PAMANTASAN NG LUNGSOD NG MAYNILA

Document Tracking System

(To be filled up by OPRES)

Department Control Number:

Date of Letter/Document: November 13, 2015

Outgoing Control Number:

_________________

Signatory: Engr. Denvert C. Pangayao

OPRES Control Number: __________________

Date Received: __________________________
Received From:
__________________________

Document Title: Request to Conduct a Fieldtrip/Plant Visit

DATE

FROM
(Name and
Office)

TO
(Name and
Office)

ACTION REQUESTED/REMARKS

MEMORANDUM
For:

DR. RENATO T. OLIVEROS

Executive Vice President

Through:

DR. CECILIA J. SABIO

Officer-In-Charge, Office of Student Development and Services

From:

CHEMICAL ENGINEERING DEPARTMENT

Date:

November 13, 2015

ACTION REQUIRED
For the Executive Vice President to approve the request to conduct a field trip/plant visit
in [company name and address] on [insert target date & time here].
REFERENCES
Attached herewith are the following references in lined with the said activity:
Course Syllabus
Approved Request Letter
Proposed time table
List of Participants
Nearest Hospital
BACKGROUND
3.1 The proposed activity serves as a course requirement for the completion of CHE 427:
Field Trips and Seminars. This aims to show students different opportunities within the
industry and to allow them to explore classroom concepts and theories with professionals.
3.2 The said activity will be conducted in [Company name and location]
3.3 It shall be conducted on the [Date and Time]
3.4 There will be a voluntary contribution amounting to Php (insert amount here) that will
cover all the expenses for the said event (transportation, fees).
ANALYSIS
1. The target date for the aforementioned event was decided to be scheduled on the
[Target Date] so that it would be in line with the availability of the students and faculty,
and the company.
2. Specific requirements such as the List of Participants, Parental Consent, Voluntary
Contribution Waiver, Insurance, and Nearby Hospital are attached in the letter.
COORDINATION
College of Engineering and Technology
[Company Name]
Office of the Students Development and Services
Vice President for Academic Affairs
Executive Vice President
RECOMMENDATION
For the Executive Vice Presidents approval and signature.

ANNEXES
Annex A:
Annex B:
Annex C:
Annex D:
Annex E:
participant
Annex F:

Course Syllabus
Approved Request Letter
Proposed Time Table
List of Participants
Parental Consent, Voluntary

Contribution

Waiver,

Insurance

per

Nearby Hospital

Requesting Party:
_____________________
Bernard K. Baluyot Jr.
BS ChE 4 -1, 2012-20050

_____________________
Justin Paul N. Conge
BS ChE 4 -1, 2012-20050

_____________________
Glyzel G. Dizon
BS ChE 4 -1, 2012-20050

_____________________
Maria Cecille S. Garcia
BS ChE 4 -1, 2012-20050

Noted by:
_____________________
Engr. Denvert C. Pangayao
Faculty-in-charge, Chairperson
Chemical Engineering Department, CET

RECOMMENDING APPROVAL:
Date:

Engr. Clydelle M. Rondaris

Dean, College of Engineering and Technology
Date:

Date:

Prof. Felix de Ocampo

Assistant Vice President for Academic Affairs
Date:
Approved
Disapproved

Dr. Cecilia J. Sabio

Vice President for Academic Affairs

[
[

]
]

Dr. Renato T. Oliveros

Executive Vice President

CERTIFICATION OF
COMPLETED STAFF WORK
I, Engr. Clydelle M. Rondaris, with official designations as Dean of the College of
Engineering and Technology, do hereby submit the subject proposal or recommendation
referred to as ChE Christmas Party/Year-End Assembly, in my official capacity, to the Office
of the Assistant Vice President for Academic Affairs of Pamantasan ng Lugsod ng Maynila
(PLM).
As part of the subject proposal or recommendation, I hereby certify that I have subjected the
abovementioned proposal or recommendation to Completed Staff Work through my Office,
College of Engineering and Technology. In this regard, I guarantee, warrant and certify that:
1. The Proposal or recommendation is the result of thorough due diligence as required by
law on Public Officials, and hence is above board, and advantageous to the University.
The proposal was prepared with absolutely no participation from the Assistant Vice
President for Academic Affairs nor his Office;
2. The proposal or recommendation does not, in any way, violate any provision or
requirement of the University Charter, The University Code, other official issuances of
the Board of Regents, and all other prescribed policies and procedures of the University;
3. The proposal or recommendation does not violate any and all provisions of R. A. 3019
(Anti-Graft and Corrupt Practices Act), and R. A. 6713 (Code of Conduct and Ethical
Standards for Government Officials and Employees) and other laws to which the
proposal or recommendation, and the recommending officials and/ or staff are bound;
4. The proposal or recommendation is strictly in accordance with the compliant to any and
all existing rules and regulations, requirements, policies and procedures of the
Commission on Audit (COA), and all over other relevant or similar regulatory bodies; and
all ordinance of the City of manila, and laws of the Republic of the Philippines;
5. All concerned and affected officials and sectors have been consulted and concurrence
by these officials have been obtained;
6. Funds are available are certified by the Vice President for Finance (if funding is
required), and any other Public Official/s as required by law;
7. The proposal is doable (i.e. technically and financially feasible) within the timeframe
indicated herein;
8. The proposal is consistent with objectives, polices, plans, and programs of the
University; and
9. Potential problems have been anticipated and corrective measures have been planned
for.
I hereby declare that the foregoing Certification is true and correct; and that I absolutely and
unconditionally agree to forever hold PLM and the Assistant Vice President for Academic Affairs
free and harmless from any all and amounts of claims, suits, liabilities, losses, damages,
actions, of whatever nature arising from and in connection to the subject recommendation

and/or proposal, and my foregoing Certification; and that I absolutely relieve, discharge and will
indemnify PLM, and its Assistant Vice President for Academic Affairs and his representatives for
any all and amounts of claims, suits, liabilities, losses, damages, actions, of whatever nature
that they may suffer as a result or arising from or in connection to my subject recommendation
and /or proposal and thus foregoing attestation.

Engr. Clydelle M. Rondaris

Dean
College of Engineering and Technology