® Commssion ON AUDIT GUEST REGISTRATION FORM (COA INTERNATIONAL TRAINING CENTER AND DORMITORY (GRF NO. : +2023-0 ANNEX A (GUEST INFORMATION SHEET (RAVEL/OFECE ORDER NO, [REFERRED BY: (For Non-COAns) [name oF coA EMPLOYEE: larnce x oFmice ADORE, [RDATONSMP Wn GUEST {hejeby agree ta conform wth the COA TCD Genes Pol ‘ul my stayin the demitory. , Mouse Rules & Regulators Yhrough> foe case or eneRGEnEY: [peesow To mone eonract na [Rowe nooREss SCHEDULE AND ASSESSMENT fosccxan DATE feoom w= KR nO. [enecacan tna: Room rvre- re HEC OUTOATE: jroo RATE 1. [pao [orecrour Tw Na, OF BARS NO: [aenanns: JsewIOR OMEN BISCOUNT: JaxsouNt To ae Pa: [pate wSUED: yet PA ‘SanATORE ave PUNTED NA PARE DESKAN CHANGE fReTomnaeo Wak FoUoWING: wes orwens: \RANCE INFORMATION feuano’on our SIGNATURE OVER lemacreD nance are FRONT DESKI-CHARGE frie AgvIEWED Br TBoRMToRaN CHARGEANNEX AA REPUBLIC OF THE PHILIPPINES COMMISSION ON AUDIT ‘Commonwealth Avene, Quezon City WAIVER AND RELEASE OF LIABILITY Thereby acknowledge and understand that COA International Training Center and Dormitory (COA ITCD) has Rules and Regulations applicable to all its guests/visitors and personnel and agree to act in accordance with the COA ITCD Rules and Regulations. With full awareness and appreciation of the risks, 1, for myself and on behalf of my family, spouse, estate, heirs, executors, administrators, assigns, and personal representatives, I will not hold the COA ITCD, its officials and employees liable nor responsible for any loss or damage to property, or for any injury suffered, including death, arising out of the use of the COA ITCD’s premises and facilities including but not limited to, claims for property damage, personal injury or wrongful death, or losses or damages occasioned by reason of any event or cause which could not be foreseen, or which, though foreseen, were inevitable such as but not limited to fire, earthquake, lightning, typhoons, flood, voleanic eruption, robbery, theft or other crimes. I further agree to indemnify, defend, and hold harmless COA ITCD from and against any and all costs, expenses, damages, claims, lawsuits, judgments, losses, and/or liabilities (including attorney's fees) arising from, either directly or indirectly from or related to any and all claims due to bodily injury, death, loss of use, monetary loss, or any other injury relating to the use of COA ITCD’s premises and facilities.; By signing below, I acknowledge and represent that I have read the foregoing Waiver of Liability, understand it and sign it voluntarily as my own free act and deed; | agree that this Wavier of Liability shall be governed by and construed in accordance with Philippine law, and that if any of the provisions hereof are found to be unenforceable, the remainder shall be enforced as fully as possible and the unenforceable provision(s) shall be deemed modified to the limited extent required to permit enforcement of the Wavier of Liability as a whole Undersigned: Signature Print Name DateANNEX B siesta A) Se, cutie ot ‘ac rome ove ive Ol Racer nthe aroun of; ANNEX BB REPUBLIC OF THE PHILIPPINES COMMISSION ON AUDIT ‘Commonwealth Avene, Quezon City WAIVER AND RELEASE OF LIABILITY Thereby acknowledge and understand that COA International Training Center and Dormitory (COA ITCD) has Rules and Regulations applicable to all its guests/visitors and personnel and 1 agree to act in accordance with the COA ITCD Rules and Regulations, With full awareness and appreciation of the risks, I, for myself and on behalf of my family, spouse, estate, heirs, executors, administrators, assigns, and personal representatives, | will not hold the COA ITCD, its officials and employees liable nor responsible for any loss or damage to property, or for any injury suffered, including death, arising out of the use of the COA ITCD’s premises and facilities including but not limited to, claims for property damage, personal injury of wrongful death, or losses or damages occasioned by reason of any event or cause which could not be foreseen, or which, though foreseen, were inevitable such as but not limited to fire, earthquake, lightning, typhoons, flood, volcanic eruption, robbery, theft or other crimes. | further agree to indemnify, defend, and hold harmless COA ITCD from and against any and all costs, expenses, damages, claims, lawsuits, judgments, losses, and/or liabilities (including attorney's fees) arising from, either directly or indirectly from or related to any and all claims due to bodily injury, death, loss of use, monetary loss, or any other injury relating to the use of COA ITCD’s premises and facilities.; By signing below, I acknowledge and represent that I have read the foregoing Waiver of Liability, understand it and sign it voluntarily as my own free act and deed; | agree that this Wavier of Liability shall be governed by and construed in accordance with Philippine law, and that if any of the provisions hereof are found to be unenforceable, the remainder shall be enforced as fully as possible and the unenforceable provision(s) shall be deemed modified to the limited extent required to permit enforcement of the Wavier of Liability as a whole Undersigned: Signature Print Name Datelocpanraiex. cash Management Service Lacs "HOUSE OF REPRESENTATIVES ELECTORAL TRIBUNAL Jortranns unit Jruocooe oxroxson Jase akancn/ntos sus ACCOUNT NO. 2165-000-54 ANNEX C | TC LST OF DUE AND DEWANDABLE ACCOUNTS PAVABLE|IDDAP) reaustion, a certed ty the Chit Accounting Service. DT "NOTE PESOS renasenwewe | woar | obtenin | cass [cross] witmownc] wav | senans se smwswmeeorscria| no | reawerna | wruncsr | _avourr | tax | amount creme vars ror oucconnion nanan | tandarks125.0085-22 | soos | axe.as-cie | soxcoonco| 7380000 7380000] omy bmcconaonaarnan | Landbank/3125.008592 | soon | aoxi2s0ri0| saxon | 4250000, ‘950000 Fancen.cancin | tandarkr475 000796 | ss000o8ox | amcsoxs | saxmooos0 | 73,80000 73an000 wncenrs.cancia | tandary475 00076 | ss0000092 | aaron | ssaxno00n | 9.50000 «930000 frsumnecaown.acor | Landbank3125-011-9 | soomecess3 | 2re1c-01n | soxeonowo | 7.80000 73,3000 Jcsunaccconta.acor | tandbns/25-010149 | esomcowst | rozosou | saxeamo | 4250000 Jaw mcm omen | Landink/25-00088 | sooooness | zonanous | seems] 7380000 700.00 lower icarn comn | Landnt/25-00048 | soowoness| zmasons | sexe | 4250000 #350000 lncayn vucarca | Landonk/ 25-09-23 | Ssoqones7 | aoarax-cu | sameoonoo| 73.0000 7350000 nena visanica | Landooly2625 085043 | ssooo00sse| 2r.402-103611 | ssooo0ea9 | axzrcscun | saxmeonen | 1.606996. 10699639 eure sytem tanamaotiss210i¢21 | ss0000090 | amr AGREEMENT ‘The hereby agrees to avail the following amenities/services from COA International Training Center and Dormitory (COA ITCD) at Areza Compound Mahogany, Tagaytay City form . ROOM REQUIREMENTS: “Arrival | Departure | # of Date Date Nights Hof Rooms Room Type Rate Per Room Total 1.1 Room inclusions: © Hair Dryer © TV, WiFi Access © Refrigerator © Electrical outlet 220V. © Kettle © Water Heater © Coffee Set & Glass Page 1of 52. BILLING ARRANGEMENTS 2.1. Total amount of the function is < Amount >. 2.2. A 50% down payment amounting to < Amount > is required on or before < Date >. 2.3. Remaining balance of the same amount shall be settled immediately upon check-out. 2.4, Any charge not included in the contract shall be settled immediately upon check-out on personal account. 2.5, Payment shall be deposited to any Land Bank of the Philippines Branches with account name: < Account Name > and account number: < Number >. 3. FUNCTION ROO! 3.1, Funetion Room Rental 3.1.1, Function room blocking for < Amount > 3.1.2. Pads, pencils and candies shall be provided for the participants during the conference proper 3.1.3. Two wide screens and three microphones shall be provided during the sessions 3.2. A charge equivalent to < Amount > per hour shall apply to the use of the _funetion rooms under this reservation agreement in excess of the hours allotted. 3.3. An energy fee is waived for the use of any electrical devices like laptops, projector, etc. during the conference proper. 4. ADDITIONAL ROOMS Subject to room availability, room in excess of those included in this booking agreement may be availed of, subject to the following charge(s)/room rates: Regular Rates ‘Type of Room Occupancy For Non For COAns COAns Other Guest | Deluxe — 2pax per | P880.00/head | P1,100.00/head | P2,000.00/head 2 single beds room th TV, reftigerator, kettle, water heater and hair dryer i | ‘Common Rooms — S pax per | 880.00/iead | 1,100.00/head | 2,000.00/head 5 single beds room -with TV , Refrigerator, kettle, water heater and hair dryer Additional Pillows 100.00/pillow | 100.00/pillow | 100/pillow [Extra bed 700.00 880.00 1,600.00 Page 2 0f 5FUNCTION ROOMS See item 3.2 HECK-IN TIME Check-in time shall start at 2:00PM of the scheduled date of arrival. Requests for early check-in may be entertained, subject to room availability. 7. CHEC UT-TIME All guests for this event must check-out at 12:00 PM of the scheduled date of departure. Subject to room availability, requests for late check-out may be accommodated at no extra charge, subject to the following conditions: 1, Late check-outs cannot extend beyond 2:00 PM of the date of departure; and 2. Only five percent (5%) of the total rooms rented for the event may avail of this accommodation. Check-out beyond 2:00 PM shall be considered as an extended stay and therefore subject to additional charges (50% of the room rate for extension until 12:00 midnight and 100% of the room rate beyond 12:00 midnight) 8. NON-COMPLIANCE If the required deposit is not received on the date indicated, reservation for the group might be subject to cancellation without prior notice. Reinstatement of the group reservation shall only be made upon receipt of payment and to the extent that rooms are available at that time. We would appreciate receiving from you a copy of the specimen signature of your authorized snatories for this group, All incidental charges should be paid immediately upon check-out by cash, Manager's Check or a validated copy of ADA-LDDAP as proof of payment. 9. CANCELLATION After any decrease in the guaranteed number of rooms shall be subject to a cancellation charge equivalent to entire duration of stay. For the function space, after decreased on the minimum guarantee will be subject to cancellation charge of per person. 10, O SHOW/CANCELLATION ON THE DAY OF ARRIVAL Page 3 of 5Ifany guests do not arrive on the scheduled date of arrival or in case of cancellation on the day of arrival, a no show or cancellation charge shall be applied equivalent to the entire duration of the stay. The guest’s reservation will also be automatically cancelled unless a request to reinstate the room for the following day is made 11, FIRE, SECURITY AND SAFETY and any outside contractor hired by the company shall adhere to the COA ITCD rules ations. The following shall therefore be strictly prohibited within the facilities: (j) obstruction to any of the fire escape or emergency exits; (ji) use of any hazardous materials such as flammable gases, pyrotechnics, fire chemicals, explosive devices, pointed objects and ‘weapons, and other props and paraphernalia of similar nature that case pose danger or risks to the property and/or persons; and (iii) bringing in of live animals. and re The COA ITCD shall not be held liable for any damage and loss of property nor for injury, harm and even loss of life of any individual within the COA ITCD premises prior, during and after any activity related to this reservation agreement arising out of negligence of the lessee and its participants in this event. 13, DAMAGES - shall be held responsible for any damage made on any of the properties of the COA ITCD and the convention in the conduct of its event and any charge corresponding to the said damage shall be billed directly to the company/event organizer. 14. FORCE MAJEURE ‘The COA ITCD will not be held liable for its failure to execute obligations specified herein directly or indirectly due to force majeure and/or occasioned by, through or in consequence of war, change of statutes of the Philippine Government, trikes, riots and other civil disturbances, typhoon, floods, natural calamities and other acts of god, fire or such other conditior events beyond the control of the COA ITCD. and In the event of non-performance due to the above reasons, the COA ITCD shall refund in full the deposits received for this function, 15. MISCELLANEOUS PROVISIONS 15.1, This Agreement shall be binding on the parties hereto, their assigns and successors- in-interest. Page 4 of 515.2. 15.3, ‘The Agreement constitutes the entire agreement of the parties hereto with respect to the subject matter hereof and shall supersede any prior expressions of interest or understanding with respect to the transaction. ‘This Agreement may be amended only by instrument in writing signed by all parties in this Agreement. If any term or provision of this Agreement shall be or shall become invalid or unenforceable for any reason, such term or provision shall be ineffective to the extent of such invalidity or unenforceability without invalidating the remaining terms and provision hereof. We would appreciate receiving a copy of the signed contract on or before in order to facilitate arrangements of your event. Failure to do so may result to the automatic release of the room block and function venue. IN WITNESS WHEREOF, the parties hereby affix their signature on this <_>"* day of . FOR: FOR: COA INTERNATIONAL TRAINING CENTER AND DORMITORY NATALIA M. ABUYEN < Authorized Representatives > Head, COA ITCD < Designation > Noted by: AMELIA P. VALDEZ Director IV General Services Office Page 5 of 5TRAINING CENTER AND DORMITORY REPUBLIC OF THE PUTLIPPINES. COMMISSION ON AUDIT COA INTERNATIONAL, Areza Compound, Mahogany, Tagaytay City Room No. CLEARANCE/CHECKLIST GRE No. Date: ANNEX F ITEM DESCRIPTION gry YES NO Key Card Bed: ‘Mattress Protector/Bed Pad. Bed Sheet Fitted Sheet Duvet Duvet Cover Pillow Pillow Case Throw Pillow ‘Throw Pillow Case Bed Runner. Coffee Set and Glass Bath Towel Hand Towel Face Towel Bath Mat Hanger Hair Dryer Kettle Remote for TV Remote for ACU. Universal Adapter ‘The above items are found to be in order. Room AttendantREQUISITION AND ISSUE SLIP ANNEX G | ty Nam and Coster piston esponsibtiy Comer Cote oH orice Jus No. ‘Requisition ‘Stock Available? Issue SoekNo [Unt] __Desrpton Guts |v xe | ean Remarks Requested oy: [approved by: sued Peeve Sins: Printed Name Designation. ouANNEX H | PURCHASE REQUEST Baty Name: Fund Cluster: fotice’Section PRNoz Responsibility Center Code ‘StoeW Property No, Hem Deseription Quantity Unit Cost] To Requested by: “Approved by Signature = Printed Name : [Designation :_ ANNEX | | STOCK CARD tity Name Fund Cluster em Stock No. [Description Reorder Point Unit of Measrement Tena Balance Feast Date | Reference — ~ No. or Days to Ce =equ sapeunsaidoy sanmussudoy oruorany 20 Antaysousty pe some) Ae -¥09 30 94 pot exo maT yo peo ou peta sho ars Jo 94 pati 380 amo a pagan, a pasoséey sq roanep pagno] Sn aD sym sre | 3010 Lguny on ond opmy, ft atumoninions, won | semen [Pann dos on = aeRO TESTA — wo Kypqesunesse ons puns Saye genes sj ————— 3m ETT TY TO HIAS— > 304 ise por wesy TXANNV | SANIOLNANI JO LNN109 ‘IWOISAHd FHL NO LAOdTE (1 om oa)ANNEX K | PROPERTY ACKNOWLEDGMENT RECEIPT Entity Name = Fund Cluster: PAR Nos. Property Date Ona Number | Acquired Amount Issued by: Signatue over Printed Name of Supply and/or Property Custodian Position/Omtice Position/Office . Date Datesuey ——nraquiny auradorg| +: uamdinbg pue rsa “cuadosg] saaysnj9 puny, EeePC cree ece eee tee eC Cee Uavo ALWAdOUd “DENNY |LANNEX M | RECEIPT OF RETURNED EQUIPMENT Bape of the Miya COMMISSION ON AUDIT Commonwealth Avenue, Quezon City RRE-2022-01-000026 Date: Jan 27, 2022 Category: EQUIPMENTIDESCRIPTION QTY PROP.NO END USERIOFFICE REMARKS: TAYSON A. RAMOS A0-00 Laptops Tow | Fossesos2 aoz34.00 [Detectve foreplacementoimonior [Computer Netbook Acer Aspro E5-47-7128 onroera015 'SNNXMMVSPOO, 4447 10°58 7600- |LOURDES D, MORAN-F0s36-5082 xwMvseOOe44719°687600 ABOVE STATED EQUIPMENT RECEIVED BY: NOTED BY: owari20z2 ‘JEROME J. TROGO ADMINISTRATIVE AIDE V NATALIA M, ABUYEN SECTION CHIEF owarren22 Datatine Prtec: 42072022 202.59 PM Pago tof t| ANNEX N PROPERTY TRANSFER REPORT Entity Name: Fund Cluste From Accountable Office/Ageney/und Cluster: [To Accountable Officer/Ageney/Fund Cluster [Transfer Type (oheck only one) C1 Donation DiRetocate [1] Reassignment others Specify) 7 : Condition of Date Acquired | Property No. Description Amount “ie Approved by: ReleasedlIssued by: Received by: signature: Printed NameANNEX |" Commission on Audit Central Office ‘Commonwealth Avenue, Quezon City Repair History of PPE From January 01, 2022 To April 19, 2022 Regular Agency Fund PENG, Description [Repair Cost “Date (Fos0s0T0-00-008-Big-2 ice Bullding (Phase W Main Bulding)FIr. Area 9872.16 "26,500.00 | 0382022 10604060-00-001-DORM2 |Othiers - Dommitory Bidg.- New (Tahanan sa COA) Floor Area 108,186.00 | 03/18/2022 "10605030-00-002-F0538-BF22 [Computer Laptop, ASU: 2,300.00 | 031772022 2 _|rsstee Sn Condcvoocszszza rossez2 10606010-00-001-F 1303-AA09 |HINO, Model RM2PSSD Plate No. SKZ477 - F7303-AAG: "36,000.00 | 02/11/2022 0606010-00-001-F1303-AA16 jenger Bus, HINO RNUB Series 4X2, 60 Seater Airconditioned, 36,000.00 | 01/18/2022 Paton. JOASEET200ANIS Total 986.00 Date/Time Printed : April 19, 2022 03:64:42 PM Page tof 1yours ___oveareor pouerr — speatez soocrr — sreave, goer greene goer: srzanuz anea —_uonej2oudoq 00g 38N, “20y ung fous6y sejnBey BEESEsEnESEr SSSRaEE d DGNNY vresv serio wyetoe. beet beetotse 1809 vonisinboy ugqenig pung ror s2yo seomes es0u99) suo sons ei2009 2240 s2oK95 reisu29 soy esomes 129099, asqueg “dsay 2080904 5 0022290 5 0022290 5 s002 1220 : 9002 2290 ona auea boy ‘p09 1unos3y ze02 ‘oz dy 0 SY viv ooanzi zoe czmey : pena owo1e0 sinc-otios - souossan2e wm o1ydco 1209 souiy ny 2dKL mopuN dH SE sunaotios = sauossaooe wim awe 09 jowey NOY 2041, MOpUIN dH FL uondussog uowsdinb3 200 quawidinby pue yueld ‘Ayedosd paye!soideg Ayn 3s17 do oxy wosond ‘onuaay spreamou03 oo reausn upny wo ors +0-0z050901 _Liwa-01404+400-0002090901 s1nc-01104-100-00-020s0901 SuNGro1 Los to0oecz0s0801 soquiny Aadord yunosoy add> TRIO RIAY OHA ED TRAY OORT (oom, (220 argmenooy jou pte no sms) jo sm pada as) fa pasontoy nog pomntnasfsadoal gr a4 6 sonH95 0 Ho opted pr wands sea! 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Printed Name, Designation, and Signature of Supervisor [Accounting Entry: Credit Account Title UACS Code De C. | Certified D. | Approved for Payment [[Tcash Available [J subject to Authority to Debit Account (when applicable) [supporting documents complete and amount claimed proper, [Signature : [Signature [Printed Name [Printed Name frosition: Tend counng Uni Rakoad Ropresntave [Position ‘Raoney ond athorzad Roproseniatve [Date Date \E. Receipt of Payment LIEV No. [Date: bani Name & Aszount Check/ADA No.: pe [Date: frnea Names Signature [Official Recelpt(Other DocumentsBUDGET UTILIZATION REQUEST AND STATUS Entity Name Responsibility ‘Center Particulars Morar | Code/ UACS Object Expenditures Amount Total Certified: Charges to appropriation/budget necessary, lawful and under my direct supervision; and supporting ‘documents valid, proper and legal Head, Requesting Oice/ Author Representative indicated above Signature Printed Name: Position Date Certified: Budget available and utilized for the purpose/adjustment necessary as Representative udget Unit/Authorized ‘STATUS OF UTILIZATION Referense mou Dalene BURSMEVIRCU | Utilization | Payable | Payment DueaRT besoe (ssaelaies RADAI No, Not Yet Due} pemandable @ © © oy 2)| ANNEX W_ PETTY CASH FUND RECORD ty Names ‘fia Dignan Nature of Payment CERTIFICATION "hry ci tut the respi cones and compte sed of al eh advan ened and tne me myx ety Ck en ro ding te pdentity Name : Fund Cluster: 1. To be filled out upon request ‘Requested by: PETTY CASH VOUCHER _ANNEX X_ Responsibility Center Code: IL, To be filled out upon liquidation [Total Amount Granted [Total Amount Paid per ORMInvoice No. Amount Refunded/ (Reimbursed) }<$——--’-’- Received Refund Signature over Printed Name Name of Requestor Approved by: Name of Immediate Supervisor Paid by: Signature over Printed Name Reimbursement Paid Signature over Printed Name Petty Cash Custodian MR eee Liquidation Submitted Signature over Printed Name Petty Cash Custodian Cash Received by. Payee Date: Signature over Printed Name Reimbursement Received by: Signature over Printed Name Payee Date:ANNEX Y | REPORT ON PAID PETTY CASH VOUCHERS Period Covered. Petty Cash pitiaaae ‘Amount Voucher No. CERTIFICATION Thereby certify to the correctness of the above information, Petty Cash Custodian"ANNEX |