Payment Request Meetinghouse Facilities Department

Project number Request number This request covers work completed through
601-6758-1901-0301
9 August 19, 2021
Project name

LASAM MEETINGHOUSE
Contractor Certificate Amount can be changed only by contractor; changes must be initialed and dated.
Starting date Contract days Original completion C.O. days Revised completion Amount of this request based on attached
date date schedule of values:
$ 1,622,851.08
14/10/2019 300 387
09/08/2020 31/08/2021
I, the contractor, certify that the above amount is true and correct, that it is due, and that all just and lawful offsets, payments and credits have been allowed.
Signature of contractor Title Date

RHYAN C. DIMAANDAL AGM 24 AUGUST 2021

Payee

ROGELIO M. DIMAANDAL CONSTRUCTION

Contractor Federal I.D. or
ROGELIO M. DIMAANDAL CONSTRUCTION Social Security #

Address

Caritan Norte
City State Zip

Tuguegarao City Philippines 3500

Architect Certificate Amount can be changed only by architect; changes must be initiated and dated.

I, the architect, certify that the above named contractor on this project is entitled to payment of this amount: $ 1,622,851.08
Signature of architect/consultant Date

Owner's Approval

I hereby approve payment in the amount of $ 1,622,851.08

Signature of owner (Authorized requester) Title Date

Project Manager
Next level supervisor's signature if applicable Title Date

Finance Information
$ Amount (s) GL BU Dept. Id. Account Project # Res Type Res Cat
1,803,167.86 CPB01 1831 601-6758-1901-0301 T30 C31
-180,316.79 CPB01 2114 601-6758-1901-0301 T00 C32
CPB01 1831 601-6758-1901-0301 T30 C60
CPB01
CPB01
Controllers Signature Date

Summary
Previous
Original Contract Change Orders Adjusted Contract Complete to Date % This Application Balance
Applications
24,407,771.00 24,407,771.00 15,083,732.03 0.62 30,877,004.69 1,803,167.86 9,324,038.97
Less retention / deficiencies -1,508,373.20 -1,328,056.42 -180,316.79 Choose method of Retention
Less liquidated damages for # of days Enter Amount

Other Deductions Enter Percentage 10.0%

Other Additions
Amount approved and due contractor this request 13,575,358.83 29,548,948.27 1,622,851.08
Explanation of other additions and deductions

CON-CBR-0077 Rev C 4 April 2006 Page 1 of 4

 Payment Request Meetinghouse Facilities Department
Billing No. Date
Project Number %
601-6758-1901-0301 9 19-Aug-21 61.80%
Project Name
LASAM MEETINGHOUSE
Contractor Certificate Amount can be changed only by contractor, changes must be initialed and dated.
Starting date Contract days Original completion date C.O. days Revised completion date Amount of this request based on attached

14/10/2019 300 09/08/2020 387 31/08/2021

schedule of values: PHP 1,622,851.08
I, the contractor, certify that the above amount is true and correct, that it is due, and that all just and lawful offsets, payments and credits have been allowed.
Signature of contractor Title Date

RHYAN C. DIMAANDAL AGM 24 AUGUST 2021

Payee PO# Sales Invoice # Sales Inv Date
ROGELIO M. DIMAANDAL CONSTRUCTION PH1-68015 4586 24-Aug-21
Architect Certificate Amount can be changed only by architect; changes must be initiated and dated.

I, the architect, certify that the above named contractor on this project is entitled to payment of this amount: PHP 1,622,851.08
Signature of architect/consultant Date

Owner's Approval

I hereby approve payment in the amount of

Signature of owner (Authrized requester) Title Date

Project Manager
Next level supervisor's signature if applicable Title Date

Area Project Manager

Finance Information

PHP Amount (s) GL BU Dept ID Account Product Project ID Activity ID Resource Type Resource Category

864,047.71 On-site 6790101 1831 601-6758-1901-0301 D99 T22 C34

190,500.65 Off-site 6790101 1831 601-6758-1901-0301 D99 T21 C34
0.00 Landscaping 6790101 1831 601-6758-1901-0301 D99 T24 C30
748,619.50 New 6790101 1831 601-6758-1901-0301 D99 T31 C31
Furnishings & Eqpt. 601-6758-1901-0301
1,803,167.86 Total
-180,316.79 Retention 1,622,851.08 Invoice Amount
-28,979.48 W/Tax 1,448,974.18 Tax Base
1,593,871.59 Net Amount Due
Controller's Signature Date

Summary
Previous
Original Contract Change Orders Adjusted Contract Complete to Date % This Application Balance
Applications
24,407,771.00 0.00 24,407,771.00 15,083,732.03 61.80% 13,280,564.17 1,803,167.86 9,324,038.97
Less retention / deficiencies
Less liquidated damages for # of days
Other Deductions
Other Additions
Amount approved and due to contractor this request
Explanation of other additions and deductions
Project: LASAM MEETINGHOUSE Project # 601-6758-1901-0301 Request # 9 Vicente "Vicson" Soriano Jr.
Change Order Adjusted Contract
Div. Item Description of Work Contract Amount Previous Application This Application Completed to Date % Complete Balance
Totals Amount
31 1 Off-site Earthwork 893,209.00 893,209.00 568,727.00 190,500.65 759,227.65 0.85 133,981.35
33 2 Off-Site Utilities
32 3 Off-Site Asphalt/Concrete Paving
32 4 Off-Site Concrete
01 5 Temporary Site Fencing
02 6 Demolition
01 7 Engineering
31 8 Earthwork - Grading & Pad 4,063,848.54 4,063,848.54 3,657,463.68 284,469.40 3,941,933.09 0.97 121,915.46
33 9 Site Utilities (to within 5' of wall) 4,155,812.72 4,155,812.72 1,246,743.82 415,581.27 1,662,325.09 0.40 2,493,487.63
32 10 Asphalt/Concrete Paving 2,067,420.77 2,067,420.77 1,635,269.91 1,635,269.91 0.79 432,150.86
31 11 Termite Control
32 12 Site Concrete 1,093,313.58 1,093,313.58 163,997.04 163,997.04 0.15 929,316.54
10 13 Site Signage
32 14 Fencing (Site & Screen walls)
26 15 Site Lighting
32 16 Landscape / Irrigation 446,506.00 446,506.00 446,506.00
31 17 Footing. Excavation/Backfill
03 18 Reinforcing Steel
03 19 Concrete Ftg/Stems/Slab
07 20 Bituminous Damp proofing
04 21 Masonry 495,855.02 495,855.02 483,978.66 11,876.36 495,855.02 1.00 0.00
04 22 Stone Sign
04 23 Cut Stone 50,054.69 50,054.69 50,054.69
06 24 Fiberglass
05 25 Structural & Misc. Steel 3,564,013.89 3,564,013.89 3,492,733.61 71,280.27 3,564,013.89 1.00 0.00
06 26 Rough Carpentry, Labor/Material. 596,706.88 596,706.88 59,670.69 59,670.69 0.10 537,036.20
06 27 Wood Trusses & Joists
07 28 Laminated Vapor Retarder
07 29 Insulation 47,945.73 47,945.73 47,945.73 47,945.73 1.00 0.00
07 30 Air Infiltration Barrier
07 31 EIFS
07 32 Roof Tiles or Shingles
07 33 Flashing and Sheet Metal
07 34 Fire stopping
07 35 Joint Sealants
10 36 Steeple
06 37 Millwork & Finish Carpentry
06 38 Doors, Frames & Hardware 222,428.66 222,428.66 22,242.87 22,242.87 0.10 200,185.79
08 39 Access Doors & Panels 555,348.75 555,348.75 277,674.38 55,534.87 333,209.25 0.60 222,139.50
08 40 Sect. Overhead Doors
08 41 Storefronts
08 42 Windows 175,858.46 175,858.46 140,686.77 17,585.84 158,272.61 0.90 17,585.85
09 43 Gypsum Drywall 535,751.34 535,751.34 140,902.60 234,123.34 375,025.94 0.70 160,725.40
09 44 Ceramic Tile 552,400.59 552,400.59 552,400.59
09 45 Acoustical Ceiling Tile 677,047.77 677,047.77 677,047.77
09 46 Wood Flooring
09 47 Resilient Flooring & Base
09 48 Floor Preparation
09 49 Acoustical Wall Panels

Page 3 of 4
09 50 Paint & Wall Coverings 1,069,071.47 1,069,071.47 320,721.45 320,721.45 0.30 748,350.03
09 51 Chalk/Tack/Appliances/Rost/Sign Labor 260,035.78 260,035.78 260,035.78
10 52 Metal Toilet Partitions & Accessories
10 53 Fire Extinguishers
10 54 Accordion Folding Partitions
10 55 Misc. Specialties 89,416.32 89,416.32 89,416.32
11 56 Athletic Equipment
12 57 Draperies
01 58 Test, Adjust & Balance Mechanical 85,972.67 85,972.67 85,972.67
21 59 Fire Suppression 19,462.51 19,462.51 19,462.51
22 60 Plumbing 293,102.61 293,102.61 205,171.83 205,171.83 0.70 87,930.78
23 61 HVAC 69,063.32 69,063.32 69,063.32
26 62 Electrical 904,942.85 904,942.85 271,482.86 45,247.14 316,730.00 0.35 588,212.85
27 63 Sound & Satellite Systems 312,181.09 312,181.09 312,181.09
00 64 General Conditions 1,111,000.00 1,111,000.00 996,233.70 25,886.30 1,022,120.00 0.92 88,880.00
00 65 Insurance
00 66 Payment & Performance Bonds
67 Building Permits
68 Taxes paid on behalf of Owner
69 Fees paid on behalf of Owner
70 Other Reimbursable Costs
71 Contractor's Fee
Total 24,407,771.00 24,407,771.00 13,280,564.17 1,803,167.86 15,083,732.03 0.62 9,324,038.97

Page 4 of 4
 ROGELIO M. DIMAANDAL CONSTRUCTION
Caritan Norte – Atulayan Boundary,
Tuguegarao City, Cagayan Email Add: rmdc47@yahoo.com
Tel No. (078) 846-3978
Tel Fax. (078) 846-4794

Date : August 24, 2021

Project : LASAM NEW MEETINGHOUSE PH-190-1

Centro 22nd District, Lasam, Cagayan

To : FINANCE DEPARTMENT
The Area Pres CJCLDS., Phils., Inc.
#13 Temple Drive cor Whiteplains, Greenmeadows
Quezon City, Metro Manila

Thru : VICENTE P. SORIANO JR

Project Manager

Dear Sir / Madam:

The undersigned respectfully request for 9th Billing for Lasam new meetinghouse facility in
the amount of One Million Eight Hundred Three Thousand One Hundred Sixty-Seven
and 86/100 (Php 1,803,167.86) for 61.80% Accomplishment.

Attached are the pertinent documents for your reference.

Thank you and God bless!

Very truly yours,

RHYAN C. DIMAANDAL
AGM
 THE CHURCH OF MANILA ADMINISTRATION OFFICE
Temple Drive, Cor. White Plains Avenue Greenmeadows, Quezon City
JESUS CHRIST 1100
OF LATTER-DAY SAINTS Tel. No. 635-9169, 635-9164 (Direct Line)
Fax No. 635-9131 (Auto Fax)

CONTRACTOR PAYMENT REQUEST

Project Management Division ACCOMPLISHMENT

General Contractor ROGELIO M. DIMAANDAL CONSTRUCTION Date 19-Aug-21 % VOW CPM

Payment Request No:

Project Name/Type LASAM NEW MEETINGHOUSE PH-190-1 Actual: 61.80% 69.53%

Project Number 601-6758-1901-0301 9 Schedule 91.20% 86.38%

Check If
Submitted REQUIREMENTS expiration Date
A. BID BOND
1. Request Payment `
2. Acknowledge Receipt
3. Photocopy of Bidders Bond
B. Requirements for First Payment request
1. Charge Invoice (Net of Retention)
2. Check Requisition/ MSOV Payment Request
3. Schedule of Values
4. Project Tracker
5. Latest copy of Payment, Performance bonds & CARI
6. Contract ( First 3 pages)

C. Requirements for Every Payment request

1. Same as Item B except No. 6
2. Affidavit of no claim when billing reaches 65% accomplishment
D. Final Payment Request (100%)
1. Charge Invoice (Net of Retention)
2. Check Requisition/ MSOV Payment Request
3. Schedule of Values
4. Project Tracker
5. Latest copy of Payment, Performance bonds & CARI
6. Contract ( First 3 pages)
7. Certificate of Substantial Completion Form (Church Form,)
8. Affidavit of Materials/Labor Payments (Notarized)

E. Retention
1. Invoice
2. Check Requisition
3. Letter to release retention
4. Utility Clearance from FM
5. Warranty Bond
6. Final Acceptance Certicifate
7. Project tracker

: Make sure that all requirements are attached. Billings with incomplete requirement(s) will not be processed until
NOTE it is complied.

Request for Payment Certified Correct Approved For Payment

RM DIMAANDAL CONSTRUCTION SCHEMA KONSULT INC. VICENTE P. SORIANO JR.

GENERAL CONTRACTOR CONSTRUCTION MANAGER PROJECT MANAGER
Project Tracker

Project Name : LASAM NEW MEETINGHOUSE PH-190-1

Project Number : 601-6758-1901-0301
Percentage of Completion : 62%
PO Number : PH1-68015
Original Contract Amount : $24,407,771.44
New Contract Amount : $24,407,772.44

Contract Starts : 14/10/2019

Contract Ends : 09/08/2020
Adjusted Completion Date : 31/08/2021
Bonds/CAR (Latest) : 31/08/2021
Accomplishment Date: : 19/08/2021
Substantial Completion : 31/08/2021
Final Completion :
Warranty Bond Date :

Change Order No. Time Extension Cost Date Approved

1 99 0.00 30-Jan-20
2 98 0.00 03-Sep-20
3 190 0.00 16-Feb-21

Total Time Extension 387 days 0.00

REMARKS

<100% complete-Accomplishment For processing

<100% complete-Bond For processing
100% complete-Accomplishment
100% complete-Bond
Retention
 ENGINEERING ENDORSEMENT SCHEDULE
---------------------------------

Line : ENGINEERING Endt.Eff.Date : August 9, 2020 12:00:00 NOON

Subline : CONTRACTORS ALL RISK Endt.Exp.Date : August 31, 2021 12:00:00 NOON
Place Issued : MAKATI CITY
Issue Date : March 2, 2021
Policy No. : EN-EAR-HO-19-0000595-00 PREMIUM : PHP 47,930.76
Endt. No. : HO-19-000003 DOCUMENTARY STAMPS : 5,991.50
Insured : RM DIMAANDAL CONSTRUCTION VAT : 5,751.69
Address : CARITAN NORTE, BOUNDARY LOCAL GOVERNMENT TAX : 95.86
ATULAYAN, TUGUEGARAO CITY

AMOUNT DUE : PHP 59,769.81

Project : LASAM PH-170-2 NEW MEETING HOUSE(RURAL) PROJECT NO. 601-6758-1901-

0301
Site of Erection : CENTRO 2 2ND DIST, LASAM CAGAYAN, PHILIPPINES
Const. Period : From : October 14, 2019 To : August 31, 2021

IT IS HEREBY DECLARE AND AGREED that effective inception date,

this policy is deemed amended as follows;

EXTENSION OF COVER
==================
FROM: OCTOBER 14, 2019 - AUGUST 09, 2020
TO: AUGUST 09, 2020 - AUGUST 31, 2021

In view thereof, there is additional premium amounting Php 59,769.81 (inclusive of taxes)

and not as previously stated.

WNL as of March 02, 2021

SCHEDULE OF RATES AND PREMIUMS

Item : MATERIAL DAMAGE

Item TSI : PHP 0.00

Item Premium : PHP 47,930.76

Coverage Sum Insured Premium

Material Damage - Other PHP 0.00 PHP 23,965.38

Perils (Basic)
Material Damage - PHP 0.00 PHP 23,965.38
Catastrophe (Allied)
TPL (Allied) PHP 0.00 PHP 0.00

EXCEPT AS HEREIN VARIED, ALL OTHER TERMS AND CONDITIONS REMAIN THE SAME.
Attached to and forming part of EN-EAR-HO-19-0000595-00 Page 2 of 2

UCPB General Insurance Company, Inc.

ATTY. DARREN M. DE JESUS

President

THIS CONTRACT IS BETWEEN RM DIMAANDAL CONSTRUCTION AND UCPB GENERAL

INSURANCE CO., INC. ALL TRANSACTIONS ARISING OUT OF OR RELATED TO THIS
CONTRACT SHALL BE BINDING ONLY BETWEEN THESE TWO (2) CONTRACTING PARTIES.
IT IS UNDERSTOOD THAT THIS TRANSACTION IS NEITHER INSURED BY THE
PHILIPPINE DEPOSIT INSURANCE CORPORATION (PDIC) NOR GUARANTEED BY THE
UNITED COCONUT PLANTERS BANK.
 INVOICE

VAT. Reg. T.I.N 000-432-798-000

BIR Permit No. 0612-116-00205-CBA/AR
Date Issued June 18, 2012
Invoice Series HO-0000000001 To HO-9999999999

Insured ROGELIO M. DIMAANDAL CONSTRUCTION Date of Issuance 05/04/2021

Invoice No. HO - 000000715339
Agent Code HA 3680 /

Address CARITAN NORTE - ATALUY BOUNDARY, CARITAN

Class : PERFORMANCE BOND

Policy No. : SU-G(13)-HO- 20- 0000007- 00 Obligee :
Bond No. : G(13) 50609
Contract Period : 02/22/2021 To 08/31/2021 THE AREA PRESIDENT OF THE
Amount Guaranteed : 4,027,282.29 CHURCH OF JESUS CHRIST OF
LATTER-DAY SAINTS IN THE
Currency : PHILIPPINE PESO PHILIPPINES, INC.

Gross Premium (VATABLE) : 11,530.16

DOCUMENTARY STAMPS : 1,441.50

LOCAL GOVERNMENT TAX : 23.06
OTHER CHARGES : 0.00
VAT : 1,383.62
NOTARIAL FEE : 0.00
I/A STAMPS : 0.00

14,378.34

"THIS DOCUMENT IS NOT VALID FOR CLAIM OF INPUT TAX"

Important:
NOTE: Should the policy be cancelled or endorsed to a lower value, the insured is still liable to pay the full amount
of the documentary stamps as stipulated in the policy prior to cancellation/endorsement.

This is a system generated form and if issued without any alteration, this does not require signature.

KHERNA - 05/05/2021
9
 INVOICE

VAT. Reg. T.I.N 000-432-798-000

BIR Permit No. 0612-116-00205-CBA/AR
Date Issued June 18, 2012
Invoice Series HO-0000000001 To HO-9999999999

Insured ROGELIO M. DIMAANDAL CONSTRUCTION Date of Issuance 05/04/2021

Invoice No. HO - 000000715343
Agent Code HA 3680 /

Address CARITAN NORTE - ATALUY BOUNDARY, CARITAN

Class : SURETY BOND

Policy No. : SU-G(16)-HO- 20- 0000136- 00 Obligee :
Bond No. : G(16) 78562
Contract Period : 02/22/2021 To 08/31/2021 THE AREA PRESIDENT OF THE
Amount Guaranteed : 2,013,641.15 CHURCH OF JESUS CHRIST OF
LATTER-DAY SAINTS IN THE
Currency : PHILIPPINE PESO PHILIPPINES, INC.

Gross Premium (VATABLE) : 6,813.28

DOCUMENTARY STAMPS : 852.00

LOCAL GOVERNMENT TAX : 13.63
OTHER CHARGES : 0.00
VAT : 817.59
NOTARIAL FEE : 0.00
I/A STAMPS : 0.00

8,496.50

"THIS DOCUMENT IS NOT VALID FOR CLAIM OF INPUT TAX"

Important:
NOTE: Should the policy be cancelled or endorsed to a lower value, the insured is still liable to pay the full amount
of the documentary stamps as stipulated in the policy prior to cancellation/endorsement.

This is a system generated form and if issued without any alteration, this does not require signature.

KHERNA - 05/05/2021
5