Appendix 11

OBLIGATION REQUEST AND STATUS Serial No. : 06-101101-2023-05-

.
Republic of the Philippines Date :
Bangsamoro Autonomous Region in Muslim Mindanao
MINISTRY OF PUBLIC WORKS Fund Cluster : 01
Cotabato City
Payee

Office

Address
COTABATO CITY
Responsibility UACS
MFO/PAP Amount
Center Object Code

To obligate the allotment for reimburse travelling

expenses to General Santos City to attend the training
on the Formulation of GAD Agenda dated March 27-
31, 2023 in the amount of. P 8,100.00

Total P 8,100.00
A. B.
Certified: Charges to appropriation/alloment are necessary, Certified: Allotment available and obligated for the
lawful and under my direct supervision;and supporting documents purpose/adjustment necessary as indicated above
valid, proper and legal

Signature : Signature :
Printed Name: NAZER P. EBUS, MPA Printed Name: ADA RIZZA L. SOLAIMAN
Position : Director II, Operations Position : Budget Officer III
Head, Requesting Office/Authorized Head, Budget Division/Unit/Authorized
Representative Representative

Date : Date :

C. STATUS OF OBLIGATION
Reference Amount
Balance
ORS/JEV/Check/ Obligation Payable Payment
Date Particulars Not Yet Due
ADA/TRA No.
(a) (b) (c) (a-b)

8,100.00 8,100.00 8,100.00

 Appendix 11

01101-2023-05-

Amount

8,100.00

8,100.00

and obligated for the

s indicated above

ZZA L. SOLAIMAN
dget Officer III
vision/Unit/Authorized
Representative

Balance
Due and
Demandable
(b-c)
incurred for the use of Construction Division,
 Appendix 11

OBLIGATION REQUEST AND STATUS Serial No. : 02-101101-2023-05-

.
Republic of the Philippines Date :
Bangsamoro Autonomous Region in Muslim Mindanao
MINISTRY OF PUBLIC WORKS Fund Cluster : 01
Cotabato City
Payee

Office

Address
COTABATO CITY
Responsibility UACS
MFO/PAP Amount
Center Object Code

To obligate the allotment for reimburse travelling

expenses to General Santos City to attend the training
on the Formulation of GAD Agenda dated March 27-
31, 2023 in the amount of. P 8,100.00

Total P 8,100.00
A. B.
Certified: Charges to appropriation/alloment are necessary, Certified: Allotment available and obligated for the
lawful and under my direct supervision;and supporting documents purpose/adjustment necessary as indicated above
valid, proper and legal

Signature : Signature :
Printed Name: ATTY. SITTIE NADIA M. KARIM, CPA Printed Name: ADA RIZZA L. SOLAIMAN
Position : Director II, Administrative and Finance Services Position : Budget Officer III
Head, Requesting Office/Authorized Head, Budget Division/Unit/Authorized
Representative Representative

Date : Date :

C. STATUS OF OBLIGATION
Reference Amount
Balance
ORS/JEV/Check/ Obligation Payable Payment Due and
Date Particulars Not Yet Due
ADA/TRA No. Demandable
(a) (b) (c) (a-b) (b-c)

8,100.00 8,100.00 8,100.00