AFFILIATION AGREEMENT

KNOW ALL MEN BY THESE PRESENTS:

The AFFILIATION AGREEMENT made and entered into by and between the following:

The BOHOL ISLAND STATE UNIVERSITY (BISU) Calape Campus, a tertiary learning
institution duly registered under the laws of the Philippines, with postal address at San Isidro, Calape,
Bohol represented herein by ANTHONY M. PENASO,Ph.D. ,University President BISU System,
herein referred to as the FIRST PARTY:
AND

The LOCAL GOVERNMENT UNIT OF CALAPE GOVERNING CALAPE MOTHER AND

CHILD HOSPITAL and CALAPE RURAL HEALTH UNIT, Calape, Bohol represented by the Calape
Municipal Mayor, ATTY. JULIUS CAESAR F. HERRERA , herein after referred to as the SECOND
PARTY.
WITNESSETH:
WHEREAS, the First Party offers PARAMEDICAL COURSES such as Diploma in Midwifery
heading towards the Bachelor of Science in Midwifery, One-Year Health Care Services NC II and
Caregiving Program at BISU Calape Campus, Calape, Bohol under the supervision of the Director of
Instruction, monitoring work by the Dean of the Health and Allied Services Department , and to linkage
with the Second Party in their Related Learning Experience;

WHEREAS, the Second Party is a Local Government Unit governing a municipal hospital and rural
health unit that are care provider/implementer of government health programs respectively, which are open
to accept On-the-Job Training (OJT) activities arrangement for all students with the First Party in relation to
care of mothers during pregnancy, labor delivery and postpartum period; care of infants and children; elderly
care and care of people with special needs.

WHEREAS, THE ACCEPTANCE OF THE Second Party to extend services through linkage
agreement; the First Party will send their students for OJT/ Clinical Practicum Duty under the arrangement
as agreed by both parties.

NOW, THEREFORE, in consideration of the foregoing premises, the First Party and the Second
Party have mutually agreed to enter this Affiliation Agreement with the following terms and conditions, to
wit:

A. THE FIRST PARTY AGREES TO:

1. Offer Paramedical courses like Diploma in Midwifery leading to Bachelor of Science in
Midwifery; One-Year Health Care Services NC II and Caregiving Program;
2. Schedule , arrange and monitor Clinical Practicum Duty Internship activities for students
with the Second Party;
3. Follow rules and regulations of the Second Party in the conduct of OJT activities of
paramedical students;
4. BISU shall pay the affiliation fee of Five Pesos (P5.00) per hour per affiliate, including
extension of duty or volunteer training to the Second Party for Calape Mother and Child
Hospital duty affiliates;
5. BISU shall pay the affiliation fee of Two pesos and fifty centavos (P2.50) per hour per affiliate,
including extension of duty or volunteer training to the Second Party for the Rural Health Unit
of Calape duty affiliates;
6. Do other related jobs for the training .
7. That BISU shall ensure that students are able to comply the Clinical Practicum Duty
requirements this COVID 19 pandemic before exposure, not holding the FIRST and SECOND
PARTY liable for whatever illness/ diseases that interns may acquire through the latter’s
negligence, for which reason, they shall submit a Notarized Parental Consent and Notarized
Liability Waiver prior to the start of the Clinical Practicum Exposure/ Internship Training
Program.
8. Shall comply with the Guidelines on the Conduct of Clinical Practicum Exposure during the
COVID-19 pandemic period.

1
B. THE SECOND PARTY AGREES TO:

1. Accept Paramedical students of the First Party to undergo exposure and training activities on
the care of mother during pregnancy, labor, delivery and postpartum period; care of infants
and children; elderly care; and care of people with special need;
2. Give assignment to students who will undergo exposure training not exposing them to highly
probable/ or COVID 19 cases areas.
3. Supervise and monitor also the students as to proper set up of their work assigned to them;
4. Implement rules and policies to the students to observe while undergoing exposure and
training;
5. Issue a certificate of completion and evaluate students performance using the Student
Competency Rating after the training;
6. Provide a student lounge which cost shall be taken from the payment of students’ affiliation
fees;

C. SPECIAL PROVISIONS:

1. Control and supervision over the trainees shall be exercised by the First Party not allowing any
of their midwifery, health care and care giving students to go on duty without the presence and
supervision of their BISU employed Clinical Instructor at any given time subject to the
restrictions as may be imposed by the Second Party within its premises and in so far as
affecting directly the medical care of the patients;
2. This Affiliation of Agreement shall take effect upon signing by the parties named herein and shall
be valid and enforceable for as long as the paramedic courses are still in operation and offered by
the institution;
3. The Second Party is not liable for payment of any wage, salary, honorarium, per diem or the like
to the personnel and the staff of the First Party under the Internship program;
4. The Second Party is not liable for any damage, loss, accident or injury to happen inside the
hospital or RHU premises in connection with or as a consequent to the training activities;
5. The payment of affiliation fees of the students shall be made in lump sum every semester to the
office of the Municipal Treasurer;
6. An endorsement from the school is required for volunteer students;
7. At any time that the circumstances may warrant, the parties hereto may execute a supplemental
agreement or make amendment hereto for the purpose of adding or deleting provisions to this
Agreement as mutually agreed upon.

D. EFFECTIVITY:
This agreement shall take effect upon the signing of this Agreement by the parties hereto and shall be
valid until May , 2025_.

IN WITNESS WHEREOF, the parties have hereunto set their hands this _______________ at
______________________ Bohol, Philippines.

BISU SYSTEM LOCAL GOVERNMENT UNIT OF CALAPE

First Party Second Party

By: By:

ANTHONY M. PENASO,Ph.D. HON. JULIUS CAESAR F. HERRERA

University President, BISU System Municipal Mayor, Calape, Bohol

SIGNED IN THE PRESENCE OF:

DR. MANUEL N. RELAMPAGOS II ABITO H. COSENAS JR

Municipal Health Officer, RHU Administrator Supervisor, CMCH

DR. SAMUEL J. GULAYAN MONETTE G. CUA,RN,RM,MAN

Campus Director Dean, HAS Department

2
 ACKNOWLEDGEMENT

Republic of the Philippines

Province of Bohol
_______________________

BEFORE ME, this _____ day of ___________, 2023 in the locality above written, personally
appeared the following:

NAME RES. TAX ISSUED ON ISSUED AT

DR. ANTHONY M. PENASO __________ _____________ ______________

HON. JULIUS CAESAR F. HERRERA ___________ _____________ ______________

Known to me the same person who executed this foregoing instrument and acknowledge the same to
be their free and voluntary act and deed.

IN WITNESS WHEREOF, I have hereto set my hand on the day, year and place above written.

Doc. No. ________________

Page No. ________________
Book No. _______________
Series of 2023

3
4