Republic of the philippines

DEPARTMENT OF HEALTH
REGIONAL OFFICE XI
J.P. LAUREL, BAJADA, DAVAO CITY
Trunk lines No: (082) J05-t90J/t9&/tm6r227-4071
Far No. (082) 22r6320
Emaili drv.o@doh.gov.ph , J Ltrllr

April 24,2018

RO XIORDER
No.2ots - ffi4f

SUBJECT:

Starting May 2, 2018, all DoH-RoXl employees are directed to use the attached
checklists (Annex A to Annex T) in every disbursement voucher. End-users are
enjoined to attach whatever checklist is applicable in their transactions.

Further, a check (/) ma'k must be indicated in the "SUBJ[{I[ED,, column to indicate
the presence of the documentary requirement as attachment to the financial claims.
Everyone is also directed to indicate on the face of the disbursement vouchers all the
supporting documents attached.

The BudgeuAccounting sections are directed not to accept disbursement vouchers

without the attachment of checklist.

For your compliance.

ABDULLAH B. R. MD, MPA, CESO III

Assistant Secretary of
FIMC - Visayas and Mi nao Cluster
and Regional Director

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"Sistemang Ayos, Serbisyong Lubos...lSO na tayo."
DOCUMEI{TARY REqUIREMET{T5 PER COA CIRCUI.AR 2OI2-IIO1 ANNEX A

"'oisbursement voucheE ond ObliEotion Request ond Stqtus are inherent documentory requitements tor o trolsoctigns rcqui ng
cqsh disbur*ments

CASH ADVANCE SUBMITTED NOT SUBMITTED REMARKS

GRANT OF CASH ADVANCE:

Authority to handle cash advance stating the amount and the purpose for
1
which it was granted
Certification from Accountant that previous cash advance has been liquidated
2
APPLIABLE TO ALL CA'H ADVANCES I
Approved application for bond and/or fidelity bond for accountability of more
3
thao P 5,000, (
OTAPPTrcABLE FORTMVELS)
ADDITIONAI, REqUIREMENTS FOR CASH ADVANCE FOR LOCAL TRAVE'
1 TravelOrder
2 Itenerary of Travel
FOREIGN TRAVEL:

1 TravelOrder

2 Itenerary ofTravel

3 Letter of lnvitation from host/sponsoring country/agency/organization

4 For plane fare, quotations of 3 travel agencies or its equivalent

5 Flight itenerary issued by the airline/travel agency

Copy of the United Nations Development programme (UNDp) rate for Daily
6 Subsistence Allowance (DSA)forthe country of destination as basis for DSA to
be claimed
Oocument to show the dollar to peso exchange rate at the date ofgrant ofcash
7
advance

8 lnvitation to the agency inviting participants (issued by foreign country)

9 Acceptance ofthe nominees as participants (issued by foreign country)

10 Program Agenda and logistics lnformation (in case oftrainings/seminars)

DOCUMENTARy REqUTREMENTS pER COA CtRCUtAR 2012_OO1 ANNEX B

'*'Disburcement vouchers and obligation Request dnd stotus ore inhetent documentory requiremeng fot oll
tronsactions rcquirtng cosh disbursements

TIQUIDATION SUBMITTED NOT SUBMITTED REMARKS

PETTY CASH FUND
------r----.-
1 Report of Disbursement
2 Petty Cash Replenishment Report
Approved purchase request with certificate of Emergency
3
Purchase,, if necessary
4 Bills, receipts, sales invoices
5 Certificate of lnspection and Acceptance
6 Report of Waste Materials in case of replacement/repairs
7 Approved trip ticket, for gasoline expeses
Canvass from at least 3 suppliers for the purchases involving p
8 1,000 and above, except for purchases made while on official
travel
9 Summary/Abstract of Canvass
10 Petty Cash Vouchers duly accomplished and signed
fi OR in case of refund
other supporting documents that may be required and/or
12 required under the company policy depending on the nature of

rocl\t TRAVET
Paper/electronic plane, boat or bus tickets, boarding pass, termin-al
1
fee
2 Certifi cate of Attendance/Appearance
3 Copy of previously approved ltinerary of Travel
Revised or supplemental Office Order or any proof supporting the
4
change of schedule
Revised ltinerary of Travel, if the previous approved itinerary uras
5
not followed
6 Llquidation Report (if cash advance was granted)
Certification of Expenses not Requiring Receipts (for expenses not
1
exceeding P 300)
Reimbursement Expense Receipt (RER) for expenses more than p
8
300 without official receipts
9t OR in case of refund of excess cash advance (in case of CA) I
ls_l Certificate of travpl comnlptpd :
T

ADDI TIONAT REQUIREMENT FOR FOREIGN TMVET

For reimbursement ofactual travel expenses in excess ofthe
i_l prescribed rate (EO No.298)"
a) Approval by the President
b) Certification from the Head of ABency that it is absolutely
necessary
 Hotel room bills with official receipts (certification or affidavit of
shall not be considered as an appropriate replacement for the

* Some requirement rcimbursement ol troveling expenses except lor no. 6 and g

lot
DOCUMENTARY REQUIREMENTS PER COA CIRCUTAR 2012{01 ANNEXC
"'Disbursement Vouchers ond Obligotion Request ond Stotus arc inherent documentory requircments for olt
tfansoctions requif ing cosh disbursements

FUND TRANSFERS SUEMITTED NOT SUBMITTED REMARKS

1 Copy of duly notarized MOA/Trust Agreement

2 Copy of Approved Program of Work (for infrastructure project)

Approved Project Expenditures or Estimated Expenses indicating

3
the project obiective and expected output (for othe rprojects)

Certification by the Accountant that funds previously transferred

4 the lmplementing Agenc.y (lA) has been liquidated and accounted
for in the books
Copy of the OR issued by the lA to the Source Agency
5 acknowledging receipt of funds transferred (for post audit
activities)
TIQUIDATION:
Report of Checks lssued and Report of Disbursements certified
1 correct by the Accountant approved by the Head of lA and duly
received by COA
Copy of OR issued for the refund of unexpended/unutilized
2
balance of fund transferred
DOCUMENTARY REQUIREMEI{TS PER COA CIRCUTAR 2ot2{rc1 ANNEX D

"'Disbursement vouche6 ond Obligotion Request ond Status dre inhercnt documentory requiremenB lor otl trdnssctions
rcq uidng cash di sburseme nts

1st SATARY SUBMITTED NOT SUBMITTED REMARKS

1 Certified true copy of duly approved Appointment

2 Certified true copy of Oath of Office
3 Certificate of Assumption
4 Statement of Assets, Liabilities and Net Worth
5 Approved DTR
6 BIR Form 1902 and 2305
Additional Requirements for transferees (from one government office to another)
Clearance from money, property and legal accountabilities from
1
the previous office
Certified true copy of pre-audited disbursement voucher of last
2 salary received from previous office duly verified by the assigned
auditor thereat
BIR Form 2315 (Certificate of Compensation payment/fax
3
withheld)
4 Cenificate of Available Leave Credits
5 Service Record
DOCUMENTARY REQUIREMENTS PER COA CIRCUTAR 2012.001 ANNEX E
***Disbursement Vouche$ ond Obligdtion
Request ond Stdtus ote inhercnt documentory requirements lor oll
tfonsactions requhing cash disburcements

NOT
HONORARIA SUBMITTED REMARKS
SUBMITTED
Office Order creating and designating the BAC
1 composition and authorizing the members to collect
honoraria
2 Minutes of BAC Meeting
Notice of award to the winning bidder of procurement
3
activity bginB claimed
Certification that the procurement involves competitive
4
bidding
Attendance Sheet listing names of attendees to the BAC
5
meeting
DOCUMENTARY REqUIREMEI{TS PER COA CIRCUI.AR 2012-q)1 ANNEX F
tttoisbu.tarncnt voudart ond obligotion Request ond saoaus a.c tnharena documentory rcquiremeots Jor ott tronsoctions rcquhtog cosr,
dlsbu6en'€,nl5

OVERTIME SUSMIITED NOT SUBMITTED REMARKS

Overtime authority statint the necessity and urgency ofthe work
1
to be done, and the duration ofovertime work
2 Ovenime Work Program
Quantified ovetime accomplishment duly signed bythe employee
3
and supervisor
4 Approved DTR
DOCUMENTARY REQUIREMENTS PER COA CIRCUI.AR 2012-OO1 ANNEX G

'*'Disbursement vouchers ood Obtigotion Request ond Stdtus ore inherent documentory requirements for oll tansoctions
rcqui rin g cosh d isbutse me nts

TERMINAL LEAVE SUBMITTED NOT SUBMITTED REMARKS

Clearance from money, property and legal accountability from the

7
office of last assignment

Certified photocopy of employees leave card as at last date of

2
service duly audited by Personnel Division and COA

3 Certificate of leave credits issued by HRMO

4 Approve leave application
5 Complete service record
6 Statement of Assets, Liabilities and Net Worth (SALN)
Certified photocopy of appointment/Notice of Salary Adjustment
7 (NOSA)showing the highest salary received if the salary under the
last appqintment is not the highest
8 Certificate of Available Leave Credits
Appliclant's authorization (in affidavit form) to deduct all financial
9
obligations with the agency
Affidavit of applicant that is no pending criminal investigation or
10
prosecution against him/her
ln case of resignation, employee's letter resignation duly accepted
11
by the Head of Agency
Additionol Requirements in cdse ol deoth oI cloimdnt
72 Death certificate authenticated by NSO
13 Marriage contract authenticated by NSO

74 Birth Cenificate of all surviving legal heirs authenticated by NSO

15 Designation of next of kin

1t Waiver of rights ofchildren 18 years old and above
DOCUMENTARY REqUTREMENTS pER COA CtRCUtAR 2012-{t01 ANNEX H

"'Disbutsement voucheR ond Obligotion Request ond Stotus ore inherent documentory requhements lor all
tronsactions rcguhing cash disbuEements

MONETIZATION SUBMITTED NOT SUBMITTED REMARKS

Approved leave application (10 days) with leave credit balance

1
certified by Human Resource Office
Request for leave covering more than 10 days duly approved by
2
the Head of Agency
3 For Monetization of 50% or more:
a. Clinical Abstract/medical procedures to be undertaken in case
of health, medical and hospital needs
b. Barangay certification in case of need for financial assistance
brought about by calamities, typhoons, fire etc.
DOCUMENTARY REqUIREMENTS PER COA CIRCUTAR 2012-OOr ANNEX I
***Disbursement vouchers ond obligotion Request
ond stotus ore inherent documentory rcquircments lor oll tmnsoctions
requi dng cosh disburseme nts

TOYALW AWARD SUBMITTED NOT SUBMITTED REMARKS

LOYALTY AWARD
1 Service Record

2 Certificate of non-payment from previous office (for transferee)

Certification from the HRMO that the claimant has not incurred
more than 50 days authorized vacation leave without pay within
3
the 10-year period or aggregate of 25 days authorized vacation
leave without pay within the 5-year period, as the case may be
DOCUMENTARY REQUIREMEI,ITS PER COA C|RCUTAR ZO12-OO1 ANNEX J
*"Disbursement voucheo ond Obligotion Request
and Stotus ore inherent documentory rcquirements lor olt trunsoctions
req u hi ng cdsh disburse me nts

LOYALW AWARD SUBMITTED NOT SUBMITTED REMARKS

l. lstatement of Account/Bill
DOCUMEI{TARY REQUIREMENTS PER COA CIRCULAR 2012.001
ANN€X K
tttDsbu6ement vouchers and obttcdtion Request ond stott
s ore inhercnt dotumentory requirements ror otl tmnsdctions rcquiring cosh disburs.ments

II{FRASTRUCTURE SUBMITTED OTSUAM|TTEO REMARXS

r8

Letter requestfrom contractorsfor advance/pro8.ess/finalpayment or substituion in

)mmon to progress/inal payments

- Statement ofwork accomplished/progress Billing
- lnspection Repori bythe Agency's Autori2ed en8ineer
.Results of Test analysis,
.Statement Ol Tlme elaosed -
.Monthly Certilicate of Payment
.Statement of Work Accomolished ISWAI
cont.a.tor''' affid"u.ion pay.6f6Jli6iEi]id-i B-
Pictures, before, during and after construciton of items of work especi,llythe

- Pnotocopyol vouchers for allprevious payments

- Certificate of Completion
Do.u."nt"ry R"qul."."ntt fo. Mobili

standby letter of credit/security bond/bank guarantee ca able upon

issued bya surety or insurance company duly licensed by the tnsurance

2 otherdocuments peculiar to the contaact and/oato the mode of procurement and

in the auditorial review and in the technicalevaluation thereof
,or Variation/Chanae/ktra Work O.d€.

ofthe approved original plans indicatin gthe affected ponionlsl of ttre pro;ect and
revised plans and specifications, if apptacable, indicating the changes made which

of the agency's report estabtishinS the necessaty/justification for the need of such
CO and/or EWO whach shatt include: la) the computation as to the quantities of the
additional works involved per item indicating the spe(ific stations where such works are
3
needed; (b) the date of inspection conducted and the results of such inspection; (c) a
estimate of the unit cost of such items of work for new unit costs includinS

of the approved/revised PERT/CPM Network Diagram.,rhich sha be6lii6Ei,

the period and the corresponding detailed computations for the
time on the contract period and the correspondinS detailed
for the additional/deductive time for the subj€,ct Change Order/Extra

sl Copyof the approved detailed breakdown of;ontract cost forthe ririation order-
the COA Technical Evaluation Report for the
lfthe Variataon Order to be reviewed is notthe 1st variation order. aI oithelbove-
requirements for all previously a pproved variation orders, if not yet reviewed,
copyof the COATechnicat Evatuation Reportforthepreviouslyapproved

performance security in theprescribed form and amount if va;;tio;rder-

€
10% of the oriSinal contract cort

other documents peculiar to the contract and/or to the mode of procurement and
in the audito.ial reviewand in the technicalevaluation
ayment
t plan5

turn over documents/trander of project and facilities such as motorvehiclq

other equipment and furnitu.e inctuded in the contract to concerned

nru'r MuncY
1e5
The total retention money shall be due for release upon fina I accepta nce of the works. The contractor may, however, request the substitrrtion
of the .etentaon money for
each progress billing with irrevocable standby letters of credit from a commercialbank, bank guaranties
or surety bonds callable on demand, ofamounts equivalent to the
retention money substituted for and acceptable to the 8overnmen! provided that the poect is on schedule
and is satisfactorily undena ken
Any security in the form otcash, bank Suarantee, irrevocable standby letterofcredit
from a commercial bank, GSIS or surety bond callable on demand
cation from the end-userthat the projeci is completed and inspected
DOCUMENIARY REqUIREMENTS PER COA CIRCUIAR 2012{01 ANNEX L
*"Di5bur9€m.nt vouche6 cnd obttgatioo Requett
ond stdtus ore inherent docufientory require.nents for o tronsoctions requi.ing cosh
disburt men,s

CONSULTING SERVICES SUEMITTED NOT SUBMITTED REMARKS

1
Additional documents under Annex D of COA Memorandum No.2OOS-027
dated February 28, 2005 required to be submitted to theAudito/s ffice
within five days from the execution ofthe contract:
- lf not in the Terms of Reference, appropriate approved docum€nts

!!4!4!!g !!ggrpected outputs/deliverables

- Copy of the Approved Manning Schedule indicating the names and
positions of the consultants and staffand the extent oftheir participation
in the project
- Copy ofthe curriculum vitae of the consultants and staff
2 Letter request for payment from the consultant
Approved Consultancy Progress/Final Reports, and/or output required
3
under the contract
4 Progresss/Final Billing
Contract of lnfrastrudue Projects subject of project Management
5
Consultancy Services
DOCUME{TARY REQUIREMENTS PER COA CIRCULAR 2012{O1 ANNEX M

"'Oisbur*rnent Vqtchers ond Obl,goaion R.qu.st ond Stotus ot. hhet nt do.um.naory rcquiref./, nrs,ot a
uantoztion rcquirin''cash dtsbursan nts
5UPPU6 MATERIALS, EqUIPMEI.T ANO MOTOR t{of
SUSMITTEO RTMARXS
vEHtcus 5UAMIT]EO
I Certificate of Erclusive Oistributorship, if
applicable

2
Sample5 and brochures/photograph' i,
applicable

-Consular lnvoice/Pro-forma invoice of the

foreitn 5upplier with the correspondin6
details
-Home Consumption Value ofthe items
-Brealdown of the erpenses incurre din the
imponation

O.itinal copy of Oealers/Supplier^ tnvoices

showint the quaotity, description ofthe
articles, unit and totalvalu€, duly risned by
thc de.ls or hir repr6lntatiya, and
indicating re.elpt by rhe proplr agency
official of itcnrs deliv..ld
5 Results of Ten Analysis, if appticabte
Tar receipts trom the Bureau ofCustoms or
BIR indicrtinSthe exact spe.ifications and/or
serial number of the equipment procrrred by
6 the Sovernment as proof of payment ol all
taxesand duties due on the same
equapme[ supplied or sold to the

lnsp€ction and Acceptance Report prepared

by the DepartmenvAeency property
inspector and signed by the Head of Atency
or hir authorized representative
For Equipment Property Adnowtedgment
Receipt

Warranty secuirty for a minimum period of

three months, in the cas€ ofexpendable
9 supplies, ora minimum period ofoneyear in
the cas€ ofnon-expendable supplies, after
acceptance by th€ procuring entitv of the
delivered supplies
Request for purdtase of supplies, materials
10 and €quipment duly approved by proper
authodies
ln cas€ of motor vehides authority to
purdrase from Atenq Head and Secretary of
11
DBM, or OP dependinS on the type of vehicte
beintprovided
t2 For Dru$ and Medicines:

. Certificate of producl r€ginratioo from tOA

Certifi cate of Sood manufacturinS p.actice
'om tDA
Batch Release Certific.t€ from tDA
- lf $e supplier ir not the manufaciurer,
certifcation Lom the manufacturer that the
supplier is an authorired distributor/dealer
of the productsrtems
tist of recepients for tood! dir€ctty received
13 by end-users andlor Requisition and tssue
Slip
ouly approved lurctrase OrdifNoEiiId
t4
Coniract
Alldocuments required to be submitted to
COAwithln 5 daysfrom execution of contra.t
15
lfor public bidding)orcopy ofduty received
COATransmittal
su(h other documents peclliar to the
contract and/or to the mode ofprocurement
15 and considered necessary in the auditorial
review and in the tedtnical eealuation
thereof
DOCUMENTARY REQUIREMENTS PER COA CIRCUTAR 2012.001 ANNEX N
t"Disbursement Vouchers ond obligdtion Request
ond Stotus arc inherent documentory requirements lot oll
tronsoctions requiring cash disbursements

VENUE/CATERING SUBMITTED NOT SUBMITTED REMARKS

1

lnspection and Acceptance Report prepared

by the Department/Agency property
inspector and signed by the Head of Agency
or his authorized representative
Certification from the contractor as to the
2
number of pax served
3 Statement of Room List (if live-in)
4 Duly approved Purchase Order/Notarized
Contract

5
Waiver of the winning bidder if applicable
6 Confirmation of venue
7 Statement of Account/lnvoices/Bills

lnspection and Acceptance Report prepared

8 by the Department/Agency property
inspector and signed by the Head of Agency
or his authorized representative
Purchase Request duly approved by proper
9
authorities
Personnel Order authorizing conduct of
10
activity
11 Duly signed Attenda nce Sheet

Such other documents peculiar to the

72 contract and/or to the mode of procurement
and considered necessary in the auditorial
review and in the technical evaluation thereof
DOCUMEMTARY REQUIREMENTS PER COA CIRCUI.AR 2012.{X}1 ANNEX O
toisbo,sement voudteE and oblEotion Bequest ond
" status ore lnherent docomentory rcquiremenb tor qll tmnsoctions rcquiring cosh
disbursements

JANTTORTAL/SECURtTY/HAULtNG ANO StMttAR SERVTCES SUAMlTTEO NOT SUBMITTED REMARKS

Contractor's bill
4 Cenificate of 4cceptance
5 Record of Attendance/Service
Proof of remittance to concerned government agency and/or GOCC,5
6
(BrR/sss/HDMF)
Such other documents peculiar to the contract and/or to the mode of
7 procurement and considered necessary in the auditorial review and in the
technical evaluation th€reof
OOCUMENTARY REQUIREMENTS PER COA CIRCUTAR 2012-OO1 ANNEX P
*'*oisbursement vouchers ood obliEotion Request ond
stotus dre inherent docufientory requirements Jo. ott tronsoctions requiing cdsh
disbuEements

RENTAT CONTRACTS SUBMITTED NOT SUEMITTED REMARXS

L Request for Payment

2 BilUlnvoices
3 Cenifi cate of occupancy (space/building)
4 MOA/Contract (rent to own contract) upon last payment
Such other documents peculiar to the contract and/or to the mode of
5 procurement and considered necessary in the auditorial review and in the
technical evaluation thereof
DOCUMENTARY REQUIREMENTS PER COA CIRCUTAR 2012{0'. ANNEX Q
t t'Disbo/sement vouchers qnd obligotion Request
ond stotus dre inherent documentory requi.ements ror oll uoosoctions rcquiring cgsh
disbursernenls

REPAIR AND MAINTENACE OF EqUIPMENT AND MOTOR VEHICI,ES SUBMITTED NOT SUBMITTED R€MARK5
1 Copy of pre-repai. evaluation report and approved detailed plans by the
agency showing in suf{icient detail the scope of work/extent of repair to
be done
2 Report of Waste Materials
3 Warranty Certificate
4 Request foj Payment
5 Bill/lnvoices
Post-lnspedion and Acceptance Report prepared by the
6 Department/Agency property inspector and signed bythe Head of Agencv
or his authorired representative
Such other documents peculiarto the contract and/orto the mode of
7 procurement and considered neces5ary in the auditorial review and in the
technical evaluation thereof
DOCUMEMIARY REQUIREMENTS PER COA CIRCUTAR 2OI2{01 ANNEX R
t'*Disburcement Vouchers dnd obligo,ion Request ond
stotus arc inhetent documenaory reguirements lor oll tronsoctions requiring cosh
disbu/.$ements

CUtTURAt AND ATHIETIC ACTIVITIES SUBMITTED NOT SUEMITTED REMARKS

1 Budget EstiTates approved by Head of Agency

Same requirements under procurement depending on the nature of
2
expense and the mode of procurement adopted

out ol the qPprcptiotions oqthorized in the GAA ,or Mqintendnce ond Oaher operuting Expenses (MOOE) lot eoch depoinent,
bureou, olfice or ogency, oo onnuol amount not exceeding one Thoussnd fwo Hundrcd pesos (p7,sM) per eoployee-
Participont may be used for ahe purchose ol cortune or unilorm, ond other rcldted expenses in the conduct ol culturol ond
 PUBIIC BIDOING SUBMITTID NOT5UBMITTEO REMARrc
I lAuthentilatedphotocopyof theapp.ovedAPPandanyamendmentrhereto
cont.act suppo(ed by the followin6 documents which are required
COA Ci.cular No. 2(x)9{O1 dat€d february 12, 2009 and COA
No- 2005-027 dated February 28,2005 to be rubmirted to the
Oftice within iv€ dayr ftom the execution of the contract:
)r EliSibility to Bid

Document5 enumerated underSection 17.1ofthe Revised IRR of

No.9184 which includ€s a.omplete ser of approved ptanr/d.awin8s
t€chnical specificationr fo. infrastructure p.oiects, comptele t€chnicat
of equipm€nt, aircraft and accessori€s, scope ofwo.kr, if
for toods, end r€ntal and.epair contracts, and T€.ms of

ofPr€-Bid Confer€nce, lApproved Sudtet for Conract

r andlor Su pplemental Bulletans, ifany

t

)n Report of T€chnical workins croup

R€solution re.omm.ndint approvalrnd app.ovatby the Head of the

ot lhe App.ov€d PERT/CPM Network Oiatram and det.it€d

includirythe detail€d brealdown ofestimate5 andlor unir co5t

fo. €ach worl item epresred in volum./arealump

khedule of basic rat€s cenified by the consuttant wirh a sworn

Derivation of the billint frctor/muttiptier ceniried by the

brealdo*n ofreimbu.sable cosB bar€d on agre€d

indic ingcostsandd.tesof acquisirion of lheequipment,quantities

cott of materials, sparr parts, and suppliea furnished by the

the monthly leare payment and oeriod of tease tor t€ase

Advertiserhent of lnvitation to Aid/request for exprersion of intere5t
Newspaper clipping of adve.tisement {ABC 5.0 milion and above for
2.Omillion and above for toods, and 1.0 mi ion o.

r PhalcEPs
fro.n th. H€ad of BAC Secretariat on the postint of

kintout copier ofadvertitement posted in aaency website, ifanv

requnements und€. Sections 23.1 and 25.2.b for infrastructure
23.1and 25.28. for goods and 24.1aod 25.2cfor coosutting services,

of Pre-procur€ment Conf€rmce for proj€cts costint above 5 J

for inftastructur€, 2.0 million and above for goods,.nd l.O milion

.opy ofpostin8 ol Norice ofAward, Notice to p.o(eed and Conrracr

Evidence ol lnvitation ofthree observers in attnaE€s of tt e procurement p.ocess

1C
to Section 13.1ofthe Revised tRR of R No.
 PUBLIC BIDDING SUEMI]TEO NOTSUBMITTED REMARrc
Request fo. purdlas€ oI r.quiritio.r of suppli.., materiats and €quipmenr duty .pproved
ll
Addltional Documentary Requi.€ments fo. General support Serrices Uanitorial, secui.ty, maintena nce, and si.ita. services)
12 The number of personnel involved and their correspondinS rates/satary
th€dule of work andplaces of assipment or starion/visits indicatin& amory oth6s, th€
numb€r of hoirrs p€r visit
Ihe type aod numb6 ot equipm€nt to be servad lin case ot visitorial maintenanc€

Ihe scaled ioor plans of the buildint and other areals covered by the s€rvice conrract
(f or janitorial servlces)

The Srolrp clarsiffcatio. o, pcrsonnel to

dergmine the Equtvatent rquipment Uonttrg
Statutory Minimum Wat€ Rat€ in a.€ordancc with the appticabt€ Rut€s lmpt€rn€ntint BA
No.6727

Approved documents indicatint the minimum requarements otthe atency on th€

numb€r of r€curity personn€l to be invo]led in the project (for security seruice contract)
The population of the aten..y where the se.vic6 are renaerea (foiiiwitvier,[i
control,
Detailed description of rhe maintenance services to be rendered or activities to be
performed (for maintenance service contracts)
'Shlppin&/Haulint Contract
13 Ihe type^ind and tllhni.al descriptionof the mode oft.ansponarion used
Ihe point of orign and d€srinaton inctuaing ttri ejti;raai;G;47;;
14
l5 Ihe estimeted weight and volume of cartoes invoived
Additional Oocumentary Requnements for Rentat Contracts
16 Fo. privat+ owned ffice/buildint

' complete copy of th€ building floor ptans indicatint in shaded cotors the rentabte soace
- Copy ofthe Ceniffcate ofoccupancy of the buitding
or appropriate approved
docum€nts showintthe d.te the buitding wa5 construct€d or ase of the buitdinr
- Compl€t€ d6cription of lhe buildint as ro typ€, kind and
class inctuding irs compon€r,t
parts and equipment faciliticx such a5, but nor timited to prrkint areas, elev.torr, air-
conditioninS syst€ms, fi refi thtint equipment etc.
- Copy of the Master of Deed oe.taration and R€skicrions tn
case of tease/rentalof offi*-

For equipment.€ntal/le.rey'pur.hare contract

' &€ncy €valuat!on oI equipment utilizaiion
Peninenl data of area ofope.ation
L7 List ofprev.ilint comparable propeny wilhin vicinity
18lvicinitymap
Basic Requirements Common to all purchases under altemative modes ANNEX T
** Documents to be submitted within five working days from the execution ofthe contEct as required under coA circular No, 2009.
001 dated February le 2fiX,

AI-TERNATIVE MODES SUBMITTED NOT SUBMITTED REMARXS

Purchase Order/tetter Order/Contract, duty approved by the officiatconcerned and

1
accepted by tle supplier (date ofacceptance must be clearly indicated, especially when
the time or date ofdelivery is dependent on or will be counted from the date of
acceptance of the purchase order/letter order/contract)
Proof of posting of invitation or request for submission of price quotation in the philGEpS
website, website ofthe procurin8 agency, ifavailable, and at any conspicuous place
re'€rved forthis purpose in the premises ofthe procurinS aSency for a period ofseven
2
d ays in case of Shopping il nde r Section 52. 1(b), a nd N eSotiated procu rement
calenda r
under Sections 53.1(two failed bidding)and 53.9 (smal value procurement) ofthe
Revis€d IRR of tlA No.9184
Performance and warranty securities, except for shopping and negotiated
3 procurement under emergency cases, small value procurement, lease of real property
and United Nation (UN)agencies
BAC Resolution recommendin8 and justifying to the Head of procuring Entity (HOPE) the
4 use of alternative mode of procurement and approval by the HOpE ofthe BAC Resolution
recommending award of contract
Proof of posting of Notice of Award in the philcEpS website, the website of the procuring
5 entity concerned, ifavailable, and at any contpicuous place resefted for thi5 purpose in
the premises of the procuring entity
6 Approved Procurement plan
Approval by the HopE o. his duly authorized representative on the u- oithe-iiErna-tive
7
methods of procuremen! as recommended by the BAC
prospecive bidder th.t it is not blacklisted or barreO frorn OrOairAty
I lStatement ofthe
Ithe Government or any of it5 agencies, otfices, corporations or LGU5

9
sworn affdavit of the bidder that it is not retateA G ttre xonr f y 6ffiu intliiihn ity
up to the third civildeBee
Ad(,itional DOCUmentarv RFduirFm.ni< Lr r imlre.l <^rr,.. rii,rih,
copy ofdirect invitation to bid served by the concerned agency to allsupptiers or
consultants appearing in the late-selected tist of manulacturers / suppliers/ distributors
10
with known experience and proven capability on the requirements Ofthe panicular
contract
11 Winning bidde/s offer or proposal
Abstract of bids showing the most rerponsive and comptying biader from amonS ttte
L2
other bidders who participated in the bidding
13 Notice ofAward
Documentary requirements under Sections 23.1 and 25.2(a) for goods, ZA.f ana ZS:(U)
t4 for infrastructu.e, 25.1 and 25.2(c) for consultancy services, of the Revised tRR of RA No.
9184

15 Such other documents peculiar to the contract and/or to the mode of procurement and
considered necessary in the auditorial reyiew and in the technicalevaluation thereof
16lBid security (requared under Section Sa.a tnn-e, RA to. 9184)

of letter to select"d."nul"ctr."r7@
,: Copy
and conditions of sale
Cenificate of Exclusive Dist.ibutorship issued by the principal under oatt
18 authenticated by the embassy/consulate nearest the place "nA
ofthe principal, in case of
foreign suppliers
certification from the agency
"uthori.ed
o@
19 lower prices and for which no suitable substitute can b€ obtained at more advantageous
terms to the government
cenification of dre BAc in case of procurementof criticatlEntiomponEns and-[ii6
20
maintain cenain standards
 AI-TERNATIVE MODES SUEMITTED NOT SUBMITTED REMARKS

Study/Survey done to determine that there are no sub-dealers selling at lower prices and
2l for which no suitable substitute can be obtained at rnore advantageous terms to the
SOVernment

22 Such oth€r documents peculiaa to the contract and/or to the mode ofprocurement and
considered necessary in the auditorial review and in the technical evaluation thereof
Additional Documentary Requirements for Repeat Order
Copy ofthe original contract us€d as basis for repeat order indicating thatthe original
23
contGct was awa.ded through public bidding
Certification from the Purchasing Departmenvoffice that the supplier has complied with
24
allthe requirements under the original
Additional Documentary RequireEglts fo, Shopping
Price quotations from at least three (3) bonafide and reputabte
25
manulacturers/suppliers/distributors
26 Abstract ofCanvass
Additional Documentary Requirements ror Negotiated procurement
2l Price quotation/bids/final offers from at least be three invited suppliers
Abstract of submitted Price Quotation
29 BAC Resolution recommending award ofcontract to Lowest Calculated Responsive Bid (LCRB
Agenq/s offer for ne8otiations with selected suppliers, contractors or consultants
31 Certification of BAC on the failure ofcompetitive bidding forthe second time
Evidence of invitation of observe6 in all stages of the negotiation
33 Eligibility documents in case of infrastructure projects
34 Justification as to th€ necessity of purchase (for emergency cases)
35 Copy ofterminated lontract (in case oftake-over of contracts)
Reasons for the termination (in case oftake-over of contracts)
Negotiation documents with the recond lowest calculated bidder or the third lowest
calculated bidder in case offailure of negotiation with the second lowest bidder. tf
37
negotiation stillfai15, invitation to at leartthree eligible contractors (in case oftake-over
ofcontracEl
Approval by the Head ofthe Procuring Agency to negotiate contracts for proiects under
38 exceptional cases(in case of take-overof contracts)
39 Letter/invitatign to submit proposals (for SVp)
Original contract and any document indicating that the same resulted from competitive
40 biddin8 (for adjacent or contiguot s projects)
Scopeofwork which should be related or similar to the scope of work of the original
4l contract (for adjacent or contiguous projects)
Latest Accomplishment report ofthe originalcontract showing that there was no
42 negative slippaSe/delay (for adjacent or contiSuous projects)