Republic of the Philippines DEPARTMENT OF SCIENCE AND TECHNOLOGY ATA|VAB FEB 0 8 2019 commanoansen 30 January 2019 MEMORANDUM, TO é All Heads of DOST Sectoral Councils, Research and Development Institutes, S&T Service Institutes, Regional Offices, Collegial Bodies, and DOST-CO Offices FROM 7 ROWEWA CRISTINA L. GUEVARA, Ph.D. Undersetretary for R&D SUBJECT : Revised DOST-GIA Forms In view of the amendments of the DOST-GIA guidelines, Administrative Order Nos. 009 Series of 2017 and 017 Series of 2019, we are sending herewith a copy of the revised DOST- GIA forms, for adoption. You may also access the said forms through our website: www.dost.gov.ph. ‘This revision shall take effect immediately. For your information and guidance. Rovewn Scone Tetntgy (OC POI Website: www.dost.gov.ph Tel. Nos.: (02) 837-20-71 to 82/ 837-3171 to 89“Table of Contents Revised DOST-GIA Forms | Form 1A = Capsule R&D Proposal (forthe Whole Progra) Form 1B — Capsule R&D Proposal for the Component Projea Form 2A — Detaled R&D Proposal (forthe Whole Programs Form 28 = Detaled R&D Proposal forthe Component Projed) Form S_—Non-R&D Project Proposal ‘Form A Project Line-ltem Budget Form B ~ Project Workplan Form C— Project Monitoning and Evaluation Plan Form = Semi-Annual Progress Report Form € = Annual Progress Report Form F - Aporaisall Assessment Form Form G- Project Monitoring and Field Evalualon Repo | Form H — Semi-Annual / Annual Financial Report Form |= Terminal Audited Financial Report Form J= List of Personnel involved Form K List of Equipment Purchased Form L = Schedule of Accounts Payable Form M_— Report of incomefInterest Generated/Eamed Form N= Terminal ReportDOST Form 14 CAPSULE RESEARCH & DEVELOPMENT PROGRAM PROPOSAL. (For the Whole Program) (To be accomplished by the research () PROGRAM PROFILE Program Tite: Program Leader/Sex: ‘Agency: ‘Address/TelephonetFax/Emal Total uation: ‘Title of Component Projects Duration: 1. a (@) PROGRAM SUMMARY (Wats exceed wo Bamam) (Giecsver a he Pram Sioncares: Moreselogy: Dseuston on te resus flats DOST-GUA ded Programspoecs previous handed ty the same Program Leader (far): (9) BUDGET SUMMARY FOR THE WHOLE PROGRAM (inci Gounterert Funds Total Budget: a ‘SOURCE OF FUND BS. MOOE EO TOTAL Total Ya Budget: 7 ‘SOURCE OF FUND. PS. MOOE EO, TOTAL Tota Yn Budget: ‘SOURCE OF FUND. PS, WOOE EO, TOTAL, Total T (4) OTHER ONGOING PROGRAMS BEING HANDLED BY THE PROGRAM LEADER: (number) Tile of the Program Funding Agony Involvement in the PregramiProject 'neroby certify the truth of the foregoing. Any wilful omissionifalse statement shall be a basis of disapproval and cancellation ofthe Program. [i ‘SUBMITTED BY (Program Leader) | ENDORSED BY (Head of the Agency Signature Printed Name Designation/T¥e Date Note Ti a eae ge es Eo ar an BRE Us FAST, Wt ‘yefece Opies regres bea for ade, rate methmat fra dag, cpt, Morgnsoe seDOST Form 1A CAPSULE R&D PROGRAM PROPOSAL |. General instruction: Submit six (6) copies of capsule R&D proposal for the whale Program together with the capsule RAD proposal of the component projects. Please attach a 1- page curriculum vitae of tne Project Leader. Use Avil typeface, 10 points 1, Operational Definition of Terms: 1. Program- refers to a group of interrelated or complementing S&T projects that require an Interdiseiplinary or multaisciplinary approach to meet established goal(s) within a specific lime frame. Title the identfcation of the program and the component projects, Program Leader- refers to the person who plans, organizes and supervises the overall actives of ‘Program and is a Project Leader of at least one (1) ofthe projects under a Program. ‘Agency. the lead institution ofthe whale Program, Duration. refers to the grant period or timeframe that covers the approved start and completion ates ofthe Program. Project- refers to the basic unit in the investigation of specific S&T problems with predetermined ‘bjective(s) to be accomplished within @ specific time frame, 2, Program Summary. brief overview of the Program, include discussione on the objectives, Signficance/impact of the Program to the advancement of Knowledge and to the society, methodology, ‘and results of related Programs/projects previously handled by the same Program Leader, if any. 3. Budget Summary- personal services (PS), msintenance and other operating expenses (MOOE), ‘and equipment outlay (EO) requirement of the whole Program by source (including Counterpart Funds) for Year‘ and for the whole curation ofthe Prooram. Please refer tothe DOST-GIA Guidelines {or the detals (Section VIL2 of DOST AO 009, s 2017). PS- total requirement for wages, salaries, honoraria, aditional hive and other personnel benefit MOOE: total requirement for supalies and materials, travel expenses, communication, and other services O- total requirement for facies and equipment needed by the Program. 4. Other Ongoing Programs Being Handled by the Program Leader- list of ongoing Programsiorojects being handled by the Program Leader funded by the DOST-GIA Program and othor sources, and the secompanying responsiblities relevant to the Programiproject. 5. Endorsed By- Head of the Agency or authorized representative who recommends the Program:OST Form 15 CAPSULE RESEARCH & DEVELOPMENT PROJECT PROPOSAL (For the Component Project) (To be accomplished by the researcher) [@) PROJECT PROFILE Program Tile: Project Tite: Project Leader'Sex: Agency. ‘Adcress/TelephonoFex/Emait: ‘Duration (in months\Date: (@) COOPERATING AGENCWES {@)SITE (S) OF WPLEMENTATION (Municipality Dietict] Province Region) Base Siation: (ther implemantation See: (4) R&D PRIORITY ARER & PROGRAM (Based on Harmonized National RED Agenda (ANRDA) 2017-2027) Agriculture, Aquat, and Natural Resources Health —— Industry, Energy, and Emerging Technotogy Disaster Risk Reduction and Cimate Change Basie Research | (@ PROJECT SUMMARY otis eaea oo oaems Objectee Herosoogr “Target Accompeterts an Expect Ououte (Po ‘Sonfcanatnpactokrowedge sdvancrart nthe sce Daun en fo result of lles DOST-QIA ded pecs revel hance bythe sre Projet Leader an) TO) IMPLEMENTING SCHEDULE Duration in month: Planned Start Date (enh Year: Pianned Completion date (Mon Yea [BUDGET BY SOURCE (neisse Canepa Fines ‘SOURCE OF FUND PS. MOOE £0, TOTAL Year 1 Souree i Year a ‘Sowea TOTAL. (8) OTHER ONGOING PROJECTS BEING HANDLED BY THE PROJECT LEADER: (umber) Title of the Project [Funding Agency Involvement in the Project | | hereby certify the truth of the foregoing. Any wilful omissior/faise statement shall be a basis of disapproval end ‘cancellation of the project. © SUBMITTED BY (Project Loader) ENDORSED BY (Head ofthe Agency) Signature Printed Name Designation Tle Date ‘Note: i the projec is part of » program, this orm should be submitted together with the capsule research aad development program proposal and one (1) curculum vitae. See guidelines/defitions atthe back, Use Ad size paper, drial typeface 10 pos or 'argor (smaller size can be used for tebles, graphs, mathematical formula, elgram caption, margin of” per side)DOST Form 28 DETAILED RESEARCH & DEVELOPMENT PROGRAM PROPOSAL (For the Whole Program) (Tobe accomplished by the researcher) () PROGRAM PROFILE Program Tite: Program Leader!Sex: Agency: ‘Adcrass/TelophonalFex/E mai “Total Duration: Title of Component Projects Duration: 1 2. (2) PROGRAM SUMMARY (ate excaed two By pears) Sbjetve fhe Presa ‘Spnitcacatrescttoknowecgeadvencmertand ee sce: Mevesoar ‘iscision on he rests fio’ DOST-GIA ede Programe pau hance by the era Progr Lead ay) Conder SeratityResponsvenes esd on he Hamonzed Gener and DevapmentGidetnes (H6D} {) BUDGET SUMMARY FOR THE WHOLE PROGRAM include Counter Funds) Total Budget: ‘SOURCE OF FUND PS MOOE EO TOTAL Total Yi Budget ‘SOURCE OF FUND PS MOOE £0 TOTAL Total i Yr Budget: ‘SOURCE OF FUND. PS MOOE EO TOTAL Total 7 (4) NUMBER OF PERSONNEL REQUIREMENT _ Fulltime Part-Time Total (5) SUMMARY OF EQUIPMENT RELEVANT TO THE PROGRAM NamoofEquipment | Existing | To Be Purchased ‘Tastiication for the Purchase Equipment inthe | (number) Agency (number) (6) OTHER ONGOING PROGRAMS BEING HANDLED BY THE PROGRAM LEADER: __(number) Title of the Program Funding Agency Involvement in the Program | hereby certiy the truth of the foregoing. Any willful omission/false statement ‘cancellation of the Program. ‘be a basis of disapproval and oo ‘SUBMITTED BY (Progra Lander) ~ ENGORSED BY Gand af iheRaansyy Signatare Printed Name Designations Date ‘Note: the projects part of @ program thi form shouldbe subwited together withthe apie research and Healopmanr rogram proposal and one (1) curriculum vias. See qudelnes/detitions atthe back Use At sz paper, ral ypefce 10 peo larger (smaller size canbe used for tables, grphs, mathematical formula, diagram caption, margin of per side),OST Form 20 DETAILED R & D PROGRAM PROPOSAL |. General instruction: Submit six (6) copies of detailed RAD proposal for the whole Program together withthe detailed proposal of the component projects. Please attach a t-page curriculum vitae of the Program Leader. Use Avial typeface, *0 points IL Operational Definition of Terms: 1. Program. refers to a group of interrelated oF complementing S&T projects that require an interdisciplinary o ‘mlidisciptinary approach to meet established goals) within a specie time frame, Title-the identification ofthe Program and the component projects Program Leader: refers to the person who plans, organizes and supervises the overall actives ofa Program and is a Project Leader of atleast one (1) ofthe projects under a Program ‘Agency: the lead institution ofthe whole Program. Duration- number of months the Program wil be implemented. Project. refers to the basic unit in the investigation of specific S&T problems with predetermined objective) to be accomplished within a spect time frame, 2. Program Summary- brief overview ofthe Program, include discussions on the objectives, significance/impact ofthe ‘study fo the advancement of knowledge and to the society, methodology, and results of related Programsiprojects previously handled by the same Program Leader, ifany. 3. Budget Summary- personal services (PS), maintenance and other operating expenses (MOOE), and equipment ‘outlay (EO) requirement ofthe whole program by source (including Counterpart Funds) for Year + and for the wnole uration of the Program. Please refer to the DOST-GIA Guidelines for the detals (Section VII2 of DOST AO 009, 8 2017), PS. total requirement for wages, salaries, honoraria, additional hire and other personnel benefits. MOOE- tote! requirement for supplies and materials, ravel expenses, communication, and other services. E0- fotel requirement for faciltios and equipment nesded by the Program. 4. Number of Personnel Requirement- number of full me and part ime personnel to be Involved in the Program. 5. Equipment Relevant to the Program. existing equipment in the agency to be used in the Program and additional nis to be purchased, if needed, and new equipment 6. Other Ongoing Programs Being Handled by the Program Leader- lst of ongoing Programs/projects being handled by the Program Leader funded by the DOST-GIA Program and other sources, and the accompanying responsibities relevant to the Programiproject. 7. Endorsed By- Head of the Agency or authorized representative who recommends the Program:OST Form 28 DETAILED RESEARCH & DEVELOPMENT PROJECT PROPOSAL (For the Component Project) (To be accomplished by the researcher) CH) PROJECT PROFILE Program Tite: Projet Tite: Project LesderiSex ‘Agency: ‘Aress/TelephoneléaxiE malt (2) COOPERATING AGENCYIES Se (9) SITE(S) OF IMPLEMENTATION wicpaiy Daa Promina) Other Site(s) of Implementation: TA) TYPE OF RESEARCH (G)RED PRIORITY AREA & PROGRAM (based on HNRDA 7077-2022) Basic Agriculture, Aquatic and Netural Resources, Apples ‘Socter: Hoaith Sector: Industy, Energy and Emerging Technology ‘Sector: Disaster isk Redueion as Cimate Cnange Adaptation Sector Basic Research Sector (6) RATIONALE (roto cnc oe page) (7) REVIEW OF LITERATURE (roto sata tree noo) (8) OBJECTIVES {9) METHODOLOGY (Googe a bak or catis) (10) TARGET ACCOMPLISHMENTS AND EXPECTED OUTPUTS: (11) TARGET BENEFICIARIES (12) GENDER AND DEVELOPMENT (GAD) SCORE (bated n he Harnonznd Ganda and Onepment Gigetnes) (13) LIMITATIONS OF THE PROJECT (14) LITERATURE CITED (13) PERSONNEL REQUIREMENT Percent Time Devoted ain eee Responsibilities Position (16) BUDGET BY SITE OF IMPLEMENTATION Site of Implementation Ps. MOOE FO Total Year ‘SteT ‘Sten earn Stet Siten TOTAL (fT) OTHER ONGOING PROJECTS BEING HANDLED BY THE PROJECT LEADER: (number) Title of the Project Funding Agency Involvement in the Project { hereby certiy the truth of the foregoing. Any willful omission/false statement shall be a basis of disapproval and ‘cancellation of the project. 1a) SUBMITTED BY (Project Leader) | _ ENDORSED BY (Head of the Agency) | Signature Printed Name Designation/Title Dato ‘Note: if the project is part of program, this form should be submitted together with detaled R&D proposals for he whole program. See guidelines/definitions at the back. This form can be Used for Technology Transfer ProjectsOST Form 28 DETAILED R & D PROJECT PROPOSAL |. General Instruction: Submit six (6) copies of detaied RAD proposal for the component project together with the detailed proposal ofthe whole Program, together with the project workplan, lina-tem budget, @ 1- age curriculum vitae of the Project Leader, and Certificate of Incorporation (if applicable), Use ‘ial typeface, 10 points, I Operational Definition of Terms: 1! Tie the dentition of te Program and the component poets Project refers fo the base unt nthe Investigation of spacte SAT probleme wih predetermined cbecvels tobe Aaccomplthed vthin a specfe ime frame. Project Leader reer tothe poreon who por, organizes and supervises the overall actives of a project “Agonoy: th Inston ofthe Project Leader. 2. Cooperating Agenoyles- refers to be agenyles that supports he projec by parlatng in ts implementaton 25 colaboraio,coranior, commited adopter of rsuling technoogy, or potenti investor in technology Geveloprent 5: Sitls of Implementation: localons where the projet wil be eonductes.Indeste munchaly, dsc pov, andregion 4" Type of Research. incest whether the projects ba of apo Basic research. is an experimental toorlal work nderiken primarly to aquke new krowledge ofthe Lnceringfoundaions of phenomena ané aosanable fact, whut any parlour or spectc appeaton user ‘Apolod rosearch- isan original ivestigaton undertaken inorder to acaure new knowledge dieced primary towarés 2 spose sim oF objective. 5. RED Priority Area and Program: based on the Hermonized National RAD Agenda 2017-2022, indicate ln whieh RAD agenda doos the oroec canbe calogrized.Agrcuure. Aquaculture and Natural Resources; eal Indy, Energy, and Emerging Technlogy Dtastor Risk Reston and Climate Change Adaptaton; and Best Inte ace the speale Sector, whether cope. Nestoc,Yoesty, arta! resources or soco-economice; fevers er eevats ‘esourees, botechical. pharmaceutical, oF health sees; Bectectology, ivormaton technology, mare scenes, Dhoteres or space tennelogy:ndusty, energy, vives or hifactucture. 6. Rationalo-ciscuss neve the signticance ofthe project othe advancement of knowledge and impacto the society Incude a laymanizod deverpton of tho project thal canbe used ee Press Matra Noto exceed one (1) page: 7. Review of Literature- discuss here the flowing: (a) related researches that have becn conc, Wate stshe-ert or current technologies rom whch the projec wil ake of () scenic basalheoracal framework, and (c) esits of Toate research concted bythe sme Project Leader. an- Noto exceed tres (3) pages. 8. Objectives: statements ofthe general ad spacfe purpases to aess tre prblom areas ofthe project. 8, Methodology discuss rere te ‘allowing: (0) varlable or parameter to be measurod and evalua or analyze; () weatments to be used and iho layout (2) expermental procedures and eign (2) satsteal snalatyG ‘valuadon method and observation to be made, sategas fr impemontaten 40, Target Accomplishments: measurabie and postive rosuts of conpltog project ate. Expected Outputs. deliverables of the project based on the 6Ps metrics (Publications, Patents/inteliectual Property, Product, People Sevcas, Places end Partnerships, ané Pole) Publeaton.publened sepoct ofthe research ore whol of. tra sl our for peer review atontintlectial Propet proprietary iwerten or scent process for portal foe pote Produet- vention witha potential for commerilzaion oop Sonvioes- people or groups of peple, wha recale erica knowedge and alng Partorship- kage forge becauze of te su. Policy scence-based ply cred ard agoped by te goverment or acadame as ares of he ty. 11. Target Bonefciaries- Fer o upspersonsuho wil be postvly acto by tne soncuctof be scot 1 Gender and Development (GAD) Scare: eer to the result of acaamplahing GAD secu eaaht he contibuton of the project inthe achievement of the bjectvos of Ropubte Act 7102 Wiosten ik Desdloe ea sna Nalon Bulcing Act, Interprets a= genderosoonsve, gonder-senstive, has promise GAD coneopa CAD 43 Limitations ofthe Project refers o restriction or conten in the conduct othe project. 14 Literature Cit an siphabotea lst of reference mateals (books. jours an eters) reviewed, Use standerd System for otaon 15. Personnel Roqurement: details on the poston of persone! to be nvived inthe projec, percent time devote the project, and responsibilities. Pa ae 18 Budget By Site of implementation: personal secices (PS), mastenance and ether operating exoenses (MOOE}), and equipment oulay EO) requirement ofthe proj! by ste of mpimontaton foc Year| orl ty er eae woe Ofte projoct. Please refer othe DOST-GIA Guldaines or the dots (Section VII2 DOSY AO 008 = ae) 17 Curiculum Vitae rie orate of te Projet Leader. One (1) pose ony, 18. Caticteof incorporation: egal document at fome a crsesny o corporation, 48, Otner Ongoing Projects Being Handled Sy The Project Leads is of sor poets being hale by the Broject Leader funded by te OOSI-GIA Program ad lhe sours, and be acaarpuangropoinines ere proj 20. Endorsed By. Head of the Agency or authorized reoresentaive who recommends ta rejectDOST Form 3 NON-R&D PROJECT PROPOSAL (Technology Transfer, 887 Promotion and Linkages, Policy Advocacy, Provision of SAT Services, Human Resource Development and Gapacity-Seilding) |. PROJECT PROFILE (Project Tit (@) Project LeaderiSex: Adsredelophone/Faxfemait (@) Cooperating Agencyiies: (@) Sites oF Implementation Base Station: Other implementation Site (@=—__———~ (] Project Duration: sunverofmonta)] Stan Date End Date (Wurceaiy aT Proanea Rago) (6) Total Project Cost (Gcete Couninpan Fures use Form Afr Une War a ‘Souree of Fund7 Site(e) of Ps MooE co Implementation ‘A. (Fund Souree 7) {implementation Ste) (Implementation Ste) 8, (Fund Source 2) {implementation Site) (implementation Site) TOTAL Total NL PROJECT SUMMARY (7) Rationale (et exeed cna ame) (By Project Description Wott moved pages) ‘Objectives: (Grea are Space) Methodology: Expected Outputs: Discussion on the resus of sted project anced bythe same pore ay) TB) Workplan (Gee Formby) (70) Project Management iat w iced one aa) ML ATTACHMENTS (Piease refer o the DOST-GIA Guidelines for the necessary documents)DOST Form 3 NON-R&D PROJECT PROPOSAL |. General instruction: Submit six (6) copies of the non-R&D proposal together with the needed attachments. Use Avial typeface, 10 points. Please refer to the DOST Administrative Order No. 008, series of 2017 (OST-GIA Guidelines) for the attachments 11 Operational Definition of Terms: 1. Project. refers to the basic unit in the investigation of specific SBT problems with predetermined objecivels to be ‘accomplished within a specific time frame. Title the identification ofthe project. 2. Project Leader- refers fo the person who plans, organizes and supervises the averall actives of a project ‘Agency: the institution ofthe Project Leader 3. Cooperating Agencyfies- agency/ies that supporls the project by participating in its implementation as ‘colaborator, co-grantor, committed aéopter of resulting technology, or potential Investor in technology development 4. Sitels of Implementation- location/s where the project wil be conducted. Indicate municipality, distict, province, and region. 5. Duration- number of months the project wil be implomented 6, Project Cost personal services (PS), maintenance and other operating expenses (MOOE), and equipment outlay (£0) requirement of the project by source (including Counterpart Funds) and site of implementation for Year 1 and for the whole duration ofthe project. Ptease refer to the DOST-GIA Guidelines forthe detalls (Section VIl2 of DOST AO (009, = 2017), 7. Rationale. set of reasons for @ course of action, including discussion on the significance of the study. Include a leymanized description ofthe project thai can be used as Press Material. No! to exceed one (1) page. 8. Project Description- includes discussion on the objectives of the study, methodology, expected outputs based on ‘GPa metrics, and discussion on the results of related project handled by the same Projec: Leader, if any. Not lo excoee 16 pages. ‘9. Workplan. refers tothe plan of completing the project within a given time and in compliance tothe set budget. 10. Project Management. includes discussion on the cxganizationa set-up by which the project shall be implemented, an alo on the montoring scheme to be done bythe Project Leader to ensure chjectves are atisined. Noto exceed ‘one (1) page.aoa OST Form A DEPARTMENT OF SCIENCE AND TECHNOLOGY Project Line-ltem Budget cy, Program Tie Project Tle Implementing Agency Total Duration (Current Duration Cooperating Agency Program Leader Project Leader Monitoring Agency |. Personal Services Direct Cost Salaries Hnerania Indirect Cost (mplementing Agency) Salavos Honararia (Monitoring Agency) Salaries Honararia Sub-total for PS Bo Pe ee I. Maintenance and Other Operating Ex tec Cost ‘Traveling Expenses Lea Foreign ‘Communication Expenses (shal be terized based on GAM) Postage and Delvarie, Telephone Expenses, ntemet Expenses, et. Repairs and Maintenence of Facts (shal be tenized based on GAM) (Offce Buldings, Office Equipment, Fumiture and cures, IT Enurmant and Sofware, Machineres anc Equipment, et Repairs and Maintenance of Vehicles ‘Traneporiaton and Delvery Expenses ‘Supoles and Materials Expenses (shall be itemized basod on GAM) (fice Suppias Expenses, Gesaine, Ol ond Lubicante Expenses: ‘Agroultural Suppfes Expenses, oc. tity Expenses (Please indicate) Water, Elocincty and Cooking Fuel Expenses ‘raining ané Scholarship Exponsos (Please indicate) [Nembership Dues and Gontrbulons io Organizations ‘Advertsing Expenses Prining and Binding Expenses Rent Expenses Representation Expenses (6.9. food for mostings, et.) ‘Subscription Expenses: ‘Survey Expenses Professional Senices Logal Servcos, Audting Sorvios, Consultancy Serco, (Othe: Professional Sonces ete ‘Tones, Ineurance Promium and Other Foos Other Maintenance and Operating Expenses (Piese iemize) Indct Cost (implementing Agency) tities Supplies and Meterots Expenses (shell be itemized based on GAM) Office Supplies Expenses, Gasolne, Ol and Lubicents Expenses ‘Agtcultural Supplies Expenses, ec. Printing and Binding ExpensesDOST Forma, DEPARTMENT OF SCIENCE AND TECHNOLOGY Project Line-ttom Budget cy. Program Title Project Tite Implementing Agency Total Duration Current Duration ‘Cooperating Agency Program Leader Project Leader Monitoring Agency (Monitoring Agency) ‘Communication Expenses ‘Transportation and Delvery Services Travoling Expenses sites Supplies and Materials Expenses (shall be tarized based on GAM) Ofice Supplies Expenses, Gasoline, Oll and Lubricants Exoenses Agricultural Supplies Exponses, eto Representation Expenses Professional Services Legal Services, Aucting Services, Consultaney Services, Other Professional Services ote Sub-Total for MOOE. Pp Pp s Equipment Outlay Pe P Indirect Cost (Monitoring Agency) ‘Sub-Total for EO GRAND TOTAL WekhiegiN-—~~----- ==. * Chargeable againsi he CY___DOST.GIA__ > Contes Correct: ‘Approved By DOST-EXECOM: (Postion) @osition) DOST-ExECOM ApprovalDOST Form 8 PROJECT WORKPLAN (4) Planned Start Date: (6) Planned End Date: (© TARGET ACCOMPLISHMENTS. Yi (eonmpmves! ee nee (quant, possiie) atTelalalala 7 vi ¥2 (8) EXPECTED OUTPUTS (@Ps) (oo Devan coy, reaie) ae ee bae Publications Patents Products People Services Places and Parinershipe PolleyOST Form B PROJECT WORKPLAN ' General instruction: Submit six (6) copies ofthis form, together with the projet proposal. Please use Aral ypefce, 10 points 1 Operational Definition of Terms: 4-2, Program/Project Title the dentication ofthe Program and its component projects 3. Project Duration- number of month the project will be implemented ‘4-5 Planned StartfEnd Dato. refers to the proposed date when the project wil be started and completed 5. Objectives- statements ofthe general and speci purposes 1 address the problem areas ofthe projec. 7. Target Activities- set of fixed works that needs o be conducted fr the achievement ofthe project objectives, 8. Target Accomplishments. measurable and postive resus of completing prolec activites 2. Expected Outputs- deliverables ofthe project based onthe GPs metrics (Publications, Patents/nteectul Property, Products, People Services, Places and Partnerships, ans Policy), Publication- published espect of te research, or the whole of i,m scintfc journal fr peer revew. Patentintellectual Property- proprietary Invention or scentic process for potenti future prof. Product invention with potent for commercilization People Services. people or groups of poople, who recelve technical knowledge and taining Partnership- linkage forged because ofthe tua Policy- science-based poy crafled and adopted by he governmant or academe 2s a result of he study 10. Deteils- specific description ofthe expected outputs, quant, # possible.Dost Form ¢ PROJECT MONITORING & EVALUATION PLAN (PROGRAM TITLE (@) PROJECT TITLE (G) IMPLEMENTING AGENCY (@) SOURCES OF FUNDS/AMOUNT (5) COOPERATING AGENCYIIES (6) DURATION (in monthe) (7) PROJECT DESCRIPTION PROJECT ‘STRATEGY (8) Objectively Verifiabie Int Ti Indicator (10) Means of Verification (11) Key Assumptions! Risks. (12) Aetion PlaniStrategy (19) GOAL: (14) Specific Objective: (78) Component ‘Activity 4 (eV Accemplishment ck ‘Accomplishment 1.2 ‘Component Activity 2 ‘Accomplishment 24 ‘Accomplishment 22 ‘Component Activity 3 ‘Accomplishment 3.1 ‘Accomplishment 3.2 Prepares by: ‘Project Leader) Vered by: (oniorng AeneyyDOST Form ¢ PROJECT MONITORING & EVALUATION PLAN General Instruction: Submit six (6) copies ofthis form, together with the project proposal. Please use Arial typeface, 10 points. |. Operational Definition of Terms: 1-2, Program/Project Title- the identification of the Program and its component project. 3. Implementing Agency- the proponent of the project proposal. 4. Sources of Funds- refers to grant-giving agencies where funds/grants and othet technical and material support ‘come from, including the Implementing Agency that commits @ counterpart fund, in kind and/or in cash 5. Cooperating Agencylies- refer to the agencies that support the project by participating in its implementation as collaborator, co-grantor, committed adopter of resulting technology, or potential investor in technology development. 6. Duration- refers to the grant period or timeframe that covers the approvad start and completion dates of the project. 7. Project Description. a briof overview of the project. 8, Objectively Verifiable Indicators (OVIs)- ciear, specific, and defined variables that can determine the achievement f project objectives, including information on its quantity, quality, and intended beneficiary, jeline- refers to the time frame for the achievement of the objective. 10. Means of Verification- refers to the source of proof that the objectives have been attained, 11. Key Assumptions/Risks- circumstances that may occur during project implementation and these may prevent the attainment of project objectives. 12, Aetion Plan/Strategy - actions that maylcan be done to address and achieve the objectives including sks. 413, Goal refers tothe long-erm effects or impacts ofthe project. 14, Objectives- statements ofthe general and specitic purposes to address the problem areas of the projec. 18. Component Activity: set of fixed works that needs to be conducted forthe achievement of the project objectives. 16. Accomplishment- measurable and positive results of completing project activities.AGENCY: (8) COOPERATING AGENCIES: OST Form D ‘SEMI-ANNUAL PROGRESS REPORT ‘or the Period: PROGRAM LEADERIPROJECT LEADER: (8 OBJECTIVES AND TARGET (B) PERCENTAGE ACCOMPLISHMENT (PROJECT activins (ACTUAL ACCOMPLISHMENTS [FORTHE | CUMULATIVE EXPENDITURES REMARKS (eoferto Form 8) PERIOD _|_ (FROM START) FOR THE PERIOD a PERCENTAGE ACCOMPLISHNENTS (9) PROECT ee reren (11) AcrUAL oureuTs FoR ee ets EXPENDITURES REMARKS PERIOD | (FROM START) zon ueeenee, Pastis Panta Frais People Satcas Fare ' erty, on my honor, tothe correctness of the above information, Project Leader: Date ‘Altested by. Reeney Head or Authorized RepresentativeDOST Form D ‘SEMI-ANNUAL PROGRESS REPORT |. General Instruction: Use Arial typeface, 10 points, |. Operational Definition of Terms: 1-8. Program. refers to a group of interralated or complementing S&T projects that require an interdisciplinary oF multiisciplinary approach to meet established goals) within a specific time frame. Project. refers to the basic unit in the investigation of specific S&T problem/s with predetermined objectivels to be accomplished within a specific time frame. Title- the identification of the Program and the component project. Duration- number of months the project will be implemented, Program Leader- refers to the person who plans, organizes and supervises the overall activities of a Program and is Project Leader of at least one (1) of the projects under a Program. Project Leader- refers to the person who plans, organizes and supervises the overall activities of a project ‘Agency- the institution of the Project Leader. Cooperating Agencylies- refers to the agencylies that supports the project by participating in its implementation as collaborator, co-grantor, committed adopter of resulting technology. or potential investor in. technoiogy development. 6-7, Target and Actual Accomplishments- measurable and positive results of completing project activities. ‘Objectives — statements of the general and specific purposes to address the problem areas of the project. 8 & 12, Percentage Achievement- comparison of actual and target accomplishments/outputs, measured by semester and in totality. 9 & 13, Project Expenditures- expenses incurred in the implementation of the project. 10-11, Expected and Actual Outputs- deliverables of the project based on the GPs metrics (Publication, Patentiintellectual Property, Product, People Service, Partnership, and Policy) Publication published aspect of the research, or the whole of tin @ scientific journal for peer review. Patent/intellectual Property- proprietary invention or sclentfie process for potential future prof, Product invention with @ potential for commercialization, People Service- people or groups of people, who receive technical knowledge and traning Partnership- linkage forged because of the study. Policy: science-based policy crafted and adopted by the goverment or academe as a result ofthe study.DOST Form ANNUAL PROGRESS REPORT Covered Project Year Period (i) PROJECT PROFILE Program Tit Project Tite: Project LeadoriGender: Agency: ‘Address/TelephonelFaxlEm: [(@) COOPERATING AGENCIE: (3) SITE (8) OF IMPLEMENTATION twsncivlty set /Provnes Region) (@) ACTUAL START DATE [[SVEXPECTED COMPLETION DATE | (6) DURATION fwmoanay (FINANCIAL STATUS ‘Source of Fund/ ‘Amount ‘Amount “Amount Spent Site of Implementation | Approved Released Get ie 2 ates ara (Source of Fund) 1.Site 1 2 Site 2 TOTAL @ACCOMPLISHME: Target Relual Percontage: Remarks ai az 3. ca Expected Ps Outputs ‘Relual Ps Outputs Percentage Romarle Publications: PatenisiP Broducs People Sewices: [Partnerships: shi Policy (8) SUMMARY OF FINDINGS AND RESEARCH & DEVELOPMENT BREAKTHROUGH Wary (id) PROBLEMS ETISUGGESTED SOLUTIONS (H)PLANS FOR THE SUCCEEDING YEAR Aativity ‘art ae? oes aia (12) PROPOSED BUDGET FOR THE SUCCEEDING YEAR (epecity Saree) tet au? aera aia ‘Soureat Ss MOOE EO TOTAL Source ‘Source n Grand TOTAL | heraby certify the truth of the foregoing. Any wilful omission/false statement shall be a basis of disapproval and ‘cancellation of the project. (13) SUBMITTED BY (Project Leader) | ENDORSED BY (Head of Agency) | Signature: Nami Designation/Title: Date:DOST Form E ANNUAL PROGRESS REPORT |. General instruction: Submit three (3) copies (two herd copies and an elestronic copy) ofthis form for each component project, together with DOST Fos D, H, I J K, L, and M. This can also be used for the annus progress report of the whole Program. Please use Arial {ypefece, 10 points 1 Operational Definition of Terms: 4. Title: the identification ofthe Program and the component projects Program. refers to a group of interrelated or complementing S&T projects that requie an interdscipinary or ‘mulldiscipinary approach to meet established goa(s) within a specific time frame, Project. refers to the Dasic unt in the investigation of specific S&T problems with predetermined ebjectvels to be accomptshed within a speci time frame. Project Leador- refers to the person who plane, organizes and supervises the overall actvilles of @ project. ‘Agency. the institution ofthe Project Leader. 2. Cooperating Ageneylies- refers to the agencyries that supports the project by participating in its implementation {88 collaborator, co-grantor, committed adopter of resulting technology, or potential investor in tochnology development. 3. Sitels of Implementation- location's where the project was conducted. Indicate municipality, district, province, and region, 4, Actual Start Date- refers to the date when the projec actually started 5. Expected Completion Date- refers tothe date the project is expected to be completed. 6. Duration number of months the project is implemented, 7. Financial Status. information on the emount approved, amount released, and the amount spent by quarter by source of fund and site of implementation, 8. Accomplishments/Outputs- refers to the measurable and postive results of completing project actives, and Geliverables of the project based on the GPs metics (Publications, Patents/intelleotual Property, Products, People Services, Places and Partnerships, and Policy), ‘Publication published aspect ofthe research, or the whole ot, in scent journal for peer review. Patent/ntelectual Property- proprietary invention or scientific process for pote futare prof Product invention with a potential for commercalization People Service- people or Groups of people, who receive technical knowiedge and taining Partnership- linkage forged because ofthe study Policy science-based policy crafted and acopted by the goverment or academe as a result ofthe study. 8. Summary of Findings and Research and Development Breakthrough- refers tothe highlighls of research results ‘generated by the project, significant improvement over an exiting produ, practice, procedure or method in lowe of Gost, speed, eficlency, skills, and acceptabilty, advances in knowledge, solutions to @ major problom, ard breakthroughs. 10. Problems Met/Suggested Solutions- refers to the obstacles met during projec implementation, iosues raised uring field visits, explanetory notes for deviation in target ‘rom actual accomplishments, changes. in dates ot Implementation, and actions to solve the problems/issues, 41, Plane forthe Succeeding Year- these are the sot of sctvites that wil b undertaken forthe folowing year on a quarterly basis. 12. Proposed Budget- refers to the quarterly PS, MOOE, and EO requirement for the folowing year by source ofOST Form F APPRAISALIASSESSMENT FORM PROJECT TITLE: IMPLEMENTING AGENCY: DURATION: LOCATION: ASSESSMENT Technical Franial Prorioton? Technology Transfer RECOMMENDATION/S. ACTION TAKEN BY THE FUNDING AGENCY, if necessary Prepared by: Altosted by: ai aa oT SRS RRS)OST Form 6 PROJECT MONITORI (For Ongoing and Completed Projects for the Period ING AND FIELD EVALUATION REPORT 3 Year IG (4) Place of Visit: () Person InterviewediContacted Designation/Agency Signature T)Evaluater ‘DosignationvAgency Signature (@) Highlights of Accompiiahments Target ‘Rotiral Accomplishments Activitias/Objectives get Accomplishments (Current and Cumulative) {(@) Probiemaiiasues Raised by the Implementing Agency: ‘Actions Taken by the Implementing Agency: (@) Recommendations by the Monitoring Agency: roblema/Concerns Observed By the Monitoring Agency: (oy Status of Equipment Remarke/Recommendation (Hay Parsonner Remmarks/Recommendation (2) Budget By Source ‘Remarks/Recommendation (ia) Budget By Sites of implomentation Remarke/Recommendation Previous Year's Comments/Recommendations: ‘Actions Taken on RecommendationsOST Form G PROJECT MONITORING AND FIELD EVALUATION REPORT |. General instruction: To be accomplished in six (6) copies by the Moritoring Agency for each of the Component projects. Use separate sheets (f necessary) fllowing the appropriate ‘sequence of items, 1. Operational Definition of Terms: 1. Tie the identtcation ofthe Program and the component projects, Program. refers to a group of interetated or complementing S&T projects that require an interescipinary or multiscipinary approach to mest established goals) within a spectic time frame. Project: refers to the basic unit in the investigation of specific S&T problems with predetermined objectives to be accomplished within e specific timeframe. 2. Project Leader refers to the person who plans, organizes and supervises the overall activities of @ project. 3. Date of Travel- date ofthe concuct of monitoring and field evaluation. 4. Place of Visit-location ofthe monitoring en fld evaluation, 5. Persons Interviewed!Contacted-refers tothe people who provided the information needed. 6. Evaluator- refers to a member ofthe monitoring and fet evavation committee, 7. Highlights of Accomplishments- summary of breakthroughisignifcant findings achieved by the project for each objective forthe period under review. Problems/issuesiConcerns and Recommendations- obstacles met curing project Implementation, issues raised curing field visits, explanatory notes for deviation in target from ‘accomplishments (administrative or technical), change in date of implementation. etc. and actions to solve the problemstissues, 10. Status of Equipment- condition ofthe equipment purchased under the project. 11, Personnel number of part-time and ful-time staff ofthe project by gender. 412-13. Budget by Source and Site/s of Implementation: indioate the total approved budget, the ‘curent year allocation and succeeding yeer budget by source and site of implementation,aie ei ee (eee Aine a == ee =a : | —<——n : : m rear a ee ee sar ee tee Pe Pe ee Soa —|— eee eae a Ay eae = ——————— = a a =a == i a oe sm nates frvahemot noel hn nt mitt nnaOST Form 1 TERMINAL AUDITED FINANCIAL REPORT (Tobe submited by accountant and researcher ogsthor with DOST Forms J K.and Mi) ‘LeaderiGender [ey Duration farsa a ToS TCT i Te [e) —Torr — 10) Total it) —Forar roar raxpended ‘Approved Budget Releases Expenditures |" Unroiased Budget ‘Balance pry mpemarng snr Pies Ceasar anne Road Authorised Represents "ete: atid Pn Rap A) mbt oi yr he peck Fr Govern Aged, atl pr yd COA wl be sid ang ADOST Form J LIST OF PERSONNEL INVOLVED Tie (2) Projet LeaderiGender (Sy mpiementing Agency: Program: Project. anation Remuneration (Percent Time —_— a = T=" (6) PorsonneiGender or Inoftice | For This Particular ) Other inert : o wromice | Pail ioe payee (a) This Project | ©) Cther of Specialization) ‘CERTIFIED CORRECT: Note: ‘jee der [ey and 3 aad ReaOST Form J LIST OF PERSONNEL INVOLVED ‘Annuel Progress, Report (OOST Form E). Upon campleton of the Programiaroject thi eine ‘accompany the Terminal Report and Terminal Audited Financial Report, Pleses’ use. Sat 'ypeface, 10 points 11. Operational Definition of Terms: eee {ler to a group of intrested or complementing SRT projects tat require an interdacplnary or ‘muitlclscptinary approach to mest established goal(s) within a speotfie me frame, Project. refors to the basic unit in the investigation of speciic S&T problem/s with predetermined abjectvels to be ‘accomplished within a specific time fame. Title-the identticaton ofthe Program and the component project. 2, Project Leader. refers tothe person who plans, organizes and supervises the overall actives ofa projec. 3. Agency- the Insittion of the Project Leader. ‘4. Personnel. composed ofthe Project Leader and project staf, who ara directly involved inthe implementation of the ‘Project, and insicating the gender whether a Male "Mor a Female “F* 5. Designation the official poston of each staf nthe agencyfoice and inthe pater project 6. Remuneration: the salary/compensation ofeach staff inthe ofce and inthe particle project. 7. Percent Timo- proportion ofthe werking me devoted to the particular projec 8. Highest Education Attainment he highest degree earned incuding tl of specialization of each stafOST Form K UST OF EQUIPMENT PURCHASED (Tobe accomplished by ropertyisunply officer, accountant and researcher together wth DOST For E) [ra Tie [Pa mplementing Agency Program: Project [@) Project Leader/Gender [9 Report for , Period Covered ()Location | (6) Person | (7) Equipment Per LIB | (8) Amount of Equipment] Accountable | Per LIB (19) Sorat | (12) Date |(13) inventory] Number | Acquired Control No, |(14) Consition (19) Total Amount Prepared by Cored by: Vere by: Noted by: Inventories by: ‘Aosouniant Project Leader ‘Agency Head DOST inventory Team LeaderDOST Form L ‘SCHEDULE OF ACCOUNTS PAYABLE As of (To be submitted by accountant and researcher together with DOST Form H) Pe Program: Project: @) Project Leader (0) Payee (8) Particulars. (8) Amount (7) Romarks -_ |S) iplementing Agency IE —_—_ CERTIFIED CORRECT: Aeproven: ‘Chief Aeountant CoardinateriLeaderOST Form mt REPORT OF INCOME/INTEREST GENERATED/EARNED upto (date) For the year starting (To be submitted by accountant and researcher together (s) Incomesinterest for this period 1. From Operation 2. Others (Specify) Particulars Total expenses ) Ending Bolance as of (date) ‘Total Incomelinterest fr the period “otal Available Incomeintarest (Geainning balance plus total incomelinterest for the period) a with DOST Form H) {© Expenses (rom the generated incomenterest ofthe project as approved by DOST) ‘Amount e (otal avaiable incomelntorest less total expenses) P. PREPARED BY: “Rasountant CERTIFIED CORRECT: NOTED: Project Leader “Aaency HeadDOST Form N TERMINAL REPORT (Attach DOST Forms J, L, and M) (i) Program Tier Project Title: Agency: ‘Address/TelephonelFaxiEmail: @) Cooperating Agencies {@) Sites of implementation naapaiy [Sea PevrcaReginy ‘Base Station: Sitels of Implementation: (a) Actual Duration (G8) Compietion Date (@ Accomplishments ‘A. Actual accomplishment of the project (vie-a-vis the objectives) ‘OBJECTIVES TARGET ACCOMPLISHMENTS [ACTUAL ACCOMPLISHMENTS B. Expected Outputs /6Ps EXPECTED OUTPUTS ‘ACTUAL OUTPUTS L Publications Patonis/P Products People Services Partnerships | Policy (7) ProbiemsiConcerns 18) Suggested solutions to the above concems (@) Publications, report on procesdinglactivives and other publishable reponsDOST Form N TERMINAL REPORT |. General instruction: Submit s0< (6) copies ofthis form together withthe Semi-Annual Financial Report. To be prepared {or each project and forthe whole Program. Please use Arial typeface, 10 points. 1 Operational Definition of Term 1, Program. rofers to @ group of interrelated or complementing S&T projects that require an interdisciplinary or ‘multcisciplinary approach to meet established goal(s) within a specific time frame. Project- refers to the basic unt in the investigation of specific S&T prablem/s with predetermined objactvals to be ‘accomplished within a specific time frame. Title- the identification of the Program and the component project. Project Leader- refers to the person who plans, orgerizes and supervises the overall activities of projec. ‘Agency: the ination ofthe Project Leader. 2. Cooperating Agencylies- refers to the agencyfies that supporis the project by partiipating in ts implementation 28 collaboretor, co-grantor. committed adopter of resulting technology, or potential investor n technology development. 3. Sitels of Implementation- location's where the project will be conducted. Indleate municipality, distit, province, ‘and region, 4, Aetual Duration- number of months the project was implemented. 5. Completion Date- refers to the date when the project was complete. 6. Target Accomplishments- measurable and postive resulls of completing project activtes. Expected Outputs- deliverables ofthe project based on the 6s metrics (Publication, Patenvintallectual Property, Product, People Service, Partnership, and Policy) ‘Publication. published aspect ofthe research, or the whole of, ina sclntife journal for peer review. Patenvintelectual Property. proprietary invention or scientific process for poten future prof, Product invention wth a potential for commercilization. People Service- people or groups of peoale, who receWve technical knowledge and traning Partnorship-Iinkage forged because of the sitdy. PPolcy- science based poly crefted and adopted by the government or academe as a result ofthe study, 7-8. ProblemsiConcems and Suggested Solutions- obstacles met during project implementation, issues raised uring field visits, explanatory notes for deviation in target from accomplishments (administrative or technical), change. in date of implementation, elc. and actions to solve the problemsiissues, 9. Publications- publshable reports, proceedings of activites, et,