Republic of the Philippines

PHILIPPINE HEALTH INSURANCE CORPORATION

PHILHEALTH REGIONAL OFFICE — CORDILLERA ADMINISTRATIVE REGION
Local Health Insurance Office Baguio City
0/F SN Oriental Traders Building, No. 19 Leonard Wood Road, Baguio City 2600
Tel. No. (074) 444-9862/ 444-8361/ 446-0371/ 444-5345 (T/F) /Call Center (02) 441-7442 warm 1•11...•o C.ra, t Minn.

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CERTIFICATE OF PREMIUM CONTRIBUTION

To Whom It May Concern:

This is to certify that the member/employer named below is registered with the National
Health Insurance Program (R.A.7875), and the required PhilHealth premium contributions were
remitted and verified from remittance reports submitted / from our contribution
database with the following information:

Name of Employer: __JOHN HAY MANAGEMENT CORPORATION

Employer Address: CAMP JOHN HAY LOAKAN RD., BAGUIO CITY

PhilHealth Number: 200211300359

Membership Status: No of Employees: 90

PREMIUM CONTRIBUTIONS:
Applicable Period Amount ME5 Number Official Reciept Validation Remitting Bank /
Number Date Office

VERIFIED FROM
JAN-NOV 2016 COMPUTER
DATABASE

This Certification is issued to JOHN HAY MANAGEMENT CORP. for the purpose/s of:

Availment of NHIP Benefits for the: { Member Dependent

sti Renewal / Securing Business Permit for CY 2017
❑ Bidding Purposes
❑ OWWA / POEA purposes
Others: Whatever legal purpose/s it may serve.

This Certification is valid until February 04, 2017

Issued this 04 day of January 2017 in Baguio City.

Control No. N.A.

/- CATALINA C.ii4.10 WEY
Chief Social Insurance •
er/ LHIO Head
Local Health Insurance Office - Baguio City
PhilHaid th
PERFORMING HIGH WITH INTEGRITY AND COMPETENCE

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