DPWH SPMS Form No.

INDIVIDUAL PERFORMANCE COMMITMENT and REVIEW (IPCR) FORM

I, _Shemaiah Khristian L. Jimenez_, _Engineer I_ of _Quality Assurance Section_, commit to deliver and agree to be rated on the attainment of the following targets in accordance with the indicated
measures for the period January 1 to June 30, 2021.

Approved by: District: Office PMT Chairman

Signature: Position: District Engineer Signature of Ratee
Name: ABRAHAM C. VILLAREAL Office: DPWH, Neg. Occ. 1st DEO Date Prepared:
*Indicate whether Bureau, Service, UPMO, Regional or District Engineering Office

Rating
Output Success Indicators (Targets+Measures) Actual Accomplishments Average Remarks
Q E T
TO BE FILLED BEGINNING OF THE SEMESTRAL RATING PERIOD TO BE FILLED DURING EVALUATION
MFO1
21GK0031
21GK0109 Field Density Test for Project undertaken / witnessed Conduct Field Density Test with minor error in 4 hours per
with minor error in 1 day per project. project.
21GK0218
21GK0219

Sampling of Construction Materials witnessed Witnesssed sampling of Construction Materials with minor
undertaken by contract with minor error in 1 day. error in 4 hours per project.

Control of Concrete Pouring w/ minor error in 8 Hours. Controlled of Concrete Pouring w/ minor error in 8 Hours.

MFO2
21GK0018
21GK0100 Sampling of Construction Materials witnessed Witnesssed sampling of Construction Materials with minor
undertaken by contract with minor error in 1 day. error in 4 hours per project.

Page 1 of 6
 MFO3
21GK0036
21GK0042
21GK0044
21GK0045
21GK0046 Control of Concrete Pouring w/ minor error in 8 Hours. Controlled of Concrete Pouring w/ minor error in 8 Hours.

21GK0047
21GK0055
21GK0057
21GK0058
21GK0061
21GK0063
21GK0067
21GK0116 Sampling of Construction Materials witnessed Witnesssed sampling of Construction Materials with minor
undertaken by contract with minor error in 1 day. error in 4 hours per project.
21GK0117
21GK0121
21GK0201
21GK0206
Total Rating
Final Average Rating
Ratee comments and recommendation for development purposes or rewards/promotion. (Note: Use additional sheet/s if necessary)

Name and Signature of Name and Signature of

Name and Signature of Final Rater:
Ratee: SHEMAIAH KHRISTIAN L. JIMENEZ Initial Rater: ARNEL P. TORREFRANCA NORMITA A. NOBLE
Position: Engineer I Position: Chief, Quality Assurance Section Position: Assistant District Engineer
Date: July 05, 2021 Date: July 05, 2021 Date: July 05, 2021

Page 2 of 6
 DPWH SPMS Form No. 1

INDIVIDUAL PERFORMANCE COMMITMENT and REVIEW (IPCR) FORM

I, _Shemaiah Khristian L. Jimenez_, _Engineer I_ of _Quality Assurance Section_, commit to deliver and agree to be rated on the attainment of the following targets in accordance with the indicated
measures for the period July 1, 2020 to December 31, 2020.

Approved by: District: Office PMT Chairman

Signature: Position: District Engineer Signature of Ratee
Name: ABRAHAM C. VILLAREAL Office: DPWH, Neg. Occ. 1st DEO Date Prepared:
*Indicate whether Bureau, Service, UPMO, Regional or District Engineering Office

Rating
Output Success Indicators (Targets+Measures) Actual Accomplishments Average Remarks
Q E T
TO BE FILLED BEGINNING OF THE SEMESTRAL RATING PERIOD TO BE FILLED DURING EVALUATION
MFO1
20GO0050
20GK0022 Field Density Test for Project undertaken / witnessed Conduct Field Density Test with minor error in 4 hours per
with minor error in 1 day per project. project.
20GK0103
20GK0230
20GK0193 Sampling of Construction Materials witnessed Witnesssed sampling of Construction Materials with minor
undertaken by contract with minor error in 1 day. error in 4 hours per project.

Control of Concrete Pouring w/ minor error in 8 Hours. Controlled of Concrete Pouring w/ minor error in 8 Hours.

MFO2
20GK0029
20GK0030 Sampling of Construction Materials witnessed Witnesssed sampling of Construction Materials with minor
undertaken by contract with minor error in 1 day. error in 4 hours per project.

MFO3
20GK0073
Control of Concrete Pouring w/ minor error in 8 Hours. Controlled of Concrete Pouring w/ minor error in 8 Hours.
20GK0118
20GK0130
Sampling of Construction Materials witnessed Witnesssed sampling of Construction Materials with minor
20GK0205 undertaken by contract with minor error in 1 day. error in 4 hours per project.

Total Rating

Final Average Rating

Ratee comments and recommendation for development purposes or rewards/promotion. (Note: Use additional sheet/s if necessary)

Name and Signature of Name and Signature of

Name and Signature of Final Rater:
Ratee: Initial Rater:
SHEMAIAH KHRISTIAN L. JIMENEZ ARNEL P. TORREFRANCA NORMITA A. NOBLE
Position: Engineer I Position: Chief, Quality Assurance Section Position: Assistant District Engineer
Date: January 4, 2021 Date: January 4, 2021 Date: January 4, 2021
 DPWH SPMS Form No. 1

INDIVIDUAL PERFORMANCE COMMITMENT and REVIEW (IPCR) FORM

I, _Ray Marben J. Tanatan_, _Engineer I_ of _Quality Assurance Section_, commit to deliver and agree to be rated on the attainment of the following targets in accordance with the indicated measures for
the period January 3, 2019 to June 30, 2019.

Approved by: District: Office PMT Chairman

Signature: Position: District Engineer Signature of Ratee
Name: JAIME SJ. JAVELLANA Office: DPWH, Neg. Occ. 1st DEO Date Prepared:
*Indicate whether Bureau, Service, UPMO, Regional or District Engineering Office

Rating
Output Success Indicators (Targets+Measures) Actual Accomplishments Average Remarks
Q E T
TO BE FILLED BEGINNING OF THE SEMESTRAL RATING PERIOD TO BE FILLED DURING EVALUATION
MFO1

Prepares Quality Control Program and Monthly Reports Prepared Quality Control Program and Monthly Reports on
on Testing with minor error in 1 day. Testing with minor error in 4 hours.

18GK0001
Prepares the Progress Billing Report on Testing with Prepared the Progress Billing Report on Testing with minor
minor error in 1 day. error in 4 hours.

18GK0061
18GK0074
Prepares Quality Control Program and Monthly Reports Prepares Quality Control Program and Monthly Reports on
18GK0075 on Testing with minor error in 1 day per Project. Testing with minor error in 4 hours per Project.
18GK0077
18GK0213

18GK0035 Prepares the Progress Billing Report on Testing with Prepared the Progress Billing Report on Testing with minor
18GK0054 minor error in 1 day per Project. error in 4 hours per Project.

MFO2

Prepares Quality Control Program and Monthly Reports Prepared Quality Control Program and Monthly Reports on
on Testing with minor error in 1 day. Testing with minor error in 4 hours.

18GK0093
Prepares the Progress Billing Report on Testing with Prepared the Progress Billing Report on Testing with minor
minor error in 1 day. error in 4 hours.
 MFO3

18GK0155 Prepares Quality Control Program and Monthly Reports Prepared Quality Control Program and Monthly Reports on
on Testing with minor error in 1 day per Project. Testing with minor error in 4 hours per Project.
18GK0156
18GK0159
18GK0181 Prepares the Progress Billing Report on Testing with Prepared the Progress Billing Report on Testing with minor
18GK0184 minor error in 1 day per Project. error in 4 hours per project.

18GK0157
18GK0158
18GK0160 Prepares Quality Control Program with minor error in 4 Prepared Quality Control Program with minor error in 2
18GK0168 hours per Project. hours per Project.
18GK0169
18GK0183

18GK0200 Prepares Quality Control Program and Monthly Reports Prepared Quality Control Program and Monthly Reports on
18GK0201 on Testing with minor error in 1 day per Project. Testing with minor error in 4 hours per Project.

Total Rating
Final Average Rating
Ratee comments and recommendation for development purposes or rewards/promotion. (Note: Use additional sheet/s if necessary)

Name and Signature of Name and Signature of

RAY MARBEN J. TANATAN ARNEL P. TORREFRANCA Name and Signature of Final Rater: NORMITA A. NOBLE
Ratee: Initial Rater:

Position: Engineer I Position: Chief, Quality Assurance Section Position: OIC - Assistant District Engineer
Date: July 1, 2019 Date: July 1, 2019 Date: