Department of the Interior and Local Government Google Drive Upload Checklist

File 1 of 2
Assessment for the Seal of Good Local Governance
CY 2019

Seal of Good Local Governance –DOCUMENT UPLOAD CHECKLIST

For Provinces
File 1 of 2: All RAT Forms + All LGU Certifications

Province of : __________________________________ Region : __________

INSTRUCTIONS: PLEASE READ BEFORE PROCEEDING TO THE ITEMS.

For the RFP/PFP: (1) This serves as cover page of all the documents listed below. (2) Please ensure that below-listed documents are
complete and duly-certified, and bear the official release stamp of respective Records Office. (3) Once all Forms are thoroughly
checked, upload to the designated LGPMS-SGLG Google Drive.

Form Form Title No. of Pages

Code
Certified by members of the Regional Assessment Team (RAT):
3.1 Financial Administration 21
3.3 Disaster Preparedness
3.3 Social Protection
3.4 Peace and Order
3.5 Business-friendliness and Competitiveness
3.6 Environmental Management
3.7 Tourism, Culture and the Arts

Certification from Department Heads:

2A Accounting Office 2
2C Budget Office 1
2D DepEd Representative 1
2E DILG Field Office 1
2H Planning and Development Office 1
2I Local PNP Office/Station 2
2K Treasurer’s Office 1
*No required Form 2B (BPLO), 2F (DRRMO), 2G (formerly from Engineering’s Office) Certification and 2J (SWDO)

I hereby certify that uploaded RAT Forms and Certifications from Department Heads are:

(1) Complete i.e., no missing pages;

(2) Duly and accordingly certified by all RAT members and LGU Department Heads; and
(3) Officially released by respective offices.

_______________________________________________
Signature over Printed
Name of the RFP

Date: ______________________________________
 Google Drive Upload Checklist
Department of the Interior and Local Government
File 2 of 2
Assessment for the Seal of Good Local Governance
CY 2019

Seal of Good Local Governance –VERIFYING DOCUMENT UPLOAD

For Provinces
File 2 of 2: Selected Document-MOVs

Province of : __________________________________ Region : __________

INSTRUCTIONS: PLEASE READ BEFORE PROCEEDING TO THE ITEMS.

For the RFP/PFP: (1) This serves as cover page of all the documents listed below. (2)Put a check (√) mark on the available/applicable
documents, based on LGU’s situation, that are to be uploaded. (3) If all Forms are completely filled-out as reviewed, upload to the
designated LGPMS-SGLG Google Drive. EXCEPT FOR ITEM(S) THE LGU WISHES TO APPLY FOR A JUSTIFICATION, YOU ONLY NEED TO
UPLOAD THE BELOW-LISTED MOVs AND IN SOME CASES, PORTION or SELECT PAGES OF INDICATED LGU DOCUMENT. PLEASE REFRAIN FROM
UNNECESSARY VOLUMINOUS SUBMISSIONS.

Criterion Available/Applicable Document for Upload

Financial Administration *No additional documents to be uploaded

Disaster Preparedness
1. Functionality of LDRRMO:
Plantilla LDRRM Officer (Head
of Office)
2. PDPFP and zoning ordinance
(in case CLUP is still under review)
Social Protection
3. Mechanisms for GAD and
VAWC
4. Local Code for Children
5. Accredited residential care
facility
6. LSWDO is a registered social
worker
Peace and Order
Business-friendliness and
Competitiveness
7. Local Investment and
Incentive Code
Environmental Management
8. SWM Plan
Tourism, Culture and the Arts
9. Inventory of cultural property
☐ Appointment of LDRRM Officer – Head of Office with CSC
attestation
☐ CSC Resolution granting the LGU authority to take final action
on its appointment (in case the LGU is accredited)
☐ Certification from Regional NEDA stating that the final draft is currently
under review and results of risk assessment is already incorporated therein
☐ Copy of draft PDPFP (only the portion showing that results of risk
assessment are already incorporate)
☐ Ordinance approving/ amending/ revising LGU’s GAD Code
☐ Ordinance approving/ amending/ revising LGU’s Code for
Children
☐ Accreditation of the facility issued by DSWD-Standards Bureau
☐ Memorandum of Agreement between LGU and partner-
organization managing the facility (in case LGU does not manage its
own RCF; but has a partner-facility)
☐ Appointment of PSWDO with CSC attestation
☐ CSC Resolution granting the LGU authority to take final action
on its appointment (in case the LGU is accredited)
☐ PRC license of PSWDO – Head of Office
☐ PRC license of registered LSWDO staff (in case the exemption
applies)
*No additional documents to be uploaded
☐ Ordinance approving/ amending/ revising LGU’s GAD Code
☐ Proof of approval of SWM Plan
☐ Received copy of LGU’s letter to NSWMC requesting for SWM
Plan review (in case plan is still under review)
☐ Page(s) from an inventory of a sample cultural property in the
LGU that contains its name, location, significance, and type.
 Department of the Interior and Local Government
Assessment for the Seal of Good Local Governance
CY 2019

Other supporting documents (as listed in the accomplished Form 2), if any
Criteria Document Title

___________________________________ ________________________________________________________
___________________________________ ________________________________________________________
___________________________________ ________________________________________________________
___________________________________ ________________________________________________________

Checked and Uploaded by:

_______________________________________________ _____________________
Signature over Printed Date
Name of the RFP