Annex 31

Form No.
Republic of the Philippines
PHILIPPINE RURAL DEVELOPMENT PROJECT (PRDP)
Province of Agusan del Sur, Caraga Region
MONTHLY WEATHER REPORT
Establishment of Quality raw Rubber Production and Marketing (Site Development and
Subproject Title: Construction of Warehouse with Perimeter Fence

Contractor: MAIR Construction & General Merchadise Contract Number:

Proj. ID Month of:

1 2 3 4 5 6

7 8 9 10 11 12

13 14 15 16 17 18

19 20 21 22 23 24

25 26 27 28 29 30

31 12PM
11PM 1PM

10PM 12AM 2PM

DAY OF THE MONTH

Legend
9AM 3AM
9PM 31 3PM
- FAIR
- CLOUDY
8PM 6AM 4PM
- RAINSHOWER
TIME OF DAY
- HEAVY RAINS 7PM 5PM
6PM
- STORMY

Consolidated by Confrome by:

Signature Signature

Name Name
Title CPMIU Resident Engineer Title Project Engineer (Contractor)
Date Date
 Republic of the Philippines
Province of Agusan del Sur
Office the Provincial Engineer

SUBPROJECT CONSTRUCTION LOGBOOK

A. Logbook Cover

Proponent Agency : PLGU-Agusan del Sur

Subproject Title
Establishment of Quality raw Rubber Production and Marketing (Site Development and
: Construction of Warehouse with Perimeter Fence
Location : Physical Target : sq.m
Contract Amount :P Duration : Calendar Days
Date Started : Date of Completion :

Contractor :
Address : Bayugan City, Agusan del Sur Project Engineer :

B. Logbook Entries
Date: Day: Weather:
Resource Inventory:
A. Equipment and Tools
No. Type Model Condition Remarks

B. Manpower
Skill No. Remarks

C. Materials on site
Item No. Description Quantity Source Remarks

D. Work Activities
•
•
•
E. Visitors on site
Name Office Purpose Signature In Out

F. General Observation

Prepared By: Noted By:

Project Engineer( Contractor) PPMIU-Project Engineer
 Form No.

REPUBLIC OF THE PHILIPPINES

PHILIPPINE RURAL DEVELOPMENT PROJECT
Province of Agusan Del Sur, Caraga Region
WORK / INSPECTION REQUEST FORM (IRF)
Name of Project Establishment of Quality raw Rubber Production and Marketing (Site Development and Construction
Project Location:

Contractor: Contract Number:

IRF Number: Date Prepared:

Construction Activity for which inspection is requested:

Ref. Pay Item
Description of Activity Location Date Time Remarks
No.

Requested by: Received by:

Signature Signature
Name Name
Title Project Engineer (Contractor) Title PPMIU Resident Engineer
Date/Time
Result of Inspection

sample:\
Surface preparation of the whole stretch was satisfactorily carried out ready for the 2nd layer
Materials for use for the Embankment are from the approved source
Signages and barricades are prepared and are availble ready for use

Inspected by:
Testing Needed Survey Needed
Signature Yes No Yes
Name
Title PPMIU Resident Engineer
Date
Time

Result of Test / Survey:

Sample
FDT on first layer was satisfactorily carried out with ref. no. FDT-(004 to 012)
Elevation and alignment were checked jointly and conform to design grade lines.
Test/ Survey witnessed by: Request to proceed is:
Approved
Signature
Name Signature
Title PPMIU Resident Engineer Name
Date Title PPMIU-Project Engineer
Time Date
Note: See form filling-out instructions at the back page Time

Form filling-out instructions (back page)

1 "Construction activity for which inspection is requested" shall be the activity defined in the Inspection and Test Plan (ITP) th
requires inspection. The reference pay item number shall be that stated in the BOQ which covers the activity subject to
inspection. The location shall define clearly the place/position of the item to be inspected. The date and time shall indicate t
expected inspection time. These shall be no less than 24hours before the time of receipt of the IRF by the PPMIU - RE.

2 The "Request by" box for the IRF shall be filled in and signed by the Contractor's personnel at the project manager level o
equivalent to the level of the RE
3 The result of the Inspection shall be filled out by the inspector concerned. Additional tests or survey tick boxes shall also be
determined by the inspector, after which, he/she signs at the "Inspected by" box
4 Test/ Survey Results shall be filled in by the PPMIU - RE, after which he signs at the "Test/ Survey Witnessed by" box.
The "Request to Proceed" box is to be filled in by the PPMIU Engineer, whether it is approved or disapproved, based on th
5 results of inspection/ test/ survey, after which, the PPMIU Engineer affixes his/her signature, date and time of approval /
disapproval.

Note:

1 Approval by the PPMIU Engineer of an IRF is not intended, nor is it to be so interpreted, as written acceptance of any of th
Contractor's previously completed work. In other words, throughout the duration of the construction of the subproject, all the
Contractor's work is subject at all times to the RPCO,PSO,NPCO Engineer's review
elopment and Construction of W

Remarks

PPMIU Resident Engineer

Survey Needed
Yes No
 Disapproved

PPMIU-Project Engineer

pection and Test Plan (ITP) that

vers the activity subject to
e date and time shall indicate the
e IRF by the PPMIU - RE.

t the project manager level or that

survey tick boxes shall also be

urvey Witnessed by" box.

d or disapproved, based on the
date and time of approval /

written acceptance of any of the

uction of the subproject, all the
Annex 5

INSPECTION AND TEST PLAN

PHILIPPINE RURAL DEVELOPMENT PROJECT TITLE: (H) Hold

Sub-Poject Title:Establishment of Quality raw Rubber Production and Marketing (Site Development
Revision No.: and Construction of Warehouse with Perimeter Fence (W) Witness
Location: KM7 Tungao, Butaun City Page 1 of 3 (S) Surveillance/Monitoring
Please update the quanitity and (X) Self Inspection
Item of Works
Description of the Operation/
Inspection and Testing
Ref. Test/Inspection Specification Procedure Acceptance
Stage/Frequency Output/Records
No. Reference No. Reference No. Criteria Contractor/ LGU-CPMIU/
Description Characteristics PSO/NPCO
LGU-CPMIU RPCO
PART C - EARTHWORKS
100 Clearing & Grubbing Item 100.1 Item 100.2.2 - 2.3 as per required As per plan X W S Inspection Report
102 Roadway Excavation (Surplus Materials) Item 102.1 Item 102.1.1 as per required As per plan X W S Inspection Report
103 Structure Excavation Item 103.1 Item 103.2.2 as per required As per plan X W S Inspection Report
104 Embankment Item 104.1-2
a.) Liquid limit Item 104.2 AASHTO T 89 as per required As per specs. X W S Test Result
b.) Plasticity index Item 104.2 AASHTO T 90 as per required As per specs. X W S Test Result
c.) Compaction Item 104.3.3 Item 104.3.3 as per required As per specs. X W S Test Result
d.) FDT Item 104.3.3 AASHTO T 180D-T191 3 @ every 500 sq. m. 95% X H/W S Test Result
e.) Material from Excavation Item 104.2.1 AASHTO T 11 as per required As per specs. X H/W S Test Result
f.) Selected Borrow Item 104.2.1 AASHTO T 11 as per required As per specs. X H/W S Test Result
105 Sub-Grade Preparation Item 105.1 Item 105.3.1-3.8
a.) Grading Item 105.3.2-3.8 Item 105.3.2-3.8 as per required As per specs. X W S Test Result
b.) Plasticity index Item 104.2 AASHTO T 90 as per required As per specs. X W S Test Result
c.) Liquid limit Item 104.2 AASHTO T 89 as per required As per specs. X W S Test Result
d.) FDT Item 104.3.3 AASHTO T 180D-T191 3 @ every 500 sq. m. 95% X H/W S Test Result
PART D - SUBBASE & BASE COURSE
200 Aggregate Subbase Course
a.) Grading Item 200.2 Item 200.2 as per required As per specs. X W S Test Result
b.) Liquid limit Item 200.2 AASHTO T 89 as per required not greater than 35% X W S Test Result
c.) Plasticity index Item 200.2 AASHTO T 90 as per required not greater than 12% X W S Test Result
d.) CBR Item 200.2 AASHTO T 193 as per required not less than 25% X W S Test Result
e.) FDT Item 200.3.3 AASHTO T 180D-T 191 3 @ every 500 sq. m. 100% X H/W S Test Result
f.) Preparation of existing surface Item 200.3.1 Item 200.3.1 as per required As per plan X W S Inspection Report
g.) Placing Item 200.3.2 Item 200.3.2 as per required As per plan X H/W S Inspection Report
h.) Spreading & compacting Item 200.3.3 Item 200.3.3 as per required As per specs. X W S Inspection Report
I.) Trial Sections Item 200.3.4 Item 200.3.4 as per required As per specs. X W S Inspection Report
j.) Tolerance Item 200.3.5 Item 200.3.4 as per required As per specs. X W S Inspection Report
201 Aggregate Base Course
a.)Grading Item 201.2 Item 200.2 as per required As per specs. X W S Test Result
b.) Liquid limit Item 201.2 AASHTO T 89 as per required not greater than 35% X W S Test Result
c.) Plasticity index Item 201.2 AASHTO T 90 as per required not greater than 12% X W S Test Result
d.) CBR Item 201.2 AASHTO T 180 as per required not less than 25% X W S Test Result
e.) FDT Item 201.3.3 AASHTO T 191 3 @ every 500 sq. m. 100% X H/W S Test Result
f.) Preparation of existing surface Item 201.3.1 Item 201.3.1 as per required As per plan X W S Inspection Report
g.) Placing Item 201.3.2 Item 201.3.2 as per required As per plan X H/W S Inspection Report
h.) Spreading & compacting Item 201.3.3 Item 201.3.3 as per required As per specs. X W S Inspection Report
I.) Trial Sections Item 201.3.4 Item 201.3.4 as per required As per specs. X W S Inspection Report
j.) Tolerance Item 201.3.5 Item 201.3.5 as per required As per specs. X W S Inspection Report
Annex 5

INSPECTION AND TEST PLAN

PHILIPPINE RURAL DEVELOPMENT PROJECT TITLE: (H) Hold

Sub-Poject Title:Establishment of Quality raw Rubber Production and Marketing (Site Dev Revision No.: (W) Witness
Location: KM7 Tungao, Butaun City Page 2 of 3 (S) Surveillance/Monitoring
(X) Self Inspection

Description of the Operation/

Inspection and Testing
Ref. Test/Inspection Specification Procedure Acceptance
Stage/Frequency Output/Records
No. Reference No. Reference No. Criteria Contractor/ LGU-PPMIU/
Description Characteristics PSO/NPCO
LGU-PPMIU RPCO
PART E - SURFACE COURSES
311 Portland Cement Concrete Pavement Item 311.2 Item 311.2 once a day As per specs. X W S Inspection Report
Material Requirement
a) Portland Cement Item 311.2.1 AASHTO T 1217 1 sample / 2000 bags 10 kg. X W S Mill Certificate
b.) Fine Aggregates Item 311.2.2 AASHTO T 71 2 sample / 2000 bags 50 kg. X W S Inspection Report
c.) Coarse Aggregates Item 311.2.3 AASHTO T 96 3 sample / 2000 bags 70 kg. X W S Inspection Report
d.) Water Item 311.2.4 PEC X W S Inspection Report
e.) Reinforcing Steel Item 311.2.5 AASHTO M 31 or 32 1 sample / 10000 kg. 1 meter X H/W S Mill Certificate
f.) Joint Fillers Item 705 Item 705 1 (400mm x 400mm) X W S Mill Certificate
g.) Admixtures
air-entraining admixtures Item 311.2.7 AASHTO M 154 As per specs. X H/W S Mill Certificate
chemical admixtures Item 311.2.7 AASHTO M 194 As per specs. X H/W S Mill Certificate
h.) Curing Materials Item 311.2.8 AASHTO M 144 As per specs. X H/W S Mill Certificate
I.) Concrete Item 311.3.10 AASHTO T 23 & T 97 1 set - 3 samples/75cu.m 1 set sample X W S Test Results
j.) Completed Pavement AASHTO T 148 & T 24 5 holes / km. Or 5 core samples X W S Inspection Report/
5 holes / 500m for 2 lanes Test Results
PART F - BRIDGES CONSTRUCTION
407 Concrete Structure
404 Reinforcing Steel Works Item 404.1- 404.3.6 Item 710 As per requirement As per specs. X W S Inspection Report
a.) Bending Item 404.3.3 Item 404.3.3 As per requirement As per specs. X W S Inspection Report
b.) Placing & Fastening Item 404.3.4 Item 404.3.4 As per requirement As per specs. X H/W S Inspection Report
c.) Splicing Item 404.3.5 Item 404.3.5 As per requirement As per specs. X W S Inspection Report
d.) Lapping of bar Item 404.3.6 Item 404.3.6 As per requirement As per specs. X W S Inspection Report
405 Structural Concrete
a.) Portland Cement Item 405.2.1 AASHTO T 121 As per requirement As per specs. X W S Mill Certificate
b.) Fine Aggregate Item 405.2.2 AASHTO T 71 As per requirement As per specs. X W S Inspection Report
c.) Coarse Aggregate Item 405.2.3 AASHTO T 96 As per requirement As per specs. X W S Inspection Report
d.) Water Item 405.2.4 PEC As per requirement As per specs. X W S Inspection Report
e.) Reinforcing steel Item 405.2.5 AASHTO M 31 or 32 As per requirement As per specs. X H/W S Mill Certificate
f.) Admixtures Item 405.2.6 AASHTO M 154 As per requirement As per specs. X H/W S Mill Certificate
g.) Curing materials Item 405.2.7 AASHTO M 148 As per requirement As per specs. X H/W S Mill Certificate
h.) Expansion joints
Preformed Sponge Rubbe & cork Item 405.2.8 AASHTO M 153 As per requirement As per specs. X H/W S Mill Certificate
Hot-poured Elastic Type Item 405.2.8 AASHTO M 173 As per requirement As per specs. X H/W S Mill Certificate
Preformed fillers Item 405.2.8 AASHTO M 213 As per requirement As per specs. X H/W S Mill Certificate
i.) Elastomeric Compression Joints seals Item 405.2.9 AASHTO M 220 As per requirement As per specs. X H/W S Mill Certificate
j.) Elastomeric Bearing Pads Item 405.2.10 AASHTO M 231 As per requirement As per specs. X H/W S Mill Certificate
Annex 5

INSPECTION AND TEST PLAN

k.) Concrete Item 405.3 AASHTO T141 & T 22 1 set samples/75 cu.m As per specs. X W S Test Results

PHILIPPINE RURAL DEVELOPMENT PROJECT TITLE: (H) Hold

Sub-Poject Title:Establishment of Quality raw Rubber Production and Marketing (Site Dev Revision No.: (W) Witness
Location: KM7 Tungao, Butaun City Page 3 of 3 (S) Surveillance/Monitoring
(X) Self Inspection

Description of the Operation/

Inspection and Testing
Ref. Test/Inspection Specification Procedure Acceptance
Stage/Frequency Output/Records
No. Reference No. Reference No. Criteria Contractor/ RPCO/PSO/NPC
Description Characteristics LGU-PPMIU
LGU-PPMIU O
Testing Requirerments
a.) Sampling of fresh concrete Item 405.3 AASHTO T141 As per requirement As per specs. X W S Inspection Report
b.) Slump of portland cement concrete Item 405.3 AASHTO T 119 As per requirement As per specs. X W S Inspection Report
c.) Compressive & flexural tests Item 405.3 AASHTO T 23 As per requirement As per specs. X W S Test Result
PART G - DRAINAGE & SLOPE PROTECTION
500 Reinf. Conc. Pipe Culverts (RCPC) Item 500.2 AASHTO M 170 As per requirement As per specs. X W S Mill Certificate
a.) Bedding Item 500.3.2 Item 500.3.2 As per requirement As per specs. X H/W S Test Result
b.) Laying Item 500.3.3 Item 500.3.3 As per requirement As per specs. X W S Inspection Report
c.) Jointing Item 500.3.4 Item 500.3.4 As per requirement As per specs. X W S Inspection Report
d.) Strutting Item 500.3.5 Item 500.3.5 As per requirement As per specs. X W S Inspection Report
e.) Backfillling Item 500.3.6 Item 500.3.6 As per requirement As per specs. X H/W S Test Result
505 Stone Masonry
Material Requirements
a.) Stones Item 505.2.1 Item 505.2.1 As per requirement As per specs. X H/W S Inspection Report
b.) Mortar Item 505.2.2 Item 505.2.2 As per requirement As per specs. X W S Inspection Report
Construction Requirements
a.) Selection and Placing Item 505.3.1 Item 505.3.1 As per requirement As per specs. X H/W S Inspection Report
b.) Beds and Joints Item 505.3.2 Item 505.3.2 As per requirement As per specs. X W S Inspection Report
c.) Headers Item 505.3.3 Item 505.3.3 As per requirement As per specs. X W S Inspection Report
d.) Backing Item 505.3.4 Item 505.3.4 As per requirement As per specs. X W S Inspection Report
e.) Pointing Item 505.3.5 Item 505.3.5 As per requirement As per specs. X W S Inspection Report
f.) Coping Item 505.3.6 Item 505.3.6 As per requirement As per specs. X W S Inspection Report
g.) Weep Holes Item 505.3.7 Item 505.3.7 As per requirement As per specs. X W S Inspection Report
h.) Cleaning Exposed Faces Item 505.3.8 Item 505.3.8 As per requirement As per specs. X W S Inspection Report

Submitted by: Reviewed By: Recommending Approval Approved By: cc: PSO/NPCO

_____________________ _______________________ ___________________________

PROJECT MANAGER (CONTRACTOR) PPMIU ENGINEER PPMIU HEAD PROVINCIAL
PAROGOVERNOR
II Head
Annex 4

(Establishment of Quality raw Rubber Production and Marketing (Site Development and Construction of Warehouse with Perimeter Fence )
QUALITY PLAN (OUTLINE)
Form No. ___________ Date : ________________________________
Responsibility/ Key Performance
Activity/Process Procedure/ Reference Control Points/ Parameters Frequency Reference Remarks
Interface Measurement
1. Project Organization
1.1 Organizational Structure - Staff Qualifications Standards - LGU-EO for Creation and Designation of CPMIU members - upon approval of change of - CPMIU/RPCO/PSO - IMA/MOA
personnel NPCO (1)

1.2 Activity Schedule - Program of Work - S-Curve/PERT-CPM - to be revised in accordance - CPMIU/RPCO/PSO - IMA/MOA
- per time Requirement of PRDP Operations Manual w/ Operations Manual NPCO (1)

1.3 Human & Material Resources - Manning Schedules - start of project - CPMIU/RPCO/PSO - construction contract
- Budget Schedule - re-alignment NPCO
(1)
- re-budgeting

2. Contract Review / Implementation Arrangement

- IBUILD Manual / - CAF/NTP - LGU BAC Resolution of - CPMIU/RPCO/PSO - RPAB Approval/ Tendering Docs. CAF/NTP Requiments:
Operations Manual Award NPCO - Permits & LGU Equity Contributions -NOL 1 & 2
- First Tranche Release - Construction Contract, - Construction Start - Permits/Clearance (CNC/ECC)
Notice to Commence - LGU Equity/LP/GOP Bank Accts. - Approve POW
(1)
- Second Tranche Release - Physical accomplishment - Physical accomplishment - IMA/MOA
- Third Tranche Release - Upon Construction Completion - Subproject Completion Report (SCR) - LGU-BAC Res. Of Award
- Final Tranche Release - LGU Equity appropriated

3. Design Review
- IBUILD Manual / a. Design Cosiderations - upon project presentation - CPMIU/RPCO/PSO - Compliance (1) Design Review may include:
Operations Manual - evaluation of existing infrastructure - after RPAB's conditional NPCO - Non-Compliance Report (NCR) (2)&(3)
- DPWH Guidelines approval - Corrective Action Report POW - Preconstruction Survey
- AASHTO/ACI - pre-construction activities - NCR Close-out Safety Manual - Allocation for soil investigation
b. Engineering Design
- Field Survey Information
- Drainage Data
- Soil and geological conditions
- Natural and Man-made features affected by the
general alignment and to be considered in the
project design
- Soil subsurface information

c. Required Design Documents

- Structural Analysis (structural members e.g.
foundations, columns, beams, roofing etc.)
- Structural Analysis (roof trusses)
- Structural engineering drawings
- Plan and Profile
 - Plumbing Analysis
-Electrical Analysis (Schedule of Loads)

e. Design concept
f. Design criteria
g. Implementation Schedule
h. Cost Estimate/Price Analysis
i. Contract Documents
j. Safety

4. Inspection/Testing
- DPWH Standard Specifications Vol. 2 a. Pre-construction Joint Survey - as required by specs - CPMIU/RPCO/PSO - survey report ITP & MMTR
- IBUILD Manual / b. Alignment (H + V) / ROW Establishment - as required by specs NPCO - survey report
Operations Manual c. Removal of Existing Structures and Obstruction - as required by specs - survey report (4)
- DPWH/ASSHTO/ASTM Standards d. Materials Testing - as required by specs - test reports (4)
- Inspection and Test Plan (ITP) d.1 Receiving Inspection and Testing (Delivered
- Min. Materials and Testing Requirements Samples Materials, Grading, CBR) For all inspection & test results.
(MMTR) d.2 In-process Inspection and Testing (FDT, Slump - Compliance
Test, Concrete Breaking, RSB Test) - Non-Compliance Report (NCR)
d.3 Final Inspection and Testing (Core Sampling, - Corrective Action Report
NDT, Drilling, etc.) - NCR Close-out

5. Document Control
Project Documentation Procedures a. Contractor Supplied Documents - as required by construction - Contractor - Traceability If by contract
contract - CPMIU/RPCO/PSO
NPCO

b. Project Communications -as required - Traceability

c. Inspection/Testing Records - as required by construction - Traceability Refer to ITP

contract

d. Contracts - as required by PRDP - Traceability

Operations Manual

e. Rural Infrastructure Monitoring Forms/Report - As required by PRDP - Traceability (1)

- Delivery Monitoring Report Operations Manual
- Weekly Materials Monitoring Report
- Weather Report Chart
- Daily Labor Attendance Report
- Heavy Equipment Usage Report
- Monthly Material Monitoring Form
- Summary of Test Results
- Physical and Financial Accomplishment Report
- Variation Order
- Suspension Order
- Time Suspension Report
- Resume Order
 - Site Instruction Order
- Site Inspection Report
- Certificate of Completion

( 1 ) IBUILD Operations Manual ( 3 ) DPWH Design Guidelines Criteria and Standards (Volume II)
( 2 ) DPWH Design Guidelines Criteria and Standards (Volume I) ( 4 ) DPWH Standard Specifications Vol 2 (Bridge; Highway and Airports) 1988

Prepared by Recommending Approval: Approved :

PPMIU ENGINEER PPMIU HEAD Local Chief Executive/PROVINCIAL GOVERNOR

Note: This Quality Plan applies to all infrastructure projects under the PRDP, however, the LGU may revised or formulate their own Quality Plan as they consider necessary and applicable CC: RPCO/PSO/NPCO
 Page 15 of 70
Philippine Rural Development Project (PRDP)

Sub-Project Title: Proposed Consolidation Rubber Cup Lump Warehouse

Location: Km 7 Tungao, Butaun City

MINIMUM MATERIALS TESTING REQUIREMENT (FOR ROADS)

Original POW Estimated Test Min. No. of Sample Test Total Test Test Amount of
Item No. Description Unit
Quantity Direct Cost (P) Required Test Req'd. Requirements Required Unit Cost Test
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)
= (4)/(8) x (7) = (9) x (10)
901(1) Concrete Masonry Blocks ha. 19.00 IR 1 whole area ### 1 -
803(1) Structure Excavation cu.m. 6.59 IR 1 whole area 1 -
803(3) Foundation Fill cu.m. 2.20 IR 1 whole area 1 -
900 Reinforced Concrete cu.m. 3.23 IR 1 whole area 1 -
1003 Capertry and Joinery Works sq.m 100.48 IR 1 whole area 1 -
1014(a) Pre-painted Metal Sheets sq.m 77.18 IR 1 whole area 1 -
1027(a) Cement Plaster Finish sq.m 23.58 IR 1 whole area 1 -
TOTAL COST

The number of tests indicated here in were based on the minimum test requirements from one source. In the event that the materials were taken from various sources, each material should be tested separately a number
of test should be on the same basis as the minimum requirements.

Prepared by: Approved

_______ ___________________________________ HON. ADOLPH EDWARD G. PLAZA

Material Engineer (Conctractor) Provicial Governor

LEGEND
IR - Inspection Report Q1 - Quality Test (Grading, Plasticity and Abrasion)
PEC - Project Engineer Certificate Q2 - Quality Test (Grading, Plasticity, Abrasion, Stripping and Bulk Specific Gravity)
G - Grading Q3 - Quality Test (Grading, Elutriation (Wash), Bulk Specific Gravity, Absorption, Mortar Strength, Soundness, Organic Imp
P - Plasticity Test Unit Weight, % Clay Lumps and Shale)
C - Laboratory Compaction Test Q4 - Quality Test (Grading Elutriation (Wash), Bulk Specific Gravity, Absorption and Mortar Strength)
FDT - Field Density Test Q5 - Quality Test (Grading, Bulk Specific Gravity, Absorption, Abrasion, Soundness and Unit Weight)
CBR - California Bearing Ratio Q6 - Quality Test (Grading, Bulk Specific Gravity, Absorption and Abrasion)
F - Fractured Face Q7 - Quality Test (Bending, Tension and Chemical Analysis) for Steel Bar
E - Extraction Qw - Physical Test for Water
R - Retained Stability Index Qp - Quality Test for Paint
Sty - Stability Ql - Quality Test for Hydrated Lime
Ft - Flexural Strength Test for Concrete Beam Sample Qs - Quality Test for Asphalt (Bituminous) Materials
Ct - Compressive Strength Test on Concrete Cylinder Sample Qc - Quality Test for Cement (Chemical or Physical)
St - Slump Test Qm - Quality Test for other Materials (Bearing Pad, Premolded Filler, Joint Filler, etc.)
Ta - Thickness Determination (Core Drilling and Compression Test) for Asphalt MC - Mill Test Certificate
Tc - Thickness Determination (Core Drilling and Compression Test) for PCC Pavement
 Page 16 of 70
Philippine Rural Development Project (PRDP)

ATERIALS TESTING REQUIREMENT (FOR ROADS)

REMARKS
(12)

vent that the materials were taken from various sources, each material should be tested separately a number

Q3 - Quality Test (Grading, Elutriation (Wash), Bulk Specific Gravity, Absorption, Mortar Strength, Soundness, Organic Impurities,

Q4 - Quality Test (Grading Elutriation (Wash), Bulk Specific Gravity, Absorption and Mortar Strength)
Q5 - Quality Test (Grading, Bulk Specific Gravity, Absorption, Abrasion, Soundness and Unit Weight)
 Republic of the Philippines
PHILIPPINE RURAL DEVELOPMENT PROJECT (PRDP)
MINIMUM MATERIALS TESTING REQUIREMENTS MONITORING REPORT
Municipality of: Province of: Region: Caraga Contract No: PRDP-IB-RO13

Establishment of Quality raw Rubber Production and Contractor: Reference No:

Project Name: Marketing (Site Development and Construction of
Warehouse with Perimeter Fence Project Location: Date Approved:

Qty Incorporated into the Work Min. No. of Test Performed into the Work
Test
Item No. Description Unit Original Qty. Previous Derivation Frequency Unit Test Previous REMARKS
This Month To Date Required This Month To Date
Month Required Month
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13)

Billing. No. ____

Note(s):The number of tests indicated here in are on the minimum tests requirements from one source. In the event that the materials are taken from various sources, each materials should be tested separately satisfy the same basis as the
minimum testing requirements.
Legend: Q f.a-Quality Test of Fine Aggregates (grading test, bulk sp. Gravity, Q c.a- Quality Test of Coarse Aggregates (grading test, bulk sp. Gravity, absorption,
FT - Flexural Test EC - Engineer's Certificate
absorption, organic impurities, soundness test, clay lumps, finess soundness, clay lumps, abrasion)
Q C - Quality Test (Cement) modulus.) IR - Inspection Report DCT- Drilled Core Test
QRSB - Quality Test (Rebars) FDT - Field Density Test A - Abrasion MCC - Manufacturer's Certificate of Compliance FF - Fractured Face Ct - Compressive Test
P - Plasticity G - Grading Test C - Lab. Compaction Qs - Soil Classification Qp - Hydrostatic/Leak Test for pipes T- Thickness Determination CBR - California Bearing Ratio

Submitted by: Checked by: Certified Correct: Reviewed By: Approved by:

Signature

Name
Title Project Manager-Contractor PPMIU Resident Engineer PPMIU Engineer PPMIU Head PROVINCIAL GOVERNOR
Date
Annex 16
 Annex 23 Form No.
Republic of the Philippines
PHILIPPINE RURAL DEVELOPMENT PROJECT (PRDP)
NON-CONFORMITY REPORT MASTER LIST
PROVINCE: REGION: Caraga CONTRACT NO.:
PROJECT NAME: Establishment of Quality raw Rubber Production and Marketing (Site Development and PROJECT LOCATION: KM Tungao, Butuan City REFERENCE NO.

Date Updated
ERROR DATE
NCR NO. CODE DESCRIPTION OF NON-CONFORMITY REFERENCE ITEM No. ITEM DESCRIPTION PRODUCT LOCATION QTY CAR (Y/N) REMARKS/ STATUS
ISSUED CLOSE-OUT

Prepared by: Concurred by: Verified by:

Signature

Name
Title CPMIU Head City Mayor RPCO / PSO/NPCO Engineer
Date

Form Filling-out Instructions

1 In the header, the PPMIU Head shall fill in the name of the Contractor and the Contract Number as per Employer's number series.
2 Under "NCR No." column, the PPMIU Head shall indicate the corresponding issuance number of the NCR.
3 The "Error Code" defines the type of Non-Conformity and is tabulated below for quick reference.
4 The "Description" column contains the reasons or causes which paved the way for the issuance of the NCR.
5 The Reference Item number shall be the pay Item indicated in the BOQ or otherwise Item number indicated in the Technical Specification
6 The "Product" will refers to description of work item (e.g, concrete, reinforcing bars, concrete aggregates, etc.)
7 The "Date Issued" column contains the date of issuance of the NCR.
8 "CAR Yes/No" column defines whether a Corrective Action Request was issued for an specific NCR.
9 The date the NCR was finally settled shall be indicated in the "Date Closed" column.
10 The PPMIU Head MUST carefully fill in all required information so as to ensure a smooth flow of business as far as NCR matter is concerned.
11 The PPMIU Head MUST indicate in the "Date Updated" box the date the table was updated and issued to avoid confusion from previously collected data.
 ANNEX 21
REPUBLIC OF THE PHILIPPINES
PHILIPPINE RURAL DEVELOPMENT PROJECT (PRDP)
Province of Agusan del Sur, Caraga Region
STATUS OF TESTS
Proponent Agency : PLGU-Agusan del Sur
Establishment of Quality raw Rubber Production and Marketing (Site Development
Subproject Title : and Construction of Warehouse with Perimeter Fence
Date :
Subproject No. : Suproject Descripion:

Location :

Physical Target : sq.m. Construction of rubber cup lump

warehouse
Contractor :

Our records indicate that he status of test on the above subproject to date are asfolows:

Number of Test
Total Estimated Minimum No. of Conducted to Date
Materials Quantity Tes Required
On File Balance
No.
Prepared by: Checked by:

Material Engineer( Contractor) PPMIU Resident Engineer

Approved by: Concurred by:

PPMIU Engineer RPCO Rural Infrastructure Engineer

Site Development

er cup lump

%
Accomp.

Note: pls input data base on MMTR

Annex 21
Form No.
Republic of the Philippines
PHILIPPINE RURAL DEVELOPMENT PROJECT (PRDP)
Province of Agusan del Sur, Caraga Region
SITE INSTRUCTIONS (SI)
Establishment of Quality raw Rubber Production and Marketing (Site
Subproj. Name: Development and Construction of Warehouse with Perimeter Fence Project ID No.
Project Location: P Date Issued:
SI Reference No
Site Instruction Issued To

Signature
Name Project Manager - Contractor
Title Project Manager - Contractor
Date

Site Instruction/s
SUBJECTS:

Site Instruction Issued by Noted

Signature Signature
Name Name
Title PPMIU Resident Engineer Title PPMIU Head
Date Date

Verified by

Signature
Name
Title PPMIU Engineer
Date
Annex 19 Form no.
Republic of the Philippines
PHILIPPINE RURAL DEVELOPMENT PROJECT (PRDP)
Province of Agusan del Sur, Caraga Region
CLEARANCE FOR PLACING OF CONCRETE

Reference No.:
Subproject Name: Establishment of Quality raw Rubber Production and Marketing (Si Proposed Date:
Location: Type of Structure:
Part of Structure: Type/Strength of Conc.:
Drawing Ref: Concrete Quantity:

INSPECTION CHECKLIST INSPECTION CHECKLIST

Yes No N/A Remarks Yes No N/A Remarks
1.0 Excavation 3.0 Reinforcement
1.2 Is the excavation correct in size? 3.1 Are the rebars free from excessive rust?
1.3 Is the base properly compacted? 3.2 Is the spacing correct?
1.4 Is the excavation dry? 3.3 Is the concrete cover as per specs?
1.5 Is the selected fill/blinding concrete in place? 3.4 Are all tie wires in place and correctly tied?
2.0 Formwork 3.5 Are there adequate spacers/all specified intervals?
2.1 Is the bracing adequate? 3.6 Correct number of bars in the reinforcement?
2.2 Has mould oil been applied evenly and thoroughly? 3.7 Are all bars of the correct size?
2.3 Is the formwork vertical 3.8 Are the starter bars in the correct position?
2.4 Is horizontal alignment correct? 3.9 Are the starter bars and splices the correct
2.5 Is access adequate? size and number?
3.0 Cement 4.0 General
3.1 Are there sufficient quantity of cement? 4.1 Is the site clean and free from all debris?
3.2 Is the quality test being carried out 4.2 Are there adequate vibratory pokers on site?
and passed proj specs. requirement? 4.3 Is curing material available on site?
3.3 Is the Concrete Mix Design approved? 4.4 Have slump test and concrete sampling
4.0 Aggregates been organized?
4.1 Are there sufficient qty. of aggregates(C.A & F.A)? 4.5 Has adequate lighting been organized?
4.2 Is the quality test being carried out 4.6 Are stop blocks on site?
and passed proj. specs. requirement? 4.7 Is the access safe?
5.O Concrete 4.8 Other/Special Requirements?
5.1 Placing of Concrete Remarks:
5.2 a. Manual b.Chute c.Pump d.Crane & Bucket
e. Others(Specify)
Contractor: Inspected by:
Approved
Disapproved
Project Engineer PPMIU Engineer
(Contractor)
1.0 This clearance shall be submitted by the contractor twenty four (24) hours prior to the actual placing of concrete.
2.0 The CPMIU Engineer shall inspect and note N/A for items not applicable.
3.0 This forms shall be attached to the Inspection Request Form (IRF).
Annex 22
Form No.

REPUBLIC OF THE PHILIPPINES

PHILIPPINE RURAL DEVELOPMENT PROJECT (PRDP)
Province of Agusan del Sur, Caraga Region
Non Conformity Report (NCR)
Name of Project Establishment of Quality raw Rubber Production and Marketing (Site Development and Construction of
Project Location:

Date Prepared:
Contractor:
NCR Report No.

Project ID Number.

Issued to Item Description

Reference Pay
Signature Item No.

Name
Location
Title Project Manager (Contractor)
Date Received: Product
Time Received: Quantity

Description of Non-Conformity
Requirement Reference Error Code

Ref. IRF No. None

Ref. QA/ QC Report No. None
Ref. Test Result None
Ref. Survey Result

Initiated by Issued by

Signature Signature

Name Name
Title PPMIU/RPCO Title PPMIU Head
Date Date
Contractor's Proposed Disposition
Waiver Rework Replace Scrap Other

Proposed by: Disposition Approved by:

Signature Signature

Name Name
Title Project Engineer (Contractor) Title PPMIU Engineer
Date Date

Disposition Verified and Recommended for Close-out: NCR Close-out Approved by

Signature Signature

Name Name
Title PPMIU/RPCO Title PPMIU Engineer
Date Date

Corrective Action Request Needed

Yes No
Corrective Action Requested by
Remarks:
Signature

Name
Title PPMIU/RPCO
Date
Form Filling-in Instructions:
1 In the header the PPMIU Head shall fill in the name of the Contractor, the ID Number as per LGU's number series, and the NCR number.
The NCR number shall be in the series of Proj ID-NCR-A-XXX, where A corresponds to Area of Discipline(A=Architectural,C=Civil
Works,E=Electrical,M=Mechanical,S=Structural, P=Sanitary and Plumbing) and the last three digits is the ordinal number series of the
NCR.

2 The "Issued to" box contains the Contractor's Project Manager's (or that equivalent to the Managerial level) name, signature and date/
time received.

3 The "Item Description box" contains the pay item per Contract BOQ referred to in the NCR subject item, and other descriptive data such as
location, product or material, and the involved quantity.

4 The "Description of Non-conformity" box defines the reason or cause why the NCR is issued. The "Requirement Reference" identifies the
provision in the specification or accepted engineering standard that has been violated or not complied with. The "Error Code" defines the
type of non-conformity as tabulated below. Reference QA/QC activities' numbers (IRF, Test/Survey, QC inspection, QA/QC inspection
leading to the issuance of the NCR), as applicable shall be indicated.

5 The Inspectorate Teams (PSO/RPCO/NPCO or from PPMIU Members), who initiates the issuance of the NCR fills in his/her name and
signature and the date the NCR was prepared in the "Initiated by" box.

6 The PPMIU Head, after due review and approval, fills in his/her name and signature and the date the NCR is issued in the "Issued by" box,
after which forwards it to the Contractor.
 The PPMIU Head, after due review and approval, fills in his/her name and signature and the date the NCR is issued in the "Issued by" box,
after which forwards it to the Contractor.

7 The "Contractor's Proposed Disposition" shall be filled in by the Contractor indicating the remedial action it intends to undertake to resolve
the NCR. Tick boxes for common dispositions are provided to facilitate filling out, other details also have to be described in the space
provided.

8 The Contractor's Project Manager (or that equivalent to the Managerial level), who proposes the disposition fills in his/her name and
signature and the date the disposition was submitted to the PPMIU Head in the "Proposed by" box. The disposition must be submitted to the
PPMIU Head not later than three (3) days after the NCR is issued.

9 The PPMIU Engineer or his designate, after due review and approval, fills in his/her name and signature and the date the disposition is
approved in the "Approved by" box, after which forwards it to the Contractor for implementation of the disposition.

10 Inspectorate Team may conduct verification and inspection to determine the acceptability conforming to the approved disposition and
witnessing that the NCR is resolved, fills in his/her name and signature and the date the disposition is verified in the "Disposition Verified"
box. If found acceptable, the Inspectorate Teams will recommends for close-out, otherwise the inspectorate teams disapproves the
Inspection Request (IRF).

11 The PPMIU Engineer, after due review and approval, fills in his/her name and signature and the date the NCR Close-out is approved in the
"NCR Close-out Approved by" box.

12 If similar type of Non-conformity occurs three (3) times, then a request for a Corrective Action (CAR) shall be initiated by the
PPMIU/RPCO/PSO/NPCO to correct concerned QA/QC procedures and/or construction methodology to prevent future occurrences of the
non-conformity.

Error Code
Administration Concrete
01 No Shop drawings submitted 30 No Concrete Mix Design and Trial Mix Result
02 No materials test report 31 Retempering of freshly mixed concrete
03 No inspection request 32 Batching of concrete not in accordance with the
approved mix design
04 No work request
05 No inspection and test plan and MMTR Master Plan 33 Inadequate compressive strength
06 No supervision 34 Inadequate flexural strength
07 No Detour/Rerouting 35 No test sample prepared
08 No Care of water 36 Bulging
09 No pre-construction/joint survey 37 Honeycomb
10 Others 38 Cold joint
Materials 39 No slump test carried out/inadequate slump
11 Incorrect materials 40 Cracks
12 Defective and damaged materials 41 Spalling
13 No materials testing and source approvals 42 Scaling
14 No submittal of material test certificate and 43 No proper curing
Manufacturer's certificate of compliance 44 Sealing of joints
16 Size/Dimension is not as per plan 45 Others
17 Test frequency not followed
18 Installation of disapproved materials Workmanship
19 Others 45 Installation/work not as per drawings
46 Vertical and horizontal misalignment
Embankment/Subbase/Base course 47 Surface preparation inadequate
20 Contaminated w/ unsuitable and oversized materials 48 Architectural finishing aesthetically
21 Insufficient number of FDT not acceptable
22 Laying of Embankment on section w/ failed FDT results 49 Wrong procedure / Construction Methodology
23 Laying of Embankment w/o reconditioning 50 Defective installation / work
compacting subgrade level 51 Concrete covering
24 Layering not respected 52 No upkeep to harmful debris at work site
25 Series of Lifts without FDT results 53 No safety measures
26 Proctor test result not representative to the in-situ materials 54 Unacceptable formworks
27 FDT was conducted without MLGU representative 55 Others
28 In place Materials is not from approved source
29 Others
 Form No.
REPUBLIC OF THE PHILIPPINES
PHILIPPINE RURAL DEVELOPMENT PROJECT (PRDP)
Province of Agusan del Sur, Caraga Region

QA/QC INSPECTION REPORT

Project Name: Establishment of Quality raw Rubber Production and Marketing Date Prepared:
Project Location IR No.

Contractor Contract Number:

Issued to:

Signature

Name
Title PPMIU Head
Date

ITEM(S) INSPECTED :

FINDINGS/OBSERVATION:

REQUIREMENT(S) :

GEOTAG PHOTOGRAPHS:
Inspected by:

Signature

Name
Title RPCO/PSO/NPCO ENGINEERS
Date
Annex 15 Form No.

REPUBLIC OF THE PHILIPPINES

PHILIPPINE RURAL DEVELOPMENT PROJECT (PRDP)
Province of Agusan del Sur, Caraga Region
QC Inspection Report (QCIR)
Name of Project Establishment of Quality raw Rubber Production and Marketing (Site Development and Construction of War
Project Location:

Date Prepared:
Contractor: PRDP-IR-RO13-
Inspection
Report No.
Contract No.
Construction Activity Inspected

Ref. Pay Description Location Date Time Remarks

Item No.

Findings/Observations

Prepared by: Test Conducted?

 Yes No
Signature
Type of Test Needed
Name
Title PPMIU Resident Engineer
Date NCR To be issued Reference NCR No.
Yes
Test/Inspection witnessed by No

Signature
Noted by:
Name
Signature
Title RPCO/PSO/NPCO
Date Name
Title PPMIU Engineer
Note: See form filling-in instructions Date

Form Filling-in Instructions:

1 Fill out the form by diligently supplying all the required information asked for in this "QC Inspection Report form".

2 The space provided for "Project" shall indicate the specific Project to be inspected.
3 The IRF/Work Request reference number shall be Proj ID No IRF A XXX
Project ID no: = Indicated in the IMA
IRF = Acronym for the Inspection Request Form
A= = Area of Discipline
A= Architectural Works C= Civil Works
E= Electrical Works M= Mechanical Works
P= Plumbing and Sanitary Works S= Structural Works
XXX = is the sequential numbering system of the IRF
4 Under the "Construction Activity Inspected" box, the PPMIU Engineer doing the inspection MUST diligently fill in all the
information required to clearly determine the details of the:
a The "Reference Pay Item No." as per Contract BOQ.
b The detailed "Description" of the 'Reference Pay Item No." which includes the specific activities under inspection as

well as its "Location, "Date", "Time" and "Remarks" in the corresponding spaces provided herein.
5 The detailed findings made or concluded after the conduct of the inspection shall be indicated in the space provided for
"Findings/Observations".
6 The PPMIU Engineer should indicate the name of any inspectorate team present during the inspection who witness the

activity, after which shall fill out the space provided for the "Test/Inspection Witnessed by".
7 The Inspector shall also indicate in the form whether the "Pay Items" inspected needs to be tested further or not and if there is
indeed a test needed, he/she must specify the particulars of the test needed.
8 If a sort of violation/out of track processes are being carried out by the people inspected, meaning, a "Non-Conformity Report"

should be issued, MUST be also indicated in the space provided so as to inform the PPMIU Head and come up with the

necessary course of action before he/she affix his/her signature.

Annex 17
Form No.
Republic of the Philippines
PHILIPPINE RURAL DEVELOPMENT PROJECT (PRDP)
SUMMARY OF QUALITY CONTROL TEST PERFORMED

as of Feb , 2019
City/Mun of: Province of: Region: Caraga Contract No.

Project Name: Establishment of Quality raw Rubber Production and Marketing (Site Development and Con Reference No.
Project Location: Period Covered:

Date Date Remarks /

Lab. No. Item Description Station Represented Quantity Represented Kind of Test Test Result Spec's
Sampled Tested Recommendation
Submitted by: Checked by: Reviewed by Approved by: Noted By:

Materials Engineer PPMIU Resident Engineer PPMIU Engineer PPMIU Head RCPO Rural Infrastructure Engineer
(Contractor)
Annex 18 Form No.
Republic of the Philipiines
PHILIPPINE RURAL DEVELOPMENT PROJECT (PRDP)
Province of Agusan del Sur, Caraga Region

Test Equipment Check Table

Check Judgment YEAR 2015

Item Equipment
frequency method Jan Feb Mar Apr May Ju Jul Aug Sept Oct Nov Dec
Existence of
clogging
Sieve Sieve Every use
Existence of
deformation

Water
Bulk density 1time leakage
Measure
and voids /12month
Volume
Volumetric
Every use Damage
flask
Specific
gravity and Existence of
absorption Mold,
Every use deformation
Tamper
or damage

Existence of
Slump Mold Every use deformation
or damage

Every use Condition

Testing
machine 1time
Calibration
Compressio /12month
n / Flexural
test Existence of
Steel mold Every use deformation
or damage

Existence of
Capping
Capping Every use deformation
plate
or damage

Water
Curing Curing tank Every day temperature(
23+/-2°C )

Every use, Condition

Weight Weight scale
Weight Weight scale 1time/12mo
Calibration
nth

Prepared by: Symbols/Notations

O : OK A : Adjustment is necessary
C : Cleaning is necessary G: Change is necessary
PPMIU Engineer Cal: Calibration is necessary R : Repair is necessary
Annex 27 Form No.
Republic of the Philippines
PHILIPPINE RURAL DEVELOPMENT PROJECT (PRDP)
Province of Agusan del Sur
CORRECTIVE ACTION REQUEST (CAR)
CAR Number: Date:

Corrective Action
Request Subject

Reference
Procedure

Cause/ Reason of Issuance Reference NCR/ Audit Report No(s).

Requested by Issued to

Signature Signature

Name
Concerned
Title RPCO/PSO/NPCO ENGINEER Entity Rep.
Date Title PPMIU HEAD
Time Date
Time

Proposed Corrective Action (CA)

CA Proposed by CA Approved by:

Signature Signature

Name Name
Title PPMIU Head Title RPCO/PSO/NPCO Engineer
Date Date

CA Verification
CA Verified and Recommended for Close-out CAR Close-out Approved by:

Signature Signature

Name Name
Title RPCO/PSO/NPCO Engineer Title RPCO/PSO/NPCO I-BUILD Component Head
Date Date

Form Filling-in Procedure:

note:

This procedure is intended to as a preventive tool to avoid recurrence of non conformity event which is part of
the project monitoring to correct deficiencies affecting the implementation of the system process, however the
sample format such as the title reflected above can be modified and replaced by the PPMIU Engineers and
addressed to the contractor in cases the corrective actions requires immediate action of the contractor to
preclude the recurrence of the non conformances and to correct procedures relevant to quality control .

1 The RPCO/PSO/NPCO ENGINEERS fills in the CAR Number. It shall be in the series: CAR-00X, where the
last three digits are the ordinal number series. Example: CAR-001 refers to the first CAR issued and CAR-002
refers to the second CAR issued and so forth.
2 The date in the header refers to the date the CAR was prepared.
3 The "Corrective Action Request Subject" defines the activity or process that requires corrective action.
4 The "Reference Procedure" pertains to the QA/QC procedure in the QA manual or Construction Methodology
that needs correction, as may be applicable.

5 The "Cause of Issuance" box is filled in with the reasons why the CAR is needed, and the respective numbers
of the related NCRs that substantiate the perpetuation (or 3 times occurrence) of a non-conformity must also
be indicated.

6 The RPCO/PSO/NPCO ENGINEERS who requests the CAR fills in his/her name in the "Requested by" box
after which affixes his/her signature with the date and time the CAR is issued.
7
After due review and approval, the RPCO/PSO/NPCO ENGINEER fills in his/her name and affixes his/her
signature and the date and time the CAR is approved for issuance in the "Approved by" box and forwards it to
the concerned entity required of a Corrective Action

8 The "Concerned Entity" box is filled in by a representative of the group/department/section, required of a CAR.
Upon receipt he/she fills in his/her name, signature and date/time the CAR is received.
9 The "Concerned Entity" representative then fills in the suggested Corrective Action in the "Proposed
Corrective Action" box.

10
After due review and approval, the RPCO/PSO/NPCO ENGINEERS fills in his/her name and affixes his/her
signature and the date and time the "Proposed Corrective Action" is approved for implementation.

11 The RPCO/PSO/NPCO ENGINEER then verifies if the corrective action is in place and is effective. The "CA
Verification Box" is filled in with reference to objective evidence of the effective implementation of the
corrective action.

12 Upon verification of the implementation of the effective corrective action, the RPO/PSO/NPCO ENGINEER
fills in the "CA verified and Recommended for Close-out" box, indicating his/her name, signature, and the
coincident date and time.

13 After due review and approval, the RPCO/PSO/NPCO IBUILD COMPONENT HEAD or its ALTERNATE fills
in his/her name and affixes his/her signature and the date and time the CAR is closed-out in the "CAR Close-
out Approved by" box.
Annex 28 Form No.
Republic of the Philippines
PHILIPPINE RURAL DEVELOPMENT PROJECT (PRDP)
Province of Agusan del Sur
QUALITY ASSURANCE AUDIT REPORT
Report Number: of Series No. Date of Audit:
Audited Group: Time of Audit:
Audited Section:
Reference QA
Manual Element

Audited Group Representative: Audited by:

Signature Signature
Name Name
Title PPMIU Head Title RPCO/PSO/NPCO Engineer

Details of Findings/ Objective Evidence

Classification:
Observation
Minor Non-conformance
Major Non-conformance
NCR/CAR Number:
NCR No.
CAR No.

Root Cause Analysis

Proposed Disposition

Date of Implementation

Disposition Proposed by Approved by:

Signature Signature
Name Name
Title CPMIU Head Title RPCO/PSO/NPCO Engineer
Date Date

Disposition Verification/ Objective Evidence

Disposition Verified and Recommended for Close-out Close-out Approved by:

Signature Signature
Name Name
Title RPCO/PSO/NPCO Engineer Title RPCO/PSO/NPCO I-BUILD Component Head
Date Date

Form Filling-out Procedure:

1 The QA Auditor fills in the report number and the total number of reports generated for the current audit. The series
number shall be in the form of QAR-I/C-00X, where I/C are indices to indicate whether the series refers to a QA Audit on
the Project Implementation. The last three digits are the ordinal number of the audits conducted.

2 The "Audited Group" refers to either the PPMIU, and the section refers to the sub-group in their respective tier.

3 The "Reference QA Manual Element" refers to the particular provision in the IQMDS Manual which served as the basis of
the audit.

4 The audited group's representative fills in his/her name, signature in the "Audited Group Representative" box.
5 The findings of the Auditor and its corresponding objective evidences are filled into the "Details of Findings/ Objective
Evidence" box. It is then classified whether it is an observation or a minor/ major non-conformance. If it turns out the
findings translate to a minor non-conformance this report becomes a "Non-conformity Report" and a corresponding NCR
number is assigned to it (See NCR numbering procedures in the NCR form). If the findings translate to a major non-
conformance, then this report becomes a "Corrective Action Request" and a corresponding CAR is assigned to it (See
CAR numbering procedures in the CAR form).

6 An analysis as to how the observation/ non-conformity has occurred is written down by the audited group representative
in the "Root Cause Analysis" box.

7 A proposed disposition as to how to resolve the observation/ non-conformity is prepared by the head of the audited group
(may not necessarily be the representative) and is indicated in the "Proposed Disposition" box, including the date of the
implementation of the disposition.

8 After due review and approval, the Lead Auditor which is the RPCO/PSO/NPCO Engineer shall affixes his/her signature
with the date and time the disposition is approved for implementation.

9 On the succeeding audit period, the implementation of the disposition will be verified by the Lead Auditor and the details
of the verification including objective evidences shall be filled-in in the "Disposition Verification" box, afterwhich he/she
affixes his/her signature in the "Disposition Verified and Recommended for Close-out" box.

10 After due review and approval, the RPCO/PSO/NPCO IBUILD COMPONENT HEAD or its ALTERNATE shall affixes
his/her signature with the date and time on the "Close-out Approved by" box.
After due review and approval, the RPCO/PSO/NPCO IBUILD COMPONENT HEAD or its ALTERNATE shall affixes
his/her signature with the date and time on the "Close-out Approved by" box.
PCO Engineer

rmance
rmance
PCO Engineer

ILD Component Head

udit. The series

ers to a QA Audit on

ective tier.

erved as the basis of

tive" box.
ndings/ Objective
f it turns out the
corresponding NCR
to a major non-
assigned to it (See

roup representative

d of the audited group

ding the date of the

xes his/her signature

ditor and the details

afterwhich he/she

NATE shall affixes

Annex 29 Form No.
Republic of the Philippines
PHILIPPINE RURAL DEVELOPMENT PROJECT (PRDP)
Province of Agusan del Sur
SURVEILLANCE REPORT
Report Number: of Series No. Date:
Concerned Group: Time:
Concerned Section:
Reference QA
Manual Element

Concerned Group Representative: Reported by:

Signature Signature

Name PPMIU Head Name RPCO / PSO / NPCO Engineer

Title Title

Details of Findings/ Objective Evidence

Classification:
Observation
Minor Non-conformance
Major Non-conformance
NCR/CAR Number:
NCR No.
CAR No.

Root Cause Analysis

Proposed Disposition

Date of Implementation
Disposition Proposed by Approved by:

Signature Signature

Name Name
Title PPMIU Head Title RPCO / PSO / NPCO Engineer
Date Date

Disposition Verification/Objective Evidence

Disposition Verified and Recommended for Close-out Close-out Approved by:

Signature Signature

Name Name
Title RPCO / PSO / NPCO Engineer Title RPCO / PSO / NPCO Component Head
Date Date

Form Filling-in Procedure:

1 The essence of the "Surveillance Report" is similar to that of the Quality Audit Report in the perspective of
enforcing/improving/correcting the Quality Assurance Manual procedures set forth for the project. This Surveillance
Report however, caters to the emergency findings needing immediate attention which cannot be covered by the
scheduled regular Quality Audit.

2 Any person within the NPCO/RPCO/PSO/ Team who finds a significant irregularity in the implementation of the Quality
Assurance Manual procedures, reports his/her finding(s) through the "Surveillance Report" form. He/she shall fill in the
report number and the total number of reports generated for the current report, in consultation with the QA/QC
Consultants. The series number shall be in the form of SR-I/C-00X, where I/C are indices to indicate whether the series
refers to a QA Audit on the system of implementation (I). The last three digits are the ordinal number of the audits
conducted.

3 The "Concerned Group" or the "Audited Group" refers to the PPMIU, and the section refers to the sub-group in their
respective tier.

4 The "Reference QA Manual Element" refers to the particular provision in the IQMDS Manual which serves as the basis of
the audit.

5 The concerned group's representative fills in his/her name, signature in the "Concerned Group Representative" box.
6 The findings and its corresponding objective evidences are filled into the "Details of Findings/ Objective Evidence" box. It
is then classified whether it is an observation or a minor/ major non-conformance. If it turns out the findings translate to a
minor non-conformance this report becomes a "Non-conformity Report" and a corresponding NCR number is assigned to
it (See NCR numbering procedures in the NCR form). If the findings translate to a major non-conformance, then this
report becomes a "Corrective Action Request" and a corresponding CAR is assigned to it (See CAR numbering
procedures in the CAR form).
 The findings and its corresponding objective evidences are filled into the "Details of Findings/ Objective Evidence" box. It
is then classified whether it is an observation or a minor/ major non-conformance. If it turns out the findings translate to a
minor non-conformance this report becomes a "Non-conformity Report" and a corresponding NCR number is assigned to
it (See NCR numbering procedures in the NCR form). If the findings translate to a major non-conformance, then this
report becomes a "Corrective Action Request" and a corresponding CAR is assigned to it (See CAR numbering
procedures in the CAR form).

7 An analysis as to how the observation/ non-conformity has occurred is written down by the concerned group's
representative in the "Root Cause Analysis" box.

8 A proposed disposition as to how to resolve the observation/ non-conformity is prepared by the head of the concerned
group (may not necessarily be the representative) and is indicated in the "Proposed Disposition" box, including the date
of the implementation of the disposition.

9 After due review and approval, the "RPCO/PSO/NPCO ENGINEER" affixes his/her signature with the date and time the
disposition is approved for implementation.

10 The implementation of the disposition will be verified by the "RPCO/PSO/NPCO ENGINEER" and the details of the
verification including objective evidences shall be filled-in in the "Disposition Verification" box, afterwhich he/she affixes
his/her signature in the "Disposition Verified and Recommended for Close-out" box.

11 After due review and approval, the RPCO/PSO/NPCO COMPONENT HEAD or its ALTERNATE affixes his/her signature
with the date and time on the "Close-out Approved by" box.
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Annex 32
Form No.
Republic of the Philippines
PHILIPPINE RURAL DEVELOPMENT PROJECT (PRDP)
Province of Agusan del Sur
DAILY DAYWORK REPORT
Work Order No.
Contractor:
Date:
Subproject Title:
Location:

Work Description

Equipment Used
No. of Time Time
Equipment Task Description Remarks
Units Started Completion Elapsed/Hrs.

Materials
Description Quantity Unit Remarks

Manpower
No. of Time
Manpower Designation Manpowe Man-Hours Remarks
r In Out
Prepared by Conforme

Signature Signature

Name Name
Title Contractor Title PPMIU Resident Engineer
Date Date

Filling-in Instructions:
note:
The Daily Day Work form may be used only if there are immediate activities that needs to
be implemented specifically extra work order and such unit prices are not included in the
BOQ. Works that are subject for payment but the derivation of unit cost are not included in
the contract. This must be referred to the Special Conditions of Contruct (SCC) if Day
Works were allowed.

1 This "Daily Daywork Report" form shall be accurately filled in with all the necessary
information asked for in this form by the Contractor's Field Construction
Engineer.
2
This form basically contain three (3) major sections namely: Equipment Used,
Materials and Manpower which are then subdivided into several columns.

3 Under Equipment section,"Equipment" column, the Field Construction Engineer

shall indicate the list of Equipment units used for the specific day of operation, the
specific Task of that equipment under "Task" column and the number of
Equipment units present

4
The time the equipment started its operation until the time it ceased operation for
that specific day shall be stated under "Time" column, still under "Equipment"
section.

5
The time elapsed or the time of operation of the particular equipment that goes
beyond the required time for the day shall be stated under "Time Elapsed" column.

6 Any remarks as far as Equipment is concerned shall be indicated under "Remarks"

column.
7 The first column of "Material" section is the "Description" column which basically
should contain the descriptive details of materials present on site and are used on
the construction operation.
8
The "Quanity" and "Unit" columns shall indicate the amount of materials present
and the unit of measurement used for the specific type of material used.

9 Any concerns with regards to the "Materials" section shall be indicated under
"Remarks" columns.
10 The "Manpower" section basically contain information regarding the people
working on site. This include the "Manpower" which indicate the name of the
person alongside the name.
11 The number of manpower present in the field participating in the construction shall
be indicated under "Number of Manpower" column.
12
The total man-hours the particular employee spent participating in the construction
shall be calculated from his/her official time-in and time-out which will be indicated
on the spaces provided in this form.

13 Comments regarding "Manpower" shall be indicated under "Remarks" column.

Annex 33 Form no.
REPUBLIC OF THE PHILIPPINES
PHILIPPINE RURAL DEVELOPMENT PROJECT
Province of Agusan del Sur

Subproject Title:

Contractor: Date Inspected:

Proj. Location: Log Sequence No.

Contract No. Weather
Project component: AM PM

DAILY INSPECTION REPORT (DIR)

Specific Location (Stationing., IRF Test Required/ Survey Drawing Manpower

Description of Activities Inspected Quantity
Reference pt, Grid line, etc.) Submitted Specification Conducted? Ref. No.
No. Designation

REMARKS
INCLUDE MATERIALS DELIVERED, SHORTAGES IN MEN OR MATERIAL, OFFICIAL VISITORS ON SITE, OFFICIAL INSTRUCTIONS ISSUED AND ACTION TAKEN CONCERNING UNACCEPTABLE
MATERIAL OR WORKMANSHIP

EQUIPMENT ON SITE (List of equipments used during construction)

Submitted by: Checked by: Noted by: Conformed by:

Signature

Name
Title PPMIU Resident Engineer PPMIU Engineer PPMIU Head Project Engineer -Contractor
Time
Annex 34 Form No
Republic of the Philippines
PHILIPPINE RURAL DEVELOPMENT PROJECT (PRDP)
Province of Agusan del Sur, Caraga Region
EQUIPMENT MONITORING REPORT
Contractor: ARQ Builders Contract Number:

SP Title Concreting of Mahapag-Dona Maxima FMR (Sta 32+320-Sta31+642.90)

Location: San Luis, Agusan del Sur Reference No.
Proj. ID PRDP-IB-RO13-SDS-008-000-000-2015 Month of:

EQUIPMENT DESCRIPTION REPORT NO. :

MODEL UNIT PLATE NO. :
OPERATOR

Operating Hour's Fuel

Total Consum Scope of Signature
Date ption
AM PM hour's works (Checker)
In Out In Out In Out In Out (Liters)
 Total's >>>>>>>>>>>

SUMMARY
TOTAL OPERATING HOURS 0:00:00
FUEL CONSUMPTION (Liters) 0.0
FUEL CONSUMPTION (Lit/hr) 0.00

Submitted by Checked by: Noted by:

Siganatue
Name
Title Field Engineer (Contractor) PPMIU Engineer PPMIU Head
Time
Annex 36 Form No.
Republic of the Philippines
PHILIPPINE RURAL DEVELOPMENT PROJECT (PRDP)
Province of Agusan del Sur, Caraga Region

Contractor: Contract No.

Subproject Title
Proj. Location: Week No.
Period Covered Reference No.
WEEKLY PROGRESS REPORT

PROJECT DESCRIPTION :

This refers to the specific description of the subproject, e.g. [The Project A is located in the ABC will include the complete construction of
vital facilities such as road network, curb and gutter, side walks, bike lane, entrance plaza 1&2, drainage system, sewer system, water
lines, perimeter fence, electrical works, telephone distribution system, & vertical structures such as Administration Building and Main Hotel.]

PROJECT DATA PROJECT STATUS

Contract Amount : Scheduled Accomplishment to Date : %

Revised Contract Amount : Previous Accomplishment : %
Contract Started : Actual Accomplishment to date : %
Contract Duration : c.d Slippage Previous +/- : %
Contract Expiration : Slippage to Date, +/- : %
Revised Contract Duration : n.a Contract time Elapsed : c.d.
Revised Expiry Date : n.a Percent Time Elapse : %

PROJECT UPDATE
REL.
CONTRAC WT. ACCOMPLISHMENT WEIGHTED (%) %
PART DESCRIPTION T AMOUNT This SCHEDULED
(Pesos) PREVIOUS THIS PERIOD TO DATE Previous To date TO DATE
Period
(%)

TOTAL CONTRACT AMOUNT -

NOTE: Indicates notes which are necessary to supply information of the above figures. SLIPPAGE, +/- 0.00

PROGRESS PHOTOS
 Photos shall reflect the accomplishment indicated in the figures of accomplishment " this period"

Captions:

ISSUES / PROBLEMS ENCOUNTERED: ACTIONS TAKEN/RECOMMENDATIONS:

Reported by: Certified by: Noted by:

Signature Signature

Name Name Name

Title PPMIU Resident Engineer Title PPMIU Engineer Title PPMIU Head
Date Date Date
Annex 53 Form No.
Republic of the Philippines
PHILIPPINE RURAL DEVELOPMENT PROJECT (PRDP)
Province of Agusan del Sur, Caraga Region
ATTENDANCE SHEET
Subproject Title:
Coordination Meeting No.:
Date:
Venue:
Attendees:

No. NAME OFFICE/ COMPANY/ DESIGNATION SIGNATURE Contact Number

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37

Time Started: Time Finished:

 Annex 17 Form No.
Republic of the Philippines
PHILIPPINE RURAL DEVELOPMENT PROJECT (PRDP)
SUMMARY OF QUALITY CONTROL TEST PERFORMED

as of _____, 2017
Municipality of: Province of: Agusan del Sur Region: Caraga Contract No.
Project Name: Reference No.
Project Location: Period Covered:

Quantity Date Date

Lab. No. Item Description Station Represented Kind of Test Test Result Spec's Remarks / Recommendation
Represented Sampled Tested

Submitted by: Check by: Reviewed by: Approved by: Noted by:

PPMIU
Material Engineer PPMIU-Resident Engineer PPMIU-Project Engineer RPCO Engineer
Head
Contractor

Page 68 SQC-R0
Annex 25 Form No.
Republic of the Philippines
PHILIPPINE RURAL DEVELOPMENT PROJECT (PRDP)
Province of Agusan del Sur, Caraga Region
PUNCHLIST FORM
PRDP-IB-RO13-ADS-008-000-000-
Sub Project Name Concreting of Mahapag-Dona Maxima FMR (Sta 32+320-Sta31+642.90) Project ID No 2015
Reference No.
Subproject Location San Luis,Agusan del Sur
Date of Inspection

Required Date
Item No. Deficient Item Date Accepted
Completion Date Inspected

Inspectorate Teams:
Name Title Signature
MPMIU and PRDP (NPCO/PSO/RPCO)
1.0

2.0
3.0

4.0
5.0
6.0

7.0
8.0
QA/QC CONSULTANT
1.0
2.0
3.0
Contractor
1.0
2.0
3.0
4.0

See Attachment (Copies of Construction Deficiency Logs may be attached, where appropriate)

Prepared by Checked by Approved by

Signature Signature Signature

Name Name Name

Title PPMIU Engineer Title PPMIU Head Title Provincial Governor
Date Date Date

Conformed

Signature

Name
Title Project Manager, Contractor
Date