RECORD/DOCUMENT TRACKING FORM (RDTF) Effectivity Date: August 16, 2018

NHA-QP-001-F01 Form Revision No. 02

Record/Document Control No. : REG – 11 – DISTRICT 2 – 2018 – 0070

Record/Document Type : CONTRACT TERMINATION

Originating Unit : TECHNICAL UNIT

Subject : Termination of Contract of the Project Construction of One (1) Unit 2 – Storey 8 –
Classroom School Building at Mont. Eagle Ville Subdivision, Brgy. Kidawa, Laak,
Compostela Valley Province.

I hereby certify that all the documentary requirements have been subjected to the principle of “complete staff work” and have been
evaluated with diligence and found in order in accordance with prescribed policies, guidelines and procedures.

OSCAR A. SAYMAN
Supervising Engineer A
Page 1 of 1
For/To From
Date Name/Position/ Remarks/Instructions
Name/Position/ Unit
Unit/Signature
Transmitting herewith the following
documents:

1. Certification of Completed Staff

ROLANDO I. TEVES, JR. SONIA J. BULSECO Work and Compliance with
OIC, Region 11 Principal Engineer C Policy
2. Memorandum for the General
Manager
3. Letter of request of Contractor
to terminate the Contract
4. Copy of Approved Suspension
Order no. 1
5. Copy of Letter of request of
Contractor to temporarily
suspend the project.
6. Copy of Notice to Proceed
7. Copy of Notice of Award
8. Copy of Contract Agreement

For your approval.

IMPORTANT: Pursuant to Section 8.B of RA 9485, response/action “shall not be longer than five (5) working days in the
case of simple transactions, and ten (10) working days in the case of complex transactions from the date the request or
application was received.”
IMPORTANT : Pursuant to Section 8.B of RA 9485, response/action “shall not be longer than five (5) working days in the
case of simple transactions, and ten (10) working days in the case of complex transactions from the date the request or
application was received.”