Contract ID : 19KI0008

Project Name : Road Widening-Primary Roads, Ozamiz City- Oroquieta City Road
K1733+670-K1736+210, Misamis Occidental
Location : Oroquieta City, Misamis Occidental
Contractor : AKN CONSTRUCTION CORPORATION
Annex K
Page 34 of 59

CHECKLIST OF SUPPORTING DOCUMENTS AND ATTACHMENTS FOR DoTS

Advance Payment
I. To be prepared by the Contractor
1. Letter Request of Contractor including Schedule of Recoupment
2. Certification that necessary scheduled Equipment for the first two months were mobilized after
issuance of NTP with geotagged pictures
3. Approved Monthly Equipment Utilization Schedule
4. Construction Safety and Health Program approved/concurred by the DOLE (if no reply is received
from DOLE within 5 days, the CSHP will be deemed concurred) by the DOLE
5. Notice to Proceed (Certified true copy by Implementing Office)
6. Copy of approved contract (Certified true copy by Implementing Office)
7. Geotagged pictures of Equipment, Billboards with complete information of contract amount, start
& completion date, duration of project, project name & source of fund (locally funded / foreign
assisted projects)
8. One set certified true copy/duplicate copy of all the documents submitted for Accounting Division/
Section/Unit's copy

I hereby certify that the above supporting documents are complete.

Print Name : JESON C. BOLANDO

Designation : Provisional Project Engineer
Date : July 29, 2023
Contract ID : 19KI0008
Project Name : Road Widening-Primary Roads, Ozamiz City- Oroquieta City Road
K1733+670-K1736+210, Misamis Occidental
Location : Oroquieta City, Misamis Occidental
Contractor : AKN CONSTRUCTION CORPORATION
Annex K
Page 35 of 59

CHECKLIST OF SUPPORTING DOCUMENTS AND ATTACHMENTS FOR DoTS

Advance Payment
II. To be prepared by the Implementing Office
1. Certified True Copy of Obligation, Request and Status (ORS)
2. Background Information / Executive Summary
3. Disbursement Voucher
4. Certification from Implementing Office that the supporting documents are verified as valid and
complete
5. Certified True Copy of Surety Bond/Bank Guarantee/Irrevocable Standby Letter of Credit duly verified
by PrS/Procurement Unit
6. Foreign portion-Withdrawal Application (if applicable)
7. Photocopy of the Transmittal of contract documents (duly received by COA)
8. One set certified true copy of all the documents submitted for Accounting Division/Section/Unit's copy

I hereby certify that the above supporting documents are complete.

Print Name : REY M. ROA

Designation : Chief, Construction Section
Date : July 29, 2023
Contract ID : 19KI0060
Project Name : Construction (Completion) of Multi-Purpose Building, City Engineer's Compound,
Upper Langcangan, Oroquieta City, Misamis Occidental
Location : Upper Langcangan, Oroquieta City, Misamis Occidental
Contractor : DDS BUILDERS
Annex K
Page 36 of 59

CHECKLIST OF SUPPORTING DOCUMENTS AND ATTACHMENTS FOR DoTS

First Progress Billing
I. To be prepared by the Contractor
1. Letter Request of Contractor for payment
2. Monthly Certificate of Payment and Statement of Work Accomplished
3. Contractor’s Affidavit - duly notarized
4. Geotagged pictures of Work Accomplished (size 3R min.) - "with proper labelling"
5. Backup Computations
6. Certificate of Materials Quality Test (Materials on Site), if any
7. Materials Test Report/Quality Test
8. Construction Safety and Health Program approved by the DPWH and concurred by DOLE (If no
Advance Payment made)
9. BIR Form No. 2307 (Certificate of Creditable Taxes Withheld at Source), if any
10. BIR Form No. 2550 M - VAT Declaration
11. Contractor’s All Risk Insurance duly verified by PrS (1M and above)
12. Copy of Performance Bond duly verified by PrS (If no Advance Payment made)
13. Copy of Contract Agreement / Bill of Quantities
14. Notice to Proceed (Certified true copy by Implementing Office), if no Advance Payment made
15. Copy of Contract of Lease/Remtal Agreement for Facilities to the Engineer/Official Receipt for
Lease/Rent/Purchase - OR and CR for vehicles and proof of purchase
16. Official Receipt and Approved Voucher of the previous payment, if not yet submitted to the
Accounting Division or copy of duly received OR by the Accounting Division (if GOP, FAP Section
and if Loan Proceed, FRS Section)
17. One set certified true copy of approved all the documents submitted for accounting's copy

I hereby certify that the above supporting documents are complete.

Print Name : JONATHAN M. CORBITA

Designation : Provisional Project Engineer
Date : July 29, 2023
Contract ID : 19KI0060
Project Name : Construction (Completion) of Multi-Purpose Building, City Engineer's Compound,
Upper Langcangan, Oroquieta City, Misamis Occidental
Location : Upper Langcangan, Oroquieta City, Misamis Occidental
Contractor : DDS BUILDERS
Annex K
Page 37 of 59

CHECKLIST OF SUPPORTING DOCUMENTS AND ATTACHMENTS FOR DoTS

First Progress Billing
II. To be prepared by the Implementing Office
1. Background Information/Executive Summary
2. Billing Summary
3. Certification from the Project Engineer as to partial and complete As Staked Plan is submitted
4. Disbursement Voucher
5. Certification from Implementing Office that the supporting documents are verified as valid and
complete
6. Certified True Copy of Obligation Request and Statues (ORS)
7. Foreign portion-Withdrawal Application (If applicable)
8. Copy of the Transmittal of contract documents (duly stamped received by COA) - if the contractor
did not collect an advance payment
9. Certification of Clearance for Labor and Materials Payment
10. Certification of Clearance for Equipment Rentals and/or lease
11. Certificate of Materials Quality Control Assurance by DPWH Materials Engineer
12. Statement of Time Elapsed (Justification Letter (including compliance with calibrated actions) is
needed if accomplishment is negative slippage of 10% and above)
13. Certificate of Inspection
14. One set certified true copy of approved all the documents submitted for accounting's copy

I hereby certify that the above supporting documents are complete.

Print Name : REY M. ROA

Designation : Chief, Construction Section
Date : July 29, 2023
Contract ID : 18KI0020
Project Name : Shoreline Protection along dipolog-Oroquieta National Road
Location : Plaridel, Misamis Occidental
Contractor : FFJJ CONSTRUCTION
Annex K
Page 38 of 59

CHECKLIST OF SUPPORTING DOCUMENTS AND ATTACHMENTS FOR DoTS

Interim Progress Billing
I. To be prepared by the Contractor
1. Letter Request of Contractor for payment
2. Statement of Work Accomplished and Monthly Certificate of Payment
3. BIR Form No. 2307 (Certificate of Creditable Taxes Withheld at Source), if any
4. BIR Form No. 2550 M - VAT Declaration
5. Certificate of Materials Quality Test (Materials on Site), if any
6. Materials Test Report/Quality Test
7. Contractor’s Affidavit - duly notarized
8. Backup Computations
9. Geotagged pictures of Work Accomplished (size 3R min.) - "with proper labelling"
10. Change Order/Extra Work Order/Time Extension/Suspension and Resume Order, if needed
11. Copy of Contract of Lease/Rental Agreement for Facilities to the Engineer/Official Receipt for
Lease/Rent/Purchase - OR and CR for vehicles and proof of purchase
12. Official Receipt and Approved Voucher of the previous payment, if not yet submitted to the
Accounting Division or copy of duly received OR by the Accounting Division (if GOP, FAP Section
and if Loan Proceed, FRS Section)
13. Materials Test Report/Quality Test
14. One set certified true copy of approved all the documents submitted for accounting's copy

I hereby certify that the above supporting documents are complete.

Print Name : JULIE C. LUMANTAS

Designation : Project Engineer I
Date : July 29, 2023
Contract ID : 18KI0020
Project Name : Shoreline Protection along dipolog-Oroquieta National Road
Location : Plaridel, Misamis Occidental
Contractor : FFJJ CONSTRUCTION
Annex K
Page 39 of 59

CHECKLIST OF SUPPORTING DOCUMENTS AND ATTACHMENTS FOR DoTS

Interim Progress Billing
II. To be prepared by the Implementing Office
1. Background Information and Executive Summary
2. Billing Summary
3. Disbursement Voucher
4. Certification from Implementing Office as to completeness of supporting documents are verified as
valid and complete
5. Certified True Copy Copy of Obligation Request and Status (ORS)
6. Foreign portion - Withdrawal Application (for foreign assisted projects, if applicable)
7. Certification of Clearance for Labor and Materials Payment
8. Certification of Clearance for Equipment Rentals and/or Lease
9. Certificate of Materials Quality Control Assurance by DPWH Materials Engineer
10. Statement of Time Elapsed (Justification Letter (including compliance with calibrated actions) is needed
if accomplishment is negative slippage of 10% and above
11. One set certified true copy of all the documents submitted for accounting's copy

I hereby certify that the above supporting documents are complete.

Print Name : REY M. ROA

Designation : Chief, Construction Section
Date : July 29, 2023
Contract ID : 18KI0042
Project Name : Construction(Completion) of Multi-Purpose Building Phase II.
Location : Brgy. Sepac, Sapang Dalaga, Misamis Occiental
Contractor : DDS BUILDERS
Annex K
Page 40 of 59

CHECKLIST OF SUPPORTING DOCUMENTS AND ATTACHMENTS FOR DoTS

Final Billing
I. To be prepared by the Contractor
1. Letter Request of Contractor for payment
2. Statement of Work Accomplished and Monthly Certificate of Payment
3. Contractor’s Affidavit - duly notarized
4. As Built Quantity/Final Change Order, if any
5. Signed Inventory of Office Equipment, Furniture, Building, Surveying, Instrument and Service Vehicle
(Turnover of Equipment Bought Out of Project Funds) with corresponding Invoice Receipt,
Acknowledgement Receipt for Equipment (ARE) or Property Acknowledgement Receipt (PAR) and
Inventory Custodian Slip (ICS)
6. Certification of BRS/Regional Office of Turnover of Laboratory Equipment - FAPs/RO for
Locally Funded
7. Certificate of Completion
8. Certificate of Acceptance (after 1 year of Completion)
9. Performance Security and CARI in the form of Surety Bond/Bank Guarantee/Irrevocable Standby
Letter of Credit duly verified as valid and genuine by PrS/Procurement Unit, if there is no
Certificate of Acceptance
10. Certified True Copy of DPWH Final Inspection Report (QAU/Inspectorate Team)
11. Geotagged pictures of Work Accomplished (size 3R min.) - "with proper labelling"
12. Back-up Computations
13. Approved Time Extensions and/or Suspension and Resume Orders, if any
14. Approved As Built-Plans/Drawings
15. BIR Form 0217, Stamped Received by BIR (indicating the date of receipt, RDO and with
Documentary Stamp)
16. BIR Form No. 2307 (Certificate of Creditable Taxes Withheld at Source)
17. BIR Form No. 2550 M - VAT Declaration
18. Materials Test Report including Core Test for Thickness Determination for Concrete/Asphalt Road,
if applicable
19. Proof of Completeness of Document duly received by COA
20. Official Receipt of the previous payment, if not yet submitted to the Accounting Division or copy of
duly received OR by the Accounting Division (GOP, FRS Section and if Loan Proceed, FAP Section)
21. Copy of Contract of Lease/Rental Agreement for Facilities to the Engineer and Official Receipt for
Lease/Rent/Purchase - OR and CR for vehicles and proof of purchase
22. One set certified true copy of all the documents submitted for accounting's copy
(once signed/approved) except pictures, back-up computations, as built plans and drawing,
and material testing results

I hereby certify that the above supporting documents are complete.

Print Name : NILO N. DYBONGCO, JR.

Designation : Project Engineer
Date : July 29, 2023
Contract ID : 18KI0042
Project Name : Construction(Completion) of Multi-Purpose Building Phase II.
Location : Brgy. Sepac, Sapang Dalaga, Misamis Occiental
Contractor : DDS BUILDERS
Annex K
Page 41 of 59

CHECKLIST OF SUPPORTING DOCUMENTS AND ATTACHMENTS FOR DoTS

Final Billing
II. To be prepared by the Implementing Office
1. Background Information and Executive Summary
2. Billing Summary
3. Disbursement Voucher
4. Property Clearance
5. Certification from Implementing Office as to completeness of supporting documents are verified as
valid and complete
6. Certified True Copy of Obligation Request and Status (ORS)
7. Foreign Portion-Withdrawal Application (for foreign assisted projects)
8. Statement of Time Elapsed
9. Certification of Clearance for Labor and Materials Payment
10. Certification of Clearance for Equipment Rentals and/or Lease
11. Certificate of Materials Quality Control Assurance by DPWH Materials Engineer
12. One set certified true copy of all the documents submitted for accounting's copy

I hereby certify that the above supporting documents are complete.

Print Name : REY M. ROA

Designation : Chief, Construction Section
Date : July 29, 2023
Contract ID : 16KI0014
Project Name : Concreting of Brgy. Lusot-Brgy. Mabini FMR

Location : Brgy. Lusot, Baliangao, Misamis Occidental

Contractor : GENETIAN BUILDERS
Annex K
Page 42 of 59

CHECKLIST OF SUPPORTING DOCUMENTS AND ATTACHMENTS FOR DoTS

Release of Retention
I. To be prepared by the Contractor
1. Letter Request of Contractor for payment
2. Surety Bond/Letter of Credit/Bank Guarantee to guarantee the release of retention money duly
verified by PrS/PU (if retention is released before the issuance of the Certificate of Acceptance
and during progress billing on a positive schedule)
3. Statement of Retention
4. Certified True Copy of Approved Vouchers
5. Official Receipt of the previous payment, if not yet submitted to the Accounting Division or copy of
duly received OR by the Accounting Division (if GOP, FRS Section and if Loan Proceed, FAP Section)
6. One set certified true copy of all the documents submitted for Accounting Division/Section/Unit's copy

I hereby certify that the above supporting documents are complete.

Print Name : JONATHAN M. CORBITA

Designation : Provisional Project Engineer
Date : July 29, 2023
Contract ID : 16KI0014
Project Name : Concreting of Brgy. Lusot-Brgy. Mabini FMR

Location : Brgy. Lusot, Baliangao, Misamis Occidental

Contractor : GENETIAN BUILDERS
Annex K
Page 43 of 59

CHECKLIST OF SUPPORTING DOCUMENTS AND ATTACHMENTS FOR DoTS

Release of Retention
II. To be prepared by the Implementing Office
1. Background Information / Executive Summary
2. Certification from Implementing Office as to completeness of supporting documents are verified as
valid and complete
3. Disbursement Voucher
4. DPWH Final Completion Inspection Report (QAU (CO)/Inspectorate Team (RO/DEO)) or QAU/
Inspectorate Team Report that defects noted during completion inspection have already been
rectified and corrected if retention is released after completion
5. Certification that the project is on-schedule if retention is released before completion/Certificate of
Completion if retention is released after completion of Project/Certificate o f Acceptance
6. One set certified true copy of all the documents submitted for accounting's copy
(once signed/approved) - For Central Office

I hereby certify that the above supporting documents are complete.

Print Name : REY M. ROA

Designation : Chief, Construction Section
Date : July 29, 2023
Contract ID :
Project Name :

Location :
Contractor :
Annex K
Page 16 of 59

CHECKLIST OF SUPPORTING DOCUMENTS AND ATTACHMENTS FOR DoTS

Variation Order (CO/EWO/FVO)
I. To be prepared by the Contractor
1. Contractor’s Request
2. If with additional cost, Performance Security (duly verified by PrS)
(if variance on the total amount of the contract is above 10% for locally-funded and above 25% or
as provided for in the conditions of contract for Foreign Assisted Projects)
3. Duly signed/approved plans for the proposed changes
4. Design Analysis & Computations for the proposed changes
5. Copy of the Complete set of the approved plans (As-staked, Original, Revised and As-built)
6. Copy of approved contract including the GCC, COPA and SCC (for applicable clause/s) and previously
approved variation order(s)
7. Detailed Quantity Calculations
8. Where substitution of original specified materials is involved, the following requirements shall be
submitted (if there’s any):
8.1. Certification on the non-availability of the specified materials by 3 leading
Manufacturers or suppliers
8.2. Technical specifications of the original and substitute materials
8.3. Design computations for the substitute material
8.4. Cost Estimate
9. Copy of borehole/piling date (original and actual), if there is piling works for this V.O.
10. Straight-line Diagram showing the proposed works
11. Copy of the Latest Approved Construction Schedule (if there is a proposed time extension for this VO)
12. Derivation of Time Extension for the proposed Variation Order (Change Order/Extra Work Order), if any
13. Detailed Unit Cost Analysis for new items of work
8.2. Detailed Estimate of items of work under the original contract or previous
approved V.O.
8.3. Canvass Price and/or Derivation of Materials Cost delivered at site
8.4. Construction Methodology (for items of work which are highly technical or unusual)
14. Copy of previously approved Time Extension (if there’s any)
15. Conformity of Contractor’s Performance Bond, if there is an extension of Contract Time
16. One set certified true copy of all approved Variation Orders (CO/EWO/FVO) documents submitted
for accounting's copy (once signed/approved)

I hereby certify that the above supporting documents are complete.

Print Name : :
Designation : :
Date : :
Contract ID : 0
Project Name : 0
0
Location : 0
Contractor : 0
Annex K
Page 17 of 59

CHECKLIST OF SUPPORTING DOCUMENTS AND ATTACHMENTS FOR DoTS

Variation Order (CO/EWO/FVO)
II. To be prepared by the Implementing Office
1. Executive Summary
2. Detailed Technical Justifications and legal basis for the proposed changes (prepared by consultant or
implementing office)
3. Comments/recommendations of DPWH officials (Regional Director, Project Director/Manager,
Inspectorate Team) and Project Consultants concerned (if any)
4. Project Engineer’s Report/Consultant Resident Engineer Report
5. Itemized Cost of Revision
6. Complete Contractual Data with Project Status Report
7. Approved Price Adjustment/Escalation (if there’s any)
8. Request for Obligation and Status (ORS)/Certificate of Availability of Funds (CAF), (if with additional
cost)
9. Certification from concerned RO/DEO for overlapping of projects (if any)

I hereby certify that the above supporting documents are complete.

Print Name : :
Designation : :
Date : :
Contract ID : 1
Project Name : 2
3
Location : 4
Contractor : 5
Annex K
Page 18 of 59

CHECKLIST OF SUPPORTING DOCUMENTS AND ATTACHMENTS FOR DoTS

Contract Time Extension
I. To be prepared by the Contractor
1. Letter request of the Contractor for Contract Time Extension
2. Approved Suspension and Resume Orders
3. Straight Line Diagram showing the critical activities affected (indicate the project limits/stations)
4. Straight Line Diagram showing the contract effectivity, contract expiry and other vital dates of the
project such as previously approved time suspension/resumption/extensions and variation orders etc.
5. Certified Copy and Summary of Previously Approved Time Extensions with ;the corresponding
inclusive dates (if there’s any)
6. Certified copy of Original Contract
7. Certified True Copy of original and latest approved PDM Network Diagram Bar Chart prior to the
request for contract time extension
8. Sworn Contractor’s Quit Claim
9. Conformity of Contractor’s Bondsman for the Time Extension
Advance supporting documents for the specific conditions:
A. Due to Rainy/Unworkable Days considered unfavorable for the prosecution of the works
at the site
1. Certification/Monthly Weather Report from PAGASA
2. Geotagged pictures (with caption i.e., location/station,etc.) showing that the site is affected by
unfavorable weather condition
3. Approved Monthly Suspension Report
4. Certified copy of Project Logbook (Suspended Days)
B. Due to Delay in the payment of Contractor’s Claim for Progress Billing/s
1. Written Notice from the Contractor informing the Implementing Office/ Consultant to suspend work
operation due to the delay in the payment of Progress Billing
2. Contractor’s Order to Suspend Work
3. Monthly Accomplishment report affected by the delay in the payment of contractors claim for
progress billing
4. Certified copy of Vouchers/Progress Billings
5. Certification from the Accounting Division of payments made for the Progress Billing/s was received
C. Due to Road Right-of-Way Problem
1. Certification from the Barangay Captain/City or Municipality Mayor that there is RROW problem and
the affected owners do not allow the entry of the contractor to their property
2. Geotagged pictures (with caption) of the site with RROW problem
D. Due to Peace and Order Condition
1. Certification from the PNP station commander concerned and confirmed by the DILG Regional
Director concerned that peace and order condition in the area is already stable
2. Proof/Evidence of peace and order situation (Pictures/Police Report/Project Engineers Incident
Report)
I hereby certify that the above supporting documents are complete.
Print Name : : 1
Designation : : 2
Date : : July 29, 2023
Contract ID : 1
Project Name : 2
3
Location : 4
Contractor : 5
Annex K
Page 23 of 59

CHECKLIST OF SUPPORTING DOCUMENTS AND ATTACHMENTS FOR DoTS

Contract Work Suspension
I. To be prepared by the Contractor
1. Letter request of the Contractor for Contract Time Extension
2. Straight Line Diagram showing the critical activities affected (indicate the project limits/stations)
3. Straight Line Diagram showing the contract effectivity, contract expiry and other vital dates of the
project such as previously approved time suspension/resumption/extensions and variation orders etc.
4. Certified Copy and Summary of Previously Approved Time Extensions with ; the corresponding
inclusive dates (if there’s any)
5. Certified copy of Original Contract
6. Certified copy of original and latest approved PERT/CPM Network Diagram Bar Chart prior to the
suspension
Additional supporting documents for specific conditions:
A. Due to Rainy/Unworkable Days considered unfavorable for the prosecution of the works
at the site:
1. Certification/Monthly Weather Report from PAGASA
2. Pictures (with caption i.e., location/station, etc.) showing that the site is affected by unworkable
4. Certified copy of Project Logbook (Date of Suspension)
B. Due to Delay in the payment of Contractor’s Claim for Progress Billing/s
1. Transmittal from the Implementing Office/Consultant submitting the Progress Billing/s and/or
Voucher complete with the required documents to the Accounting Division for appropriate action.
C. Due to Road Right-of-Way Problem
1. Certification from the Barangay Captain/City or Municipality Mayor that there is RROW problem and
the affected owners do not allow the entry of the contractor to their property
2. Geotagged pictures (with caption) of the site with RROW problem
D. Due to Peace and Order Condition
1. Certification from the PNP station commander concerned and confirmed by the DILG Regional
Director concerned that peace and order condition in the area is already stable
2. Proof/Evidence of peace and order situation (Pictures/Police Report/Project Engineers Incident Report)
E. Due to Inaccessibility to Project
1. Exhibit geottaged Pictures (with caption i.e.,location/station,etc.) showing the obstruction at the project
2. Straight Line Diagram/Structural Mapping showings t
F. Due to Obstruction
1. Exhibit geottaged Pictures (with caption i.e., location/station, etc.) showing the obstruction was resolved
2. Information on the inclusive dates that the project was affected and what activities were affected
3. Straight Line Diagram/Structural Mapping showing the location of the inaccessibility to the project
4. Relevant documents such as permit issued, communication letters, minutes of the meeting, etc.
G. Due to Failure of the Government to provide necessary construction plans and/or drawings
1. Geottaged pictures (with caption i.e., location/station, etc.) showing the effect of the absence of
construction plan and/or drawings

I hereby certify that the above supporting documents are complete.

Print Name : : 1
Designation : : 2
Date : : July 29, 2023
Contract ID : 1
Project Name : 2
3
Location : 4
Contractor : 5
Annex K
Page 24 of 59

CHECKLIST OF SUPPORTING DOCUMENTS AND ATTACHMENTS FOR DoTS

Contract Work Suspension
H. Due to non-availability of construction materials
1. Pictures showing effect of the non-availability of Construction Materials
2. Certification from DTI and the suppliers that the required materials specified in the plans and/or
substitute materials are not available in the market
I. Due to effect of Force Majeure
1. Geotagged pictures (with caption i.e., location/station,etc.) showing effect of the force majeure
on the project
2. Narrative account of force majeure with complete attachment
J. Due to absence of MMDA Permit/Clearance for Road Repair/Excavation/Traffic Clearance
1. Contractor’s request duly received by the Implementing Office for the Suspension of Work
2. Copy of the original letter request of the Contractor duly received by the MMDA to Issue clearance/permit
3. Copy of Application Form for MMDA Permit/Clearance for Road Repair/Excavation{Traffic Clearance
K. Due to absence of LGU Permit/Clearance/Homeowners Association Clearance/Permit
1. Contractor’s request duly received by the Implementing Office for the Suspension of Work
2. Copy of the original letter request of the Contractor duly received by the LGU to Issue
Clearance/Permit
L. Due to DENR Clearance/Permit to cut/remove trees/Coconut within the Road-Right-of-Way
1. Contractor’s request duly received by the Implementing Office for the Resumption of Work
2. Copy of the original DPWH letter request duly received by the DENR to issue Clearance/Permit to
cut/remove trees
3. PCA Clearance (for Coconut)
M. Delayed delivery of Imported Materials due to truck ban and/or port congestion
1. Contractor’s request duly received by the Implementing Office for Extension of Contract
2. Certified true copy of Bill of Lading
3. Certification from the Implementing Office that the delayed delivery of materials due to truck ban and
port congestion
N. Due to Encountered Hard Strata
1. Approved Drilling Monitoring Report
2. Approved Original and Actual Bore Log Data
3. Geottaged pictures/photographs showing the encountered hard strata

I hereby certify that the above supporting documents are complete.

Print Name : : 1
Designation : : 2
Date : : July 29, 2023
Contract ID : 1
Project Name : 2
3
Location : 4
Contractor : 5
Annex K
Page 25 of 59

CHECKLIST OF SUPPORTING DOCUMENTS AND ATTACHMENTS FOR DoTS

Contract Work Suspension
II. To be prepared by the Implementing Office
1. Executive Summary
2. Proposed Suspension Order in a standard format per existing department order
3. Project/Consultant Engineer’s Report relative to the request for contract time extension
4. Evaluation/Recommendation with justification from the Implementing Office/Consultant of the
requested time extension
5. Complete Contractual Data
6. Copy of latest approved PERT/CPM/PDM Network Diagram Bar Chart prior to the request for contract
time suspension
7. Letters/Communication/Minutes of the Meeting made between the Implementing Office, Contractor
and Other Concerned Parties
8. Chronology of Events from the start until the Resolution of the problem (if any). It should contain the
efforts made by the Implementing Office in order to resolve the problem and resume the
implementation of the Projects at the soonest possible time
Additional supporting documents for specific conditions:
A. Due to Rainy/Unworkable Days considered unfavorable for the prosecution of the works
at the site
1. Project Weather Chart duly signed by the Project/Resident Engineer
B. Due to Delay in the payment of Contractor’s Claim for Progress Billing/s
1. Certification from the DPWH Accountant duly noted by the Head of Implementing Office that payment
was not yet paid beyond forty-five (45) calendar days from the time the contractor’s claim has
been certified to by the procuring entity’s representative that the documents are complete.
C. Due to Road Right-of-Way Problem
1. Copy of approved Parcellary Survey/ROW Plan showing the affected lots and improvements
2. Certified copy of Permit to Enter duly received/acknowledged but disapproved/unsigned by the owner
4. List of Properties/Lots/Structures affected by RROW
D. Due to failure of the government to provide necessary construction plans and/or drawings
1. Certification from the Implementing Office that construction plan and/or drawings were not provided
on time.
2. Explanation from the Implementing Office/Consultant for failure to provide the necessary
Construction Plans
E. Due to non-availability of Construction Materials
1. Certification from the Implementing Office that non-availability of Construction Materials has
occurred
2. Certification from the Implementing Office stating the distance/location of the nearest available
supplier of the said materials and its cost

I hereby certify that the above supporting documents are complete.

Print Name : : REY M. ROA

Designation : : Chief, Construction Section
Date : : July 29, 2023
Contract ID : 1
Project Name : 2
3
Location : 4
Contractor : 5
Annex K
Page 26 of 59

CHECKLIST OF SUPPORTING DOCUMENTS AND ATTACHMENTS FOR DoTS

Contract Work Suspension
E. Due to non-availability of Construction Materials
1. Certification from the Implementing Office that Non-availability of Construction Materials has occurred
2. Certification from the Other Suppliers that the Materials is unavailable
3. Certification from the Implementing Office stating the distance/location of the nearest available
supplier of the said materials and its cost
F. Due to effect of Force Majeure
1. Certification from Implementing Office that force majeure has occurred
G. Due to Peace and Order Condition
1. List of similarly affected projects undertaken by other Contractors within the vicinity of the Projects
H. Due to Obstruction
1. List of Utilities affected by RROW
I. Due to DENR Clearance/Permit to Cut/Remove Trees within the Road-Right-of-Way
1. Letter from the Implementing Office to the Secretary regarding the request for DENR Permit
2. DPWH letter to the DENR requesting for the issuance of a tree cutting Permit
J. Due to absence of MMDA Permit/Clearance for Road Repair/Excavation/Traffic Clearance
1. Contractor’s request duly received by the Implementing Office for the Suspension of Work
2. Copy of the original letter request of the Contractor duly received by the MMDA to Issue Clearance/Permit
3. Copy of Application Form for MMDA Permit/Clearance for Road Repair/Excavation/Traffic Clearance
K. Due to absence LGU Permit/Clearance/Homeowners Association Clearance/Permit
1. Contractor’s request duly received by the Implementing Office for the Suspension of Work
2. Copy of the original letter request of the Contractor duly received by the LGU to Issue Clearance/Permit
L. Due to DENR Clearance/Permit to cut/remove trees/Coconut within the Road-Right-Of-Way
1. Contractor’s request duly received by the Implementing Office for the Suspension of Work
2. Copy of the DPWH Letter to the DENR requesting for the issuance of a Tree Cutting Permit
3. PCA Clearance (for Coconut)
4. Letter from the Implementing Office to the Regional Office requesting the DENR for the issuance of
a Tree Cutting Permit
5. DPWH letter reuesting the DENR for the issuance of a Tree Cutting Permit
M. Due to DENR Clearance/Permit to cut/remove trees/Coconut within the Road-Right-Of-Way
1. Contractor’s request duly received by the Implementing Office for the Suspension of Work
2. Certified true copy of Bill of Lading
3. Certification from the Implementing Office that the delivery of materials was delayed due to truck
ban and/or port congestion
N. Due to Revision of Plans
1. Original Construction Plans approved by Authorized DPWH Officials. Proposed revision should be reflected

I hereby certify that the above supporting documents are complete.

Print Name : : REY M. ROA

Designation : : Chief, Construction Section
Date : : July 29, 2023
Contract ID : 1
Project Name : 2
3
Location : 4
Contractor : 5
Annex K
Page 27 of 59
CHECKLIST OF SUPPORTING DOCUMENTS AND ATTACHMENTS FOR DoTS
Contract Work Resumption
General Requirements:
I. To be prepared by the Contractor
1. Letter request of the Contractor for Contract Time Resumption
2. Approved Suspension Order
3. Certified True Copy of Original Contract
Additional supporting documents for specific conditions:
A. Due to Rainy/Unworkable Days considered unfavorable for the prosecution of the works
at the site:
1. Geottaged pictures (with caption i.e., location/station, etc.) showing that the site is workable
B. Due to Delay in the payment of Contractor’s Claim for Progress Billing/s
1. Certified copy of Vouchers/Progress Billings
2. Certification from the Accounting Division of payments made for the progrees billing/s was received
C. Due to Road Right-of-Way Problem
1. Geottaged pictures (with caption i.e., location/station, etc.) of the site before and after the RROW
problem was resolved pictures/photographs of the site with RROW problem
2. Certification from the Barangay Captain/City or Municipality Mayor that the RROW problem was resolved
D. Due to Peace and Order Condition
1. Certification from the PNP station commander concerned and confirmed by the DILG Regional
Director concerned that peace and order condition in the area is already stable
E. Due to Inaccessibility to Project
1. Exhibit geottaged Pictures (with caption i.e.,location/station,etc.) showing proof or resolution of
inaccessibility
2. Relevant document showing the issue of inaccessibility has already been resolved
F. Due to Obstruction
1. Exhibit geottaged Pictures (with caption i.e., location/station, etc.) showing the obstruction was resolved
2. Relevant document showing the issue of inaccessibility has already been resolved
G. Due to Failure of the Government to provide necessary construction plans and/or drawings
1. Proof of the date of approval of construction plan and/or drawings
H. Due to non-availability of construction materials
1. Certification from DTI and the suppliers that the required materials specified in the plans and/or
substitute materials are available in the market
I. Due to effect of Force Majeure
1. Pictures (with caption i.e., location/station,etc.) showing the effect of force majerure was already
addressed to effect Resumption Order
2. Relevant documents such as communication letters, minutes of the meeting relative to the measures
undertaken to address the effect of forece majeure that necessitates issuance of Resumption Order
J. Due to absence of MMDA Permit/Clearance for Road Repair/Excavation/Traffic Clearance
1. Contractor’s request duly received by the Implementing Office for the Suspension of Work
2. Copy of the MMDA Permit/Clearance for Road Repair/Excavation/Traffic Clearance issued for the project

I hereby certify that the above supporting documents are complete.

Print Name : : 1
Designation : : 2
Date : : July 29, 2023
Contract ID : 1
Project Name : 2
3
Location : 4
Contractor : 5
Annex K
Page 28 of 59

CHECKLIST OF SUPPORTING DOCUMENTS AND ATTACHMENTS FOR DoTS

Contract Work Resumption
K. Due to absence of LGU Permit/Clearance/Homeowners Association Clearance/Permit
1. Contractor’s request duly received by the Implementing Office for the Suspension of Work
2. Copy of the LGU Permit/Clearance/Re-blocking permit/clearance issued for the project
L. Due to DENR Clearance/Permit to cut/remove trees/Coconut within the Road-Right-of-Way
1. Contractor’s request duly received by the Implementing Office for the Resumption of Work
2. Copy of the DENR Clearance/Permit to cut/remove trees
3. PCA Clearance (for Coconut)
M. Delayed delivery of Imported Materials due to truck ban and/or port congestion
1. Contractor’s request duly received by the Implementing Office for the Resumption of Work
2. Certified true copy of Bill of Lading
3. Original copy of Custom Clearance
4. Certification from the Implementing Office that the delayed delivery of materials due to truck ban
and port congestion has been resolved

I hereby certify that the above supporting documents are complete.

Print Name : : REY M. ROA

Designation : : Chief, Construction Section
Date : : July 29, 2023
Contract ID : 1
Project Name : 2
3
Location : 4
Contractor : 5
Annex K
Page 29 of 59

CHECKLIST OF SUPPORTING DOCUMENTS AND ATTACHMENTS FOR DoTS

Contract Work Resumption
General Requirements:
II. To be prepared by the Implementing Office
1. Executive Summary
2. Copy of the proposed Resume Order in accordance with the Format per existing department order
3. Project/Consultant Engineer’s Report relative to the resolution of the problem which caused the
issuance of suspension order
4. Complete Contractual Data
Additional supporting documents for specific conditions:
A. Due to Road Right-of-Way Problem
1. Certified True Copy of Payments/Vouchers for RROW acquisition
2. Certified True Copy of Permit to Enter/writ of possession
B. Due to failure of the government to provide necessary construction plans and/or drawings
1. Certification from the Implementing Office that construction plan and/or drawings were already provided
C. Due to non-availability of Construction Materials
1. Certification from the Implementing Office that Construction Materials are already available

I hereby certify that the above supporting documents are complete.

Print Name : : REY M. ROA

Designation : : Chief, Construction Section
Date : : July 29, 2023