CDD E-30: Form CBIM Form B-15

Republic of the Philippines

Department of Social Welfare and Development
KALAHI-CIDSS NCDDP Additional Financing
OFFICE OF THE BARANGAY DEVELOPMENT COUNCIL TECHNICAL WORKING GROUP

CERTIFICATE OF COMPLETION AND ACCEPTANCE

To Whom It May Concern:

THIS IS TO CERTIFY that the following Sub-Project has been 100% satisfactorily completed in
accordance with the approved plans and specifications:

RETROFITTING OF EVACUATION CENTER TO BE USED AS

Name of Sub-Project:
Date of Completion
Address:
GPS Coordinates:
Project Category:
Physical Measurement:
Mode of Implementation:
Actual Total Project Cost:
TEMPORARY QUARANTINE FACILITY WITH PROVISION
OF AMENITIES, MEDICAL TOOLS, SUPPLIES AND
EQUIPMENT
July 1, 2022
Sitio Sugod, Sicmil, Gigmoto, Catanduanes
Latitude: 13.8315200805664
Longitude: 124.401496887207
Public Goods
27.21 sq. m.
Community Force Account, Community Shopping for Goods
Php 291,503.00

We hereby CERTIFY to have accepted each and every item accomplishment by the Barangay
Development Council – Technical Working Group Committee, which have been inspected and were found to be
in accordance with the plans and specification of the contract.

This certification is issued for whatever legal purpose it may serve best.

Done this ________ day of ____________________, 2022 at Barangay Sicmil, Gigmoto, Catanduanes.

Certified by the INSPECTORATE TEAM:

EDGAR VISTAL KRIZZA T. ARCILLA RENATO T. TIMBAL JR.

C/MIT Chairperson Financial Analyst Technical Facilitator

ARNIEL T. SUALIBIO HAZEL L. LOMEDA ENGR. CHONA T. TURADO

BDC-TWG Chairperson Area Coordinator Municipal Engineer

CHERYL T. BENAVIDES, MD
Municipal Health Officer
Accepted by:

EREBERTO T. OLESCO
Barangay/PIMC Chairperson