REPUBLIC OF THE PHIL

DEPARTMENT OF THE INTERIOR AND

OFFICE OF PROJECT DEVELOPM

SUBAYBAYAN ANG PROYEKTONG BA

DATA CAPTURE FO
* to be filled-up by the encoder (if data are not available - please leave it blank)
** to be fillep-up by the encoder (required)

PROJECT PROFILE
REGION PROVINCE

NAME OF PROGRAM

PROJECT CODE

DESCRIPTION OF THE PROJECT

FUNDING YEAR

TYPE OF PROJECT

EXACT LOCATION *

IMPLEMENTING UNIT (please select one - DILG RO, Provincial LGU, City LGU, Municipal LGU)**

ROAD PROJECTS - ROAD LENGTH *

REMARKS *

IMPLEMENTATION INFORMATION
ORIGINAL ALLOCATION (LGU Counterpart/Cash Equity) *
CANCELLED ALLOCATION (National Subsidy) *
REVERTED AMOUNT (National Subsidy) *
CONTRACT DETAILS
NAME OF CONTRACTOR *

CONTRACT PRICE *

DATE OF RECEIPT OF NTP * INTENDED DATE OF COMPLETION OF CONSTRUCTION *

CHANGES IN THE IMPLEMENTATION

NEW ENTRY ** VARIATION ORDER * DESCRIPTION *

REVISED CONTRACT/CONSTRUCTION COST * REVISED DATE OF COMPLETION/DELIVERY

ADMINISTRATION DETAILS
UNIT IMPLEMENTING THE PROJECT * TOTAL ESTIMATED COST OF PROJECT *

INTENDED COMPLETION DATE *

GOODS/MATERIALS DETAILS
PROCUREMENT NO. *
GOODS PROCURED *
NAME OF SUPPLIER *

DATE OF NOTICE OF AWARD *

INTENDED DATE OF DELIVERY *

MILESTONES

LGSF PROJECTS *
DED/POW Preparation and Submission of Notarized
LCE Certification

Submission of Certificate on the Receipt of Funds

Date of NADAI
Installation of Community Billboard
Invitation to Bid (IB) Posted

Bid Opening/Bid Evaluation

NOA Issuance

Date of Receipt of Notice to Proceed

PHYSICAL ACCOMPLISHMENTS
TARGET ACCOMPLISHMENT * ACTUAL ACCOMPLISHMENT *

OBLIGATION
AMOUNT *

DISBURSEMENT
AMOUNT * TRANCHE * (please select - 1, 2)

LIQUIDATION
AMOUNT *
 REPUBLIC OF THE PHILIPPINES
T OF THE INTERIOR AND LOCAL GOVERNMENT
E OF PROJECT DEVELOPMENT SERVICES

AN ANG PROYEKTONG BAYAN (SubayBAYAN)

DATA CAPTURE FORM

CITY/MUNICIPALITY BARANGAY

PROJECT TITLE

NATIONAL SUBSIDY

SUB-TYPE OF PROJECT

GU)** MODE OF IMPLEMENTATION (please select one - Contract, Administration) **

NO. OF BENEFICIARIES (in population) *

WITH NAU (select from Yes, None) *

 OFFICE ADDRESS *

CONTRACT DURATION *

N OF CONSTRUCTION * DATE OF PERFECTION OF CONTRACT * DATE OF EXPIRATION OF CONTRACT *

ION * SUSPENSION OF WORK/TIME EXTENSION *

DATE OF COMPLETION/DELIVERY OF GOODS * REMARKS *

TIMATED COST OF PROJECT * DURATION *

ACTUAL START OF CONSTRUCTION *

NEW ENTRY **

OFFICE ADDRESS *

DATE OF PERFECTION OF CONTRACT *

ACTUAL DATE OF DELIVERY OF GOODS *

MOA-BASED PROJECTS *
FS/Technical Specification and DED/POW
Preparation

MOA Signing

DED/POW Preparation
DED/POW Review & Approval
 Invitation to Bid (IB) Posted

Bid Opening/Bid Evaluation

NOA Issuance

Date of Receipt of Notice to Proceed

ACCOMPLISHMENT * DATE *

DATE *

* (please select - 1, 2) DATE *

DATE *
**
TRACT *

*
Type of Data Format/Type
All dates Date (YYYY-MM-DD)
All amounts Decimal
MOI Contract
Administration
IMPLEMENTING UNIT DILG RO
Provincial LGU
City LGU
Municipal LGU
ROAD LENGTH Decimal
BENEFICIARIES Whole number
Disbursement Tranche 1
2
With NAU Yes
No
Variation Order Change Order
Extra Work Order
New Entry Yes
No