FORM A - PUBLIC SECTOR BUDGET STRATEGY FOR PPP IMPLEMENTATION

This form shall contain the yearly projected costs to be incurred by the implementing agency (IA) in implementing the PPP project. This shall be submitted by the IA to the PPP Center fifteen (15) business days after signing of each contract. IIn accomplishing Form A, the yearly projected spending indicated by the IA must
be consistent with their requested government support via Letter of Commitment (LOC) pursuant to DBM National Budget Circular No. 564 – Guidelines for Issuance of LOC Covering National Government Support for Multi-year Solicited PPP Projects, if applicable
all amounts only shouldered by the government
1. Name of Project:
2. Project Site/Location/Region:
3. Implementing Agency:
4. Implementing Agency's Funding Source(s):
5. Project Proponent:
6. NEDA Board Approved Project Cost (in PHP):
7. Contract Cost (in PHP):
8.A. Development Cost (in PHP) 8.B. Funding Source:

9. BUDGET ITEMS Funding Source YEAR 1 YEAR 2 YEAR 3 YEAR 4 YEAR 5 YEAR 6 YEAR 7 YEAR 8 YEAR 9 YEAR X
(in PHP Million)
A. Right-of-Way
i. Acquisition of Land
ii. Relocation of Utilities
iii. Relocation of Informal Settler Families
iv. Others (please specify)
B. Independent Consultant
C. Other Consultancy Services
D. Availability Payments
E. Viability Gap Funding
F. Real Property Tax
G. Funding for Project Management Office
H. Others (please specify)
TOTAL (A+B+C+D+E+F+G+H)

Notes:
15 Calendar days
GOCC-PPP/JV Board Approval
Letter of Commitment
Adopt Financial model during bidding Based on implementation schedule submitted after contract signing
For hybrid projects, add a budget item and indicate source
One-time submission
FORM B - PROJECTED MONTHLY SPENDING FOR PPP PROJECT
This form shall contain the projected monthly spending of both project proponent and implementing agency to be spent for the PPP project. This shall be submitted by the IA to the
PPP Center fifteen (15) business days after signing of contract.

PROJECT PROPONENT

YEAR X
1. PROJECT PROPONENT BUDGET ITEMS
Q1 Q2 Q3 Q4
(in PHP Million) Remarks
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
A. Capital Expenditure
i. Engineering Design
ii. Civil Works
iii. Construction Supervision
iv. Others (please specify)
B. Operational Expenditure
C. Independent Consultant
D. Other Consultancy Services
E. Concession Payments
F. Real Property Tax
G. Others (please specify)
TOTAL (A+B+C+D+E+F+G)
Private Sector through implementing agency

IMPLEMENTING AGENCY

YEAR X
2. IMPLEMENTING AGENCY BUDGET ITEMS Funding
Q1 Q2 Q3 Q4
(in PHP Million) Source Remarks
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
A. Right-of-Way
i. Acquisition of Land
ii. Relocation of Utilities
iii. Relocation of Informal Settler Families
iv. Others (please specify)
B. Independent Consultant
C. Other Consultancy Services
D. Availability Payments
E. Viability Gap Funding
F. Real Property Tax
G. Funding for Project Management Office
H. Others (please specify)
TOTAL (A+B+C+D+E+F+G+H)

Annual submission
FORM C - ACTUAL MONTHLY SPENDING FOR PPP PROJECT
This form shall contain the actual monthly spending of both project proponent and implementing agency spent for the PPP project. This shall be submitted by the IA to the PPP Center
ttwenty (20) business days from the close of every quarter thereafter.

PROJECT PROPONENT

YEAR X
1. PROJECT PROPONENT BUDGET ITEMS
Q1 Q2 Q3 Q4
(in PHP Million) Remarks
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
A. Capital Expenditure
i. Engineering Design
ii. Civil Works
iii. Construction Supervision
iv. Others (please specify)
B. Operational Expenditure
C. Independent Consultant
D. Other Consultancy Services
E. Concession Payments
F. Real Property Tax
G. Others (please specify)
TOTAL (A+B+C+D+E+F+G)

IMPLEMENTING AGENCY

YEAR X
2. IMPLEMENTING AGENCY BUDGET ITEMS Funding
Q1 Q2 Q3 Q4
(in PHP Million) Source Remarks
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
A. Right-of-Way
i. Acquisition of Land
ii. Relocation of Utilities
iii. Relocation of Informal Settler Families
iv. Others (please specify)
B. Independent Consultant
C. Other Consultancy Services
D. Availability Payments
E. Viability Gap Funding
F. Real Property Tax
G. Funding for Project Management Office
H. Others (please specify)
TOTAL (A+B+C+D+E+F+G+H)
FORM D - SUMMARY REPORT
This form shall contain the summary of the projected and actual spending of the implementing agency and the project proponent, as well as the physical accomplishment,
projects. This shall be submitted by the PPP Center to the DBCC and the PPP Governing Board, copying the ICC-Secretariat, thirty (30) business days from the close of e

2018 Q1 Cumulative (as of date)

Financial Physical Financial
Project Name
Projected Actual Accomplishment Accomplishment Projected Actual Accomplishment
Projected Actual
(in PhP Million) (in PhP Million) (in %) (in %) (in PhP Million) (in PhP Million) (in %)

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
A. Project Name
1. Implementing Agency
2. Project Proponent
B. Project Name
1. Implementing Agency
2. Project Proponent
C. Project Name
1. Implementing Agency
2. Project Proponent
X. Project Name
1. Implementing Agency
2. Project Proponent
TOTAL
 accomplishment, for each of the PPP
rom the close of every quarter.

(as of date)
Physical
Remarks
Accomplishment
Projected Actual
(in %)

(11) (12) (13) (14)

 INSTRUCTIONS IN FILLING UP
FORM A: PUBLIC SECTOR STRATEGY FOR PPP IMPLEMENTATION

General Information
1. Name of Project Indicate the name of the PPP Project, as specified in the PPP contract
2. Project Site/Location/Region Indicate the location and region of the project where it is being implemented
3. Implementing Agency Indicate the Implementing Agency or Agencies for the PPP Project
Indicate all applicable funding sources used on the PPP project (e.g. PPP only, ODA
4. Implementing Agency's Funding Source(s)
and PPP, GAA and PPP, etc.)
5. Project Proponent Indicate the Project Proponent for the PPP Project
6. NEDA Board Approved Project Cost (in PHP) Indicate the NEDA Board Approved Project Cost in Philippine Pesos
Indicate the contract cost as stated in the PPP contract or the Project Proponent’s
7. Contract Cost (in PHP)
financial model
Indicate the total cost for the development of the PPP project (e.g. costs for pre-
8. A. Development Cost
feasibility study, feasibility study, business case, etc.)
Indicate all applicable funding sources for the development of the PPP project (e.g.
8. B. Funding Source
PDMF, GAA, etc.)
9. Budget Items
A. Right-of-Way (ROW)
Indicate the annual budget strategy for the acquisition of land in relation to the ROW
i. Acquisition of Land
requirements of the project
Indicate the annual budget strategy for the relocation of utilities in relation to the ROW
ii. Relocation of Utilities
requirements of the project
Indicate the annual budget strategy for the relocation of informal settler families in
iii. Relocation of Informal Settler Families
relation to the ROW requirements of the project
Indicate other annual budget items related to the ROW requirements of the project, if
iv. Others (please specify)
any
Indicate the annual budget strategy for the services of the Independent Consultant of
B. Independent Consultant
the project
Indicate the annual budget strategy for the other consultancy services needed for the
C. Other Consultancy Services
project, if any
Indicate the annual budget strategy for Availability Payments (e.g. Lease Payments,
D. Availability Payments Annual Grantor Payment, Amortization Payments), if the project is an availability-based
PPP
E. Viability Gap Funding Indicate the annual budget strategy for the Viability Gap Funding shouldered by the IA
F. Real Property Tax Indicate the annual budget strategy for the Real Property Taxes to be paid by the IA
Indicate the annual budget strategy for the funding of the Project Management Office
G. Funding for Project Management Office
of the IA, if any
Indicate other budget items not mentioned above, in relation to implementation of the
H. Others (please specify)
project, if any
Indicate the total budgetary requirements in implementing the project for the specified
Total Cost
year.
Indicate the funding source to be used for the particular budget item (e.g. GOCC's
Funding Source
corporate fund, GOCC's subsidy from GAA, IA's GAA, IA's ODA, etc.)

INSTRUCTIONS IN FILLING UP
FORM B: PROJECTED MONTHLY SPENDING FOR PPP PROJECT
1. Project Proponent Budget Items
A. Capital Expenditure
Indicate the monthly projected cost for the engineering design in relation to the CAPEX
i. Engineering Design
requirements of the project

Indicate the monthly projected cost for the civil works (e.g. Equipment/Machineries,
ii. Civil Works
Materials/Supplies, Labor Costs) in relation to the CAPEX requirement of the project

Indicate the monthly projected cost for construction supervision in relation to the
iii. Construction Supervision
CAPEX requirement of the project
Indicate other projected costs in relation to the CAPEX requirements of the project, if
iv. Others (please specify)
any
B. Operational Expenditure Indicate the monthly projected total cost for the Operational Expenditure of the project
Indicate the monthly projected cost for the services of the Independent Consultant of
C. Independent Consultant
the project
Indicate the monthly projected cost for the other consultancy services needed for the
D. Other Consultancy Services
project, if any
E. Concession Payments Indicate the monthly projected cost for Concession Payments, if any
Indicate the monthly projected cost of Real Property Taxes to be paid by the project
F. Real Property Tax
proponent
Indicate other projected costs not mentioned above, in relation to the implementation
G. Others (please specify)
of the project
Indicate the total monthly projected cost for the implementation of the project for the
Total Cost
specified period
2. Implementing Agency Budget Items
A. Right-of-Way
i. Acquisition of Land
ii. Relocation of Utilities
iii. Relocation of Informal Settler Families
iv. Others (please specify)
B. Independent Consultant
C. Other Consultancy Services
D. Availability Payments
E. Viability Gap Funding
F. Real Property Tax
G. Funding for Project Management Office
H. Others (please specify)
Total Cost
Funding Source
INSTRUCTIONS IN FILLING UP
FORM C: ACTUAL MONTHLY SPENDING FOR PPP PROJECT
1. Project Proponent Budget Items
A. Capital Expenditure
i. Engineering Design
ii. Civil Works
iii. Construction Supervision
iv. Others (please specify)
B. Operational Expenditure
C. Independent Consultant
D. Other Consultancy Services
E. Concession Payments
F. Real Property Tax
G. Others (please specify)
Total Cost
2. Implementing Agency Budget Items
A. Right-of-Way
i. Acquisition of Land
ii. Relocation of Utilities
iii. Relocation of Informal Settler Families
iv. Others (please specify)
B. Independent Consultant
C. Other Consultancy Services
D. Availability Payments
E. Viability Gap Funding
F. Real Property Tax
Indicate the monthly projected cost for the acquisition of land in relation to the ROW
requirements of the project, as allocated in the IA's GAA or GOCC's corporate fund
Indicate the monthly projected cost for the relocation of utilities in relation to the ROW
requirements of the project, as allocated in the IA's GAA or GOCC's corporate fund
Indicate the monthly projected cost for the relocation of informal settler families in
relation to the ROW requirements of the project
Indicate other monthly projected costs in relation to the ROW requirements of the
project, if any
Indicate the monthly projected cost for the services of the Independent Consultant
Indicate the monthly projected cost for the other consultancy services needed for the
project, if any
Indicate the monthly projected cost for Availability Payments (e.g. Lease Payments,
Annual Grantor Payment, Amortization Payments), if any, as allocated in the IA's GAA
or GOCC's corporate fund
Indicate the monthly projected cost for Viability Gap Funding shouldered by the IA
Inidicate the monhtly projected cost of Real Property Taxes to be paid by the IA
Inidicate the monthly projected cost for the funding of the Project Management Office
of the IA
Indicate other projected costs not mentioned above, in relation to the implementation
of the project, if any
Indicate the total projected cost for implementation of the project for the specified
period
Indicate the funding source (GOCC's corporate fund, GOCC's subsidy from GAA, IA's
GAA, IA's ODA, etc.) to be used for the particular budget item
Indicate the monthly actual cost spent by the project proponent for the engineering
design in relation to the CAPEX requirements of the project
Indicate the monthly actual cost spent by the project proponent for the civil works (e.g.
Equipment/Machineries, Materials/Supplies, Labor Costs) in relation to the CAPEX
requirement of the project
Indicate the monthly actual cost spent by the project proponent for construction
supervision in relation to the CAPEX requirement of the project
Indicate other actual costs spent by the project proponent in relation to the CAPEX
requirements of the project, if any
Indicate the monthly actual total cost spent by the project proponent for the
Operational Expenditure of the project
Indicate the monthly actual cost spent by the project proponent for the services of the
Independent Consultant of the project
Indicate the monthly actual cost spent by the project proponent for the other
consultancy services needed for the project, if any
Indicate the monthly actual cost for Concession Payments, if any
Indicate the monthly actual cost of Real Property Taxes paid by the project proponent
Indicate other projected costs spent by the project proponent not mentioned above, in
relation to the implementation of the project
Indicate the total monthly actual cost spent by the project proponent for the
implementation of the project for the specified period
Indicate the monthly actual cost disbursed by the IA for the acquisition of land in
relation to the ROW requirements of the project
Indicate the monthly actual cost disbursed by the IA for the relocation of utilities in
relation to the ROW requirements of the project
Indicate the monthly actual cost disbursed by the IA for the relocation of informal
settler families in relation to the ROW requirements of the project
Indicate other monthly actual costs disbursed by the IA in relation to the ROW
requirements of the project, if any
Indicate the monthly actual cost disbursed by the IA for the services of the
Independent Consultant
Indicate the monthly actual cost disbursed by the IA for the other consultancy services
needed for the project, if any
Indicate the monthly actual cost disbursed by the IA for Availability Payments (e.g.
Lease Payments, Annual Grantor Payment, Amortization Payments), if any
Indicate the monthly actual cost for Viability Gap Funding shouldered by the IA
Inidicate the monhtly actual cost of Real Property Taxes paid by the IA
 Inidicate the monthly actual cost for the funding of the Project Management Office of
G. Funding for Project Management Office
the IA
Indicate other actual costs not mentioned above, in relation to the implementation of
H. Others (please specify)
the project, if any
Indicate the total monthly actual cost for implementation of the project for the specified
Total Cost
period
Indicate the funding source (GOCC's corporate fund, GOCC's subsidy from GAA, IA's
Funding Source
GAA, IA's ODA, etc.) used for the particular budget item

INSTRUCTIONS IN FILLING UP
FORM D: SUMMARY REPORT
General Information
Indicate the name of the PPP Project, as specified in the PPP contract and consistent
1. Project Name with the NEDA Board and/or ICC approval of the said project, along with the name of
the Implementing Agency and the Project Proponent
Quarterly Financial Spending of the PPP Project
Indicate the projected quarterly spending for the PPP Project as reflected in Form B.
2. Projected Financial Spending (in PhP Million)
Ensure that the entries in Column 2 are consistent with those in Form B.
Indicate the actual quarterly spending for the PPP Project as reflected in Form C.
3. Actual Financial Spending (in PhP Million)
Ensure that the entries in Column 3 are consistent with those in Form C.
Indicate the accomplishment (in percentage) of the actual quarterly spending against
4. Accomplishment (in %)
the projected quarterly spending of the PPP project.
Quarterly Physical Accomplishment of the PPP Project
Indicate the projected physical accomplishment of the PPP project for the particular
5. Projected Physical
quarter
Indicate the actual physical accomplishment of the PPP project as of the end of the
6. Actual Physical
quarter
Indicate the accomplishment (in percentage) of the actual quarterly physical
7. Accomplishment (in %) accomplishment against the projected quarterly physical accomplishment of the PPP
project
Cumulative Financial Spending of the PPP Project
Indicate the projected cumulative spending of the PPP Project as reflected in Form B.
8. Projected Financial Spending (in PhP Million)
Ensure that the entries in Column 8 are consistent with those in Form B.
Indicate the actual cumulative spending of the PPP Project as reflected in Form C.
9. Actual Financial Spending (in PhP Million)
Ensure that the entries in Column 9 are consistent with those in Form C.
Indicate the accomplishment (in percentage) of the actual cumulative spending against
10. Accomplishment (in %)
the projected cumulative spending of the PPP project.
Cumulative Physical Accomplishment of the PPP Project
11. Projected Physical Indicate the projected cumulative physical accomplishment of the PPP project
12. Actual Physical Indicate the actual cumulative physical accomplishment of the PPP project
Indicate the accomplishment (in percentage) of the actual cumulative physical
13. Accomplishment (in %) accomplishment against the projected cumulative physical accomplishment of the PPP
project
Indicate any remark or note relevant to the financial spending and physical
14. Remarks accomplishment of the PPP project, such as cause of delays, underspending, among
others