PHILIPPINE CROP INSURANCE CORPORATION

Regional Office No.8, Tacloban City

Name: EDGAR L. PALCONIT
Position : RCA Division : CAD
T.O. No.: 2023-7 Date : 07/21/2023
STATEMENT OF REIMBURSEMENT

TIME Means of No. of ALLOWABLE EXPENSES

Date Places Visited Dep. Arri. Transpo. Kilometers Fare Per Diem Total
07/17/2023 BILIRAN (HOME) - LONOY,KANANGA 06:00am 5:00pm MCH 46 111.00
LONOY - NATUBGAN MCH 2 5.00
NATUBGAN - POB. KANANGA MCH 4 10.00
POB. KANANGA - TUGBONG MCH 2 5.00
TUGBONG - TEMP RES (KANANGA) 5:00pm MCH 2 5.00 136.00
07/18/2023 TEMP RES - TAGAYTAY,KANANGA 06:00am MCH 6 15.00
TAGAYTAY - LIBERTAD MCH 5 12.00
LIBERTAD - TEMP RES (KANANGA) 5:00pm MCH 11 27.00 54.00

07/19/2023 TEMP RES - SANTO NINO,KANANGA 06:00am MCH 4 10.00

SANTO NINO - TEMP RES. (KANANGA) 5:00pm MCH 4 10.00 20.00
07/20/2023 TEMP RES - NAGHALIN,KANANGA 06:00am MCH 3 7.00
NAGHALIN - LIBUNGAO MCH 2 5.00
LIBUNGAO - CACAO MCH 7 18.00
CACAO - MONTE ALLEGRE MCH 6 15.00
MONTE ALLEGRE - KAWAYAN MCH 8 20.00
KAWAYAN - PEO ORMOC 5:00pm MCH 22 53.00 118.00
07/21/2023 PEO ORMOC - BILIRAN (HOME) 07:00am 5:00pm MCH 73 175.00 175.00

HONORRARIUM 5DAYS X 680.00 3,400.00

Note Total traveling expense: 503.00

Honoraria: 3,400.00
Total amount for reimbursement: 3,903.00

Note: Submit in two (2) original copies with complete documentary requirements.
 CERTIFICATE OF TRAVEL COMPLETED

JULIUS P. BATENGA PHIL. CROP INS. CORP.

Agency Head Station

OIC-PCIC R08 TACLOBAN CITY

I hereby certify that I have completed the travel authorized in the itinerary of travel -
Travel Order No. 2023-07 dated July 21, 2023 under the conditions
indicated below.

[ ] Strictly in accordance with the approved itinerary.

[ ] Cut short as explained below. Excess payment in the amount of

was refunder per OR No.
[ ] Extended as explained below. Additional itinerary was submitted.

[ ] Other deviations as explained below.

EXPLANATION OR JUSTIFICATION: ____________________________________________

EVIDENCE OF TRAVEL ATTACHED HERETO:

Respectfully Submitted:

EDGAR L. PALCONIT
Officer/Employee

On evidence and information of which I have knowledge, the travel was actually
undertaken.

Checked: Noted:

JUNINE E. MONTEVERDE BENITA M. ALBERTO

TEAM LEADER/PEO ORMOC Supervisor

Approved:

JULIUS P. BATENGA
OIC-PCIC R08