fth,, Repablic of the Philippines

I, tli PHILIPPINE HEALTH INSURANCE CORPORATION

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Camarines Sur Local Health Insurance Office

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Westpark Leisure Hub, Magsaysay Avenue, Naga City
Healthline (O54) 472-1 483 I 47 3-5632
Call Center (02) 441-7442 Trunkline (02) 441-7444
www.philhealth. gov.ph

CERTIFICATE OF REMITTANCE

This is to certify thot RIDERS ADVENTURE LTD CO with oddress ot BLDG I

DOOR 5 PLDC COMP DIVERSION ROAD, CONCEPCION PEQ., NAGA CITY hOS
remitted to the Philippine Heolth lnsuronce Corporotion premium contributions for
the period JANUARY 2017 to NOVEMBER 2017 representing employer ond
employee contributions.

This certificotion is issued upon the request of the soid employer for whotever
legtrl purposes this moy serve.

lssued this 20th doy of December 2017.

This certificotion is volid one (1) yeor from dote of issue.

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Errrployee Counf: 1146

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teamphilhealth $l www.facebook.com/PhilHea ,com/teamphilhealth $l actioncenter@philhealth.gov.ph