Republic of the Philippines

Department of the Interior and Local Government Form B-2

2022 RBME of LGU Infrastructure Projects

RBME of LGU Infrastructure Projects (RLIP) – DATA CAPTURE FORM

Form B-2. Forms Review – Progress & Results Monitoring

INSTRUCTIONS | PLEASE READ

(1) The form shall be completed by the DILG Municipal (for municipal LGUs) / City (for city LGUs) / Provincial (for provincial
LGUs) Office; (2) Please refer to RLIP Form B Guidance Notes for instructions on how to accomplish RLIP Form B; (3) Please
accomplish the Certification Page. (4) Upload PDF of this Form through the designated folder on https://tinyurl.com/RLIP-2022-
FoldersDocs.

I. Local Government Unit Name and Location

☐ City / ☒ Municipality of : _Clarin_______________________________________
☒ Province of : Misamis Occidental______________________________________
Region : __10______________________________________

II. Project Details

Please supply the requested information below:

Project Name / Title Improvement/Construction of Drainage

System_____________________________________________________________________
_____________________________________________________________________________
________
Type of Project ☒ ☐ ☐ ☐
Roads and Water Evacuation Others
Bridges Supply and Center /
Sanitation MP Hall
Facilities

Provide details if Others: _________________________________________________

Project Fund _____________________________________________________________________________
With LGU Counterpart Fund ☐
Amount of LGU Counterpart Fund _______________________________

Fund Source ☒ ☐ ☐ ☐ ☐
Development NTA Loans / Other Internally-
Fund (DF) (except DF) Borrowings Externally- Sourced
Sourced Income
Income
Provide details if not DF: _________________________________________________

Exact Project Location _____________________________________________________________________________

Start Date (Date on _____________________________________________________________________________

Notice to Proceed)

End Date (Projected _____________________________________________________________________________

Completion Date per S-
Curve or equivalent)
 III. Documents Submitted
Please indicate which conditions apply relative to the enrolled project:

Submitted
Submitted
w/in deadline
Form 2
Year __________2022___________
January ☐ ☐
February ☐ ☐
March ☐ ☐
April ☒ ☒
May ☐ ☐
June ☐ ☐
July ☐ ☐
August ☐ ☐
September ☐ ☐
October ☐ ☐
November ☐ ☐
December ☐ ☐
Year __________2022____________
January ☐ ☐
February ☐ ☐
March ☐ ☐
April ☐ ☐
May ☐ ☐
June ☐ ☐
July ☐ ☐
August ☒ ☒
September ☐ ☐
October ☐ ☐
November ☐ ☐
December ☐ ☐
Form 3 Please indicate if Form 3s were made for the project
implementation months with observed slippage (per Section VI: Form 2,
4th column) between Target and Actual Physical Accomplishments
Year __________2022____________
January ☐ ☐
February ☐ ☐
March ☐ ☐
April ☒ ☒
May ☐ ☐
June ☐ ☐
July ☐ ☐
August ☐ ☐
September ☐ ☐
October ☐ ☐
 November ☐ ☐
December ☐ ☐
Year __________2022____________
January ☐ ☐
February ☐ ☐
March ☐ ☐
April ☐ ☐
May ☐ ☐
June ☐ ☐
July ☐ ☐
August ☒ ☒
September ☐ ☐
October ☐ ☐
November ☐ ☐
December ☐ ☐
Form 4 ☐ ☐

IV. Form 2
Physical and Financial Accomplishment Report Form
Please provide the required information for Form 2, and tick whether positive (+) or negative (-)
slippage was observed between target and actual physical accomplishments:

Year __________2022____________

CONSISTENT VERIFIABLE Slippage

RPMES Form 2 vs SubayBAYAN- Entries consistent with LGU Observed?
RLIP encoded data documentation (+) (-)
Physical
January ☐ ☐ ☐ ☐
February ☐ ☐ ☐ ☐
March ☐ ☐ ☐ ☐
April ☒ ☒ ☒ ☐
May ☐ ☐ ☐ ☐
June ☐ ☐ ☐ ☐
July ☐ ☐ ☐ ☐
August ☐ ☐ ☐ ☐
September ☐ ☐ ☐ ☐
October ☐ ☐ ☐ ☐
November ☐ ☐ ☐ ☐
December ☐ ☐ ☐ ☐
Financial
January ☐ ☐
February ☐ ☐
 March ☐ ☐
April ☐ ☐
May ☐ ☐
June ☐ ☐
July ☐ ☐
August ☒ ☒
September ☐ ☐
October ☐ ☐
November ☐ ☐
December ☐ ☐

Year _________2022____________

CONSISTENT VERIFIABLE Slippage

RPMES Form 2 vs SubayBAYAN- Entries consistent with related Observed?
RLIP encoded data LGU documentation (+) (-)
Physical
January ☐ ☐ ☐ ☐
February ☐ ☐ ☐ ☐
March ☐ ☐ ☐ ☐
April ☒ ☒ ☒ ☐
May ☐ ☐ ☐ ☐
June ☐ ☐ ☐ ☐
July ☐ ☐ ☐ ☐
August ☐ ☐ ☐ ☐
September ☐ ☐ ☐ ☐
October ☐ ☐ ☐ ☐
November ☐ ☐ ☐ ☐
December ☐ ☐ ☐ ☐
Financial
January ☐ ☐
February ☐ ☐
March ☐ ☐
April ☐ ☐
May ☐ ☐
June ☐ ☐
July ☐ ☐
August ☒ ☒
September ☐ ☐
October ☐ ☐
November ☐ ☐
December ☐ ☐
 V. Form 3
Project Exception Report Form
Please indicate which conditions apply to the accomplished Form 3:

Findings Possible Reasons Recommen-

/ Causes dations
Clearly states Findings / Causes /
☐ ☐ ☐
Recommendations
Provides specific and verifiable
☐
findings
Provides proximate causes for the
☐
slippage observed
Provides recommendations for every
☐
finding
Submitted to the Local Development
Council (LDC) or its Executive ☐
Committee (ExeCom)
Included in the LDC’s meeting
☐
agenda for discussion
Recommendations were forwarded
by the LDC to the implementing ☐
office for appropriate action
Recommendations were
☐
implemented or findings resolved
Unresolved findings were referred to
☐
higher level Development Council

VI. Form 4
A. Project Results Form
Please indicate which conditions apply to the accomplished Form 4:

Impact Outcome Output

Objectives
Consistent with those included in the
☒ ☒ ☒
LogFrame
Indicators
Consistent with those included in the
☒ ☒ ☒
LogFrame

If NOT according to the LogFrame, tick applicable boxes below (Accomplish ONLY IF the
“Objectives” and/or “Indicators” in the Logframe differ from those in Form 4. Otherwise,
leave boxes below unticked):
Impact Outcome Output
Objectives
Clearly states objectives ☒ ☒ ☒
Provides statements related to lower- ☒ ☒ ☒
 level objectives
Provides objectives stated as long-
term results, consistent with the
relevant Sectorial Goal on
☒
Comprehensive Development Plan
covering CY 2022 (see typed Sectoral
Goal above)
Provides objectives stated as
immediate-term development
☒
objective, logically resulting from the
accomplishment of the Output
Provides objectives stated as
deliverables arising from activities
carried out using the project ☒
resources, and accomplished at the
end of project implementation
Indicators
Provides specific performance target
☒ ☒ ☒
rates
Provides clearly stated timeline for
achievement of performance target ☒ ☒ ☒
measures
Provides specific target beneficiaries
(if unspecified, DO NOT TICK. Assumed ☒ ☒ ☒
that whole LGU population is covered)
Relates to corresponding objectives ☒ ☒ ☒
 Republic of the Philippines
Department of the Interior and Local Government Form B-2
2022 RBME of LGU Infrastructure Projects

VI. Form 4
B. Observed Results Form
Please supply needed values and refer to other documents, as necessary:
Met
Value / Target Baseline Actual MOV Target
(Per Form 4) (Per RLIP Form A) (Per MOV) (Specify document title) / On
Track
Output
Indicator (Overall Statement):
Beneficiary / Population Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐

Performance Rate Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐

Date of Completion Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐

Indicator (Overall Statement): Click or tap here to enter text.

Beneficiary / Population Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐

Performance Rate Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐

Date of Completion Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐

Indicator (Overall Statement): Click or tap here to enter text.

Beneficiary / Population Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐

Performance Rate Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐

Date of Completion Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐

Outcome
Indicator (Overall Statement): Click or tap here to enter text.
Beneficiary / Population Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐
 VI. Form 4
B. Observed Results Form
Please supply needed values and refer to other documents, as necessary:
Met
Value / Target Baseline Actual MOV Target
(Per Form 4) (Per RLIP Form A) (Per MOV) (Specify document title) / On
Track
Performance Rate Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐

Date of Completion Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐

Indicator (Overall Statement): Click or tap here to enter text.

Beneficiary / Population Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐

Performance Rate Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐

Date of Completion Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐

Indicator (Overall Statement): Click or tap here to enter text.Click or tap here to enter text.
Beneficiary / Population Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐

Performance Rate Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐

Date of Completion Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐

Impact
Indicator (Overall Statement): Click or tap here to enter text.
Beneficiary / Population Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐

Performance Rate Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐

Date of Completion Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐

Indicator (Overall Statement): Click or tap here to enter text.Click or tap here to enter text.
 VI. Form 4
B. Observed Results Form
Please supply needed values and refer to other documents, as necessary:
Met
Value / Target Baseline Actual MOV Target
(Per Form 4) (Per RLIP Form A) (Per MOV) (Specify document title) / On
Track
Beneficiary / Population Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐

Performance Rate Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐

Date of Completion Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐

Indicator (Overall Statement): Click or tap here to enter text.

Beneficiary / Population Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐

Performance Rate Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐

Date of Completion Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. ☐