Republic of the Philippines

Surigao Del Sur State University

Rosario, Tandag City, Surigao del Sur 8300
Telefax No. 086-211-4221
Website: www.sdssu.edu.ph

STATEMENT OF WORKS ACCOMPLISHMENT

Period Covered from : October 30, 2018 - November 5, 2018

Name of Project : Repair of Water Tank

Location : Surigao del Sur State University (SDSSU) Main Campus, Tandag, Surigao del Sur
Subject : FINAL BILLING
Contract Date Started : October 30, 2018
Contract Date Completion : November 5, 2018
Contract Amount :

Previous
ITEM NO. DESCRIPTION % Wt. QTY UNIT Total Amount
Qty. % Amount Qty.

Repair of Water Tank

100.00% 1.00 LOT 4,900.00 - 0.00% - 1.00

Scope of Works

a. Welding of crack portion

TOTAL 100.00% 4,900.00

A. Certification
I hereby certify that the work itemized above has been accomplished in accordance with plans and specifications and other requirements thereof.

Inspected by:

Inspectorate Team

MC DONALD G. AMPARO, C.E. ROBERTO M. SAHILAN, JR. ERNESTO R. CUARTERO, M.E.

Plant Engineer/Project Inspector Project Inspector Project Inspector

REMOR D. JACQUEZ, C.E. JUSTINE G. GONZALES, C.E.

Asst. Plant Engineer/Project Inspector Asst. Plant Engineer/Project Inspector

Recommending for Approval:

Checked by:

CHRISTOPHER D. BADAYOS, MEP-M.E. FLORIFE O. URBIZTONDO, DPA

Asst. to the President on Physical Facilities Chief Administrative Officer
 Philippines Document Code: QR-PPF-007J

State University Revision No.: 000

Surigao del Sur 8300 Effective Date: 8/1/2018

6-211-4221 Page: 12/31

sdssu.edu.ph

ORKS ACCOMPLISHMENT
October 30, 2018 - November 5, 2018

ACCOMPLISHMENT (%)
This Period To Date

Qty. % Amount Qty. % Amount

1.00 100.00% 4,900.00 1.00 100.00% 4,900.00

4,900.00

nspectorate Team

ERNESTO R. CUARTERO, M.E. ALJON G. LANGUING, C.E

Project Inspector Asst. Plant Engineer/Project Engineer

JUSTINE G. GONZALES, C.E.

Asst. Plant Engineer/Project Inspector

Approved by:

BACELEDES R. ESTAL, Ph.D.

SUC - President II
 Republic of the Philippines Document Code: QR-PPF-007I

Surigao Del Sur State University Revision No.: 000

Rosario, Tandag City, Surigao Del Sur 8300 Effective Date: 8/1/2018

Telefax No. 086-211-4221 Page: 1/1

Website: www.sdssu.edu.ph

PROGRESS BILLING
As of
Period Covered from : October 30, 2018 - November 5, 2018

Name of Project : Repair of Water Tank

Location : SDSSU-Main Campus, Tandag, Surigao del Sur
Contractor : REX B. ASIBAL
Billing no. : Final Billing
% Work Accomplished : 100.00%
% bill
To date : 100% - 0.00% = 100.00%

SUMMARY OF PROGRESS BILLING

1. Total Amount …………………………………………………………. : P 4,900.00

2. Total Value of Work Accomplished
This period …………………………………………………………. : P 100.00%
To date …………………………………………………………. : P 100.00%
3. Payment this billing (% bill to date - % bill Previous)=(100%-0%) = 100.00% : P 4,900.00
4. Progress Billing/Payment for Final Billing ………………………………………………….. : P 4,900.00
5. Deduction 1st
2 nd
Final
Gross Amount 4,900.00 P 4,900.00
AP Recoupment P
VAT ( 3% ) 147.00 P 147.00
EVAT ( 2% ) 98.00 P 98.00
Retention ( 10% ) P
Water Bill P
Electric Bill P
Billed (NET) 4,655.00 P 4,655.00
6. Net Amount ( This Billing ) P 4,900.00 Less 245.00 P 4,655.00

Inspectorate Team

ROBERTO M. SAHILAN, Jr. MC DONALD G. AMPARO, C.E. REMOR D. JACQUEZ, C.E. ERNESTO R. CUARTERO, M.E.
Project Inspector Plant Engineer Asst. Plant Engineer Project Inspector

ALJON G. LANGUING, C.E. JUSTINE G. GONZALES, C.E.

Asst. Plant Engineer
Asst. Plant Engineer

Recommending Approval: Approved for payment:

FLORIFE O. URBIZTONDO, DPA BACELEDES R. ESTAL, PH.D.

Chief Administrative Officer SUC - President II
 Republic of the Philippines Document Code: QR-PPF-007H

Surigao Del Sur State University Revision No.: 000

Rosario,Tandag City, Surigao del Sur 8300 Effective Date: 8/1/2018

Telefax No. 086-211-4221 Page: 1/1
Website: www.sdssu.edu.ph

CERTIFICATE OF PAYMENT

PROJECT: Repair of Water Tank COP No. 1

LOCATION: SDSSU - Main Campus Period covered: October 30, 2018 - November 5, 2018
MUNICIPALITY/CITY: Tandag City, Surigao del Sur Remarks:
CONTRACTOR : REX B. ASIBAL
CONSTRUCTION CONTRACT DATA/INFORMATION:
Original Contract Amount P 4,900.00 Orig. Const. Period: October 30, 2018 - November 5, 2018
% of Contract Paid % in Time Elapsed : 100.00%
Previous: 0.00% This Period: 100.00% To date: 100.00%
% of Work Done
Previous: 0.00% This Period: 100.00% To date: 100.00%
1. Original Contract Amount…..……….………………………………………..…………………… P 4,900.00
3. Advance Payment (AP)…………………… P -
a.Previous Recoupment………......………………… P -
b.Balance of AP.…………..……………….………… P -
4. Previous Certificate……....…….………………………………………...…………………………. P -
a.Retention 10%......................................... P -
b.Value Added Tax……...…….………………….…… P -
c.EVAT…...……………...……...………………… P -
d.Liquidated Damages………….....………………… P -
e.Water and Electrical bill…….....…….. P -
TOTAL DEDUCTION…........…..………………….. P -
NET AMOUNT RECEIVED……......…..………….. P -
5. Balance Before this Certificate………..………………………………….....…….…………….…… P 4,900.00
6. This Certificate.…...……………………………………..…………...………………………………… P 4,900.00
a.Retention (10%) ........................................ P -
b.Value Added Tax……......…………………………. P 147.00
c.EVAT……..…...…………………...……………… P 98.00
d. AP Recoupment ……………...……………… P -
e.Liquidated Damages……......……………..……… P -
f.Others water & electric bill…...……..………… P -
TOTAL DEDUCTION……......……..……………….. P 245.00
NET AMOUNT RECEIVED…...………………..….. P 4,655.00
7. Balance after this Certificate…………………...………………............………………… P -

Amount Due and Payable This Certification (in words) : Four Thousand Six Hundred Fifty Five Pesos (P 4,655.00)

Prepared by:

MC DONALD G. AMPARO, C.E.

Plant Engineer

Recommending for approval: Approved for payment:

 FLORIFE O. URBIZTONDO, DPA BACELEDES R. ESTAL. Ph.D.
Chief Administrative Officer SUC President II

Attachements:
Contractors Letter Request
Statement of Works Accomplished (SWA)
Contractors Accomplishment duly reviewed and evaluated by the SDSSU In-Charge
Progress Photographs
 Republic of the Philippines Document Code: QR-PPF-007L

Surigao Del Sur State University Revision No.:

000
Rosario, Tandag City, Surigao Del Sur 8300 Effective Date: 8/1/2018
Telefax No. (086) 211-4221 Page: 1/1
Website: www.sdssu.edu.ph

CERTIFICATE OF ACCOMPLISHMENTS

This is to certify that the Labor for Repair of Water Tank located at the Surigao del Sur State University

Tandag Campus, Tandag City, Surigao del Sur undertaken by REX B. ASIBAL as per contract and awards

dated October 30, 2018 is 100% accomplished and was duly inspected on November 6, 2018.

The work is satisfactorily done in accordance with the approved plans and specifications.

The undersigned issued this certification for 100% completion of project

Inspected by:

MC DONALD G. AMPARO, C.E. ALJON G. LANGUING, C.E. REMOR D. JACQUEZ, C.E.

Plant Engineer / Asst. Plant Engineer / Asst. Plant Engineer /
Project Inspector Project Inspector Project Inspector

JUSTINE G. GONZALES, C.E. ERNESTO R. CUARTERO, M.E. ROBERTO M. SAHILAN, Jr.

Asst. Plant Engineer / Project Inspector Project Inspector
Project Inspector

Recommending for Approval : Approved by:

FLORIFE O. URBIZTONDO, D.P.A. BACELEDES R. ESTAL, Ph.D.

Chief Administrative Officer SUC - President II
 Republic of the Philippines Document Code: QR-PPF-007K

Surigao Del Sur State University Revision No.:

000
Rosario, Tandag City, Surigao Del Sur 8300 Effective Date: 8/1/2018
Telefax No. (086) 211-4221 Page: 1/1
Website: www.sdssu.edu.ph

CERTIFICATION

THIS IS TO CERTIFY that the Final Progress Billing for Labor for Repair of Water Tank, located at
SDSSU - Main Campus, Tandag City is within the scope of work, plan and specifications.

THIS CERTIFICATION is issued on the basis of the Final Billing of the contractor.

ISSUED this 9th day of November, 2018 at Surigao Del Sur State University, Tandag, Surigao Del Sur.

Inspected by:

MC DONALD G. AMPARO, C.E. ALJON G. LANGUING, C.E. REMOR D. JACQUEZ, C.E.

Plant Engineer / Asst. Plant Engineer / Asst. Plant Engineer /
Project Inspector Project Inspector Project Inspector

JUSTINE G. GONZALES, C.E. ERNESTO R. CUARTERO, M.E. ROBERTO M. SAHILAN, Jr.

Asst. Plant Engineer / Project Inspector Project Inspector
Project Inspector

Recommending for Approval : Approved by:

FLORIFE O. URBIZTONDO, D.P.A. BACELEDES R. ESTAL, Ph.D.

Chief Administrative Officer SUC - President II
 Republic of the Philippines Document Code: QR-PPF-007M

Surigao Del Sur State University Revision No.:

000
Rosario, Tandag City, Surigao Del Sur 8300 Effective Date: 8/1/2018
Telefax No. (086) 211-4221 Page: 1/1
Website: www.sdssu.edu.ph

INSPECTION REPORT

Be it known that the contract with Rex B. Asibal for Labor for Repair of Water Tank located at SDSSU-

Main Campus, Tandag City has complied 100% as of November 5, 2018 in accordance with approved plans and

specifications,and that the same is hereby accepted by this office.

Contract Amount : PHP 4,900.00

Contract date started : October 30, 2018
Actual date started : October 30, 2018
Target date of completion (original) : November 5, 2018
Actual date of completion : November 5, 2018
Remaining calendar days : 0 WD
Time elapse : 6 WD
Slippage : 0% (+)
Contract Duration : 6 WD
Actual Accomplishment : 100%
Date of Inspection(this billing) : November 6, 2018

Done this 9th day of November, 2018 at Surigao Del Sur State University, Main Campus, Tandag City, Surigao del Sur

Inspected by:
Inspectorate Team

MC DONALD G. AMPARO, C.E. ALJON G. LANGUING, C.E. REMOR D. JACQUEZ, C.E.

Plant Engineer / Asst. Plant Engineer / Asst. Plant Engineer /
Project Inspector Project Inspector Project Inspector

JUSTINE G. GONZALES, C.E. ERNESTO R. CUARTERO, M.E. ROBERTO M. SAHILAN, Jr.

Asst. Plant Engineer / Project Inspector Project Inspector
Project Inspector
Recommending for Approval : Approved by:

FLORIFE O. URBIZTONDO, D.P.A. BACELEDES R. ESTAL, Ph.D.

Chief Administrative Officer SUC - President II