ANTI-DRUG ABUSE COUNCIL (ADAC) PERFORMANCE AUDIT: DOCUMENT CHECKLIST FOR CITY AND MUNICIPAL ADACs Det City / Municipality Region Province Date Accomplished Instructions: (1) Data to be used forCY_auditis CY__data. (2) Kindly puta check (v) under column 2 if he required document fs available for submission while put a cross () ifthe document is unavailable. (8) In case of correcton/s, affix signature beside the corrected items, (8) CIMADAC Chairperson must affix a signature atthe bottom of every page ofthis document. (6) Certified True Copies of the required documents must be attached ta the checklist before submission to CIMLGOO andior City Director. (6) Document checkist and all its tachment must be submited to C/MLGOO andlor Cy Director on or before May 24, 2021. ats ols] Etoll]I st odefolo N=) Ge CONDITIONAL (1) i DOCUMENT/REMARKS 3) Indicator 1 — Organized Local ADAG — Organized Local ADAC 1 Certification from concemed NGA stating that mandatory ADAC Member is Vacan¥Net Applicable in City/Municipality Tne EE Executive Order or Local Ordinance containing 1 | the creation or reorganization of the Anti-Drug ‘Abuse Council ‘Approved POPS Pian 1 z ‘Annual Budget 3 ‘Annual Invesiment Plan Cerliication from the Budget Officer re: Allocation of funds for the implementation of Anti-\llegal Drug Activities or for the activities in the POPS Plan {declare under oath that al the information contained herein are true, correct and complete pursuant tothe provisions of pertinent laws ules and regulations of the Republic ofthe Plippines. authorize the agency hea or his duly uthoriad represemative to veri and validate the contents stated herein, [agree that any misrepreseatation made i his document and all atachments shal be grounds for the Ang ofapprepriate administrative and/or eriminalcase/s against me. C/MADAC Chairperson Signature over printed nameANTI-ORUG ABUSE COUNCIL (ADAC) PERFORMANCE AUDIT: DOCUMENT CHECKLIST FOR CITY AND MUNICIPAL ADACs pet Indicator 3 - Implementation of Plans and Programs 1 | Certification from Accountant re: Fund ullization on Anti-lilegal Drug campaign >| ADAC Annual Accomplishment Report signed by Mayor Ceriiication from POEA/Regional Oversight Committee (ROC) stating the following: Number of Drug within the CityiMunicipality as of end of | | ~ Number of Drug-Cleared Barangays within City’Municipality as of end of Or if applicable, Cerification from PDEA that CityrMunicipatity has achievedimaintained Drug- free status i Adlivily Design of all implemented Anii-llegal | Drug Activities forall quarters 5 | Post Activity Reports for all implemented Ani- ilegal Drug Activites for all Quarters Ieee eke a eee 1 | CSAR plan or CBDRP plan Executive Order OR Gerlifcalion from the 2 | accountant regarding the financial support given to the component BADACS Executive Order OR Terminal Report regarding Ch Caenleyiot necaarmen 3 | the technical support given to the component pores = BADACS relation to supportiprovided for Anlicllegal Orug Activities {declare under ath that all the information contained herein are tre, correct and complete pursuant to the prevsions of pertinent taws rules, and repations ofthe Repel Pilipines authorize the agency head or his ly thorized representative to verify and validate the contents stated herein, Lagre that ay misrepresentation made fn this document and lls atachents shall be pronnds fr the ‘ling ofapprepriate administrative and/or ermal ease/s against me C/MADAC Chairperson Signature over printed name 45ANTI-DRUG ABUSE COUNCIL (ADACs) PERFORMANCE AUDIT: (; DOCUMENT CHECKLIST FOR CITY AND MUNICIPAL ADACs Dc4 ees Tarr "| | Notice for Quarterly meetings 2 | Minutes of Quarterly meetings conducted it eee 1 | For LGU — Initiated Activties/Facility/Program | Interviews | - Articles | = _Report on initiative : 2 |For ADAC Member Agency — Initiated Activity/Facilty/Program ‘ADAC Member Agency report on initiative + ADAC Resolution endorsing ADAG member agency initiative 3 | For CSO ~ Initiated Activity/Facility/Program + CSO Report on initiative + ADAC Resolution endorsing CSO initiative No. of documents present: _ No. of documents unavailable: | declare underoath tha al the information contained heel are true, corret and complete pursuant to the provisions of pertinent laws, rules and regulations of the Republic ofthe Philippines. | authorize the agency heul or his duly authorized representative to verify and validate the contents stated herein. agree that ny mistepresentation made i this document and ll is atachments shall be ground forthe Alin of appropriate administrative and/or eriialcase/s against me. C/MADAC Chairperson Signature over printed nameRepublic ofthe Phippines DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT DILG-NAPOLCOM Canter, EDSA comer Quezon Avene, Quezon City ci. aovph ATTESTATION | declare under oath that all the information contained herein are true, correct and complete pursuant to the provisions of pertinent laws, rules, and regulations of the Republic of the Philippines. | authorize the Secretary of the Department of the Interior and Local Government or his duly authorized representative to verify and validate the contents stated herein | agree that any misrepresentation made in this document and all its attachments shall be grounds for the filing of appropriate administrative and/or criminal case/s against me. Accomplished and signed this__ day of. 2021. Signed by: Local Chief Executive 51