Republic of the Philippines
PROVINCE OF BUKIDNON,
Provincial Capitol
Name of Project: Construction of Farm to Market Road
Project Location: Sitio Bagalangit, Kalugmanan, Manolo Fortich Bukidnon
WORK REQUEST
(in triplicate)
To:
PROVINCIAL ENGINEER'S OFFICE
Requested Work to Start On;
Date: January 25,2022
Time: 8:00 AM
From: (Contractor)
Note: Contractor has to submit request in triplicate and with @
Y CONSTRUCTION AND SUPPLY minimum of 48 hoursin advance of scheduled start.
PAY ITEM REQUESTED:
Item No.: 311 Equipment to be used:
Description: PCCP Estimated Quantity to | Quantity Tait:
be Accomplished: sam
Description of Work Requested:
CCONGCRETE POURING @ sec:1.sa.0+520-st.0+540
sec.2.sta.0.1080-5ta.0+360
Submitted by Received by
Date Time
antrgetor
inspected: Findings/Comments: Recommendations
Site Inspector/Project in-charge
Surveyor
ROMEL B. CADION
Engineer I, Resident Engineer
Checked by:
Recommended Action:
‘Marlow B.Yabunan
ME/MTQA
Reviewed by:
RANDY P. DIAZ
Engineer Iv/OIC, MTQA Division
Recommended for Approval:
JOSE PASTOR P. DELA CERNA, Ill
Engineer IV/Chief, Maintenance Division
‘Approved:
ALBERT D. YULO
Provincial Engineer
‘Accepted by: