ID NUMBER:

SHORT TERM HIRE INVOICE

Name:
Location:
Description of Work: CASE MANAGER
HOURS WORKED
DATE OF SERVICE
(1 DAY=8 HOURS) Payment Details
03/10/2023 8 Hours Bank Name:
04/10/2023 8 Hours Bank Address:
05/10/2023 8 Hours AccountNumber:
06/10/2023 8 Hours
09/10/2023 8 Hours Signature_______________________
10/10/2023 8 Hours CIHP staff Supervising STH
11/10/2023 8 Hours
12/10/2023 8 Hours Name : UWEM ESSIEN
13/10/2023 8 Hours
16/10/2023 8 Hours Signature & Date_ _______________ 20/10/2023
17/10/2023 8 Hours
18/10/2023 8 Hours Verified by (CIHP Human Resource Unit)
19/10/2023 8 Hours
20/10/2023 8 Hours Name _________________________

Signature ___ ___________________

Date ___________________________

TOTAL HOURS WORKED 114 Hours

TOTAL DAYS WORKED
14 Days
To Nearest Quarter
APPROVED DAILY RATE ₦ 75,000.00
5% WHT THEREON -₦ 3,750.00

TOTAL ₦ 71,250.00
Certification by the Supervisor
KEY PERFORMANCE INDICATORS DELIVERABLE ACHIEVEMENT (%)
Ensure at least 95% ARV refills in the last (a)No. of clients expected for ARV refill in % ARV refills = No. refilled/No. expected for refill in August X 100
month (August): August (b)No. refilled in August
Ensure at least 95% Viral Load Coverage & (a) No. of clients eligible for VL sample % VL coverage = No. results received/No. eligible for VL in August
Suppression for all clients in the last month collection in August (b) No. who had X 100 % VL Suppression = No.
(August) sample collection with results received (c) results suppressed/No. results received X 100
No. results suppressed

Ensure virtual treatment support provided (a) No. of newly enrolled, MMD3&6 clients % Clients who received virtual treatment support via check-in
to at least 95% of newly enrolled clients, with phone numbers refilled in August and calls = No. who had check-in calls in August/No. new & old clients
clients on MMD3&6 and IPT through documented in the check-in call log refilled and documented in the check-in call log X 100
periodic check-in calls in the last month (b) No. who had check-in calls in August