Document Code: DCAVRKMI-F-ICF

MANUEL S. ENVERGA UNIVERSITY FOUNDATION

Lucena City
An Autonomous University
DR. CESAR A. VILLARIBA RESEARCH AND
KNOWLEDGE MANAGEMENT INSTITUTE
QUALITY FORM
Document Title: Informed Consent Form
Page No.: Page 1 of 5
Revision No.: 0
Effectivity Date: August 2017
Prepared by: DCAVRKMI
Reviewed by: QMR
Approved by: President

INFORMED CONSENT FORM

TITLE
Proposed Design of a Four-Storey Municipal Building Located in Brgy.Bagumbayan Pililla Rizal

STUDY PROPONENT/PRINCIPAL INVESTIGATOR

Rhowelle M. Tibay, 09296926288

CONFLICT OF INTEREST
Declaration
There are no conflicts of interest to declare in relation to this study.

INTRODUCTION
The Municipality of Pililla is a 1st class municipality in the province of Rizal and it is planning to
construct a new Municipal Building to provide better inclusive facilities, security, and
accessibility to the public, staffs and employees. In every construction project, financial and
other risks are involved. This study aims to perform the feasibility and design of a new Municipal
Building of Pililla that considered several different aspects in order to determine whether the
project should be viable or not.
This feasibility study was conducted through Site Location Setting, Structural Analysis, Design
Calculation, Design of Structural Elements and Cost Estimate. Data were collected for hazard
maps that involves the site location to identify the potential hazards and assess the risks of the
location. In analyzing the structure, the design criteria for dead load, live load, earthquake load
and wind load were conformed to the guidelines from the NSCP 2015 Edition and analyzed
through manual calculation and Excel Program. Cost Estimate were calculated and the design
of structural members were based on the obtained results from structural analysis and its
design calculation.
The findings indicated that the proposed location of the new building of Pililla at Brgy.
Bagumbayan is easily accessible by transportations to serve the public. Based on the hazard
maps obtained from several government sites, it can be concluded that the location is at
minimal risk in terms of earthquakes, landslides and flooding. To conclude, the proposed project
at Pililla, Rizal is feasible in terms of purpose, site location and structural analysis.
STUDY BACKGROUND AND RATIONALE
Municipal buildings are enormous yet significant, which power, authority and influence involved
from nominal progress to better development of the country either regional, provincial, municipal
or barangay governance. A municipal hall could be an investment of great workplace,
competitive and reasonable for constant productivity and development in meeting task and
responsibilities which gives a profess of gains for everyone.
The Municipality of Pililla is a 1st class municipality in the province of Rizal and built last April
1992, based on the Local Government Code of the Republic of the Philippines. It is bounded by
 Document Code: DCAVRKMI-F-ICF
MANUEL S. ENVERGA UNIVERSITY FOUNDATION
Lucena City Document Title: Informed Consent Form
An Autonomous University Page No.: Page 2 of 5
Revision No.: 0
DR. CESAR A. VILLARIBA RESEARCH AND Effectivity Date: August 2017
KNOWLEDGE MANAGEMENT INSTITUTE Prepared by: DCAVRKMI
QUALITY FORM Reviewed by: QMR
Approved by: President

small mountains, farms, trees, and plains. Pililla is known as the Green Field Municipality of
Rizal.
BENEFITS
The proposed target is to design a new municipal building of Pililla that will serve the public and
will accommodate the staffs and employees and to give inclusive facilities, security, and
accessibility. Wherein, this study main objective is to provide structural and civil analysis of the
new proposed Pililla Municipality Building.
ALTERNATIVES TO THIS STUDY
In case the proposed project is not accepted, an alternative project titled “A proposed four
Storey construction building for Municipal building of Pililla”

ONE’S PARTICIPATION
STAGE 1 – ANALYSIS
This stage of study identifies the title topic and objective/desired outcome of the project.
STAGE 2 – Design
This stage of study creates the activities or methods to be use in the completion of Structural
design. In design phase it the initial method of gathering information prior to have an output
process.
STAGE 3- Development
This stage of study consists of developing the procedure and methods to obtain all the
information gather, test results and objective.
STAGE 4- Implement
This stage of study will show the output and hypothesis method of the calculation. In
implementation all the necessary output will ensure the possible completion of the study.
STAGE 4- Evaluation
This stage of study is the last process that show results to validate all the procedure and
method being create. The final remark and conclusion shall be the result of this study.

RISKS
In the analysis of a structure, the required criteria of the design are significant to identify the
loads of what should be applied to the design. The National Structure Code of the Philippines
(NSCP) 2015 Edition is referred to meet the necessary requirements from the dead loads, live
loads, wind loads, and earthquake loads. Tables from NSCP, it will determine from the dead
load, the weight of the materials that will be used for the project, whilst for the live load, is the
type of occupancy that the slap will be using, as for this project is the occupancy category
office. It also shows the requirements to analyze the earthquake load pressure that the structure
may experience. All the tables are attached on the appendences for reference.
 Document Code: DCAVRKMI-F-ICF
MANUEL S. ENVERGA UNIVERSITY FOUNDATION
Lucena City Document Title: Informed Consent Form
An Autonomous University Page No.: Page 3 of 5
Revision No.: 0
DR. CESAR A. VILLARIBA RESEARCH AND Effectivity Date: August 2017
KNOWLEDGE MANAGEMENT INSTITUTE Prepared by: DCAVRKMI
QUALITY FORM Reviewed by: QMR
Approved by: President

PRIVACY AND CONFIDENTIALITY

Privacy and confidentiality are basic rights in our society. Safeguarding those rights, with
respect to an individual’s professional work output, is our ethical and legal obligation as
researcher. Doing so in today’s in engineering research is increasingly challenging that’s for the
safety of the project document all paper shall be in specimen signed by the researcher.

GROUP CONFIDENTIALITY
This is not applicable since the research paper was done by one person only.

OPEN DATA
No data involved on the report all are based on the guidelines and code of NSCP 2015

CONTACT INFO

If you have further questions or concerns about your participation in this study, or if you suffer
any injury related to the study, please contact:

_Rhowelle M. Tibay______ ___09296926388_____

Name Telephone

If you have questions about your rights as a participant or about ethical issues related to this
study, you can talk to someone who is not involved in the study at all. That person is:

_Rhowelle M. Tibay______ ___09296926388_____

Name Telephone

SIGNATURES

● I understand that my taking part is voluntary; I can withdraw from the study at any time
and I do not have to give any reasons for why I no longer want to take part.
● All of my questions and concerns have been answered
● I understand the information indicated this informed consent form
● I understand that my participation in this study includes being <<interviewed, recorded
(audio or video), <other activities expected>>>.
● [Optional (usually clinical trial)] I allow access to my records and specimens, as
explained in this consent form
 Document Code: DCAVRKMI-F-ICF
MANUEL S. ENVERGA UNIVERSITY FOUNDATION
Lucena City Document Title: Informed Consent Form
An Autonomous University Page No.: Page 4 of 5
Revision No.: 0
DR. CESAR A. VILLARIBA RESEARCH AND Effectivity Date: August 2017
KNOWLEDGE MANAGEMENT INSTITUTE Prepared by: DCAVRKMI
QUALITY FORM Reviewed by: QMR
Approved by: President

● By signing this form, none of my legal rights have been given up

● [Optional: Clinical Trial: I understand that my doctor or healthcare provider may be
informed of my participation in this study.]

RHOWELLE M. TIBAY NOVEMBER11, 2021

___________________________________ _________________
Signature Over Printed Name of Participant/ Date
Substitute Decision-Maker

RHOWELLE M. TIBAY NOVEMBER11, 2021

___________________________________ _________________
Signature Over Printed Name of Date
Person Conducting the Consent Discussion
 Document Code: DCAVRKMI-F-ICF
MANUEL S. ENVERGA UNIVERSITY FOUNDATION
Lucena City Document Title: Informed Consent Form
An Autonomous University Page No.: Page 5 of 5
Revision No.: 0
DR. CESAR A. VILLARIBA RESEARCH AND Effectivity Date: August 2017
KNOWLEDGE MANAGEMENT INSTITUTE Prepared by: DCAVRKMI
QUALITY FORM Reviewed by: QMR
Approved by: President

ONLY IF the participant is unable to read or requiring oral translation, accomplish this sub-
section:

● This form was accurately explained to, and apparently understood by, the
participant/substitute decision-maker, and
● Informed consent was freely given by the participant/substitute decision-maker.

___________________________________ _________________
Signature Over Printed Name Date
of Impartial Witness/Translator