VENDOR LOGO

ACTUAL WORK DONE (AWD)

Project Description: ____________________________________________________

Work Order No.: ____________________________________________________

Project Duration: ____________________________________________________

ITEM MAT. CODE DESCRIPTION UNIT QUANTITY AMOUNT COST

Total Php___

Vendor: PLDT:

______________________ __________________________
Prepared By: Checked/Validated:

__________________________
Approved by: Div Head
 CERTIFICATE OF ACCEPTANCE
Work Order :
Project Description

This is to certify that FIBERHOME PHILS., INC. has satisfactory completed the Corrective Maintenance Works (original scope and additional works).

FIBERHOME PHILS., INC. shall guarantee the materials and workmanship of the project for a period of one (1) year and to repair any defects that may arise within the period free of charge to PLDT. However,
in the event that PLDT found out later that certain Violations were made / done in the terms and conditions of the contract, plans, specifications, applicable structural codes and restrictions
set by DPWH, PLDT has the right to revoke this Certificate and reject the whole or any portion of the aforementioned work

Region Division Section Description Location Date Started Date Completed Date Accepted

PLDT Facility at Antipolo - Lowering

GMMNE NORTHEAST FFS1 Manhole ALONG MANUEL QUEZON EXT. 5/1/2022 6/1/2022 6/20/2022
Cover

Accepted by (PLDT): Approved by (PLDT): Certified by (PLDT):

___________________________ ___________________________________ ____________________________________

ZONE Supervisor ZONE Head AREA Head
 ACTUAL WORK DONE (AWD)

FH TEAM LEADER:
WORK ORDER NO.:
PROJECT DESCRIPTION:
SITE NAME :
AREA/ZONE:
DATE/TIME DISPATCHED:
DATE/TIME STARTED:
DATE/TIME COMPLETED: HANDLING TIME (DISPATCHED TO COMPLETED):
DATE/TIME ACCEPTED: HANDLING TIME (DISPATCHED TO ACCEPTED):

DESCRIPTION
MATERIAL CODE UNIT QUANTITY COST TOTAL
Pre-Works (Survey & Design) SCOPE OF WORK
Pre-Works (Survey & Design
Contracted Services
P2005868 OSP: Site Inspection, Verification, Validation and Design Pole 1.00 4,700.00 4,700.00

Civil works, No ADD-ON Cost required (ALL-IN)

Civil Works, Requires Add-On Cost, refer to Matrix

TOTAL AMOUNT (VAT Ex) -

TOTAL AMOUNT (VAT In) -
AFTER PICTURES
After:

*Site Prep Mob/Demob also included and acknowledged on this approval.

CERTIFICATION
THIS IS TO CERTIFY THAT THE ABOVE ACTUAL WORK DONE IS TRUE AND CORRECT
PREPARED BY: INSPECTED BY: APPROVED BY: ACCEPTED BY: VALIDATED BY: CONCURRED BY: APPROVED BY:

FH CMDR Billing Coordinator FH CMDR Project Supervisor FH CMDR Project Manager PLDT ZONE Supervisor PLDT ZONE Head PLDT AREA Head PLDT SECTOR Head
 SURVEY FORM

FH TEAM LEADER:
WORK ORDER NO.: WO-20240307-00641
PROJECT DESCRIPTION: Relocation of one (1) concrete pole in San Placido Roxas Isabela
SITE NAME : Relocation of one (1) concrete pole in San Placido Roxas Isabela
AREA/ZONE: ISABELA
DATE/TIME DISPATCHED:
DATE/TIME STARTED:
DATE/TIME COMPLETED: HANDLING TIME (DISPATCHED TO COMPLETED):
DATE/TIME ACCEPTED: HANDLING TIME (DISPATCHED TO ACCEPTED):

DESCRIPTION
MATERIAL CODE UNIT QUANTITY COST TOTAL
SCOPE OF WORK
Setting of poles
P2005843 1.1 Pole installation (First 2 poles) PC 1.00

TOTAL AMOUNT (VAT Ex) -

TOTAL AMOUNT (VAT In) -

CERTIFICATION
THIS IS TO CERTIFY THAT THE ABOVE SURVEY IS TRUE AND CORRECT
PREPARED/CERTIFIED BY: APPROVED BY: ACCEPTED BY: VALIDATED AND APPROVED BY:

MICHAEL PAGULAYAN MENARD DELA CRUZ MICHAEL ANGELO TIU MELTIADES QUIROS
CMDR Project Engineer Regional Operations Manager NFS EAST NL FFS5 - Telecom Engineer NFS EAST NL FFS5 Team Coordinator NFS EAST NL Division Head