Republic of the Philippines

Province of Albay
MUNICIPALITY OF OAS
BARANGAY BALOGO ( ) - Replacement
( ) - Repair /Maintenance
( ) - Installation
STATEMENT OF WORK ACCOMPLISHED ( ) – Construction
As of OCTOBER 9, 2021

Name of Project: Clean and Green Program 2021

Location: Balogo, Oas, Albay
Project Cost: Php. 50,000.00
Source of Fund: 10% SK Fund

Item Unit of Work Percentage of Cost of Project Cost of Project Cost for Cost for Total % T0
No. DESCRIPTION work Accomplished as Completion Previous This Payment (Peso) Total Cost
Measurement of this date Accomplis (Percentage)
Accomplished hed

CLEAN AND
GREEN Php. 49,800
11 days 100% Php 49,950 Php. 49,800
PROGRAM
2021

BY ADMINISTRATION:
Work Actually Started : October 9,2021 Project Cost : Php. 50,000.00
Work Actually Finished : October 17,2021 Less: Labor Only :
Number of Workers : 17 Laborers Cost for Previous Payment :
Number of Men days : 11 Days Present Payment :
Balance : 0
This is to certify that the works has been accomplished in accordance with the plans, specification and requirements thereof and that it has been duly inspected, verified and provisionally
accepted for purpose of payment.

Prepared by:

MA. GLADYS B. HIPOLITO JESSA O. SEDUTAN ENGR. DOMINGO Z. RENALES JR. ANDRIA D. MIRABUENO
SK Treasurer SK Kagawad Municipal Engineer SK Chairman Committee on Infrastructure