Republic of the Philippines

Mountain Province
BONTOC
OFFICE OF THE PROVINCIAL HEALTH OFFICER

ITINERARY OF TRAVEL
APPENDIX A

Name: ANNIE CLAIRE B. PEKAS Position: PHO II

Official Station: PHO BONTOC Monthly Salary: ________________
Purposes of Travel: To Augment in the Covid – 19 Vaccination Catch – up Activity in Paracelis on March 29 – 30, 2022.
MEANS OF TRANSP
TOTAL
DATE PLACES TO VISIT DEPARTURE ARRIVAL TRANSPOR ORTA PER DEIM
AMOUNT
TATION TION FEE
MARCH
28 Bontoc – Paracelis 4:00 PM 8:30 PM RP 360 360

29 Poblacion – Bantay 8:00 AM 8:30 PM RP 360 360

Bantay- Poblacion 3:30 Pm 4:50 Pm

30 Poblacion- Bacarri 8:00 AM 9:00 AM RP 360 360

Bacarri – Poblacion 4: 00 PM 5:00 PM RP
180
31 Paracelis – Bontoc 3:00 AM 7:00 AM RP 180

TOTAL 1,260.00 1,260.00

I certify that (I) have reviewed the (I) Prepared by:
foregoing itinerary (2) the travel is
necessary to the service (3) the period
covered is reasonable (4) the expenses ANNIE CLAIRE B. PEKAS, MD
claimed are proper Official/ Employee

(2) Approved by:

ERNESTO B. EMILIO
Supervising Administrator Officer
(by Authority of the Provincial Officer)

………………………………………………………………………………………………………………………………………
CERTIFICATE OF TRAVEL COMPLETED
Appendix B

Agency Head: ANNIE CLAIRE B. PEKAS, MD Station:

Date: ___________________________________________
I HEREBY CERTIFY that I have completed the travel authorized in the itinerary of travel under condition below:
_______x_______ strictly in accordance with the approved itinerary.
______________ but short cut as explained below in excess payment in the amount of P_____________
Was refunded under OR # ___________ dated _________________ extended as explained below:
EXPLANATION OR JUSTIFICATION: MISSION ACCOMPLISHED______________
Evidence of Travel: TRAVEL ORDER, After Travel Report and Certificates of Appearance on evidence and information of
which I have acknowledged, the travel was actually undertaken.

ERNESTO B. EMILIO ANNIE CLAIRE B. PEKAS, MD

Supervising Administrator Officer Signature of Employee
(by Authority of the Provincial Officer)
 Republic of the Philippines
Mountain Province
BONTOC
OFFICE OF THE PROVINCIAL HEALTH OFFICER

ITINERARY OF TRAVEL
APPENDIX A

Name: NORMA S. KALANG-AD Position: MEDWIFE IV

Official Station: PHO BONTOC Monthly Salary: ________________
Purposes of Travel: To provide technical assistance on the launching of 5-11 years old vaccination in Barlig on March 28, 2022.
to augment in the COVID – 19 Vaccination Catch up Activity in Paracelis on March 29, to 31, 2022.

MEANS OF TRANSP
TOTAL
DATE PLACES TO VISIT DEPARTURE ARRIVAL TRANSPOR ORTA PER DEIM
AMOUNT
TATION TION FEE
MARCH
28 Bontoc- Barlig 7:00 AM 8:00 AM RP
Barlig- Paracelis 2:30 PM 4:30 PM RP 540 540

29 Poblacion -Buringal 8:00 AM 9:200 AM RP 360 360

Buringal -Poblacion 3:30 PM 5:00 PM RP

Poblacion - Bunot 8:00 AM 9:00 AM RP 360 360

30 Bunot - Poblacion 3:30 PM 4:30 PM RP

Poblacion - Bananao 8:00 AM 8:30 AM RP 360 360

31 Bananao –Poblacion 4:00 PM 4:30 PM RP

April 01, Poblacion Paracelis- 1:00 PM 5:30 PM RP 540 540

2022 Bontoc
TOTAL 2,160.00 2,160.00
I certify that (I) have reviewed the (I) Prepared by:
foregoing itinerary (2) the travel is
necessary to the service (3) the period
covered is reasonable (4) the expenses NORMA S. KALANG-AD
claimed are proper Official/ Employee

(2) Approved by:

ANNIE CLAIRE B. PEKAS, MD,FPSGS,FPCS

Provincial Health Officer II

………………………………………………………………………………………………………………………………………
CERTIFICATE OF TRAVEL COMPLETED
Appendix B

Agency Head: ANNIE CLAIRE B. PEKAS, MD Station:

Date: ___________________________________________
I HEREBY CERTIFY that I have completed the travel authorized in the itinerary of travel under condition below:
_______x_______ strictly in accordance with the approved itinerary.
______________ but short cut as explained below in excess payment in the amount of P_____________
Was refunded under OR # ___________ dated _________________ extended as explained below:
EXPLANATION OR JUSTIFICATION: MISSION ACCOMPLISHED______________
Evidence of Travel: TRAVEL ORDER, After Travel Report and Certificates of Appearance on evidence and information of
which I have acknowledged, the travel was actually undertaken.
 ANNIE CLAIRE B. PEKAS, MD,FPSGS,FPCS NORMA S. KALANG-AD
Provincial Health Officer II Signature of Employee

Republic of the Philippines

Mountain Province
BONTOC
OFFICE OF THE PROVINCIAL HEALTH OFFICER

ITINERARY OF TRAVEL
APPENDIX A

Name: ALBERT LONGAYAN Position: DRIVER

Official Station: PHO BONTOC Monthly Salary: ________________
Purposes of Travel: To provide technical assistance on the launching of 5-11 years old vaccination in Barlig on March 28, 2022.
to augment in the COVID – 19 Vaccination Catch up Activity in Paracelis on March 29, to 31, 2022.

MEANS OF TRANSP
TOTAL
DATE PLACES TO VISIT DEPARTURE ARRIVAL TRANSPOR ORTA PER DEIM
AMOUNT
TATION TION FEE
MARCH
28 Bontoc- Barlig 7:00 AM 8:00 AM RP
Barlig- Paracelis 2:30 PM 4:30 PM RP 540 540

29 Poblacion -Buringal 8:00 AM 9:200 AM RP 360 360

Buringal -Poblacion 3:30 PM 5:00 PM RP

Poblacion - Bunot 8:00 AM 9:00 AM RP 360 360

30 Bunot - Poblacion 3:30 PM 4:30 PM RP

Poblacion - Bananao 8:00 AM 8:30 AM RP 360 360

31 Bananao –Poblacion 4:00 PM 4:30 PM RP

April 01, Poblacion Paracelis- 1:00 PM 5:30 PM RP 540 540

2022 Bontoc
TOTAL 2,160.00 2,160.00
I certify that (I) have reviewed the (I) Prepared by:
foregoing itinerary (2) the travel is
necessary to the service (3) the period
covered is reasonable (4) the expenses ALBERT LONGAYAN
claimed are proper Official/ Employee

(2) Approved by:

ANNIE CLAIRE B. PEKAS, MD,FPSGS,FPCS

Provincial Health Officer II

………………………………………………………………………………………………………………………………………
CERTIFICATE OF TRAVEL COMPLETED
Appendix B

Agency Head: ANNIE CLAIRE B. PEKAS, MD Station:

Date: ___________________________________________
I HEREBY CERTIFY that I have completed the travel authorized in the itinerary of travel under condition below:
_______x_______ strictly in accordance with the approved itinerary.
______________ but short cut as explained below in excess payment in the amount of P_____________
Was refunded under OR # ___________ dated _________________ extended as explained below:
EXPLANATION OR JUSTIFICATION: MISSION ACCOMPLISHED______________
Evidence of Travel: TRAVEL ORDER, After Travel Report and Certificates of Appearance on evidence and information of
which I have acknowledged, the travel was actually undertaken.

ANNIE CLAIRE B. PEKAS, MD,FPSGS,FPCS ALBERT LONGAYAN

 Provincial Health Officer II Signature of Employee

Republic of the Philippines

Mountain Province
BONTOC
OFFICE OF THE PROVINCIAL HEALTH OFFICER

ITINERARY OF TRAVEL
APPENDIX A

Name: Dr. CAROLYN D. YAWAN Position: PHO I

Official Station: PHO BONTOC Monthly Salary: ________________
Purposes of Travel: To provide technical assistance on the launching of 5-11 years old vaccination in Barlig on March 28, 2022.
to augment in the COVID – 19 Vaccination Catch up Activity in Paracelis on March 29, to 31, 2022.
MEANS OF TRANSP
TOTAL
DATE PLACES TO VISIT DEPARTURE ARRIVAL TRANSPOR ORTA PER DEIM
AMOUNT
TATION TION FEE
MARCH
28 Bontoc- Barlig 7:00 AM 8:00 AM RP
Barlig- Paracelis 2:30 PM 4:30 PM RP 540 540

29 Poblacion -Buringal 8:00 AM 9:200 AM RP 360 360

Buringal -Poblacion 3:30 PM 5:00 PM RP

Poblacion - Bunot 8:00 AM 9:00 AM RP 360 360

30 Bunot - Poblacion 3:30 PM 4:30 PM RP

Poblacion - Bananao 8:00 AM 8:30 AM RP 360 360

31 Bananao –Poblacion 4:00 PM 4:30 PM RP

April 01, Poblacion Paracelis- 1:00 PM 5:30 PM RP 540 540

2022 Bontoc
TOTAL 2,160.00 2,160.00
I certify that (I) have reviewed the (I) Prepared by:
foregoing itinerary (2) the travel is
necessary to the service (3) the period
covered is reasonable (4) the expenses CAROLYN D. YAWAN, MD
claimed are proper Official/ Employee

(2) Approved by:

ANNIE CLAIRE B. PEKAS, MD,FPSGS,FPCS

Provincial Health Officer II

………………………………………………………………………………………………………………………………………
CERTIFICATE OF TRAVEL COMPLETED
Appendix B

Agency Head: ANNIE CLAIRE B. PEKAS, MD Station:

Date: ___________________________________________
I HEREBY CERTIFY that I have completed the travel authorized in the itinerary of travel under condition below:
_______x_______ strictly in accordance with the approved itinerary.
______________ but short cut as explained below in excess payment in the amount of P_____________
Was refunded under OR # ___________ dated _________________ extended as explained below:
EXPLANATION OR JUSTIFICATION: MISSION ACCOMPLISHED______________
Evidence of Travel: TRAVEL ORDER, After Travel Report and Certificates of Appearance on evidence and information of
which I have acknowledged, the travel was actually undertaken.

ANNIE CLAIRE B. PEKAS, MD,FPSGS,FPCS CAROLYN D. YAWAN, MD

 Provincial Health Officer II Signature of Employee

Name: ALBERT LONGAYAN Position:

Official Station: Monthly Salary: ________________
Purposes of Travel: To ferry PHO staff
MEANS OF TRANSP
TOTAL
DATE PLACES TO VISIT DEPARTURE ARRIVAL TRANSPOR ORTA PER DEIM
AMOUNT
TATION TION FEE
MARCH
 15 Bontoc- Barlig 7:00 AM 8:00 AM RP
Barlig- Natonin 8:30 AM 10:30 AM RP
Natonin- Paracelis 11:30 AM 12:25 PM RP
Poblacion- Palitud 3:00 PM 4:00 PM RP 1620 1620

16 Paracelis- Bontoc 4:00 AM 8:00 AM RP 180 180

18 Bontoc- Barlig 8:00 AM 9:00 AM RP

Barlig- Natonin 12:00 PM 2:00 PM RP
Natonin- Paracelis 5:30 PM 6:20 PM RP 1440 1440

19 @ Paracelis 1620 1620

20 Paracelis- Bontoc 1:00 PM 5:00 PM RP 180 180
TOTAL 5,040 5,040.00
I certify that (I) have reviewed the (I) Prepared by:
foregoing itinerary (2) the travel is
necessary to the service (3) the period
covered is reasonable (4) the expenses _______________________
claimed are proper Official/ Employee

(2) Approved by:

ANNIE CLAIRE B. PEKAS, MD

Provincial Health Officer II

………………………………………………………………………………………………………………………………………
CERTIFICATE OF TRAVEL COMPLETED
Appendix B

Agency Head: ANNIE CLAIRE B. PEKAS, MD Station:

Date: ___________________________________________
I HEREBY CERTIFY that I have completed the travel authorized in the itinerary of travel under condition below:
_______x_______ strictly in accordance with the approved itinerary.
______________ but short cut as explained below in excess payment in the amount of P_____________
Was refunded under OR # ___________ dated _________________ extended as explained below:
EXPLANATION OR JUSTIFICATION: MISSION ACCOMPLISHED______________
Evidence of Travel: TRAVEL ORDER, After Travel Report and Certificates of Appearance on evidence and information of
which I have acknowledged, the travel was actually undertaken.

ANNIE CLAIRE B. PEKAS, MD __________________________

Provincial Health Officer II Signature of Employee

Republic of the Philippines

Mountain Province
BONTOC
OFFICE OF THE PROVINCIAL HEALTH OFFICER

ITINERARY OF TRAVEL
APPENDIX A

Name: PRIMA DONNA TE-ELAN Position: AO V

Official Station: Monthly Salary: ________________
Purposes of Travel:To facilitate the BHW Congress and ditrinution of Aid to BHW in Barlig, Natonin and Paracelis
MEANS OF TRANSP
TOTAL
DATE PLACES TO VISIT DEPARTURE ARRIVAL TRANSPOR ORTA PER DEIM
AMOUNT
TATION TION FEE
 MARCH

18 Bontoc- Barlig 8:00 AM 9:00 AM RP

Barlig- Natonin 12:00 PM 2:00 PM RP
Natonin- Paracelis 5:30 PM 6:20 PM RP 1440 1440

19 @ Paracelis 1620 1620

20 Paracelis- Bontoc 1:00 PM 5:00 PM RP 180 180

TOTAL 3,240.00 3,240.00

I certify that (I) have reviewed the (I) Prepared by:
foregoing itinerary (2) the travel is
necessary to the service (3) the period
covered is reasonable (4) the expenses _______________________
claimed are proper Official/ Employee

(2) Approved by:

ANNIE CLAIRE B. PEKAS, MD

Provincial Health Officer II

………………………………………………………………………………………………………………………………………
CERTIFICATE OF TRAVEL COMPLETED
Appendix B

Agency Head: ANNIE CLAIRE B. PEKAS, MD Station:

Date: ___________________________________________
I HEREBY CERTIFY that I have completed the travel authorized in the itinerary of travel under condition below:
_______x_______ strictly in accordance with the approved itinerary.
______________ but short cut as explained below in excess payment in the amount of P_____________
Was refunded under OR # ___________ dated _________________ extended as explained below:
EXPLANATION OR JUSTIFICATION: MISSION ACCOMPLISHED______________
Evidence of Travel: TRAVEL ORDER, After Travel Report and Certificates of Appearance on evidence and information of
which I have acknowledged, the travel was actually undertaken.

ANNIE CLAIRE B. PEKAS, MD __________________________

Provincial Health Officer II Signature of Employee

Republic of the Philippines

Mountain Province
BONTOC
OFFICE OF THE PROVINCIAL HEALTH OFFICER

ITINERARY OF TRAVEL
APPENDIX A

Name: NORMA KALANG-AD Position: MIDWIFE

Official Station: Monthly Salary: ________________
Purposes of Travel: To monitor and assist in the COVID-19 vaccination for 5-11 years old, facility visit at Palitud BHS
DATE PLACES TO VISIT DEPARTURE ARRIVAL MEANS OF TRANSP PER DEIM TOTAL
TRANSPOR ORTA AMOUNT
 TATION TION FEE
MARCH
15 Bontoc- Barlig 7:00 AM 8:00 AM RP
Barlig- Natonin 8:30 AM 10:30 AM RP
Natonin- Paracelis 11:30 AM 12:25 PM RP
Poblacion- Palitud 3:00 PM 4:00 PM RP 1620 1620

16 Paracelis- Bontoc 4:00 AM 8:00 AM RP 180 180

TOTAL 1,800 1,800.00

I certify that (I) have reviewed the (I) Prepared by:
foregoing itinerary (2) the travel is
necessary to the service (3) the period
covered is reasonable (4) the expenses _______________________
claimed are proper Official/ Employee

(2) Approved by:

ANNIE CLAIRE B. PEKAS, MD

Provincial Health Officer II

………………………………………………………………………………………………………………………………………
CERTIFICATE OF TRAVEL COMPLETED
Appendix B

Agency Head: ANNIE CLAIRE B. PEKAS, MD Station:

Date: ___________________________________________
I HEREBY CERTIFY that I have completed the travel authorized in the itinerary of travel under condition below:
_______x_______ strictly in accordance with the approved itinerary.
______________ but short cut as explained below in excess payment in the amount of P_____________
Was refunded under OR # ___________ dated _________________ extended as explained below:
EXPLANATION OR JUSTIFICATION: MISSION ACCOMPLISHED______________
Evidence of Travel: TRAVEL ORDER, After Travel Report and Certificates of Appearance on evidence and information of
which I have acknowledged, the travel was actually undertaken.

ANNIE CLAIRE B. PEKAS, MD __________________________

Provincial Health Officer II Signature of Employee

Republic of the Philippines

Mountain Province
BONTOC
OFFICE OF THE PROVINCIAL HEALTH OFFICER

ITINERARY OF TRAVEL
APPENDIX A

Name: RAMON GUNAN Position: DRIVER

Official Station: Monthly Salary: ________________
Purposes of Travel: To fetch the resource speaker- Mr. Jojet Lamberto R. Mondares
DATE PLACES TO VISIT DEPARTURE ARRIVAL MEANS OF TRANSP PER DEIM TOTAL
 TRANSPOR ORTA
AMOUNT
TATION TION FEE
APRIL
27 Bontoc- Baguio 9:00 AM 3:00 PM RP 1620 1620

28 Paracelis- Bontoc 2:00 AM 8:00 AM RP 180 180

TOTAL 1,800 1,800.00

I certify that (I) have reviewed the (I) Prepared by:
foregoing itinerary (2) the travel is
necessary to the service (3) the period
covered is reasonable (4) the expenses _______________________
claimed are proper Official/ Employee

(2) Approved by:

ANNIE CLAIRE B. PEKAS, MD

Provincial Health Officer II

………………………………………………………………………………………………………………………………………
CERTIFICATE OF TRAVEL COMPLETED
Appendix B

Agency Head: ANNIE CLAIRE B. PEKAS, MD Station:

Date: ___________________________________________
I HEREBY CERTIFY that I have completed the travel authorized in the itinerary of travel under condition below:
_______x_______ strictly in accordance with the approved itinerary.
______________ but short cut as explained below in excess payment in the amount of P_____________
Was refunded under OR # ___________ dated _________________ extended as explained below:
EXPLANATION OR JUSTIFICATION: MISSION ACCOMPLISHED______________
Evidence of Travel: TRAVEL ORDER, After Travel Report and Certificates of Appearance on evidence and information of
which I have acknowledged, the travel was actually undertaken.

ANNIE CLAIRE B. PEKAS, MD __________________________

Provincial Health Officer II Signature of Employee