Appendix 34

CHECKS AND ADVICES TO DEBIT ACCOUNT DISBURSEMENTS RECORD

WESTERN VISAYAS MEDICAL CENTER

LBP MDS Account No. 2003-9043-88 Fund Clu 101101
Sheet No 1
SAO - CASH SECTION
JANET B. SUSTENTO
Official Designation Station
NCA/Ds/Dv/Payroll CHECK/ADA UACS Nature NCA Check ADA NCA/
Serial No. Date Object of Received/ Issued Issued Bank
DATE Check ADA Date Released PAYEE Code Payment Deposit Made Balance
-
NTCA NO. 025
NCA
1/18/2022 1/18/2022 NO. BMB-B-22-0000328 10,000,000.00 10,000,000.00
NTCA NO. 024
NCA
1/18/2022 1/18/2022 NO. BMB-B-22-0000328 1,920,000.00 11,920,000.00
Payment for Salary of H.R.H. Personnel for the
DEVELOPMENT BANK OF THE period of JANUARY 01 - 15, 2022. (NURSING
1/27/2022 3129866 1/27/2022 PHILIPPINES SERVICE DIVISION) 3,382,472.46 8,537,527.54
NTCA NO. 062
NCA
1/28/2022 1/28/2022 NO. BMB-B-22-0000328 1,000,000.00 9,537,527.54
DEVELOPMENT BANK OF THE Payment for Salary of H.R.H. Personnel for the period of
1/28/2022 3129867 1/28/2022 PHILIPPINES JANUARY 01 - 15, 2022. (NELMAR NEBIT and RODEL TABLE) 17,991.60 9,519,535.94
DEVELOPMENT BANK OF THE Payment for Salary of H.R.H. Personnel for the period of
1/28/2022 3129868 1/28/2022 PHILIPPINES JANUARY 01 - 15, 2022. (MEDICAL DIVISION) 1,064,572.51 8,454,963.43

WESTERN VISAYAS MEDICAL CENTER Payment of Coop remittance of loans of some WVMC Personnel
1/31/2022 3129869 1/31/2022 EMPLOYEES COOPERATIVE from Salaries for the month of JANUARY, 2022. 284,844.00 8,170,119.43
Remit payment of UCPB Loan of some WVMC Personnel
1/31/2022 3129870 1/31/2022 UCPB deducted from Salary for the month of JANUARY, 2022. 843,827.62 7,326,291.81
DEVELOPMENT BANK OF THE Remit payment of DBP Loan of some WVMC Personnel
1/31/2022 3129871 1/31/2022 PHILIPPINES deducted from Salary for the month of JANUARY, 2022. 2,276,341.87 5,049,949.94
5,049,949.94
5,049,949.94
5,049,949.94
TOTAL 12,920,000.00 7,870,050.06 0.00 5,049,949.94
CERTIFICATION
I hereby certify on my official oath that the foregoing is a correct and complete record of all checks/ADA's issued by me in my capacity as
Supervising Administrative Officer - Cash, during the period of JANUARY 1 - 31, 2022, inclusive as indicated in the corresponding columns.

JANET B. SUSTENTO
SAO - Cash Section
 5020000000 NCA No. 19-0010788 /6/24/19

55,945,000.00 21,626,277.19

- 33,827,000.00

NCA No. 19-0024137 dtd. 11/22/19

NCA No. 19-0024137 dtd. 11/22/19

NCA No. 19-0024137 dtd. 11/22/19

7,870,050.06
 NCA Balance as of 12/13, 2019

NCA No. 19-0019732 dtd. 10/14/19 NCA No. 19-0013434 dtd 10/01/19 NCA No. 19-0020321 dtd. 10/01/19 NCA No. 19-0019013 dtd. 10/04/19 NCA No. 19-0019160 dtd. 10/04/19 NCA No. 19-0021508 dtd. 10/07/19 NCA No. 19-0019715 dtd. 10/14 NCA No. 19-0023387 dtd. 11/19/19 NCA No. 19-23380 dat. 11/19/19 NCA No. 19-23500 dat. 11/19/19

0.75 299,786.92 0.40 246.43 793,208.87 393,908.50 0.02 0.38 6,750,000.00 236,227.00

9,600,000.00 24,350,000.00 1,065,000.00

 Terminal Leave Monetization Terminal Leave
NCA No. 19-0024137 dtd. 11/22/19 NCA No. 19-0024253 dtd. 11/22/19 NCA No. 19-0024279 dtd. 11/22/19 NCA No. 19-0025701 dtd. 11/22/19 NCA No. 19-0025711 dtd. 12/06/19 NCA No. 19-0025917 dtd. 12/10/19 Total
2,310,157.00 9,413,499.50 484,000.00 42,307,312.96

24,000.00 1,520,064.00 4,034,467.00 7,924,000.00 82,344,531.00

 CHECKS AND ADVICES TO DEBIT ACCOUNT DISBURSEMENTS RECORD

WESTERN VISAYAS MEDICAL CENTER

LBP MDS Account No. 2003-9043-88

SAO - CASH SECTION

JANET B. SUSTENTO
Official Designation
NCA/Ds/Dv/Payroll CHECK/ADA UACS
Serial No. Date Object
DATE Check ADA Date Released PAYEE Code

2/3/2022 3129872 2/3/2022 VANNIE CONSTRUCTION SUPPLY

2/4/2022 3129873 2/4/2022 UCPB SAVINGS

NTCA NO. 137

NCA
2/4/2022 2/4/2022 NO. BMB-B-22-0000328
NTCA NO. 296
NCA
2/10/2022 2/10/2022 NO. BMB-B-22-0000328
2/10/2022 3129874 2/10/2022 OBF HEALTHCARE PLUS, INC.

2/10/2022 3129875 2/10/2022 DEVELOPMENT BANK OF THE PHILIPPINES

2/14/2022 3129876 2/14/2022 RICHARD SALTIN

2/14/2022 3129877 2/14/2022 CLAUDINE LASQUITE

2/14/2022 3129878 2/14/2022 DEVELOPMENT BANK OF THE PHILIPPINES

2/14/2022 3129879 2/14/2022 HOME DEVELOPMENT MUTUAL FUND

2/23/2022 3129880 2/23/2022 DEVELOPMENT BANK OF THE PHILIPPINES

2/23/2022 3129881 2/23/2022 DEVELOPMENT BANK OF THE PHILIPPINES

2/23/2022 3129882 2/23/2022 DEVELOPMENT BANK OF THE PHILIPPINES

2/23/2022 3129883 2/23/2022 DEVELOPMENT BANK OF THE PHILIPPINES

TOTAL
CERTIFICATION
I hereby certify on my official oath that the foregoing is a correct and complete record of all checks/ADA's issued by me in my capacity as
Supervising Administrative Officer - Cash, during the period of FEBRUARY 01 - 28, 2022, inclusive as indicated in the corresponding columns.
 Appendix 34

CHECKS AND ADVICES TO DEBIT ACCOUNT DISBURSEMENTS RECORD

Fund Cluster 101101

Sheet No. 1

Station
Nature NCA Check ADA NCA/
of Received/ Issued Issued Bank
Payment Deposit Made Balance
5,049,949.94

Payment for the Final Billing for the Labor and Materials
for the Conversion of Geriartric/Hospice Care Rooms to
Isolation Rooms - IB No. 2021-006-1. 1,022,226.73 4,027,723.21

Remit payment of UCPB Loan of some WVMC

Personnel deducted from Salary for the month of
JANUARY, 2022. 843,827.62 3,183,895.59
3,183,895.59

14,943,769.65 18,127,665.24

690,708.96 18,818,374.20
award, notice to proceed and other documents attached. IB
No. 2021-013. 863.94 18,817,510.26
Payment for Salary of H.R.H. Personnel for the period of
JANUARY 16 - 31, 2022. 17,991.60 18,799,518.66
Payment of Cellular Phone Allowance of Mr. Saltin for the
month of FEBRUARY, 2022. 1,200.00 18,798,318.66
Payment for the services rendered of H.R.H. Personnel for the
period of JANUARY 10 - 31, 2022. 16,178.94 18,782,139.72
Payment for Salary of H.R.H. Personnel for the period of
JANUARY 16 - 31, 2022. (MEDICAL DIVISION) 198,802.14 18,583,337.58
Remit PAG - IBIG Contribution of Human Resource of Health
(H.R.H.) of WVMC for the month of JANUARY, 2022. 31,665.34 18,551,672.24
Payment for the services rendered by HRH personnel for the
period FEBRUARY 1-15, 2022 (Nurses, NA) 1,676,004.70 16,875,667.54
Payment for the services rendered by HRH personnel for the
period FEBRUARY 1-15, 2022 (Nebit, Table) 17,925.15 16,857,742.39

Payment for the services rendered by HRH personnel for the

period FEBRUARY 1-15, 2022 (Bueron Justine - Vinluan Therese) 166,849.65 16,690,892.74
Payment for the services rendered by HRH personnel for the
period FEBRUARY 1-15, 2022 (Med Tech, Rad Tech, Pharmacist,
MET, AA) 617,080.49 16,073,812.25

15,634,478.61 4,610,616.30 0.00 16,073,812.25

CERTIFICATION
rd of all checks/ADA's issued by me in my capacity as
ndicated in the corresponding columns.

JANET B. SUSTENTO
SAO - Cash Section
12,920,000.00 15,634,478.61 28,554,478.61
 NCA Balance as of 12/13, 2019

5020000000 NCA No. 19-0010788 /6/24/19 NCA No. 19-0019732 dtd. 10/14/19 NCA No. 19-0013434 dtd 10/01/19 NCA No. 19-0020321 dtd. 10/01/19 NCA No. 19-0019013 dtd. 10/04/19

55,945,000.00 21,626,277.19 0.75 299,786.92 0.40 246.43

NCA No. 19-0010788 /6/24/19

Okey
4,610,616.30
NCA No. 19-0019160 dtd. 10/04/19 NCA No. 19-0021508 dtd. 10/07/19 NCA No. 19-0019715 dtd. 10/14 NCA No. 19-0023387 dtd. 11/19/19 NCA No. 19-23380 dat. 11/19/19 NCA No. 19-23500 dat. 11/19/19

793,208.87 393,908.50 0.02 0.38 6,750,000.00 236,227.00

 Terminal Leave Monetization Terminal Leave
NCA No. 19-0024137 dtd. 11/22/19 NCA No. 19-0024253 dtd. 11/22/19 NCA No. 19-0024279 dtd. 11/22/19 NCA No. 19-0025701 dtd. 11/22/19 NCA No. 19-0025711 dtd. 12/06/19 NCA No. 19-0025917 dtd. 12/10/19

2,310,157.00 9,413,499.50 484,000.00

Total
42,307,312.96
 Appendix 34

CHECKS AND ADVICES TO DEBIT ACCOUNT DISBURSEMENTS RECORD

WESTERN VISAYAS MEDICAL CENTER

LBP MDS Account No. 2003-9043-88 Fund Cluster 101101
Sheet No. 1
SAO - CASH SECTION
JANET B. SUSTENTO
Official Designation Station
NCA/Ds/Dv/Payroll CHECK/ADA UACS Nature NCA Check ADA NCA/
Serial No. Date Object of Issued Issued Bank
DATE Check ADA Date Released PAYEE Code Payment Deposit Made Balance
2/28/2022 BALANCE 16,073,812.25
16,073,812.25
NTCA NO. 364
NCA
3/1/2022 3/1/2022 NO. BMB-B-22-0000328 Notice of Cash Allocation. 23,389,585.03 39,463,397.28
NTCA NO. 486
NCA
3/3/2022 3/3/2022 NO. BMB-B-22-0000328 Notice of Cash Allocation. 300,000.00 39,763,397.28

Payment for the services rendered

DEVELOPMENT BANK OF THE of H.R.H. Personnel for the period of
3/7/2022 3129884 3/7/2022 PHILIPPINES FEBRUARY 16 - 28, 2022. 17,991.60 39,745,405.68

Payment for the services rendered

DEVELOPMENT BANK OF THE by H.R.H. Personnel for the period
3/7/2022 3129885 3/7/2022 PHILIPPINES February 16-28, 2022 (Nurses, NA). 1,647,096.77 38,098,308.91

Payment for the services

rendered by H.R.H. Personnel for
DEVELOPMENT BANK OF THE the period of February 16 - 28,
3/7/2022 3129886 3/7/2022 PHILIPPINES 2022 (Nurse I) 168,461.61 37,929,847.30

Payment for the services

rendered by H.R.H. Personnel for
the period of February 16 - 28,
DEVELOPMENT BANK OF THE 2022 (Med Tech, Rad Tech, AA,
3/7/2022 3129887 3/7/2022 PHILIPPINES Pharmacist etc.) 809,727.18 37,120,120.12

Payment for 15% Mobilization for Construction

of Twin Tower Building A, Phase IV per contract,
award. Notice to proceed and other documents
3/7/2022 3129888 3/7/2022 KRJ CONSTRUCTION attached IB# 2021-058-1 2,027,538.18 35,092,581.94
Payment for the purchase of 1 piece WHO
Classification of Tumors etc. per PO No. 2021-0-
TOPBOOKS HEALTH INFORMATION 175 dtd 9/21/2021 for the use of Dept. of
3/7/2022 3129889 3/7/2022 PROVIDER INC. Pathology -Hispathology Residents 91,140.00 35,001,441.94
 Payment for the purchase of 501 racks Pipette
Tip, 10ul aerosol resistant, racked, sterile,
nuclease free, extended per PO# 2020-07-173
ALLIED HOSPITAL SUPPLY INTERNATIONAL dtd 7/30/2020 for the use of Sub National
3/7/2022 3129890 3/7/2022 CORPORATION Laboratory 204,579.77 34,796,862.17

Payment for final billing for the labora and

amaterials for the Conversion of Geriatrics/
3/7/2022 3129891 3/7/2022 VANNIE CONSTRUCTION AND SUPPLY Hospice Care Rooms to Isolation Rooms 3,500,573.77 31,296,288.40
Payment for final billing for the project
construction of Twin Tower Building A (Phase
3/7/2022 3129892 3/7/2022 IJOJPA CONSTRUCTION 3B ) with IB No. 2021-015-1 480,112.92 30,816,175.48

Payment for 2 units van rental per JO# 2021-09-

0029 dtd 9/7/2021 for transportation services
of WVMC personnel on duty at COVID areas
3/7/2022 3129893 3/7/2022 SST TRANSPORT INC. from 10/11/2021 to 11/11/2021 (32 days) 138,000.00 30,678,175.48
Payment for 200 packs surgical gauze
balls )cherry balls) per award, contract, notice
to proceed and other documents attached IB#
3/8/2022 3129894 3/8/2022 BEROVAN MARKETING INC. 2020-009 42,963.35 30,635,212.13
Payment for the purchase of 1 set
Choledochoscope per contrtact, award, notice
to proceed and other dpcuments attached IB#
3/8/2022 3129895 3/8/2022 MERIJR ENTERPRISES INCORPORATED 2021-020 3,549,064.28 27,086,147.85
Payment for the purchase of 2 pcs 16GB
DDR45SODIMM per contract, award, notice to
proceed and other documents attached IB#
3/8/2022 3129896 3/8/2022 RJR MARKETING 2021-052 181,276.75 26,904,871.10
Remit payment of UCPB Loan of some WVMC
Personnel deducted from Salary for the month
1/31/2022 3129870 1/31/2022 UCPB of JANUARY, 2022. (843,827.62) 27,748,698.72
NTCA NO. 521
NCA
3/9/2022 3/9/2022 NO. BMB-B-22-0000328 17,000,000.00 44,748,698.72
NTCA NO. 543
NCA
3/10/2022 3/10/2022 NO. BMB-B-22-0000328 121,000.00 44,869,698.72
Transfer of fund for drugs and medicines used
by NBB patients charged to MAIP for the period
3/10/2022 3129897 3/10/2022 WVMC - INCOME of JANUARY, 2022. 8,562,981.32 36,306,717.40

CANCELLED - HOME DEVELOPMENT

MUTUAL FUND - ERRONEOUS AMOUNT
INDICATED IN THE DISBURSEMENT Remit PAG - IBIG Contribution of Job Hires of
3/10/2022 3129898 3/10/2022 VOUCHER WVMC for the month of DECEMBER, 2021. 36,306,717.40
Remittance of Disallowance deducted from
Terminal Leave Benefits for unused leave
3/10/2022 3129899 3/10/2022 BUREAU OF TREASURY credits. 38,436.61 36,268,280.79
Remittance of Disallowance deducted from
Terminal Leave Benefits for unused leave
3/10/2022 3129900 3/10/2022 BUREAU OF TREASURY credits. 48,941.50 36,219,339.29
Payment of terminal pay in relation to
3/10/2022 3129901 3/10/2022 JOHANNA MARIE IDIO retirement effective MAY 18, 2021. 130,113.69 36,089,225.60

CANCELLED - BONA DEA BRETAÑA - Payment of terminal pay in relation to

3/10/2022 3129902 3/10/2022 ERRONEOUS ENCODING OF PAYEES' NAME retirement effective July 09, 2019. - 36,089,225.60
Payment of terminal pay in relation to
3/10/2022 3129903 3/10/2022 AICO JANE LEGITA retirement effective MAY 16, 2021. 54,484.06 36,034,741.54
Payment of terminal pay in relation to
3/10/2022 3129904 3/10/2022 CHRISTINE GUMBAN retirement effective OCTOBER 01, 2021. 244,214.12 35,790,527.42
 Payment of terminal leave benfits due to
resignation/retired/end of contract effective
3/10/2022 3129905 3/10/2022 THERRIE GRACE LORILLA NOVEMBER 01, 2021. 540,816.64 35,249,710.78
Payment of terminal pay in relation to
3/10/2022 3129906 3/10/2022 ARTURO POSTOLERO retirement effective AUGUST 01, 2021. 574,330.14 34,675,380.64
Payment of terminal pay in relation to
3/10/2022 3129907 3/10/2022 RALPH GREGOR LEONO retirement effective JANUARY 01, 2022. 621,896.88 34,053,483.76
Payment of terminal pay in relation to
3/10/2022 3129908 3/10/2022 BONA DEA BRETAÑA retirement effective July 09, 2019. 220,543.39 33,832,940.37
NTCA NO. 551
NCA
3/11/2022 3/11/2022 NO. BMB-B-22-0000328 Notice of Cash Allocation. 20,340,519.55 54,173,459.92
54,173,459.92
Remittance of Disallowance deducted from
Terminal Leave Benefits for unused leave
3/14/2022 3129909 3/14/2022 BUREAU OF TREASURY credits of Dr. Florenor Abonado. 3,015.10 54,170,444.82
Remittance of Disallowance deducted from
Terminal Leave Benefits for unused leave
3/14/2022 3129910 3/14/2022 BUREAU OF TREASURY credits of Dr. Florenor Abonado. 15,747.28 54,154,697.54
Payment of Terminal Pay in relation to
3/14/2022 3129911 3/14/2022 DR. FLORENOR ABONADO retirement effective NOVEMBER 16, 2021. 495,183.18 53,659,514.36
Transfer of fund for drugs and medicines used
by NBB patients charged to MAIP for the period
3/14/2022 3129912 3/14/2022 WVMC - DRUGS AND MEDICINES of JANUARY, 2022. 1,437,018.68 52,222,495.68

Remit PAG - IBIG Contribution of Job Hires of

3/15/2022 3129913 3/15/2022 HOME DEVELOPMENT MUTUAL FUND WVMC for the month of DECEMBER, 2021. 30,261.77 52,192,233.91

Payment for the purchase of two (2)

pieces Network Attached Storage (NAG)
NAS - Synology with Installed Hard
Drives 4 units x 2 Tera Byte 3 - 5 HDD.
TECHNOSURE ELECTRONICS AND IB No. 2021-060, Sales Invoice No.
3/16/2022 3129914 3/16/2022 ELECTRICAL SUPPLY AND SERVICES 554 88,024.28 52,104,209.63
Payment for the Performance Based
Bonus (PBB) to WVMC Employees for
3/17/2022 3129915 3/17/2022 DEVELOPMENT BANK OF THE PHILIPPINES the Year 2019. 16,511,975.48 35,592,234.15
NTCA NO. 618
NCA
3/17/2022 3/17/2022 NO. BMB-B-22-0001972 Notice of Cash Allocation. 38,070,000.00 73,662,234.15
Payment of hospital supplies of NBB patients
charged against MAIP for the period of
3/23/2022 3129916 3/23/2022 WVMC - INCOME JANUARY, 2022. 500,000.00 73,162,234.15
Transfer of fund for drugs and medicines used
by NBB patients charged to MAIP for the period
3/23/2022 3129917 3/23/2022 WVMC - DRUGS AND MEDICINES of JANUARY, 2022. 609,171.75 72,553,062.40
Transfer of fund for drugs and medicines used
by NBB patients charged to MAIP for the period
3/23/2022 3129918 3/23/2022 WVMC - DRUGS AND MEDICINES of JANUARY, 2022. 1,000,000.00 71,553,062.40
Payment of hospital bills, etc., of NBB patients
charged against MAIP for the period of
3/23/2022 3129919 3/23/2022 WVMC - INCOME FEBRUARY, 2022. 1,755,882.44 69,797,179.96
Payment of hospital bills, etc., of NBB patients
charged against MAIP for the period of
3/23/2022 3129920 3/23/2022 WVMC - INCOME JANUARY, 2022. 3,390,828.25 66,406,351.71
Transfer of fund for drugs and medicines used
by NBB patients charged against MAIP for the
3/23/2022 3129921 3/23/2022 WVMC - DRUGS AND MEDICINES period of FEBRUARY, 2022. 244,117.56 66,162,234.15
Transfer of fund for drugs and medicines used
by NBB patients charged against MAIP for the
3/23/2022 3129922 3/23/2022 WVMC - DRUGS AND MEDICINES period of FEBRUARY, 2022. 283,813.05 65,878,421.10
 Payment of hospital bills, etc., of NBB patients
charged against MAIP for the period of
3/23/2022 3129923 3/23/2022 WVMC - INCOME FEBRUARY, 2022. 1,466,186.95 64,412,234.15
64,412,234.15

CANCELLED - DEVELOPMENT BANK OF THE

PHILIPPINES - ERRONEOUS AMOUNT Payment of One Covid 19 Allowance (OCA) for
INDICATED IN THE DISBURSEMENT the period of JANUARY - FEBRUARY, 2022.
3/23/2022 3129924 3/23/2022 VOUCHER. (Regular Employees) - 64,412,234.15
Payment of One Covid 19 Allowance (OCA) for
the period of JANUARY - FEBRUARY, 2022.
3/23/2022 3129925 3/23/2022 DEVELOPMENT BANK OF THE PHILIPPINES (Jobhire Employees) 18,456,000.00 45,956,234.15
Remittance of GSIS Life and Retirement
Premium Personal and Governemnt Share and
loans of some WVMC Employees for the month
3/23/2022 3129926 3/23/2022 GOVERNMENT SERVICE INSURANCE SYSTEM of MARCH, 2022. 13,328,694.63 32,627,539.52
Payment of hospital bills, etc., of NBB patients
chrged against MAIP for the period of
3/23/2022 3129927 3/23/2022 WVMC - INCOME FEBRUARY, 2022. 12,760,251.71 19,867,287.81
Payment of hospital bills, etc., of NBB patients
chrged against MAIP for the period of
3/23/2022 3/23/2022 WVMC - INCOME FEBRUARY, 2022. 19,867,287.81
Payment of One Covid 19 Allowance (OCA) for
the period of JANUARY - FEBRUARY, 2022.
3/23/2022 3129928 3/23/2022 DEVELOPMENT BANK OF THE PHILIPPINES (REGULAR EMPLOYEES) 18,126,499.63 1,740,788.18
Purchase of two (2) units Defibrillator with
Cardiac Monitor as per contract, award, notice
PINNACLE SUPPLIES AND SERVICES to proceed and other documents attached. IB
3/28/2022 3129929 3/28/2022 UNLIMITED INC. No. 2021-044 567,565.72 1,173,222.46

Payment for the purchase of 100 bottles

Disinfectant Spray Plastic Bottle 500 ml. with
trigger spray as per contract, award, notice to
proceed and other documents attached. IB
3/28/2022 3129930 3/28/2022 ELM INDUSTRIAL SALES NO. 2022-003; Sales invoice No. 25791 6,742.28 1,166,480.18
Payment for her last salary payroll for the
3/28/2022 3129931 3/28/2022 FRANCES MARIE TOLEDO month of FEBRUARY, 2022. 6,337.19 1,160,142.99
Payment for the purchase of 1,008 Rolls Paper
Towel Laminated, 2 ply as per contract, award,
notice to proceed and other documents
attached. IB No. 2022-003; Sales Invoice No.
3/28/2022 3129932 3/28/2022 RJR MARKETING 0543 368,128.80 792,014.19
Payment for the purchase of sixty (60) packs
Microcentrifuge tubes, 1.5 ml., as per P.O. No.
2020-09-0211 dated SEPTEMBER 11, 2020 for
the use of Sub - National Laboraotry (Covid
3/28/2022 3129933 3/28/2022 MEDICAL TEST SYSTEMS, INC. Testing). 81,308.57 710,705.62

Payment of Coop remittance of loans of some

WESTERN VISAYAS MEDICAL CENTER Payemnt
WVMC for the purchase
Personnel of 130
from Hazard Paysacks White
for the
3/28/2022 3129934 3/28/2022 EMPLOYEES COOPERATIVE Milled
month Rice 50 kilos/sack
of MARCH, 2022. for the Znutrition and 190,894.22 519,811.40
Dietetics Service use for the period of
FEBRUARY 14, 2022 as per contract, award,
notice to proceed and other documents
attached. IB No. 2021-031; Sales Invoice No.
3/28/2022 3129935 3/28/2022 RJR MARKETING 539. 262,827.41 256,983.99
Payment for two (2) lot Courier Service with
Quarantine Permit as per J.O. No. 2021-02-
0002 dated FEBRUARY 08, 2021. Waybill No.
3/28/2022 3129936 3/28/2022 LIBCAP SUPER EXPRESS CORPORATION 873783 and
Payment for 873782.
the purchase of 1,500 pieces KN 95 2,433.75 254,550.24
Respirator Mask and etc., as per contract,
award, notice to proceed and other documents
attached. IB No. 2022-003; Sales Invoice
3/28/2022 3129937 3/28/2022 ELM INDUSTRIAL SALES No. 25758 and 25760. 170,781.16 83,769.08
 Payment for the purchase of one (1) Unit
Centrifuge, 24 placer as per contract, award,
notice to proceed and other documents
attached. IB No. 2021-073, Sales Invoice No.
3/28/2022 3129938 3/28/2022 MEDICOTEK, INC. 5974 79,596.43 4,172.65

To remit SSS Contribution of Job Hires of WVMC

3/30/2022 3129939 3/30/2022 SOCIAL SECURITY SYSTEM for the month of MARCH, 2022. 476.47 3,696.18

To remit SSS Contribution of Job Hires of WVMC

3/30/2022 3129940 3/30/2022 SOCIAL SECURITY SYSTEM for the month of MARCH, 2022. 3,696.18 (0.00)

(0.00)

TOTAL 99,221,104.58 115,294,916.83 0.00 -

CERTIFICATION
I hereby certify on my official oath that the foregoing is a correct and complete record of all checks/ADA's issued by me in my capacity as
Supervising Administrative Officer - Cash, during the period of MARCH 01 - 31, 2022, inclusive as indicated in the corresponding columns.

JANET B. SUSTENTO
SAO - Cash Section
 99,100,104.58 127,654,583.19 128,619,410.81
12,920,000.00 843,827.62 88,398,959.93
15,634,478.61 128,498,410.81 40,220,450.88
127,654,583.19 127,775,583.19 115,294,916.83
(127,654,583.19) 722,827.62 26,895,956.90
5020000000 NCA No. 19-0010788 /6/24/19

55,945,000.00 21,626,277.19

- 33,827,000.00
 114,484,911.04

(58,539,911.04)

55,453,277.19

Obligation -

55,453,277.19

42,313,912.97
 6,000.00

42,307,912.97
90,174,209.63

Okey
115,294,916.83
 NCA Balance as of 12/13, 2019

NCA No. 19-0019732 dtd. 10/14/19 NCA No. 19-0013434 dtd 10/01/19 NCA No. 19-0020321 dtd. 10/01/19 NCA No. 19-0019013 dtd. 10/04/19 NCA No. 19-0019160 dtd. 10/04/19 NCA No. 19-0021508 dtd. 10/07/19 NCA No. 19-0019715 dtd. 10/14NCA No. 19-0023387 dtd. 11/19/19 NCA No. 19-23380 dat. 11/19/19

0.75 299,786.92 0.40 246.43 793,208.87 393,908.50 0.02 0.38 6,750,000.00

9,600,000.00 24,350,000.00 1,065,000.00

0.75 9,899,786.92 0.40 246.43 25,143,208.87 1,458,908.50 0.02 0.38 6,750,000.00

- - - - - -

0.75 9,899,786.92 0.40 246.43 25,143,208.87 1,458,908.50 0.02 0.38 6,750,000.00

784.00
 Terminal Leave Monetization Terminal Leave
NCA No. 19-23500 dat. 11/19/19 NCA No. 19-0024137 dtd. 11/22/19 NCA No. 19-0024253 dtd. 11/22/19 NCA No. 19-0024279 dtd. 11/22/19 NCA No. 19-0025701 dtd. 11/22/19 NCA No. 19-0025711 dtd. 12/06/19 NCA No. 19-0025917 dtd. 12/10/19 Total
236,227.00 2,310,157.00 9,413,499.50 484,000.00 42,307,312.96

24,000.00 1,520,064.00 4,034,467.00 7,924,000.00 82,344,531.00

 -

236,227.00 2,310,157.00 9,413,499.50 508,000.00 1,520,064.00 4,034,467.00 7,924,000.00 124,651,843.96

- - - - - - - -

236,227.00 2,310,157.00 9,413,499.50 508,000.00 1,520,064.00 4,034,467.00 7,924,000.00 124,651,843.96

124,651,843.96
-
 Appendix 34

CHECKS AND ADVICES TO DEBIT ACCOUNT DISBURSEMENTS RECORD

WESTERN VISAYAS MEDICAL CENTER

LBP MDS Account No. 2003-9043-88 Fund Cluster 101101
Sheet No. 1
SAO - CASH SECTION
JANET B. SUSTENTO
Official Designation Station
NCA/Ds/Dv/Payroll CHECK/ADA UACS Nature NCA Check ADA NCA/
Serial No. Date Object of Received/ Issued Issued Bank
DATE Check ADA Date Released PAYEE Code Payment Deposit Made Balance
3/31/2022 BEGINNING BALANCE -
NTCA NO. 731
NCA
4/1/2022 4/1/2022 NO. BMB-B-22-0002724 Notice of Cash Allocation. 3,058,328.34 3,058,328.34
NTCA NO. 823
NCA
4/1/2022 4/1/2022 NO. BMB-B-22-0002724 Notice of Cash Allocation. 8,109,120.15 11,167,448.49
Payment of terminal pay in relation to resignation
4/6/2022 3129941 4/6/2022 JEU LONGNO effective DECEMBER 01, 2021. 188,442.40 10,979,006.09
Payment of terminal pay in relation to resignation
4/6/2022 3129942 4/6/2022 ALLEN MARK MATUTINA effective JANUARY 05, 2022. 111,114.32 10,867,891.77
Payment of terminal pay in relation to retirement
4/6/2022 3129943 4/6/2022 LEAH VALENCIA effective JANUARY 08, 2022. 545,375.53 10,322,516.24
Payment of terminal pay in relation to resignation
4/6/2022 3129944 4/6/2022 KIM STEVE PEÑARANDA effective DECEMBER 10, 2021. 505,302.34 9,817,213.90
Payment of terminal pay in relation to retirement
4/6/2022 3129945 4/6/2022 JOLA BALAGOSA effective OCTOBER 30, 2021. 170,906.57 9,646,307.33
Payment of terminal pay in relation to resignation
4/6/2022 3129946 4/6/2022 SHEILA MAE SOBREVEGA effective AUGUST 15, 2021. 70,680.28 9,575,627.05
Payment of terminal pay in relation to resignation
4/6/2022 3129947 4/6/2022 FREDDIE JUNE ESCULTERO effective FEBRUARY 15,2022. 145,737.75 9,429,889.30
Payment of terminal pay in relation to resignation
4/6/2022 3129948 4/6/2022 SWEDEN JAVIER - PALMARES effective FEBRUARY 01,2022. 147,505.90 9,282,383.40
Payment of terminal pay in relation to retirement
4/6/2022 3129949 4/6/2022 FLORENTINA MANGYAN effective JANUARY 05,2022. 565,208.48 8,717,174.92
Payment of terminal pay in relation to retirement
4/6/2022 3129950 4/6/2022 EVELYN LANDERO effective JANUARY 15,2022. 504,495.29 8,212,679.63
Remittance of Disallowance for Drugs and Medicines
of Jola Balagosa deducted from her terminal leave
4/6/2022 3129951 4/6/2022 WVMC - DRUGS AND MEDICINES benefits for unused leave credits. 33,288.07 8,179,391.56

Remittance of Subsistence Disallowance of LEAH

VALENCIA deducted from terminal leave benefits for
4/6/2022 3129952 4/6/2022 BUREAU OF TREASURY unused leave credits . (for remittance to FUND 101) 14,056.00 8,165,335.56
 Payment for the water bills of WVMC for the period of
4/22/2022 3129953 4/22/2022 METRO PACIFIC ILOILO WATER INC. FEBRUARY 18, 2022 to MARCH 17, 2022., 482,526.00 7,682,809.56
DEVELOPMENT ACADEMY OF THE Payment for the Course Tuition Fee on Hospital
4/22/2022 3129954 4/22/2022 PHILIPPINES Quality Improvement Batch 3. 22,500.00 7,660,309.56

CANCELLED - CHRISTINNE FAITH

PEFIANCO - ERRONEOUS ENCODING Payment for 2019 PBB of the deceased Ms. Teresita
4/22/2022 3129955 4/22/2022 OF PAYEE'S NAME Pefianco, former Nurse Supervisor of WVMC. - 7,660,309.56
Payment for PBB of deceased husband Mr. Rowell
4/22/2022 3129956 4/22/2022 GIRLY TUBID Tubid. 15,454.50 7,644,855.06

Payment for the purchase of fifty (50) bottles

Ultrapure Distilled Water, Rnase/Dnase Free,
Molecular Grade 500 ml., as per contract, award,
notice to proceed and other documents attached. IB
4/22/2022 3129957 4/22/2022 BIOSITE MEDICAL INSTRUMENTS No. 2021-043; Sales Invoice No. 12810. 50,567.15 7,594,287.91

Payment for 2019 PBB of the deceased Ms. Teresita

4/22/2022 3129958 4/22/2022 CHRISTINNE FAITH PEFIANCO Pefianco, former Nurse Supervisor of WVMC. 18,700.00 7,575,587.91

Payment for the one percent (1%) Retention Fee for

the purchase of Mobile Sterilizer Cabinet etc., as per
PRO - LIFE HEALTHCARE SYSTEM IB No. 2020-043 and other supporting documents
4/28/2022 3129959 4/28/2022 CORPORATION attached. 3,499.00 7,572,088.91
Payment for one percent (1%) Retention Fee for the
purchase of medical supplies for the use of Central
4/28/2022 3129960 4/28/2022 APCO MEDICAL SUPPLY AND SERVICES Supply as per IB No. 2021-007. 2,400.00 7,569,688.91
7,569,688.91
7,569,688.91
7,569,688.91
TOTAL 11,167,448.49 3,597,759.58 - 7,569,688.91
CERTIFICATION
I hereby certify on my official oath that the foregoing is a correct and complete record of all checks/ADA's issued by me in my capacity as
Supervising Administrative Officer - Cash, during the period of APRIL 01 - 30, 2022, inclusive as indicated in the corresponding columns.

JANET B. SUSTENTO
SAO - Cash Section
7,569,688.91
7,569,688.91
5,020,000,000.00 NCA No. 19-0010788 /6/24/19

55,945,000.00 21,626,277.19

0.00 33,827,000.00
NCA No. 19-0010788 /6/24/19

Okey
3,597,759.58
 NCA Balance as of 12/13, 2019

NCA No. 19-0019732 dtd. 10/14/19 NCA No. 19-0013434 dtd 10/01/19 NCA No. 19-0020321 dtd. 10/01/19 NCA No. 19-0019013 dtd. 10/04/19 NCA No. 19-0019160 dtd. 10/04/19NCA No. 19-0021508 dtd. 10/07/19 NCA No. 19-0019715 dtd. 10/14 NCA No. 19-0023387 dtd. 11/19/19 NCA No. 19-23380 dat. 11/19/19 NCA No. 19-23500 dat. 11/19/19

0.75 299,786.92 0.40 246.43 793,208.87 393,908.50 0.02 0.38 6,750,000.00 236,227.00

9,600,000.00 24,350,000.00 1,065,000.00

 Terminal Leave Monetization Terminal Leave
NCA No. 19-0024137 dtd. 11/22/19 NCA No. 19-0024253 dtd. 11/22/19 NCA No. 19-0024279 dtd. 11/22/19 NCA No. 19-0025701 dtd. 11/22/19 NCA No. 19-0025711 dtd. 12/06/19 NCA No. 19-0025917 dtd. 12/10/19 Total
2,310,157.00 9,413,499.50 484,000.00 42,307,312.96

24,000.00 1,520,064.00 4,034,467.00 7,924,000.00 82,344,531.00

 Appendix 34

CHECKS AND ADVICES TO DEBIT ACCOUNT DISBURSEMENTS RECORD

WESTERN VISAYAS MEDICAL CENTER

LBP MDS Account No. 2003-9043-88 Fund Cluster : 101101
Sheet No. : 1
SAO - CASH SECTION
JANET B. SUSTENTO
Official Designation Station
NCA/Ds/Dv/Payroll CHECK/ADA UACS Nature NCA Check ADA NCA/
Serial No. Date Object of Received/ Issued Issued Bank
DATE Check ADA Date Released PAYEE Code Payment Deposit Made Balance
4/30/2022 4/30/2022 BEGINNING BALANCE 7,569,688.91
NTCA NO. 1020
5/2/2022 5/2/2022 NCA NO. BMB-B-22-0002724 Notice of Cash Allocation. 9,504,473.22 17,074,162.13
NTCA NO. 975
5/2/2022 5/2/2022 NCA NO. BMB-B-22-0002724 Notice of Cash Allocation. 14,455,000.00 31,529,162.13

NTCA NO. 1044

5/4/2022 5/4/2022 NCA NO. BMB-B-22-0002724 Notice of Cash Allocation. 1,019,685.74 32,548,847.87
MACARE MEDICALS, INCORPORATED Payment for five (5) pieces, six (6) Shooter Saeed Multi - Band Ligator-6 bands as per contract, award, notice
5/4/2022 3129961 5/4/2022 to proceed and other documents attached. IB No. 2020-027. 27,975.80 32,520,872.07
ENDURE MEDICAL, INC. Payment for the purchase of 15 boxes Inoculating Loop 1 ul 10 pieces/pack and etc., as per contract, award,
5/4/2022 3129962 5/4/2022 notice to proceed and other documents attached. IB No. 2021-023; Sales Invoice No. 322611. 109,671.16 32,411,200.91
FAS DIAGNOSTIC GROUP INC. Payment for 180 tests Vidas TSH 60 T and etc., for the month of FEBRUARY, 2022 as per contract, award,
5/4/2022 3129963 5/4/2022 notice to proceed and other documents attached. IB No. 2020-005. 178,576.93 32,232,623.98
Payment for the purchase of 272 galloons Alcohol Isoprophyl 70% Solution and etc., as per contract, award,
5/4/2022 3129964 5/4/2022 JOSMEF ENTERPRISES notice to proceed and other documents attached. IB No. 2022-003; Sales Invoice No. 0062646. 1,112,214.46 31,120,409.52
Payment for the purchase of 167 pieces Monofilament Absorbable 3/0 Round Needle 90 cm. 26 mm. and etc.,
as per contract, award, notice to proceed and other documents attached. IB No. 2021-033; Sales Invoice No.
5/4/2022 3129965 5/4/2022 JOSMEF ENTERPRISES 62694 1,241,724.15 29,878,685.37
Payment for 43,812.57 cubic meter Liquid Oxygen as per contract, award, notice to proceed and other
5/4/2022 3129966 5/4/2022 NEW PRIME GAS, INC. documents attached. IB No. 2021-039. 1,887,257.75 27,991,427.62
Payment for the purchase of 82 Jars Disinfecting Tablet 2.5 g 50% Troclosene Sodium effective against
5/4/2022 3129967 5/4/2022 BEROVAN MARKETING, INC. bacteria, fungi, viruses, etc., as per IB No. 2022-003; Sales Invoice No. 39373. 191,967.85 27,799,459.77
Payment for the services rendered of H.R.H. Personnel for the period of APRIL 16 - 30, 2022. (MEDICAL
5/6/2022 3129968 5/6/2022 DEVELOPMENT BANK OF THE PHILIPPINES DIVISION) 285,187.87 27,514,271.90
Payment for the services rendered of H.R.H. Personnel for the period of APRIL 16 - 30, 2022. (MEDICAL
5/6/2022 3129969 5/6/2022 DEVELOPMENT BANK OF THE PHILIPPINES DIVISION) 747,546.11 26,766,725.79
Payment for the services rendered of H.R.H. Personnel for the period of APRIL 16 - 30, 2022. (NURSING
5/6/2022 3129970 5/6/2022 DEVELOPMENT BANK OF THE PHILIPPINES SERVICE DIVISION) 942,566.46 25,824,159.33
CANCELLED - CHRISTINNE KATE PEFIANCO - ERRONEOUS
5/11/2022 3129971 5/11/2022 ENCODING OF PAYEES' NAME Payment for 2019 PBB of the deceased Ms. Teresita Pefianco. - 25,824,159.33

4/22/2022 3129958 4/22/2022 CHRISTINNE FAITH PEFIANCO Payment for 2019 PBB of the deceased Ms. Teresita Pefianco, former Nurse Supervisor of WVMC. (18,700.00) 25,842,859.33

5/11/2022 3129972 5/11/2022 CHRISTINNE KATE PEFIANCO Payment for 2019 PBB of the deceased Ms. Teresita Pefianco. 18,700.00 25,824,159.33

5/11/2022 3129973 5/11/2022 NELMAR NEBIT Payment for the services rendered of H.R.H. Personnel for the perido of APRIl 16 - 30, 2022. 8,995.80 25,815,163.53
Payment for the services rendered of H.R.H. Personnel for the period of APRIL 16 to 30, 2022. (Sobremisana,
5/11/2022 3129974 5/11/2022 DEVELOPMENT BANK OF THE PHILIPPINES Claire and Sumayo, Grenel Josefin) 41,948.89 25,773,214.64

5/11/2022 3129975 5/11/2022 JULIUS CAEZAR GADAYAN Payment of Terminal Pay in relation to Resignation effective FEBRUARY 15, 2022. 282,991.78 25,490,222.86
REMITTANCE OF OVERPAYMENT OF SALARY AND BENEFITS OF JULIUS CAEZAR GADAYAN DEDUCTED FROM
5/11/2022 3129976 5/11/2022 BUREAU OF TREASURY TERMINAL LEAVE BENEFITS 49,732.55 25,440,490.31

5/11/2022 3129977 5/11/2022 SEIGFRED LLOYD PALMARES Payment of Terminal Pay benefit due to resignation effective of APRIL 01, 2022. 197,009.71 25,243,480.60

5/11/2022 3129978 5/11/2022 JAN CARL BARBASAN Payment of Terminal Pay benefit due to resignation effective of JANUARY 17, 2022. 400,286.23 24,843,194.37
Remittance of GSIS Loan of JAN CARL BARBASAN deducted from his terminal leave benefits for unused leave
5/11/2022 3129979 5/11/2022 GOVERNMENT SERVICE INSURANCE SYSTEM credits. 89,665.47 24,753,528.90
NTCA NO. 1146
5/11/2022 5/11/2022 NCA NO. BMB-B-22-0002724 Notice of Cash Allocation. 2,240,750.00 26,994,278.90
NTCA NO. 1248
5/12/2022 5/12/2022 NCA NO. BMB-B-22-0002724 Notice of Cash Allocation. 1,470,358.89 28,464,637.79
NTCA NO. 1269
5/12/2022 5/12/2022 NCA NO. BMB-B-22-0002724 Notice of Cash Allocation. 20,306,593.75 48,771,231.54

5/13/2022 3129980 5/13/2022 SHALATELELE DELOVIAR Payment for the restoration of absences deducted from salary for the period March 16-31, 2022 21,058.20 48,750,173.34

5/13/2022 3129981 5/13/2022 PHILIPPINE HEALTH INSURANCE CORPORATION Payment for HRH personnel Philhealth premium for the period April 2022 64,021.53 48,686,151.81

5/13/2022 3129982 5/13/2022 PHILIPPINE HEALTH INSURANCE CORPORATION Payment for HRH personnel Philhealth premium for the period April 2022 38,636.07 48,647,515.74
 Payment for the Job Order One COVID - 19 Allowance (OCA) for the period of JANUARY 01 to FEBRUARY 28,
5/17/2022 3129983 5/17/2022 DEVELOPMENT BANK OF THE PHILIPPINES 2022. 2,240,750.00 46,406,765.74
Transfer of fund for drugs and medicines used by NBB patients patients charged to MAIP for the period of
5/17/2022 3129984 5/17/2022 WVMC - DRUGS AND MEDICINES MARCH, 2022. 173,214.24 46,233,551.50

5/17/2022 3129985 5/17/2022 WVMC - INCOME Payment of hospital bills, etc., of NBB patients charged against MAIP for the period of MARCH, 2022. 826,785.76 45,406,765.74

5/19/2022 3129986 5/19/2022 DEVELOPMENT BANK OF THE PHILIPPINES Payment for ONE COVID Allowance for the period of MARCH, 2022. 7,146,446.22 38,260,319.52
Payment for the services rendered of H.R.H. Personnel for the period of MAY 01 - 15, 2022. (MEDICAL
5/20/2022 3129987 5/20/2022 DEVELOPMENT BANK OF THE PHILIPPINES DIVISION) 277,531.21 37,982,788.31
Payment for the services rendered of H.R.H. Personnel for the period of MAY 01 - 15, 2022. (NURSING
5/20/2022 3129988 5/20/2022 DEVELOPMENT BANK OF THE PHILIPPINES SERVICE DIVISION) 962,566.75 37,020,221.56
Payment for the services rendered of H.R.H. Personnel for the period of MAY 01 - 15, 2022. (MEDICAL
5/20/2022 3129989 5/20/2022 DEVELOPMENT BANK OF THE PHILIPPINES TECHNOLOGIST) 737,839.26 36,282,382.30

5/20/2022 3129990 5/20/2022 DEVELOPMENT BANK OF THE PHILIPPINES Payment for the services rendered of H.R.H. Personnel for the period of MAY 01 - 15, 2022. (H.E.M.U.) 8,995.80 36,273,386.50

5/20/2022 3129991 5/20/2022 GRACE DONASCO Payment of Terminal Pay in relation to Resignation effective FEBRUARY 09, 2022. 971,088.07 35,302,298.43

5/20/2022 3129992 5/20/2022 ALYSSA GWEN LAUDATO Payment of Terminal Pay in relation to Resignation effective FEBRUARY 01, 2022. 43,139.40 35,259,159.03

5/20/2022 3129993 5/20/2022 FRANCES MARIE TOLEDO Payment of Terminal Pay in relation to Resignation effective FEBRUARY 05, 2022. 76,020.84 35,183,138.19

5/20/2022 3129994 5/20/2022 SONIA CAMACHO Payment of Terminal Pay in relation to Resignation effective JANUARY 31, 2022. 324,668.48 34,858,469.71
Remittance of Disallowance deducted from Terminal Leave Benefits for unused leave credits of Hazard
5/20/2022 3129995 5/20/2022 BUREAU OF TREASURY Disallowance of Grace Donasco. 10,760.10 34,847,709.61
Remittance of Disallowance deducted from Terminal Leave Benefits for unused leave credits of Hazard
5/20/2022 3129996 5/20/2022 BUREAU OF TREASURY Disallowance of Grace Donasco. 44,682.00 34,803,027.61
Payment for the services rendered of H.R.H. Personnel for the period of MAY 01 to 15, 2022. (Sobremisana,
5/20/2022 3129997 5/20/2022 DEVELOPMENT BANK OF THE PHILIPPINES Claire and Sumayo, Grenel Josefin) 41,043.39 34,761,984.22
Payment for the various telephone bill of various departments of WVMC for the billing period of APRIL 17,
5/20/2022 3129998 5/20/2022 PLDT, INC. 2022. 2,464.78 34,759,519.44
Payment for the purchase of28,085.55 cubic meter Liquid Oxygen as per contract, award, notice to proceed
5/20/2022 3129999 5/20/2022 NEW PRIME GAS, INC. and other documents attached. IB No. 2021-039. 1,209,805.13 33,549,714.31
Payment for 2,000 pieces Abdominal Pack Surgical Lap Sponge etc., as per contract, award, notice to proceed
5/20/2022 3130000 5/20/2022 BEROVAN MARKETING, INC. and other documents attached. IB No. 2021-032. 161,908.50 33,387,805.81
Payment for the purchase of 100,000 pieces Capillary Blood Glucose Strips as per contract, award, notice to
5/20/2022 3137001 5/20/2022 BIOSPECTRA MARKETING proceed and other documents attached. IB No. 2022-003. 1,465,324.12 31,922,481.69
Payment for the purchase of 36,563.22 cubic meter Liquid Oxygen, as per contract, award, notice to proceed
5/20/2022 3137002 5/20/2022 NEW PRIME GAS, INC. and other documents attached. IB No. 2021-039; Sales Invoice No. 48864, 48863, 48862, 48861. 1,574,986.82 30,347,494.87
Payment for the purchase of 1,295 cylinders Medical Oxygen as per contract, award, notice to proceed and
5/20/2022 3137003 5/20/2022 NEW PRIME GAS, INC. other documents attached. IB No. 2021-061. 363,802.50 29,983,692.37
Payment for the purchase of 1,000 tests Procalcitonin Reagent, as per contract, award, notice to proceed and
5/20/2022 3137004 5/20/2022 ALLIED HOSPITAL SUPPLY INTERNATIONAL CORPORATION other dcouments attached. IB No. 2021-023; Sales Invoice No. 168068. 1,404,642.85 28,579,049.52
Payment for the purchase of 150,000 pieces Medical Face Mask, Disposable as per contract, award, notice to
5/20/2022 3137005 5/20/2022 APCO MEDICAL SUPPLY AND SERVICES proceed and other documents attached. IB No. 2022-003. 172,771.07 28,406,278.45
Payment for the one percent (1%) Retention Fee for the purchase of various office supplies as per IB No.
5/20/2022 3137006 5/20/2022 AM'S TRADING 2021-023 and 2021-028 and other supporting documents attached. 21,847.65 28,384,430.80
Payment for the purchase of six (6) pieces Cordless telephone, Model: D1 (Os50036s) as per contract, award,
5/20/2022 3137007 5/20/2022 RJR MARKETING notice to proceed, and other documents attached. IB No. 2021-052. 16,293.85 28,368,136.95
Payment for the purchase of twelve (12) pieces UPS Battery and etc., as per contract, award, notice to
5/20/2022 3137008 5/20/2022 RJR MARKETING proceed and other documents attached. IB No. 2021-039 346,394.29 28,021,742.66
TECHNOSURE ELECTRONICS & ELECTRICAL SUPPLY & Payment for the purchase of four (4) units Laptop with USB Headphone and microphone as per contract,
5/20/2022 3137009 5/20/2022 SERVICES award, notice to proceed and other documents attached. IB No. 2021-060. 153,497.85 27,868,244.81
Payment for the purchase of one (1) unit Biological Safety Cabinet Class II as per contract, award, notice to
5/20/2022 3137010 5/20/2022 DRAKE MARKETING & EQUIPMENT CORPORATION proceed and other documents attached. IB No. 2021-005. 282,124.93 27,586,119.88
Payment for the purchase of 400 tests Procalcitonin Reagents and etc., as per contract, award, notice to
5/20/2022 3137011 5/20/2022 ALLIED HOSPITAL SUPPLY INTERNATIONAL CORPORATION proceed and other documents attached. IB No. 2021-023; Sales Invoice No. 167910 1,170,535.72 26,415,584.16
Payment for the purchase of 400 pieces Disposable Needle Gauge 19" x 1 1/2 Ultra Sharp, Smooth
5/20/2022 3137012 5/20/2022 JOSMEF ENTERPRISES Penetration and etc., as per contract, award, notice to proceed and other documents attached. 3,483,534.33 22,932,049.83
Payment for the purchase of 1 piece 2 x 2 Video Wall Controller Splicing 4 Video Display., as per contract,
5/20/2022 3137013 5/20/2022 RJR MARKETING award, notice to proceed and other documens attached. IB No. 2021-052; Sales Invoice No. 555. 13,110.00 22,918,939.83
CANCELLED - DEVELOPMENT BANK OF THE PHILIPPINES -
NO ADVICE ON FILE AS THE REASON - DBP ALREADY
5/20/2022 3137014 5/20/2022 ISSUED AN OFFICIAL RECEIPT Payment for ONE COVID - 19 ALLOWANCE for the period of JANUARY to FEBRUARY, 2022. - 22,918,939.83
CANCELLED - RJR MARKETING - ERRONEOUS ENCODING Payment for ten (10) sacks White Milled Rice 50 kilos/sack as per contract, award, notice to proceed and
5/23/2022 3137015 5/23/2022 OF AMOUNT other documents attached. IB No. 2022-004. - 22,918,939.83
TECHNOSURE ELECTRONICS & ELECTRICAL SUPPLY & Payment for the purchase of two (2) units Fanless Soft Router Six (6) Ports Gigabit LAN, as per contract, award,
5/23/2022 3137016 5/23/2022 SERVICES notice to proceed and other documents attached. IB No. 2021-060; Sales Invoice No. 648. 27,127.57 22,891,812.26
Payment for ten (10) sacks White Milled Rice 50 kilos/sack as per contract, award, notice to proceed and
5/23/2022 3137017 5/23/2022 RJR MARKETING other documents attached. IB No. 2022-004. 20,217.49 22,871,594.77

5/24/2022 3137018 5/24/2022 DEVELOPMENT BANK OF THE PHILIPPINES Payment for ONE COVID Allowance for the period of MARCH, 2022. (Nelmar Nebit and Rodel Table) 17,966.10 22,853,628.67
Payment for the ONE COVID ALLOWANCE of Job Order at ADMINISTRATIVE Department of WVMC for the
5/24/2022 3137019 5/24/2022 DEVELOPMENT BANK OF THE PHILIPPINES period of MARCH 01 to 31, 2022. 186,148.77 22,667,479.90
 Payment for the ONE COVID ALLOWANCE of Job Order at FINANCE Department of WVMC for the period of
5/24/2022 3137020 5/24/2022 DEVELOPMENT BANK OF THE PHILIPPINES MARCH 01 to 31, 2022. 269,491.51 22,397,988.39
Payment for the ONE COVID ALLOWANCE of Job Order at MEDICAL Department (ALLIED) of WVMC for the
5/24/2022 3137021 5/24/2022 DEVELOPMENT BANK OF THE PHILIPPINES period of MARCH 01 to 31, 2022. 574,915.22 21,823,073.17
Payment for the ONE COVID ALLOWANCE of Job Order at MEDICAL DIVISION of WVMC for the period of
5/24/2022 3137022 5/24/2022 DEVELOPMENT BANK OF THE PHILIPPINES MARCH 01 to 31, 2022. 589,864.47 21,233,208.70
Payment for the ONE COVID ALLOWANCE of Job Order at NURSING SERVICE DIVISION (NSO) of WVMC for the
5/24/2022 3137023 5/24/2022 DEVELOPMENT BANK OF THE PHILIPPINES period of MARCH 01 to 31, 2022. 934,237.24 20,298,971.46
Payment for the ONE COVID ALLOWANCE of Job Order at HOUSEKEEPING AND H.F.D.U. of WVMC for the
5/24/2022 3137024 5/24/2022 DEVELOPMENT BANK OF THE PHILIPPINES period of MARCH 01 to 31, 2022. 1,280,084.68 19,018,886.78
Payment for the ONE COVID ALLOWANCE of Job Order at MEDICAL DIVISION of WVMC for the period of
5/24/2022 3137025 5/24/2022 DEVELOPMENT BANK OF THE PHILIPPINES MARCH 01 to 31, 2022. 2,422,159.14 16,596,727.64
Payment for the ONE COVID ALLOWANCE of Job Order at NURSING SERVICE DIVISION (NSO) of WVMC for the
5/24/2022 3137026 5/24/2022 DEVELOPMENT BANK OF THE PHILIPPINES period of MARCH 01 to 31, 2022. 4,533,820.37 12,062,907.27

5/27/2022 3137027 5/27/2022 DEVELOPMENT BANK OF THE PHILIPPINES Payment for ONE COVID - 19 ALLOWANCE for the period of JANUARY to FEBRUARY, 2022. 172,254.68 11,890,652.59
Payment for the purchase of 200 pieces Nebulizer Kit Neonatal as per contract, award, notice to proceed and
5/30/2022 3137028 5/30/2022 JOSMEF ENTERPRISES other documents attached. IB No. 2021-037. Sale s Invoice No. 65021. 28,509.43 11,862,143.16
11,862,143.16
11,862,143.16
11,862,143.16
TOTAL 48,996,861.60 44,704,407.35 - 11,862,143.16
CERTIFICATION
I hereby certify on my official oath that the foregoing is a correct and complete record of all checks/ADA's issued by me in my capacity as
Supervising Administrative Officer - Cash, during the period of MAY 01 - 31, 2022, inclusive as indicated in the corresponding columns.

JANET B. SUSTENTO
SAO - Cash Section

44,723,107.35
28,464,637.79 0.00 5/17/2022
48,771,231.54 3,364,465.80

1,019,685.74

23,075,568.41
 143,745.25 2,573,135.40

11,689,888.48 172,254.68 48,427.82

7,569,688.91
7,569,688.91
11,689,888.48 172,254.68
18,700.00
5,020,000,000.00 NCA No. 19-0010788 /6/24/19
55,945,000.00 21,626,277.19

0.00 33,827,000.00
 33,331,386.79

22,613,613.21

55,453,277.19

Obligation 0.00

55,453,277.19

42,313,912.97

6,000.00

42,307,912.97
 22,912,375.02

0.00

22,912,375.02

NCA No. 19-0023500 dtd. 11/19/19

NCA No. 19-0023500 dtd. 11/19/19

NCA No. 19-0023500 dtd. 11/19/19

NCA No. 19-0023500 dtd. 11/19/19

NCA No. 19-0010788 /6/24/19

Okey
44,704,407.35
 NCA Balance as of 12/13, 2019

NCA No. 19-0019732 dtd. 10/14/19 NCA No. 19-0013434 dtd 10/01/19 NCA No. 19-0020321 dtd. 10/01/19 NCA No. 19-0019013 dtd. 10/04/19 NCA No. 19-0019160 dtd. 10/04/19NCA No. 19-0021508 dtd. 10/07/19NCA No. 19-0019715 dtd. 10/14/19NCA No. 19-0023387 dtd. 11/19/19NCA No. 19-23380 dat. 11/19/19 NCA No. 19-23500 dat. 11/19/19
0.75 299,786.92 0.40 246.43 793,208.87 393,908.50 0.02 0.38 6,750,000.00 236,227.00

9,600,000.00 24,350,000.00 1,065,000.00

0.75 9,899,786.92 0.40 246.43 25,143,208.87 1,458,908.50 0.02 0.38 6,750,000.00 236,227.00

0.00 0.00 0.00 4,533,820.37 0.00 0.00 0.00

0.75 9,899,786.92 0.40 246.43 25,143,208.87 -3,074,911.87 0.02 0.38 6,750,000.00 236,227.00

784.00
 Terminal Leave Monetization Terminal Leave
NCA No. 19-0024137 dtd. 11/22/19NCA No. 19-0024253 dtd. 11/22/19NCA No. 19-0024279 dtd. 11/22/19NCA No. 19-0025701 dtd. 11/22/19NCA No. 19-0025711 dtd. 12/06/19NCA No. 19-0025917 dtd. 12/10/19 Total
2,310,157.00 9,413,499.50 484,000.00 42,307,312.96

24,000.00 1,520,064.00 4,034,467.00 7,924,000.00 82,344,531.00

 0.00

2,310,157.00 9,413,499.50 508,000.00 1,520,064.00 4,034,467.00 7,924,000.00 124,651,843.96

0.00 0.00 0.00 0.00 0.00 0.00 4,533,820.37

2,310,157.00 9,413,499.50 508,000.00 1,520,064.00 4,034,467.00 7,924,000.00 120,118,023.59

120,118,023.59

0.00