REPUSLIC OF THE PHILIPPINES

DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENTA. Francisco Gold Condominium ll, EDSA Cor., Mapagmahal St.

Diliman. Quezon Citv

April 13, 2012CIRCULARMEMORANDUM

NO. 2012 - 66

TO:

SUBJECT :

ALL PROVINCIAL GOVERNORS, CIWMUNICIPAL MAYORS, DILGREGIONAL, PROVINCIAL AND CITY DIRECTORS, GLGOOS,MLGOOS, CLUSTER HEADS, AND ALL OTHERS CONCERNED

IMPLEI{ENTING GUIDELINES IN THE AVAILMENT OF 2OI2PERFORMANCE CHALLENGE FUND (PCF)

I. PREFATORYSTATEMENT

The Philippine Development Plan (PDP) 2011-20'16 (Chapter Vll) puts premium on thepromotion of effective and honest goveman@ to create an enabling environment for citizens andthe private sector to reach their full potential. This is envisioned through high quality, efficient,transparent, accountable, financially and physically accessible and nondiscriminatory delivery ofpublic service. At the local level, the PDP identifies the importance of empowering local govemmentunits (LGUS) to improve their ability to deliver public services and in promoting public accountabilitywhich shall be canied out through the following strategies:

. lmplementration of systems to determine performance of LGUS in terms of their state of localgovemance and compliance with policies;

r Public disclosure of LGU performance; and. Institution of pedormance-based LGU incentives or awards.

In support of the Philippine Development Plan particularly in instiMionalizing incentives tostrengthen local govemance and performance, ttle Departnent initiabd the implementation of thePerformance Challenge Fund (PCF), an inentive system for local governments excelling good

local govemance performance.

II. GUIDING PRINCIPLES

Th6 administration of the Performance Challenge Fund (PCF) shall be govemed by thefollowing guiding principles:

1. The Department of the Interior and Local Govemment (DILG) shall establish a PerfomanceChallenge Fund {PCF) as an incentive b qualfied Local Govemment Units (LGUS) for theimplementation of local development projec{s aligned with the national govemment strategicthrusts and goals.

2. The PCF shall encourage convergence of local development projects with the priority programsof the National Govemment in order to achieve the Millennium Development Goals (MDGS);

maintaining of core road network to boost tourism and local economic development; promote

transparency and accountability in all govemment hnsactions; and comply with the PhilippineDisaster Risk Reduction and Management Ac{ of 2O1O (RA 10121), and the Ecological SolidWaste Management Act of 2000 (RA 9003).

3. The PCF shall recognize LGUS exhibiting exemplary performance in intemal housekeepingparticularly in the areas of planning, fiscal management, transparency and accountability and

valuing performance monitoring.

III. OBJECTIVES OFTHE PERFORMANCE CHALLENGE FUND

The PCF is a facility that envisions to:

1 . help stimulate local govemments to put premium on transparency and accountability toenable them to avail themselves of financial support to jumpstart and sustain socio-economic development initiatiYes;

2. complement with other programs of other national government agencies providingincentives to LGUS: and

3. address support requirements of the LGUs in the delivery of their responsibilities such asthe supply side requirements of the Pantawicl Pamilyang Pilipino Program (4Ps)

IV. PCF OPERATIONAL GUIDELINES

A. Eligibllity Requircments

1. Eligible LGUsfor2Ol2 PCF

a) Provincies, cities and municipalities belonging to the 1d to 3'd income class, and thenewly created 4s and 5h class cities both passed the Seal of Good HousekeepingRound 2 assessment dated August 26, 2011 and have not received the PCF subsidy in2011. Target recipients shall be prioritized according to the following raking:

. 1$ priority - 3d income class LGUs and the 2O1 1 newly-converted cities

2'd prianty - 2'd income claa LGUs

3d priority - 1s income class LGUS

In the event that the fund shall not be enough to cover all eligible LGUs, they shall be

further ranked according to poverty incidence based on 20m NSCB Survey.

b) 2012 Gawad Pamana ng Lahi awardees shall be eligible to receive the 2012 PCF.

2. Eligible Projects

a) Projects eligible for the PCF subsidy are those consistent with the cunentadministration's thrusts and the provisions of the General Appropriations Act of 2012, asfollows:

Attainment of MDGS (e.9. school buildings, rural health units;/health c€nte6, birthing orlying-in facilities, water and saniEtion, and housing and settlements)

Local Economic Development (e.9. core local roads and bridges, farm-to-marketroads, tourism facilities, inigation systems, post harvest facilities, cold storage facilities,ports and wharves and other economic structures and growth enhancement projec'ts likemarket, slaughter houses)

. Preparedness for Disasterc/Adaptation to Climate Change (e.9. flood control,reforestations, storm drainage, dikes, seawall and related flood protection measures andslope protection, evacuation centers, rainwater collection facility, early wamingsystem/devices and rescue equipment)

. Ecological Solid Waste Management (e.9. sanitary landfill, material re@veryfacilities, sewerage system)

. Promotion of Transparency and AccountabilityWebsite)

PG Fund Allocation and utilization

1. The amount of the 2O12 PCF subsidy is allocated as follows;

a) As subsidy for the 1d to 3d class LGU and 2011 newly-converted cities that passed the2011 SGH shall be apportioned according io LGU level :

. Province - P7,0OO,0O0.0O

. City - P3,000,000.00

. Municipality - Pl,000,000.00

b) As incentive to the 2012 Gawad Pamana rrg Lahi Regional awardees which shall beapportioned according to LGU level:o Province - P3,000,000.0Or City - P2,000,000"00. Municipality - P'|,000,000.00

c) As incentive to the 2012 Gawad Pamana ng Lahi National awardees with P5,0OO,O00,00each for province, city and municipality.

2. The PCF shall be used to finance local development projecls indicated in the 2012 Annuallnvestment Program (AlPs) of LGUs.

C. LGU PGF-Sub ProFct lmplementation Timeframe

The 2012 PCF subsidized-projects must be implemented by the recipient LGU within one(1) year from the date of receipt of the PCF Check.

V. PROCEDURES IN ACCESSING THE PC FUND

A. Submission of Documentary Requirements

1. The concemed LGU shall submit within 3O calendar days, upon proper notification ofeligibility, to the DILG Regional Office, a Letter of Intent accompanied by the followingdocuments tor evaluation:

. Proiect Proposal whicft shall contain the ff:a. Description (Brief Summary of the Proiec( P@ect Goals and Obiectives, Location,

Type and Estimated Number of Target Beneficiaries, Project Partners)b. Project Components and lmplementation Scfiedulec. Work and Financial Plan (or Project lmplementation Plan)d. Project Management (including composition of Proiect lmplementation and

Management Team)e. Project Sustainabilityf. ProlectOutpuUOutcomeg. Risk Management

. Program of Work

. Detailed Cost Estimates of the Project

. Detailed Engineering Design (for infrastructure projects)

. Copy of the 2012 Annual Investment Prcgram (AlP)

. Local Sanggunian Resolution authcrizing the Local Chief Executive to enter into aMemorandum of Agreement (MOA) with A|e DILG through its Regional Diredor for thePCF subsidy and implementalion of the PCF projects.

. Administrative/Executive Order creating the LGU PCF Proiect lmplementationUnivTeam

The LGUS shall ensure that all engineering designs, plans, specifications, etc. related to theconstructions, installation, operations and rnaintenance of agricultural , aquaculture andfishery, and for€st product machinery, agricultural buildings and structures, inigation anddrainage systems, farm-to market roads, post harvest facilities etc. shall be signed andsealed by a licensed and registered agricultural engineer as required pursuant to item e),

Section 21, RA 8559 {Philippine Agricultural Engineering Act of 1998) and item 4.9 of DILGMemorandum Circular No. 2008 - 167 dated November 1 1, 2008 implementing certainorovisions of RA No. 8559.

2. lJpon receipt of the documents, the DILG Regional PCF Focal Person shal| check LGUcompliance to all requirements and immediately notify concerned LGU if there areincompleteness of documents. Reviedappraisal of proposed poecls shall not proceedunless all the documents (e.9. Sanggunian Resolution authorizing the Local Chief ExecutiveGCE) to enter into a MOA with DILG, etc.) are completely complied with.

B. Review and Assessment of Project Proposays

1. Within fifteen (15) calendar days after receipt of the documentary requirements, theRegional PCF Management Team (RPCFMT) shall conduct thorough review and appraisalof the LGU's project proposal and supporting documents. For infrastructure projects, theTeam shall conduct on-site inspection and validation to assess the location and physicalviability of the proposed project.

2. The Team shall ensure that the project proposaus shall conform with the existing nationalstandards/guidelines, such as for:

Typical urban and rural roads and bridges per DPWH technical standardsHospital, lying-in facilities, health centers per DOH established standardsSchool buildings per DepEd established standardsSanitary landfill, Material Recovery Facility (MRF) per DENR guidelinesPost haNest facilities, processing plants/facilities, irrigation, etc. per DA guidelines

Evacuation Centers and other DRRM and Climate Change Adaptation (CCA) requiredfacilitiesRainwater Collection Facilities pursuant to RA 6716DBM procurement guidelines pursuant to RA 9184 (Gov't. Procurement Reform Act)Tourism facilities per DOT guidelines

In the case of procuremenuacquisition of motor vehicles and relevant equipment for use inthe implementation of DRRM and ESWM laws and sourced from the national govemmentfunds under the General Appropriations Act (e.9. PCF) , the Team shall ensure that the LGUproponent shall have secured approval ftom the Department of Budget and Management(DBM) to purchase vehicledequipments pursuant to Seclion 8.0 of A.O. No. 233, Series2008, as amended by Section 2 of A.O. No. 15 dated May 25, 2011.

In the case of change of project proposal owing to LGU's in view of a natural calamity,and/or unavoidable circumstances, the Team shall facilitate LGU proponent's compliance todocumentary requirements for a new projeci and forging of new Memorandum of Agreement(MOA) with the region. Further, the Team shall ensure that the change of project shall besupported by a Local Sanngunian Resolution stating thereat, among others, the validreason/s or justifications for such change.

5. The Team shall not endorse LGU's proposed project unless previous projects fundedunder the PCF had been completed, fully liquidated, and audited and certified by the localCOA Auditor.

5. After satisfactory compliance of the requiremenb and approval of the proposed projects ofLGUS, the Regional Office shall immediately submit the list of LGUS with attached projectproposals to the Bureau of Local Govemment Development (BLGD) as basis for the releaseof sub-.allotment by the Finance and Management Service (FMS).

C. Modality/Schedule of Release of PCF Subsidy

1 . The FMS shall suFallot to the Regions the PCF subsidy within three (3) calendar days uponreceipt of list of target LGU beneficiaries from BLGD.

2. Upon receipt of sub-allotment from Central Office, the Regional Office shall notify concernedPCF LGU beneficiary to submit the following documents prior to the forging of Memorandumof Agreement between the LGU and the DILG through the Regional Director:

' Certification from a Govemment Bank that the LGU had opened a Trust Fund accountfor PCF, including the details of the account

. Memorandum of Agreement (MOA) which shall contain, among others, informationrelated to the proposed proiecl such as project title, brief description of the project,location, date of start or projecl; estimated date of completbn of project; type andestimated number of target beneficiaries, and proj'eci implementation schedule.

3. The PCF check shall be released to the LGU beneficiary only after the other requireddocuments had been complied with and the MOA had been forged. Schedule of release isas follows:

. To the 2011 SGH passers between April and June 2012

. To the 2:012 Gawad Pamana rp Lahi awardees in November 2012

4. Upon receipt of the PCF check, concemed LGU shall issue an Official Receiptconesponding to the amount of the subsidy received, reflecting lhe'Name of the Projeclbeing funded and the Location of the Projecf' .

Monitoring and Evaluation

1. Monitoring and evaluation of the PCF shall cover LGU projecls implemented in 2010, 2011and2012.

2. The LGU beneficiary shall:

. Submit to the Regional Office through channel the following reports within 5 days of theensuing month or quarter:

- Monthly Physical and Financial Accomplishment Report for projects with six (6)

months implementiation period

- Quarterly Physical and Financial Accomplishment Report for projecls with more thansix (6) months implementation period

. In poects involving procurement of goods and services (e.9. motor vehicleJequiprnent),submit wilhin 15 calendar days the Physical and Financial Accomplishment Reportaudited and certified by the local COA Auditor

. Submit within 15 calendar days, Project Completion Report, for completed projects,supported with pictorials (with video documentation, if possible) accompanied with thefollowing documents:

- Certific€te of Completion- Certificate of Acceptance (il the groject is By Conbac{)- Report of Disbursement audited and certiFred by the local COA Auditor

. Post in @nspicuous places within public buildings (in front of Provincial Capitol,City/Municipal Halls, public library, market, etc.) the monthly/quarterly progress of ptojectimplementation, completed projects including disbursed PCF subsidy. In the absence ofwebsite in the case of cities/municipalities, said documents shall be posted in theProvincial Govemment website or in the DILG Regional/Central website; and

. \r'Vithin three (3) months after completion of the project, submit anAssessmenuEvaluation Report containing:

- Quantitative dimensions such as acilual work accomplishment and fund disbursed,number and type of beneficiaries of the project, employment generated during projectimplementation, etc.; and

- Qualitative dimensions sucfi as valuing LGU performance, positive attitudinal changesamong local officials and functionades, positive ouilmk on compliance to policies andrequirements

The RPCFMT shall:

o ln coordination with the Provincial PCF Focal Person, Cluster Head, and C/[,|LGOO,mnduct periodic monitoring on PCF utilization and status of LGU projectimplementation;

. Ensure submission of concerned LGUs the required reports to Regional O,ffice lhroughchannel:

. Conduct validauon and ocular inspection of projects implemented to validate reportssubmitted and substantiate commentyobservations and recommendalions. In case ofnegative findings and observations or slippage, the LGU beneficiary shall be required tosubmit exception report $rhich contains the neggtive finding and obseryations orslippage, its cause/s, recommendations and adions taken;

. Submit to the PCF Project Management Team-Central Office (thru the BLGD) aquarterly consolidaled physical and financial accomplishment report with necessaryattachments such as comments/observations, recommendations or exception Eport;

' submit to trt: l-cf Project Management re€m a consolidated Assessment /EvaluationReport based on submihed evaru;tio;-;rrts by the Leu o*"ili"ri!r; "no' Post the consolidated report of status of project implementation and fund utilization intheir respective regional websites.

4. The pCF Management Team (Centrat Office) shall:

' Review submitted .-regional reports and come up with comments/observations anclrecommendations, if any;

' conduct varidation and ocurar inspection of compreted or on-going LGU project, ifnecessary;

' submit on a quarterly basis consoridate_d reports on financiar and physicalaccomplishments on the PCF utilization to the Department oi g"ug"t i"d Management(DBM), House_.of Representatives committee bn npprolriati"i., l"o the senateCommittee on Finance copy turnish the O|LG ptanning SiJrv-i;,--- - -o submit an Annuar Assessrnent /Evaruation Repod to DBM, senate committee onFinance ana^llo!_pommittee on Appropriations nateJ'on

-suoritted Regionalevaluation reports; and

' Post the consolidated report of status of project implementation in the DILG centralOff ice website.

All DILG Regional Offices through the Regional PCF. Focal persons, Cluster Heads, andcity/Municipal Local Govemment opeftons omUrs-are directed to extend assistance to LGUbeneficiaries as deemed necessary and as appropriate.

Vl. Etrec-tivity. This Memorandum Circular shall take effect immediately.

,r#frffi"*=oo" Secretary

Repubtic of lhe phitippinesDEPARTIE {T OF IHE INTERICR

stLG12.002grt3

ill il11ilililIilililililililtffi illtr

Attachment A

XIETORANDUT OF AGREETENT

This ilEI{ORANDUIS OF AGREEnENT entered into and executed this

The Deparfonent of the Interior andOILG-Region

- with principal address

Govetnmont (DILG) herein referred to as the

represented herein by Regional Director

- and -

The Local Govemment Unit of , herein referred to as LGU PCF

grantee with principal office at and represented in this Agreement by its

(Governorrcityrtunicipal lleyor)No. _, Series of

-.

by virtue of Sanggunian Resolution

WITNESSETH

WHEREAS, the Department of the Interior and Local Govemment (DILG) through the Bureau ofLocal Govemment Development (BLGD) is the Office with primary responsibility in localizing theMillennium Development Goals (MDGs), and through the Regionat ffice in capacirtating LGUs toeffec*ively discharge their powers and functions towards improving the delivery of basic services andfacilities to their constituents;

WHEREAS, the Development Budget Coordinating Gommiftee (DBCC) of the Deparlment ofBudget and Management (DBM) approved the Performan@ Based Incentive Policy (PBIC) whichprovides for an incentive framework to rationalize national govemment and intergovemmental transfersto LGUs towards improving LGU performance in goveman@ and delivery of basic services;

WHEREAS, the Performance Challenge Fund (PCF) for Local Govemment Units is a flagshipprogram of the DILG that serves as a facility that will help stimulate LGUs that put premium ontransparency and accountability to enable them to avail themselves of financial support to jumpstart

and sustain locaf socio-economic development initiatives supportive of national govemment goals andpriorities. lt is an incentive fund to eligible LGUs to support in the implementation of high-impaci capitalinvestment projects in the Annual Investrnent Program (AlP);

WHEREAS, the Performance Challenge Fund (PCF) is being administered by the Departmentof the Interior and Local Govemment in collaboration with the Department of Budget and Management(DBM) to recognize god govemance performance particularly in the adoption of "good housekeeping'along the govemance areas of development planning, sound financial management, transparency andaccountability, and valuing perfomance monitoring;

WHEREAS, the Performance Challenge Fund progressive realization to achieve the Millennium

Development Goals (MDGs), maintenance of core road network to boost tourism and local economic

development; comply with the Philippine Disaster Risk Reduc{ion (DRR) and Management Act of 2010

and Ecological Solid Waste Management Act of 2000; and promole transparency and accountability;

programs and projects are anchored on the contribution of local govemment units (LGUs), as well as

non{ovemment and private sec{or organizations;

ofby:

Localat

IwHEREAS, the Local Govemment Units (LGUS), as provided for under the Local GovemmentCode of 1991 or Repubtic Act 7160, assume the primary responsibility of providing basic services and

facilities lo improve the quality of life of their constituents thror.gh programs and projecf,s geared

towards the achievement of MDGs; preparedness to disasters and adaptation to climate change;

sustainable environmental management; and transparent and accountable local govemance;

WHEREAS, the Province/City/Municipality of ,has been awarded the

Seal of Good Housekeeping in 20_ thereby entitles the LGU to receive the PCF Subsidy amounting

to a maximum of (P ).

NOW, THEREFORE, for and in consideration of ttre above premises and of the mutual

covenanls stipulated hereinafter set forth the PARTIES hereto agree to enter into this Mamorandum of

Agreement to adhere to the following terms and conditions:

Section l. Proiect Dotails

a.

b. Brief Description of Project :

Date of Start : -----------; Estimated Date of Comdetion :

Number and Type of Target Beneficiaries :

Projed lmplementation Schedule :

Section 2- Eligible Proiects

Eligible projeds for the PCF subsidy are those lhat support the national priorities of the present

administration in achieving the MDGs; preparedness to disasters and adaptation to dimate change;

sustainable environmental management; and hansparent and accountable local govemance, which

are implementable within one (1) year from the date of receipt of the PCF Check.

Section 3. Delineation of Responsibilities

The PCF Recipient LGU shall:

1. Submit a Certification from a Govemment Bank that the LGU had opened a Trust Fund forPC, together with the details ofthe account;

2. Maintain a Book of Accounts for the PC Fund;

3. lssue an Official Receipt conesponding to the amount of PC Fund subsidy received;

4. Create a PCF Prolect lmplementation Team responsible for the implemenlation of theproject/s;

5. Submit to the DILG Regional Office the follorving reports within prescribed period asstipulated in Memorandum Circular No. 2012

- dated

o Monthly Physical and Financial Accomplishment Report for projeds with six (6) monthsimplementation Period

o Quarterly Physical and Financial Accomplishment Report for projec{s with more than six(6) months im plementation period

. Report on proiects involving procurement of goods and services

d.

e.

t_

. Project Completion Report once thepictorials (with video documentation,doc ments:

- Certificate of Completion- Certificate of Acceptance (if the project is By Contract)- Report of Disbursement audited and certified by local COA Auditor

. AssessmenVEvaluation Report containing:

- Quantitative dimensions such as actual work accomplishment and fund disbursed,number of beneficiaries of the proiect, employment generated during proiect

implementation, etc.; and

- Qualitative dimensions such as valuing LGU performance, positive attitudinalchanges among local offcials and funclionaries, positive outlook on compliance topolicies and requirements

6. Put up a signage of the projecus using any of these formats such as billboard, tarpaulin,banner or poster on the place where the project is implemented follordng thetemplate/design as stipulated in Memorandum Circular No. 2012 -28 dated February 9,

2012.

7. Post in conspicuous places within public buildings (in front of Provincial capitol,City/Municipal Halls, public library, market, etc.) monthly/quarterly progress of prolec{

project had been completed supported withif possible) accompanied with the following

implementation, completed projec{s including disbursed PCF subsidy.website in the case of cities/municipalities, said documents shallProvincial Govemment website or in the DILG RegionaUCentral websites.

DILG Reaional Ofrice shail:

1 . Prepare and issue checks as financial subsidy to the LGU grantee;

2. Facilitate the release of the PCF chec* amounting to P to therecipient LGU upon signing of the Memorandum of Agreement and the satisfaclorysubmission of documeniary requirements under Section 1 of Procedures in Accessing thePC Fund of MC No. 2012 --dated ------;ln coordination with the Provincial PCF Focal Person, Cluster Head, and C/MLGOO'conduct periodic monitoring on the progress of project implementation and disbursement ofPC Fund by the LGU;

Conduct validation and ocular inspection of the LGU projed/s to validate reports submitted

and substantiate comments/observations and recommendations. ln case of negativefindings and observations or slippage, the LGU beneficiary shall be required to submit

exception report whicfr contains the negative finding and observalions or slippage, its

cause/s, recommendations and actions taken;

Submit the following to the PCF Proiect Management Team - Central ffice:

o Quarterly physical and financial accomplishment reports on the PCF-funded pmject

. Report of Disbursement

. AssessmenUevaluation report based on the assessmenUevaluation report submitted by

the LGU recipient

Post the status of project implementation and fund utilization in the DILG Regional website

This agreement shall take effect immediately upon signing by the representatives of the Parties

hereto and shall be enforced within one (1) year upon completion ofthe project.

ln the absence ofbe posted in the

3.

4.

lN WTTNESS WHEREOF, the Parties hereunto affixed their signatures on this

- day of

Philippines.

DILG-Regional Office

Department of the Interior and Local GovemmentRegion _

Local Govemment Unit of

Governor and/or City/Municipal Mayor

SIGNED IN THE PRESENCE OF:

ACKNOWLEDGEi'ENT

REPUBLIC OF THE PHILIPPINES)) s.s.

BEFORE mE, a notary public, for and in the above jurisdiction, personally appeared on this :

cTc. No. DATE/PLACE OF ISSUE

DILG Regional Direclor

MAYOR

Known to me to be the personis vvho executed the foregoing instrument and acknowledge to me

is their free and voluntary act and deed.

The parties have signed this Memorandum of Agreement consisting of -

pages, including the

page where the acknowledgement is written, and their instrumental witnessed on the left margin of

each and every page.

lN WITNESS WHEREOF, I have hereunto set my hand on the date and place above written.

Documentary Number :

Page Number

Book Number

Series of 20_

Attachment BFor Proiecls with 6 Months lmolementation Period

Republic of the PhilippinesProvince of_

CITY/MUNICIPALITY OF

-

Physical and Financial Accomplishment ReportFor the Month of

Project TitleProiect Description

Total ProJect CostDate Start of ProjectNo. and Tvoe of Beneficiaries

Certified by:

Estimated Date of Project Completion

Approved by:

Physical FinancialRemarks (lndicate

reasons for delay, ifanyJ

Maior Activities PCF

SubsidyVo ofUtilization LGU

Counterpart/Other Source, if

any

Yo of UtilizationPlanned Actual o/o of

Accomplishment

Local Engineer Local Accountant Local Chief Executive

Attachment CFor Proiects with more than 6 Months lmplementatjon Period

I

Republic of the PhilippinesProvince of-

CITY/MUN IClPALITY OF

Physical and Financial Accomplishment ReportFor the Quarter ending _

Proiect TitleProject Description

Total Project CostDate Start of ProiectNo. and Type of Beneficiaries

Certified by:

Estimated Date of Project Completion

Approved by:

Physical FinancialRemarks (lndicate

reasons for delay, if any)Maior Activities PCF

[per activityJ7o of Utilization Other Source, if

any

[per activity]

% of UtilizationPlanned Actual o/o of

Accomplishment

Local Accountant Local Chief Executive

Attachment'D

Republic of the PhilippinesProvince of_

CITY/MUNICIPALITY OF

PENTORMANCE CHAI.IENGE TUilD-SUPPORIED PROJECIReport of Disbursement

As of

Amount received per ChecklOfficial Receipt No.

l,ess: Disbursemcnt:

Balance as of

Payee Nature of Payment Check No. Date Amount Remarks

Certified Correct: Verified and Found correct by:

Local Chief Executive Local COA Audttor

Attachment E

PENIORMANCE CHAII.ENGE f UND-SUPPORIED PROJECT

Quarterly Physical and Financial Accomplishment ReportFor the Quarter ending _

Region

Submitted by :

LCU Titleof

Project

Date StartofProject

!stimatedDate ofProJect

Completion

Beneficiaries Total Project Cost Status of lmplemenhtion

Number Type PCF

SubsidyLGtJ

Counter-part, ifany

Tohl Physical Financial Remarks (indicatereasons for delay,

if any)

Major Activities

o/o ofUtilization ofPCF Subsidy

%ofUtilization of

LCUCounterpad,

if any

Irlanned Actual Y. cfAccomplish-

mcnt

Noted by :

Ilegional Director

Attachment'E

PERFORMANCE CHATI.ENGE FUND-SUPPORTED PROJECT

Assessment/Evaluation ReportAs of

LGU Name r

ProiectTitle

ProlectDescrlption

Total Prolect Cost WorkAccomDlishment

Fund Disbursed Beneficiaries

Benellts of the Proiect

(e.g. employmentgenerated, etc. during

proiect lmplementatlon)

RemarksPCr

Subsidytcu

Counter-parLlfany

Total PerProposed

WorkProgram

Actual PCF

subsldy

LGUCounter-part, lf

any

Type Numbor

PerProposedProiect

Actrral

Submitted by : Noted by :

I-ocal Chicf Exc'cutivc

Attachment C

PERTORMANCE CHAI.IENGE f UND.SUPPORIED PROJECI

Region:

Consolidated Assessment/Evaluation ReportAs of

LGU

ProlectTltle

ProiectDescription

Total Proiect Cost WorkAccomDllshment

Fund Disbursed Beneficlaries

Benents of the Proiect

{e.g. employmentgenerabd, etc, during

proi ect implementatlon)

RemarksPCF

SubsidyLGU

Counter-part,ifany

Total PerProposed

workProgram

Actual PCFSubsldy

LGUCounter-part, tf

any

Type Number

PerProposedProiect

Actual

Submitted by :

Iiegional PCF Focal Person

Noted by :

Regional Director

Attachment H

PERFONMAilCE CHAI.TENGE FUND.SUPPORIED PROJECT

Project Completion Report

1. Name of LGU:

2. Brief Profile of LGU :

3. Title of Pmject

4. Location:

5. Date MOA Signed:

6. ProiectDescription:

7. fluration of Proiect

. Project Start Date

. Proiect Completion Date

8. Project Beneficiaries (including no. and type of beneficiaries)

9. Maior Activitiee Undertaken:

10. Project Cost

. LGU Counterpart, if any

. Amount of PCF Subsidy Received:

11. Date o{ PCF Subsidy Received:

12. Fund Utilizatiorr

. o/o of LGU Counterpart Utilized, if any

. t" olPCl Subsidy Utilized

. o/o of Unexpended Fun4 if any

13. Proiect Results:

14. Problems Encountered/Action Taken:

15. Pictorials

16. Other Supporting Documents

Prepared b5r Certified Correct

LGU-PCF Proiect In-Charge Local Chief Executive

Attachment I

Republic of the PhilippinesProvince of

-

Municipality of

CERTIFICAfi OF ACCEPTANCE

TITLE OF PROIECT:

LOCATION

THIS IS TO CERTIFY TFIAT L (Name ) . (Position )

representing the which is the end-user of

the above-mentioned projec! hereby accepts from the Province/CityMunicipality ofthe said project.

As the proiect end-user, we assume the responsibility for proper operation and maintmance of

the (structure/facility/etc -)

(Name & Signature)

(Position/Designation)

NOTED:

(Provincial/CityAr,Iunicipaf Engineer)