RAFANAN

Designation : Project Engineer
Date
Republic of the Philippines
DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS
ISABELA SECOND
DISTRICT ENGINEERING OFFICE
REGIONAL OFFICE II
Roxas, Isabela
CONTRACTOR'S STATEMENT OF WORK ACCOMPLISHED

For the period February 7- 27,2017
Project ID 17BF0012
Project Name: Construction of Barangay Disusuan Community Center,
CONTRACTOR :
SMT CONSTRUCTION Payment Certificate No. First Partial Payment
Sheet No. 1 Of 1
Total Unit Price Total Total Qty Total Qty Balance
Cost of
Item Contract in Contract Approved in To This of Cost to Balance
Description Unit
No. Quantity Peso Cost Previous This Quantity Previous This Date of Cost
Date
Billing Billing Billing Billing
A. Building
900(a) R.C. for Column & PC Cu.m. 3.59 5,154.55 18,504.83 - 3.59 3.59 - - 18,504.83 18,504.83 -
404(a) R.S. for Column & PC Kgs. 482.66 50.92 24,577.05 - 482.66 482.66 - - 24,577.05 24,577.05 -
900(b) R.C. for RB & RTB Cu.m. 5.70 9,249.24 52,720.67 - 5.70 5.70 - - 52,720.67 52,720.67 -
404(b) R.S. for RB & RTB Kgs. 820.24 53.72 44,063.29 - 820.24 820.24 - - 44,063.29 44,063.29 -
403(a) Structural Steel Works Kgs. 6335.59 96.75 612,968.33 - 3,809.28 3,809.28 2,526.31 - 368,547.84 368,547.84 244,420.49
1014 Pre-Painted Long Span Metal Roofing Sq.m. 306.00 571.96 175,019.76 - - - 306.00 - - - 175,019.76
B. MISCELLANEOUS - - - - - - - -
B.7 Occupational Safety & Health Program MD 480.00 12.18 5,846.40 - 240.00 240.00 240.00 - 2,923.20 2,923.20 2,923.20
B.9 Mobilization/Demobilization LS ALL 6,792.80 6,792.80 - 50% 50% 50% - 3,396.40 3,396.40 3,396.40
******* - - - - - - - - -
- - - - - - - - -
- - - - - - - - -
- - - - - - - - -
- - - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
TOTAL 940,493.13 - ### ### ###
WE HEREBY CERTIFY that the Statement of Work Accomplished on this page is true and correct.
Submitted by: Checked by: APPROVED:
SMT CONSTRUCTION DANILO R. RAFANAN REYNATO M. UBIA

Contractor Project Engineer District Engineer
Department of Public Works and Highways
ISABELA SECOND
REGIONAL OFFICE II
Roxas, Isabela
STATEMENT OF TIME ELAPSED AND WORK ACCOMPLISHED

PROJECT ID: 17BF0012
PROJECT NAME: Construction of Barangay Disusuan Community Center,
CONTRACTOR: SMT CONSTRUCTION
Period Covered February 7- 27,2017

Original Contract Time 60 CD
Date of Effectivity of Contract February 7,2017
Original Contract Amount 940,493.13
Revised Contract Amount Due to Approved
Change Order/Extra Order -
Original Expiry Date April 7,2017
Approved Time Extension 0 CD
Shutdown Days due to Suspension of Work 0 CD
Total Time Extension 0 CD
Total Calendar Days Elapsed to Date 21 CD
Contract Time (After Extension) - CD
Revised Expiry Date due to Extension -
Percentage of Time Elapsed 35.00%
Schedule of Work Accomplished 27.30%
Actual Work Accomplished 54.73%
Slippage + 27.43%
Actual Completion Date
DANILO R. RAFANAN
Project Engineer
Republic of the Philippines MONTHLY CERTIFICATE OF PAYMENT
Department of Public Works & Highways Payment Cert. No. First Partial Payment
Isabela Second District Engineering Office For the Period from : February 7- 27,2017 Sheet No. 1 of 1
Roxas, Isabela Date : March 06,2017
Project ID 17BF0012
Project Name: Construction of Barangay Disusuan Community Center, 14. I HEREBY CERTIFY that the attached Statement
Disusuan, San Mariano,Isabela of Work is correct and just and does not include items
and/or portions thereat for which payment has already CHECKED & REVIEWED
CONTRACTOR: SMT CONSTRUCTION been received. In regards to this Items materials
ORIGINAL CONTRACT AMOUNT: 940,493.13 are on site and are properly protected. FELIPE A. LASAM
REVISED CONTRACT AMOUNT: - Chief, Construction Section
1. Total Value of Work to Date 514,733.28 SMT CONSTRUCTION

2. Total Value of Work Previously - Contractor's Representative/s
3. Total Value of Work this Billing 514,733.28 Recommending for Payment:
4. Deductions: 15. I HEREBY CERTIFY that the materials incorporated
a) 10% Retention 51,473.33 in this Monthly Certification of Payment have been verified JOCELYN P. PALEG
Recoupment from Advances and tested in accordance with specifications. Assistant District Engineer
Sub-Total 51,473.33 Noted:
b) 2% Withholding Tax 8,272.50
5% VAT 20,681.25 NEMESIO A. CONCEPCION ROLLY M. CABAUATAN
Others: Specify Materials Engineer Chief, Quality Assurance Section
Sub-Total 28,953.75 Approved For Payment:
Total Deductions 80,427.08 16. I HEREBY CERTIFY that the quantity of work approved
5. Amount Approved for Payment 434,306.20 for payment in the attached statement have been accomplished,
that the quantities including materials brought to the site and REYNATO M. UBIA
6. Foreign Component of billing(_______% of 5) consistent with all previous recommendations for payment and District Engineer
7. Foreign Currency Equivalence of Foreign the work quantities and the amount are consistent with the
Component S/Y requirement of the contract.
8. Local Component Approved Amount (5-6)
9. Less: Peso Cost Financing to be paid by RDC/
IBRD/OEFC, etc. under category LOUIE O. MACNI DANILO R. RAFANAN
________________% of 5 Project Inspector Project Engineer
10. Less Local Expenditures Category
________________% of 5 Scheduled Physical Progress: 27.30%
11. Less: Request No.________ for previous Actual Physical Progress : 54.73%
Payment of materials on hand Slippage (+) or (-) : + 27.43%
12. Add: Request No. _________ for materials Contract Expiry Date : April 7,2017
materials on hand Revised Expiry Date: -
13. NET AMOUNT DUE TO CONTRACTOR 434,306.20
DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS
ISABELA SECOND
REGIONAL OFFICE II
Roxas,Isabela
March 06,2017
Date
FOR: REYNATO M. UBIA

District Engineer
FROM: DANILO R. RAFANAN

Project Engineer
SUBJECT: First Partial Payment
BACKGROUND:

Project ID No. 17BF0012
Project Name Construction of Barangay Disusuan Community Center,
Project Location San Mariano,Isabela
Contractor SMT CONSTRUCTION
Original Contract Amount 940,493.13
Revised Contract Amount -
Original Contract Time 60 CD
Revised Contract Time - CD
Effectivity of Contract February 7,2017
Original Expiry Date April 7,2017
Revised Expiry Date -
%, Time Elapsed 35.00%
Sched. Work Accomplished 27.30%
Actual Work Accomplished 54.73%
%, Slippage + 27.43%
Date Project Completed -
Date Project Accepted
Kind of Bank Guarantee or -
Letter of Credit
Expiry Date of Bank Guarantee or
Letter of Credit
REMARKS:
First Partial Payment
DANILO R. RAFANAN
Project Engineer
BILLING SUMMARY
March 06,2017
PAYEE SMT CONSTRUCTION

PROJECT ID 17BF0012
PROJECT NAME Construction of Barangay Disusuan Community Center,
IMPLEMENTING OFFICE DPWH-ISDEO, Roxas, Isabela
NATURE OF CONTRACT Straight Contract
CONTRACT AMOUNT 940,493.13

REVISED CONTRACT AMOUNT -
PREVIOUS BILLING 0.00
THIS BILLING 514,733.28
BALANCE 425,759.85
PAYMENT BREAKDOWN
See Attached SWA
SIGNATORIES
DANILO R. RAFANAN
Project Engineer
REMARKS: First Partial Payment

Reference No. _______________
Date: March 06,2017
EXECUTIVE S U M MARY
FOR: DISTRICT ENGINEER

DPWH-ISDEO ROXAS,ISABELA
SUBJECT: First Partial Payment

Project ID No. 17BF0012
Project Name: Construction of Barangay Disusuan Community Center,
1 Period Covered February 7- 27,2017

2 Action Recommended For Payment
3 Implementing Agency DPWH-ISDEO,Roxas,Isabela
4 Reviewing Office Accounting Section
5 Contractor SMT CONSTRUCTION
6 Contract Data Original Revised
7 Amount 940,493.13 -
8 Duration 60 CD - CD
9 Starting Date February 7,2017
10 Expiry Date April 7,2017 -

11 Percent Time Elapsed 35.00%
12 Physical Accomplishment -
13 Scheduled 27.30%
14 Actual 54.73%
15 Slippage + 27.43%
16 Contractor's Performance Bank Guarantee/Letter of Credit in liue of Retention
Money if needed -
17 Kind -
18 Amount -
19 Issued by: -
20 Expiry Date -
21 Validated -
22 Is performance Bank Guarantee
Letter of Credit still valid? -
23 Remarks -
DANILO R. RAFANAN
Project Engineer
ISABELA SECOND
REGIONAL OFFICE II
Roxas, Isabela
March 06,2017
Date
CERTIFICATION OF CLEARANCE FOR LABOR & MATERIALS PAYMENT

PROJECT ID 17BF0012
NAME OF PROJECT/ Construction of Barangay Disusuan Community Center,
THIS IS TO CERTIFY that as of March 06,2017 no written complaints
have been filed in this office on unpaid materials against the Contractor SMT
CONSTRUCTION.
This certification is issued to the Contractor as a requirement in connection
with the request for First Partial Payment of the projects.
DANILO R. RAFANAN
Project Engineer
DEPARTMENT OF PUBLICS WORKS AND HIGHWAYS
ISABELA SECOND
REGIONAL OFFICE II
Roxas, Isabela
CERTIFICATION OF CLEARANCE FOR

EQUIPMENT RENTALS AND/OR LEASE

PROJECT ID 17BF0012
NAME OF PROJECT: Construction of Barangay Disusuan Community Center,
THIS IS TO CERTIFY that as of March 06,2017
no claims against him on Equipment lease or rental obligations filed with office, or amount
due to the Department.
This certification is issued to the Contractor as a requirement in connection
with their request for First Partial Payment of the Project.
DANILO R. RAFANAN
Project Engineer
SMT CONSTRUCTION
Ilagan City, Isabela
March 06,2017
The District Engineer REYNATO M. UBIA

DPWH-Roxas, Isabela District Engineer
Attention : DANILO R. RAFANAN

Project Engineer
SUBJECT: REQUEST FOR RELEASE OF First Partial Payment

Projct ID No. 17BF0012
PROJECT: Construction of Barangay Disusuan Community Center,
Dear Sir:
We are submitting herewith our First Partial Billing covering from the period
from February 7- 27,2017 in the amount of Php 514,733.28
We have accomplished the work satisfactorily in accordance to the terms and conditions
of the contract. We also certify that the Performance Security of Contractor's Comprehensive All Risk
Insurance (CARI) is valid and documents are hereto attached for your review and approval.
We hope above is in order and request your preferential attention hereof.
Very truly yours,
SMT CONSTRUCTION
Contractor
SMT CONSTRUCTION
Ilagan City, Isabela
March 06,2017
The District Engineer

DPWH-Roxas, Isabela
Thru: DANILO R. RAFANAN

Project Engineer
Dear Sir:
In view of my request for Inspection (First Partial Payment) of Work Accomplished
relative to my contract for Construction of Barangay Disusuan Community Center,
Disusuan, San Mariano,Isabela with Project ID: 17BF0012 ,PCMA ID: P00140501LZ-CW1
Statement of Work Accomplished (SWA) as of February 7- 27,2017
a request for the representative of your office to conduct an an inspection and/or verification thereof.
It is further requested that the report of such inspection/verification be forwarded
to the Budget Officer to be incorporated in the supporting documents to be attached to the voucher.
Your favorable action will be highly appreciated.
Very truly yours,
SMT CONSTRUCTION
Contractor
Republic of the Philippines Fund Cluster :
ISABELA SECOND
REGIONAL OFFICE II
Roxas, Isabela
Date :
DV No. :
DISBURSEMENT VOUCHER
Mode of
MDS Check Commercial Check ADA Others (Please specify)
Payment
TIN/Employee No.: ORS/BURS No.:

Payee SMT CONSTRUCTION
134-240-886
Address Ilagan City, Isabela
Particulars Responsibility Center MFO/PAP Amount
To First Partial Payment of his contract for the : Office/Unit/Project
Construction of Barangay Disusuan Community Center, CONSTRUCTION SECTION
Disusuan, San Mariano,Isabela Code:
309-05-14-05
Contract Amount : 940,493.13

-
Previous Billing : 0.00
This Billing : 514,733.28
Less:
10% Retention 51,473.33
463,259.95
2% Tax 8,272.50
5% Vat 20,681.25
28,953.75 28,953.75
Contract ID: 17BF0012
PCMA ID: P00140501LZ-CW1
Amount Due 434,306.20
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.
FELIPE A. LASAM
Chief, Construction Section
B. Accounting Entry:
Account Title UACS Code Debit Credit
C. Certified: D. Approved for Payment

Cash available Four Hundred Thirty Four Thousand Three Hundred
Subject to Authority to Debit Account (when applicable) Six Pesos and 20/100 only.
Supporting documents complete and amount claimed proper Amount
Php 434,306.20
Signature Signature
Printed Name Printed Name

EVANGELINE C. DUYAG REYNATO M. UBIA
Position Accountant III Position District Engineer
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 Fund Cluster :
ISABELA SECOND
REGIONAL OFFICE II
Roxas, Isabela
Date :
DV No. :
Mode of
MDS Check Commercial Check ADA Others (Please specify)
Payment
TIN/Employee No.: ORS/BURS No.:

Payee BUREAU OF INTERNAL REVENUE
Address Naguilian, Isabela

Particulars Responsibility Center MFO/PAP Amount
To remittance of taxes withheld from SMT CONSTRUCTION Office/Unit/Project
for the : CONSTRUCTION SECTION
Construction of Barangay Disusuan Community Center, Code:
Disusuan, San Mariano,Isabela 309-05-14-05
2% Tax 8,272.50
5% Vat 20,681.25
Contract ID: 17BF0012

PCMA ID: P00140501LZ-CW1
Amount Due 28,953.75
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.
FELIPE A. LASAM
Chief, Construction Section
B. Accounting Entry:
Account Title UACS Code Debit Credit
C. Certified: D. Approved for Payment

Cash available Twenty Eight Thousand Nine Hundred Fifty Three
Subject to Authority to Debit Account (when applicable) Pesos and 75/100 only.
Supporting documents complete and amount claimed Amount
proper Php 28,953.75
Signature Signature
Printed Name Printed Name

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

OFFICE OF THE DISTRICT ENGINEER
Isabela Second District Engineering Office
Roxas, Isabela
No.
Mode of
MDS Check Commercial Check ADA Others
Payment
TIN/Employee No. OR/BUR No.
Payee SMT CONSTRUCTION 102-208-372
Responsibility Center
Office/Unit/Project Code:
Address ILAGAN CITY, ISABELA CONSTRUCTION SECTION 309-05-14-05
EXPLANATION AMOUNT
To First Partial Payment of his contract for the

Construction of Barangay Disusuan Community Center,
Original Contract Amount : 940,493.13

Revised Contract Amount: 0.00
Previous Billing : 0.00
This Billing : 514,733.28
Less:
10% Retention 51,473.33

Recoupment from advances
463,259.95
2% Tax 8,272.50
5% Vat 20,681.25
28,953.75
-
PMS NO: P00140501LZ-CW1
Project ID 17BF0012 NET AMOUNT DUE.. 434,306.20
Cash Control No. Payee/Creditor Bank Acct. No.

NCA No./Date
Back Acct. No. LDDAP Batch No./Date
A. Certified B. Approved for Payment
Two Million Eight Hundred Fifty Six Thousand Six Hundred
Cash available TRA Forty Six Pesos and 82/100
Amount
Subject to Authority to Debit Account (when applicable)
Php 434,306.20
Supporting documents complete
Signature Signature
Printed Printed
Name Name

Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
C. Received Payment JEV No.
Check/ Date Bank Name
ADA No.
Date Printed Name Date
Signature
Official Receipt/Other Documents
ACCOUNTING ENTRIES
RESP. ACCOUNT AMOUNT
ACCOUNTS AND EXPLANATIONS REF
CENTER CODE DEBIT CREDIT
Department of Public Works & Highways
Roxas, Isabela
November 22,2013
Date
CERTIFICATION OF PROJECT COMPLETION
Project ID :
Project Name : EXPANSION OF SAN MANUEL RHU, SAN MANUEL, ISABELA

#REF! #REF!
#REF! #REF!
#REF! #REF!
#REF! #REF!
#REF! #REF!
#REF! #REF!
Contractor :
THIS IS TO CERTIFY that the above-mentioned project under contract with

in the amount of
The DPWH Inspectorate Team has inspected the project on

together with representatives of the Consultant, Contractor and DPWH-ISDEO, Roxas, Isabela.
A copy of Inspection Report dated November 22, 2013 is attached for reference.
Since the Contractor has satisfactorily complied with the requirements of the
Inspectorate Team, this certificate of completion is hereby issued. The warranty Period
commences from the completion.
This Certification, however, does not relieve the Contractor of his obligations and
responsibilities in undertaking repair works, in accordance with accepted standards, on any
defect or failure that may occur on any section of the Project during the one (1) year defects
liability period. During this period, the Contractor is responsible for the repair of any defects,
fair wear and tear excepted, and these should be rectified by the Contractor, at his own
expense prior to final acceptance.
EDILBERTO B. DE GUZMAN
Project Engineer
CONCURRED:
REYNATO M. UBIA
District Engineer
CERTIFICATE OF ACCEPTANCE
( By the End-User )
November 22,2013
Date
PROJECT NAME: EXPANSION OF SAN MANUEL RHU, SAN MANUEL, ISABELA
LOCATION San Manuel, Isabela
This is to Certify That

which is the End-User of the above-mentioned
project, hereby accepts from the DPWH- Isabela Second District Engineering
Office, Roxas, Isabela, the said project structure.
As Project End-User, we assume full responsibility for the proper operation

and maintenance of the project.
NOTED:
EDILBERTO B. DE GUZMAN
Project Engineer
ITEMIZED COST OF REVISION
(Proposed Variation Order No. 1)
Project: EXPANSION /COMPLETION OF QUIRINO RHU

Location: Qurino, Isabela
Contractor:L. C. TALON CONSTRUCTION
Original Contract Additive Deductive REVISED QUANTITY and
Unit Cost
Item No. DESCRIPTION Unit Quantity Amount Qunatity Amount Qunatity Amount AMOUNT
(Php)
(Php) (Php) (Php) Quantity Amount (Php)
I Earthworks
a. Gravel Fill CU.M. 838.26 43.65 36,590.05 43.65 36,590.05
II Structural Concrete "A" CU.M. 4,660.34 54.56 254,268.15 54.56 254,268.15
III Reinforcing Steel Bars kgs. 67.40 2306.304 155,444.89 2306.304 155,444.89
IV Doors and Windows SQ.M. 4,751.90 130.83 621,691.08 130.83 621,691.08
V .Plastering SQ.M. 194.71 2,356.34 458,802.96 271.86 52,933.86 2,084.48 405,869.10
VI Electrical Works LS 307,596.92 ALL 307,596.92 ALL 307,596.92
VII Plumbing Works LS 84,747.57 ALL 84,747.57 ALL 84,747.57
VIII Tile Works SQ.M. 1,248.76 366.2 457,295.91 42.23 52,735.14 408.43 510,031.05
IX Health and Safety Measures LS 14,459.98 ALL 14,459.98 ALL 14,459.98
X Mobillization/Demolization LS 24,080.00 ALL 24,080.00 ALL 24,080.00
Total ### 52,735.14 52,933.86 ###
Submitted By: Verified as to Quantities:
ROLLY M. CABAUATAN ROGELIO A. CURAMENG FELIPE A. LASAM

Project Engineer Chief, Planning and Design Section Chief, Construction Section
Conformed:
L. C. TALON CONSTRUCTION
Contractor
0203-15-S-00070
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BACK-UP COMPUTATION
PROJECT: EXPANSION/COMPLETION OF QUIRINO RHU, QUIRINO, ISABELA
LOCATION: QUIRINO, ISABELA
I. EARTHWORKS
A. GRAVEL FILL:
QTY= [(34.50 X 12.00) + (10.00 X 1.00) + (10.00 +9.00)2(2.00)]0.01 = 44.30 cu.m.
II STRUCTURAL CONCRETE CLASS"A"
QTY= [(34.50 X 12.00) + (10.00 X 1.00) + (10.00 +9.00)2 (2.00)]0.125 = 55.375 cu.m.
III. REINFORCING STEEL BARS
QTY. = (0.616 X 6) (624) = 2,306.304 Kgs.
IV. DOORS AND WINDOWS:

1. DOORS:
D1 = (1.87 X 2.40) = 4.488 sq.m.
D2 = (0.90 X 2.10)(2) = 3.78 sq.m.
D3 = (0.80 X 2.10)(9) = 15.12 sq.m.
D4 = (1.20 X 2.10)(3) = 7.56 sq.m.
D5 = (0.80 X 2.10)(8) = 13.44 sq.m.
D6 = (0.60 X 2.10)(14) = 17.64 sq.m.
2. WINDOWS:
W1 = (1.96 X 1.50) + (1.97 X 1.50) + (1.98 X 1.50)2 + (1.99 X 1.50)6 + (2 X 1.50)2 + (2.01 x 1.50)
= 38.76 sq.m.
W2 = (3.00 X 1.50) + (2.98 X 1.50) = 8.97 sq.m.
W3 = (1.21 X 0.89) + (1.20 X 0.88) = 2.133 sq.m.
W4 = (0.59 X 0.89)12 + (0.59 X 0.90) + (0.60 X 0.90) = 7.372 sq.m.
Others (0.89 X 1.50) + (0.80 X 1.50) + (0.79 X 1.50) + (1.87 X 2.40)2

= 12.696 sq.m.
TOTAL AREA: DOORS + WINDOWS

= 131.959 SQ.M.
V. PLASTERING:
1. CHB WALLS:
LINE 1
QTY = {[(21.50 x 3.40) + (10.00 x 2.80) + (3.0)(3.4 +3.90)/2)] -
[(5.25 x 2.40) + (2.00 x 1.50)7 + (0.60 X 0.90)3 + (0.80 X 1.5 = 151.26
= 151.26
LINE2
QTY = {[28.10 x 2.80] - [(0.90 x 2.10)3 + (1.20 X 2.10)2 + (0.80 X 2. = 132.58
= 132.58
LINE 3
QTY = {[33 x 2.80] -[(0.90 x 2.10)6 + (1.20 X 2.10) + (0.80 X 2.10) + (0.60 X 2.10) + (2 144.8
= 144.8
LINE 4
QTY = {[(22.00 x4.05) + (7.00 x 4.65) + (5.50)(4.65 +5.20)/2)] - = 247.2
[(2.00 x 1.50)6 + (0.90 x 1.20)3 + (0.90 X 0.60)5 + (0.80 X 1.50)]} 2
= 247.2
LINE i
QTY = (2.00 x 2.80)2 = 11.2
= 11.2
LINE 2i
QTY = (2.50 X 2.80)2 = 14
= 14
LINE3i
QTY = {[13.60 x 2.80]- [(0.90 x 2.10) + (0.80 x2.10)2 + (0.60 x 2.10)= 63.14
= 63.14
LINE 4i
QTY = (1.50 X 2.80)2 = 8.4
= 8.4
Sub Total 772.58
LINE 5i
QTY= {[10.50 x 2.80] - [(1.20 x 2.10) + (0.60 x 2.10)]}2 = 51.24
= 51.24
LINE 6i
QTY = (1.20 X 2.80)2 = 6.72
= 6.72
LINE7i
QTY= [(3.00 x 2.80) - (0.60 x 2.10)]2 = 14.28
= 14.28
LINE 8i
QTY = (1.50 X 2.80)2 = 8.4
= 8.4
LINE9i
QTY = (1.50 X 2.80)2
= 8.4 = 8.4
LINE A
QTY = [(5.00 x 3.70) + (2.00 x 2.80) + (5.00 x 4.05)] -
[(1.50 x 3.00)2 + (0.90 x 2.10)]} 2 = 66.92
= 66.92
LINE B
QTY = (5.00 X 2.80)2
= 28 = 28
LINEC
QTY = (5.00 X 2.80)2
= 28 = 28
LINE D
QTY = [(7.00 X 2.80) - (0.60 x 2.10)]2
= 36.68 = 36.68
LINE E
QTY = [(10.00X 2.80) - (0.90 x 2.10)]2
= 52.22 = 52.22
LINE F
QTY = [(8.00X 2.80) - (0.80 x 2.10)]2
= 41.44 = 41.44
LINE G
QTY = (10.00 x 2.80)2
= 56 = 56
LINE H
QTY = [(10.00X 2.80) - (0.60 x 2.10)]2
= 53.48 = 53.48
LINE I
QTY = [(10.00X 2.80) - (0.60 x 2.10)]2
= 53.48 = 53.48
LINE J
QTY = {[12.00 x 3.50]-[(0.90 x 2.10) + (0.60 x 0.90)5]}2
= 74.82 = 74.82
LINE a
QTY= [(2.00 x 2.80) -(0.60 x 2.10)]2
= 8.68 = 8.68
LINE b
QTY = [(2.00 x 2.80) -(0.60 x 2.10)]2
= 8.68 = 8.68
LINE c
QTY= (5.00 x 2.80)2
= 28 = 28
LINEd
QTY = [(5.00 x 2.80) -(0.80 x 2.10)2]2
= 21.28 = 21.28
LINE e
QTY = (5.00 X 2.80)2
= 28 = 28
LINE f
QTY = [(1.75 x 2.80) -(0.60 x 2.10)2]2 = 7.28
= 7.28
LINE g
QTY = [(5.00 x 2.80) - (0.60 x 2.10)]2 = 25.48
= 25.48
LINE h
QTY = [(3.00 x 2.80) - (0.80 x 2.10)]2 = 13.44
= 13.44
Sub-Total 720.92
LINE i
QTY = [(1.00 X 2.80) - (0.60 x 2.10)]2 = 3.08
= 3.08
LINE j
QTY = [(3.00X 2.80) - (0.60 x 2.10)]2 = 14.28
= 14.28
LINE k
QTY = [(7.70X 2.80) - (0.60 x 2.10)4]2
= 33.04 = 33.04
LINE L
QTY = (1.500 x 2.80)2 = 8.4
= 8.4
WINDOWS:
QTY. = [(7.00 X 13) +- (9 X 12) + (4.20 x 2.0) + ( 4.80 X 1) + (4.60 x 2)][0.15 = 39.02
= 39.02
BEAMS
QTY. = [(34.50 X 2) +- (12.0 X 2)](0.10)( 1.50) = 13.95
= 13.95
QTY. = [(10 X 1) +- (4 X 1)2 + (11 X 1) + (1 X 9) + (4 x 3)](0.39)(2.00) = 39
= 39
COLUMNS:
QTY = [(3.4 X 6) +- (3.9 X 1) + (4.05 x 6.0) + ( 4.65 X 3) + (5.20 x 1) + (3.07 X 1) + (2.80 X 19) + (3.50 X 2 ) + (4.05 x 1) ] (1.4)(1.5)
284.97
QTY = (2.80 X 2) (1.25) (2.0) = 284.97
14
= 14
4 FASCIA BOARD
QTY= [36.50(2) + (14)(2) + (3)(2)](0.80)(1.15)
= 98.44 = 98.44
QTY= [36.50(2) + (14)(2) + (3)(2)](0.20)(2.0)
= 42.8 = 42.8
SubTotal 590.98
TOTAL PLASTERING = 772.58 + 720.92 + 590.98 = 2,084.48

= 2,084.48 SQ.M.
VI. ELECTRICAL WORKS:

QTY. = ALL LS
VII. PLUMBING WORKS:

QTY. = ALL LS
VIII. TILE WORKS:

AREA OF CR = (1.15 X 1.98) + (1.65 x 1.30) + (1.25 X 1.70) +
(1.90 X 1.30) + (1.50 x 5.00) + (2.70 X 1.50) +
(1.50 X 2.00) + (2.50 x 2.00)
= 28.567 SQ.M.
AREA OF CORRIDOR = (10 X 1) + (10+9)/2 = 29 SQ.M.
QTY. = (34 X 12) + 29 - 28.567 = 408.433 SQ.M.
IX HEALTH AND SAFETY MEASURES:

QTY. = ALL LS
X MOBILIZATION AND DEMOLIZATION:

QTY. = ALL LS
PREPARED BY: CHECKED BY:
ROLLY M. CABAUATAN FELIPE A. LASAM

Project Engineer Chief, Construction Section
Department of Public Works & Highways
Roxas, Isabela
February 28,2014
CERTIFICATION
THIS IS TO CERTIFY that LEONARDO C.TALON , General Manager of
L. C. TALON CONSTRUCTION with business address at Cabatuan, Isabela has submitted all the
documentary requirements necessary for the processing of the First and Final Payment in the
amount of Php 303,135.54 relative to the construction of WATER AND SANITATION
FACILITIES at Dicamay Integrated School, San Mariano, Isabela.
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.
JOCELYN P. PALEG
Assistant District Engineer
COMPUTATION OF LIQUIDATED DAMAGES
PROJECT NAME: #REF!

#REF!
CONTRACTOR: 0
Original Contract Expiry Date: January 29, 2014

Actual Project Completion Date: February 14, 2014
Revised Contract Expiry Date:
Original Contract Amount: Php290,386.82
Revised Contract Amount: -
Value of the Completed Portion of the
Contract upon Expiry date (Jan. 29, 2014): 290, 386.82 x 96.04% '= 278,887.50
TOTAL LIQUIDATED DAMAGES, T.L.D.
T.L.D. = One tenth(1/10) of One(1) percent of the Cost of the Unperformed portion of the
Work for every day of delay.
Where the Cost of Unperformed portion of the work = 290,386.82 - 278,887.50

= 11,499.32
Total days of delay = 61 - 45 = 16 days
T.L.D = 1/10 x 0.01 x Php 11,499.32 x 16 days

= Php 183.99
Prepared by: Checked By:
ROLLY M. CABAUATAN FELIPE A. LASAM

Project Engineer Chief, Construction Section
Approved By:
REYNATO M. UBIA
District Engineer
Roxas, Isabela
No.
Mode of
MDS Check Commercial Check ADA Others
Payment
TIN/Employee No. OR/BUR No.
Payee BUREAU OF INTERNAL REVENUE
Responsibility Center
Office/Unit/Project Code:
Address Naguilian, Isabela
CONSTRUCTION SECTION 309-05-14-05
EXPLANATION AMOUNT
To remittance of taxes withheld from A. DE GUIA CONSTRUCTION regarding

#REF!
0 33,068.30
2% Tax 9,448.09
5% Vat 23,620.21
NET AMOUNT DUE.. 33,068.30
Cash Control No. Payee/Creditor Bank Acct. No.

NCA No./Date
Back Acct. No. LDDAP Batch No./Date
A. Certified B. Approved for Payment
Thirty Three Thousand Sixty Eight Pesos and 30/100 only.
Cash available TRA
Amount
Subject to Authority to Debit Account (when applicable)
Php 33,068.30
Supporting documents complete
Signature Signature
Printed Printed
Name Name

Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
C. Received Payment JEV No.
Check/ Date Bank Name
ADA No.
Date Printed Name Date
Signature
Official Receipt/Other Documents
ACCOUNTING ENTRIES
RESP. ACCOUNT AMOUNT
ACCOUNTS AND EXPLANATIONS REF
CENTER CODE DEBIT CREDIT
#REF!

17bf0012 Brgy - Disusuan CC 1st

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DPWH-Isabela Second District Engineering Office

Project (Contract) ID No.: 17BF0012

Name of Contractor: SMT CONSTRUCTION

Print Name: SAMUEL M. TORIBIO

Print Name: DANILO R. RAFANAN

CONTRACTOR'S STATEMENT OF WORK ACCOMPLISHED

SMT CONSTRUCTION DANILO R. RAFANAN REYNATO M. UBIA

STATEMENT OF TIME ELAPSED AND WORK ACCOMPLISHED

PCMA ID No. P00140501LZ-CW1

CONTRACTOR: SMT CONSTRUCTION

Period Covered February 7- 27,2017

1. Total Value of Work to Date 514,733.28 SMT CONSTRUCTION

FOR: REYNATO M. UBIA

FROM: DANILO R. RAFANAN

SUBJECT: First Partial Payment

PCMA ID No. P00140501LZ-CW1

PAYEE SMT CONSTRUCTION

PCMA ID No. P00140501LZ-CW1

IMPLEMENTING OFFICE DPWH-ISDEO, Roxas, Isabela

NATURE OF CONTRACT Straight Contract

CONTRACT AMOUNT 940,493.13

PREVIOUS BILLING 0.00

THIS BILLING 514,733.28

REMARKS: First Partial Payment

FOR: DISTRICT ENGINEER

SUBJECT: First Partial Payment

1 Period Covered February 7- 27,2017

10 Expiry Date April 7,2017 -

CERTIFICATION OF CLEARANCE FOR LABOR & MATERIALS PAYMENT

PCMA ID No. P00140501LZ-CW1

THIS IS TO CERTIFY that as of March 06,2017 no written complaints

This certification is issued to the Contractor as a requirement in connection

with the request for First Partial Payment of the projects.

CERTIFICATION OF CLEARANCE FOR

PCMA ID No. P00140501LZ-CW1

THIS IS TO CERTIFY that as of March 06,2017

due to the Department.

This certification is issued to the Contractor as a requirement in connection

with their request for First Partial Payment of the Project.

The District Engineer REYNATO M. UBIA

Attention : DANILO R. RAFANAN

SUBJECT: REQUEST FOR RELEASE OF First Partial Payment

PCMA ID No. P00140501LZ-CW1

We hope above is in order and request your preferential attention hereof.

Very truly yours,

The District Engineer

Thru: DANILO R. RAFANAN

In view of my request for Inspection (First Partial Payment) of Work Accomplished

relative to my contract for Construction of Barangay Disusuan Community Center,

Statement of Work Accomplished (SWA) as of February 7- 27,2017

It is further requested that the report of such inspection/verification be forwarded

Your favorable action will be highly appreciated.

Very truly yours,

TIN/Employee No.: ORS/BURS No.:

Contract Amount : 940,493.13

C. Certified: D. Approved for Payment

Printed Name Printed Name

Position Accountant III Position District Engineer

Official Receipt No. & Date/Other Documents

TIN/Employee No.: ORS/BURS No.:

Address Naguilian, Isabela

Contract ID: 17BF0012

C. Certified: D. Approved for Payment