Republic of the Philippines

PHILIPPINE HEALTH INSURANCE CORPORATION

www.philhealth.gov.ph

Date/Time Generated : 07/19/2022 05:53:41

SPA No : SPA100029818499
Applicable Period : 06-2022
Report Type : Regular
EMPLOYEES PREMIUM REMITTANCE LIST
PhilHealth Number : 021000012719
Employer Name : I.F. CLEMENTE CONSTRUCTION CORPORATION
Employer Address : BALIUAG BULACAN
Employer TIN : 009435767000
Employer Type : Private
No. PhilHealth No. Surname Given Name Middle Name PS ES Status | Remarks
1 022538129120 ALQUIROZ MA LORAINE INANOD 240.00 240.00 A

2 212500896105 CAO JANINA MAE CLEMENTE 300.00 300.00 A

3 212500896091 CAO JOCEL CLEMENTE 300.00 300.00 A

4 210501899776 CAO JUDITH CLEMENTE 300.00 300.00 A

5 212005257287 CAO JULIE ANN CLEMENTE 300.00 300.00 A

6 212500862715 CLEMENTE KRISTINE KATE GIRON 300.00 300.00 A

7 070253003233 CLEMENTE MELISA VENERACION 280.00 280.00 A

8 210000161254 DE GUZMAN MARIA FRANCHESCA ALBANIA 300.00 300.00 A

9 080507341857 MARIANO REYNANTE CAYANAN 260.00 260.00 A

10 030502565555 TORRES MARIBEL CABRAL 260.00 260.00 A

Subtotal 2,840.00 2,840.00

GRAND TOTAL 5,680.00

Prepared by : Certified True and Correct by :

Signature over Printed Name and Designation Signature over Printed Name and Designation