Republic of the Philippines

Department of Health
OFFICE OF THE SECRETARY
MAY 02 2023
ADMINISTRATIVE ORDER
No. 2023- 0009
SUBJECT: Guidelines on the Implementation of Projects Funded Under the
Health Facilities Enhancement Program (HFEP) Fiscal Year 2023

I. RATIONALE

The funds appropriated for the implementation of the HFEP for the Fiscal Year
2023 adhered
to
the directives of His Excellency President Ferdinand “Bongbong” Marcos
Jr. to build more health centers and hospitals, and to upgrade the existing health facilities.
In the message of the President on the approved budget for HFEP in the General
Appropriations Act (HFEP GAA) 2023, he emphasized the need to continuously strengthen
the country’s health care system not only to address the country’s present needs but also to
prepare and be mindful for the uncertainties of the future. The President underscored the
importance of the systematic upgrading of the country’s healthcare facilities. The
appropriation has also considered the priorities set forth by the Department of Health
(DOH) for the achievement of
the Philippine Health Facility Development Plan (PHFDP)
2020-2040 and to
attain the objectives of the Republic Act (R.A.) No. 11223 otherwise
known as the Universal Health Care Act.

The approved budget in the amount of Twenty-Six Billion Seven Hundred Thirty-
Seven Million Eight Hundred Fifteen Thousand Pesos (Php 26,737,815,000.00) was
primarily allotted for the construction of 309 new Barangay Health Stations (BHS) and 309
new Super Health Centers. The funding also includes the completion of 847 BHS, 97 Super
Health Centers, 265 Rural Health Centers (RHU), and 5 Polyclinics. The appropriation
further includes the renovation and upgrading of 233 LGU Hospitals, 12 Military Hospitals,
3 State Universities, 3 Drug Abuse Treatment and Rehabilitation Centers (DATRCs), and
82 DOH Hospitals including the projects for the establishments of Specialty Centers and
Multi-year Obligation Authority (MYOA) projects of Apex Hospitals.

A portion of the HFEP GAA 2023 shall be used for the procurement of medical
equipment which includes the hemodialysis equipment packages for 20 health facilities,
and the acquisitions of medical transport vehicles.

The amount Four Billion Fifty Seven Million Three Hundred Forty Eight Thousand
Pesos (Php 4,057,348,000.00) was also appropriated in the GAA 2023 under direct the
hospital operations. The amount was allotted for the construction of new Specialty Centers,
construction, renovation, upgrading, expansion, and/or repair of health facilities, land
acquisition, and Multi-Year Obligation Authority (MYOA) of the DOH Retained
Hospitals.

The issuance of this Administrative Order is necessary in order to provide

guidelines for the proper and systematic implementation and monitoring of projects all
funded under the HFEP GAA 2023.

Building 1, San Lazaro Compound, Rizal Avenue, Sta. Cruz, 1003 Manila e Trunk Line 651-7800 local 108, 1111, 1112, 1143
)
Direct Line: 711-9502; 711-9503 Fax: 743-1829 @ URL: http://www.doh.gov.ph; e-mail: dohoseq@doh.gov.ph
 I. OBJECTIVE

This Administrative Order provides the guidelines for the procurement,

implementation, monitoring, and evaluation of HFEP-funded projects for infrastructure,
medical equipment, and medical transport vehicles as prescribed in the Republic Act (R.A.)
No. 11936, otherwise known
(GAA FY 2023).
as
the “General Appropriations Act” for the Fiscal Year 2023

Ill. SCOPE OF APPLICATION

This Order covers all the projects appropriated in the HFEP GAA FY 2023 to be
implemented by the DOH Central Office, Centers for Health Development (CHDs), DOH
Hospitals, DATRC, LGU Health Facilities, and other government health facilities.

In the case of Bangsamoro Autonomous Region in Muslim Mindanao

(BARMM), the adoption of this Order shall be in accordance with the Bangsamoro Organic
Act (RA No.11054) and subsequent laws and issuances to be issued by the Bangsamoro
Government.

IV. DEFINITION OF TERMS

A. Defects Liability Period — refers to the period after the completion of

infrastructure projects wherein the building contractor is
liable for any defects that
may occur.
B. Detailed Architectural and Engineering Design (DAED) — refers to a
comprehensive technical document that describes the design, materials,
dimensions, and construction methods for a construction project. The DAED
includes detailed drawings and plans, detailed specifications for materials and
equipment to be used, and detailed cost estimates to be used in construction.

C. For Comprehensive Release — means the appropriations are automatically

released as allotments without any further approvals.

D. Geotagging — refers to the acquisition of geographical information showing the

coordinates and photograph of a particular site taken from a camera of a mobile
device or from a drone shot.

E, Government Health Facility — shall refer to all health facilities owned and
managed by the public sector such as the DOH, Armed Forces of the Philippines,
Philippine National Police, State Universities and Colleges, and Local
Government Units (LGU).

F. Health Facility — refers to a government-owned infrastructure that provides

healthcare services such as diagnostic, therapeutic, rehabilitative, palliative, and/or
other related health services.

G. Implementing Unit — refers to government health facilities, DOH-Central Office,

CHDs, MOH-BARMM, LGUs, and other government agencies, where the fund is
appropriated and/or transferred, capable of carrying out the implementation
proposed project(s).
the of

( Oat
. Master Site Development Plan (MSDP) refers to a thorough document that
-—

lays out criteria for a site’s long term development over a predetermined time
frame. MSDP consists of site plans with details of all existing and future
development on the project site, building elevation and placement, architectural
landscape, easements, parking, road networks and driveways.

Medical Transport Vehicle — refers to motor vehicles designed and equipped to

transport patients and/or provide medical services such as land ambulances, sea
ambulances, mobile dental vans, mobile clinics, patient transport vehicles, etc.

Multi-Year Obligational Authority (MYOA) - a document issued by the

Department of Budget and management (DBM) either for locally funded projects
or foreign assisted projects implemented by agencies in orderto authorize the latter
to enter into multi-year contracts for the full project cost. A MYOA, which
contains an annual breakdown of the full project cost, obligates agencies to include
in their budget proposal for the ensuring years the amount programmed for the
said year(s).

. Negative Slippage refers to the delay in work execution occurring when actual
—

accomplishment falls below the target as measured by the

difference between the
scheduled and actual accomplishment of the Work by the Contractor as established
from the work schedule. This is described as a percentage of the whole work.

Permit to Construct (PTC)

-
a permit issued by DOH through Health Facility
Services Regulatory Bureau (HFSRB) to an applicant who will establish and
operate a hospital or other health facility, upon compliance with required
documents set forth in this Order prior to the actual construction of the said facility.
A PTC is also required for hospitals and other health facilities with substantial
alteration, expansion, renovation, increase in the number of beds,
services (add-ons) beyond their service capability.
or for additional

. Physical and Financial Performance Real-Time Report (PAFPRR) — is a web

based spreadsheet program (Google Sheet) that allows Implementing Units and
other stakeholders real-time access to view, enter or update data on the status of
a
the physical and financial performance of particular project.

Site Development Plan (SDP) — refers to a plan reflecting the position of the
proposed project in relation to its property and its surrounding infrastructures. SDP
consists of details of all existing features of the site, building elevation and
placement, architectural landscape, easements, parking, road networks and
driveways.

Site Readiness (Infrastructure) — refers to an area/lot, owned by the

Agency/Facility that is complete with the documentary requirements such as
certifications and plans, cleared of obstructions, and with right of way, and is
available for the implementation of infrastructure projects.

Site Readiness (Medical Equipment) — refers to the availability of the

infrastructure such as building, room/s, areas, with the required dimensions and/or
floor area, utilities such as electrical supply and water supply, ventilation,
 shielding (where applicable), and other required fixtures for the proper installation
of a medical equipment, including the availability of technically-trained human
resource complement.

. Variation Order — refers to any of the following: Change Order, Extra Work
Order, or Supplemental Agreement, issued to cover any increase or decrease in
work quantity, including the introduction of new work items not included in the
original contract, including the reclassification of work items that are due to
change of plans and specifications.

GENERAL GUIDELINES

A. Approved Budget

1. The totalapproved budget under GAA 2023 forthe implementation of HFEP

projects in the DOH-Central Office, CHDs, DOH Hospitals, other DOH
facilities and LGU health facilities is Twenty Six Billion Seven Hundred
Thirty Seven Million Eight Hundred Fifteen Thousand Pesos
(Php 26,737,815,000.00) shall be used exclusively for the following
purposes:

Project For Comprehensive Release

Infrastructure Php 17,850,796,000.00

Medical Equipment Php 7,985,019,000.00

Medical Transport Vehicle Php 902,000,000.00

Total Php 26,737,815,000.00

Total approved budget for the Implementation of HFEP Projects under

GAA 2023

2. The GAA FY 2023 also allotted the amount of Four Billion Fifty Seven
Million Three Hundred Forty Eight Thousand Pesos
(Php 4,057,348,000.00) under the direct hospital operations to be used for
the construction of new Specialty Centers, construction, renovation,
upgrading, expansion, and/or repair of health facilities, land acquisition for
hospital operations, and Multi-Year Obligation Authority (MYOA) of DOH
Hospitals.

B. Release of Budget

Upon the release of the budget from the Department of Budget and Management
(DBM), the DOH Central Office shall sub-allot or transfer the fund to the
Implementing Units such as the CHDs, MOH-BARMM, DOH Hospitals, and

{ot
other government health facilities. The sub-allotment or transfer shall be in
 accordance with the National Budget Circular (NBC) No. 590: Guidelines on
the Release of Funds for Fiscal Year 2023 dated January 3, 2023 issued by
DBM.

C. Project bnplementation

1. The Implementing Units, where the fund is sub-allotted or transferred, shall

be primarily responsible for the implementation, execution, and
management of the infrastructure, medical equipment and/or medical
transport vehicle projects.

2. The implementation, execution and management of the infrastructure

projects, medical equipment projects, and medical transport vehicle projects
shall be in accordance with the RA. No. 11032, otherwise known
Act Promoting Ease of Doing Business and Efficient
as the “An
Delivery of
Government Services, Amending for the Purpose Republic Act No. 9485,
Otherwise known as the Anti-Red Tape Act of 2007, and for Other
Purposes.” Furthermore, under Section 9, b. Action of Offices, the timeline
on applications or requests submitted shall be acted upon by the assigned
officer or employee within the prescribed processing time stated in the
Citizen’s Charter which shall not be longer than three (3) working days in
the case of simple transactions and seven (7) working days in the case of
complex transactions from the date the request and/or complete application
or request was received, For applications or requests involving activities that
pose danger to public health, public safety, public morals, public policy, and
highly technical application, the prescribed processing time shall in no case
be longer than twenty (20) working days or as determined by the
government agency or instrumentality concerned, whichever is shorter.

3. All procurements for infrastructure, medical equipment, and medical

transport vehicle projects shall be in accordance with the pertinent
provisions of RA. No. 9184, otherwise known as the “Government
Procurement Reform Act” and its Revised Implementing Rules and
Regulations (IRR), and other pertinent accounting and auditing laws, rules,
and regulations. The pertinent provisions of RA 9184 and the Government
Procurement Policy Board (GPPB) issuances shall apply in the absence of
applicable provisions in this Order.

4. On the implementation of HFEP-funded infrastructure projects to LGUs,

this issuance shall be in accordance with the provisions stipulated in R.A.
No. 7160 “Implementation of Nationally Funded Projects”. Accordingly,
the delegation, execution and monitoring of the allocation of projects shall
be in compliance with the regularities and procedures of the said law.

D. Project Monitoring and Evaluation

1. All CHDs, DOH Hospitals, other DOH Healthcare Facilities, DOH-Central

Office (for the DOH-CO funded projects), LGU Health Facilities, and
MOH-BARMM shall submit to the HFEP MO the monthly Physical and
Financial Performance Real-Time Report (PAFPRR) of each project via
Google Sheets (https://sites.google.com/view/hfep-rpmu) for all projects
 not later than the 10 day of each succeeding month, in both signed soft
and hard copies. The initial report shall include geotagging showing the
coordinates of the locations of the projects.

The HFEP MO Performance Monitoring Unit (PMU) shall adopt a system

a
of geo-tagging as reflected in the PAFPRR as reference in
the location of
pending HFEP projects and aid in the planning before procurement proper.

HFEP MO
shall
periodically consolidate the submitted reports through
PAFPRR to efficiently/effectively assess and evaluate ongoing projects, and
ensure timely implementation of projects and full utilization of budget.
HFEP MO shail furnish a copy of the consolidated report to the respective
Field Implementation and Coordination Team (FICT).
In cases where an Implementing Unit failed to submit the report within
two (2) consecutive reporting periods and/or there is a delay in the
project implementation, HFEP MO shall issue a Notice to Explain
requiring the Implementing Unit to justify the delays, and to devise and
execute a plan of action/catch up plan.
ii. Failure to submit a response to the Notice to Explain issued by HFEP
may
MO warrant a HFEP monitoring team to validate the projects in
question. The HFEP MO monitoring team shall furnish a copy of the
validated report to the concerned Field Implementation and
Coordination Team (FICT) for appropriate action.

VI. SPECIFIC GUIDELINES

A. Implementation of Medical Equipment Projects

1, The Implementing Unit shall prepare and approve the Purchase Request
(PR) and/or Terms of Reference (TOR), and other pertinent procurement
documents. The PR or TOR shall include amongst others, the detailed
equipment technical specifications, accessories, technical documents,
compliance with applicable product standards, warranty, completion period
for the delivery and installation (if applicable), functional testing and
commissioning, training for end-users and maintenance staff, preparation of
the installation site (if applicable), payment terms, etc. The technical
specifications of medical equipment issued by the World Health
Organization (WHO) can be used as a reference in preparing for the PR or
TOR. The WHO specifications can be found on the WHO official website.

The warranty period recommended by HFEP MO

is two (2) years for parts
and services. The Implementing Unit may require an extended warranty or
a warranty of more than 2 years provided that there will be no increase in
the Approved Budget for the Contract (ABC) due to the increase in the
warranty period. The warranty shall include but not limited to the following:
a. The supplier shall either repair or replace any item or part in the
equipment that is found to be defective in material or in workmanship
under normal use.
b. Within the warranty period, the supplier shall conduct a preventive
maintenance on the equipment at
least every six months or according to
 the manufacturers’ recommendations on the schedule of preventive
maintenance.
c. The supplier shall conduct the necessary corrective maintenance within
fourteen (14) calendar days upon notification from the end-user
regarding the equipment breakdown/defects.
d. The supplier shall have the responsibilities and accountabilities that
upon evaluation of equipment defects/faults, the equipment are
appropriately repaired or replaced and shall be in good working
condition thereafter.
e. The number of days where the equipment is unusable due to equipment
defects/faults shall be added to the warranty period.
f. The supplier shall specify post warranty comprehensive preventive
maintenance costs including list and prices of major spare parts of the
equipment for the next three (3) years after the warranty period.

. For radiologic equipment, the Implementing Unit shall use the TOR (and its
amendments, if any) issued by HFEP MO and cleared by the Physics
Laboratory Support Division, Common Services Laboratory (CSL) of the
Food and Drug Administration.

. The Implementing Units hall establish its own Technical Working Group
(TWG) that shall prepare the PR and/or TOR. The TWG shall be
composed of representatives from the end-users and from the
at
least
engineering
and/or biomedical department of the health facility.

The TWG shall have the responsibility and accountability to ensure that no
is
.
item in the PR or TOR referenced to a specific brand of equipment in
compliance with Rule VI, Sec. 18 of the Revised Implementing Rules and
Regulations of RA 9184. To ensure that no item in the PR and/or TOR is
referenced to a particular brand, the Bids and Awards Committee (BAC) of
the Implementing Unit shall require the TWG
an attestation signed by each member of
to
the
indicate in the PR or TOR
TWG that no item in the
technical specifications and other requirements are referenced
brand of the equipment.
to a specific

. For equipment that requires the preparation of the installation site, the
Implementing Unit shall ensure that prior to procurement, the installation
site has the required infrastructure including the electrical utilities and if
necessary, adequate water supply. The installation site must be ready and
must not cause any delay in the delivery, installation, and commissioning of
the equipment. The Implementing Units shall likewise ensure the
availability of trained personnel for the operation of the equipment.

. The Implementing Unit shall ensure that the required documentations,

accreditations, and permits must also be readily available or prepared prior
to the delivery, installation, and commissioning of the equipment to avoid
delay and penalties. Coordination must be established with agencies
providing permits such as in the case of generator sets or any pollution
source equipment which require the following: Environmental Compliance
Certificate (ECC) or Certificate of Non-Coverage (CNC), Permit to Operate
(PTO), accredited Pollution Control Officer, and other requirements.
 8. The Implementing Unit shall verify that the suppliers who participated in
the bidding for the equipment projects are not included in the current
Government Procurement Policy Board (GPPB) list of blacklisted entities
(gpbb.gov.ph/blacklistedsuppliers.php).

Immediately after the completion of the procurement, the Implementing

Unit shall ensure that the equipment is properly classified and recorded in
the books of assets of the health facility.

10. For the equipment procured by the CHD for the LGU health facilities, the
turnover of the equipment shall be accompanied by the corresponding Deeds
of Donation (DOD) as appropriate and shall be in accordance with the
Government Accounting and Auditing Manual (GAAM). The sample
template for the DOD is provided in Annex A: Sample template for the
Deed of Donation.

11. Implementation of the Hemodialysis Equipment Packages.

a. The procurement of the twenty (20) hemodialysis equipment packages

funded under item 6.d of the HFEP GAA 2023 and additional ten (10)
packages under the Unprogrammed Appropriations shall be
implemented by HFEP MO. The procurement shall be facilitated the
DOH Central Office Procurement Service.

b. The HFEP-MO shall ensure assessment of site readiness of prospective

recipient sites shall prior to procurement. The sites shall have the
infrastructure compliant with installation requirements and with the
requirements for physical facilities specified in DOH AO 2012-0001:
Licensing of Dialysis Facilities. In the case where a prospective site
failed to comply with the site readiness on the date specified by HFEP
MO,
a replacement health facility compliant with site readiness shall be
recommended by HFEP MO. The recommendation shall be approved by
the Undersecretary of the Health Policy and Infrastructure Development
Team (HPIDT).

c. Upon completion of the delivery and installation of the hemodialysis

equipment package in particular recipient site, the HFEP MO or CHD
technical staff and the representative/s of the recipient site shall conduct
the inspection and acceptance of the equipment package.

B. Implementation of Infrastructure Projects

Design Stage

1. The Implementing Units shall ensure that the utilization of the Capital
Outlays shall conform to the GAA 2023 General and Special Provisions for
infrastructure projects.

For new constructions and/or major renovation projects, the Implementing

Unit shall submit the revised/final architectural schematic plan and the

ee
9
 Master Site Development Plan (MSDP) based on the approved allocated
budget to the HFEP MO (for DOH Hospital projects) and to their respective
CHDs (for LGU projects) for review and evaluation. This shall to ensure
that the revised architectural schematic plan and the Master Site
Development Plan are in compliance with the Manual on Technical
Guidelines for Hospitals and Health Facilities Planning and Design prior to
submission to DOH-Health Facilities Services Regulatory Bureau (HFSRB)
or to specific CHD-Regulations, Licensing and Enforcement Division
(RLED), to secure a Permit to Construct (PTC) prior to the preparation of
the Detailed Architectural and Engineering Design (DAED). The
Implementing Unit shall also submit to HFEP MO (for DOH Hospital
Projects) and to the respective CHDs (for LGU projects) appropriate
document proving ownership or the right to use the property/lot such as
certified true copy of the Original Certificate of Title or Transfer
Certificate of Title, or Memorandum of Agreement for the use of lot, or
Deed of Donation showing the lot is owned by the health facility and/or
DOH
(for DOH Hospitals) or by the LGU (for the Primary Healthcare
Facilities).

. For Primary Healthcare Facilities such as BHS, RHUs, and SHCs, where
the architectural schematic plans shall be already provided by HFEP MO,
the concerned LGU shall submit to their respective CHDs the Site
Development Plan (SDP) showing the proposed site/lot where the PHC
facility will be constructed. The SDP shall also show the exact project site
boundaries, any existing natural features such as rivers, waterways, canals,
and road access that are close by or on the project lot.

. A Memorandum of Agreement shall be executed between the LGU and

CHD
stipulating that the site or location for the PHC facility will not be
changed once the construction has already commenced and/or
is a change in the LGU leadership.
in case there

. The Implementing Unit shall ensure the readiness of the site through site
validation report showing that the site is already cleared with setback
requirements, right-of-way, presence of obstructions (natural or man-made)
on, above, and underground, identifying the boundaries, and other possible
risks and hazards such as but not limited to trees, uneven terrain, soil
quality/type, water features and the like.

. Fornew construction and expansion, the Implementing Unit shall ensure the
environmental conditions of the project site are considered in the
preparation of Detailed Architectural and Engineering Design using the

a. Soil Investigation
is
following tests whichever applicable:

b. Geotechnical Report
c. Geohazard assessment
d. Topographical Survey/Site Survey

. The Implementing Unit shall prepare and approve the DAED Plans, and

(vi
other bidding documents required for the procurement of the project.
8. The building design shall strictly conform to the provisions of the latest
edition of the National and Local Building Codes, other pertinent Laws and
their IRRs, and DOH Manuals and Standards, such as but not limited to:
National Building Code of the Philippines (PD No. 1096)
gD
Philippine Green Building Code, a Referral Code of PD No.1096
Accessibility Law (BP 344)
ee
National Structural Code of the Philippines (NSCP) Latest Edition
Plumbing Code of the Philippines (RA No. 1378)
of
me
Uniform Plumbing Code the Philippines (UPCP) Latest Edition
Philippine Electrical Code 2017 Edition
BR
The Philippine Electronics Code Book I (Vol. 2 Building Telephone
Facilities)
II
- The Philippine Electronics Code Book (Fire Detection Alarm
Systems)
2012 Philippine Mechanical Engineering Code
Fire Code of the Philippines (RA No. 9514)
Ecological Solid Waste Management Act (RA No. 9003)
. DOH
RPOBRCRS

Healthcare Waste Management Manual 4" Edition

Philippine Clean Air Act of 1999 (RA No. 8749)
Philippine Clean Water Act (RA No. 9275)
DOH
Hospital Licensing Standards for Physical Plant (DOH AO 2012-
0012)
DOH Rules and Regulations Governing the Licensure of Primary Care
2
Facilities In the Philippines (Administrative Order 2020-0047)
r. Joint DOH and DENR Administrative Order (JAO 2005-02}- Policies
and guidelines on effective and proper handling, collection, transport,
treatment, storage and disposal of health care waste
s. Energy Efficiency and Conservation Act (RA 11285)

-
. Local ordinances and regulations
u. DOH Green and Safe Health Facilities Manual 2021

9. The building design shall likewise strictly adhere to the DOH AO 2020-
0011, “Guidelines in the Implementation of the Unified Color, Signage
Features, and Design of Identified Interior Spaces for Health Facilities
Enhancement Program (HFEP)-funded and coordinated Health
Facilities and Medical Transport Vehicles”. The CHDs and DOH
Hospitals shall furnish a copy of the approved prescribed color (color
application plan), signage, exterior marker, and design to HFEP MO.

10. For the new construction, expansion, repair or renovation projects of health
facilities with a total floor area of 10,000 square meters and above, the
building design is required to comply with Green Certification from Green
Building Rating System as stipulated in the DOH Department Circular No.
2019-0059 Green Certification of Healthcare Facility Projects. The
Implementing Units can seek Green Certification through third party
certification such as the Building for Ecologically Responsive Design
Excellence (BERDE) Program or the Leadership in Energy and
Environmental Design (LEED) rating system. The Implementing Units can
be used as a guide for the Green Building Scorecard, the Green and Safe
Health Facilities Manual of the Health Facility Development Bureau

fom
 (HFDB). Likewise, the health facilities with a total floor area of less than
10,000 square meters are encouraged to apply the principles of the Green
Building Design and further seek Green Certifications from the Green
Building Rating System.

11. For new construction and for retrofitting projects, the Implementing Unit
shall ensure that the design of the facilities can withstand the wind speed
of 300 kilometers per hour and seismic activity of at least 8.0 magnitude
of the Richter Scale as stipulated in the GAA 2023.

12. For the repair and/or renovation of buildings/sites that are already more than
15 years old or damaged due to natural hazards such as an earthquake,
typhoons, etc., an assessment on structural integrity and soundness in
conformance tothe latest NSCP shall be conducted prior to the conduct of
the repair and/or renovation works. The assessment shall be conducted and
duly signed by an accredited professional/s of the Association of Structural
Engineers of the Philippines (ASEP).

Procurement Stage

13. The Implementing Unit shall clearly indicate in the bill of quantities and in
the contract that the contractor shall be the one responsible for securing
the required national and local government permits such as but not
limited to Building Permit, Occupancy Permit, Utility Power Company
approval, DENR Permit, and all required Environmental Permit, etc.
(as applicable) The contract shall also specify that all documents needed
for the application of the permits originating from the Implementing Unit
shall be promptly provided to the contractor.

14. The Implementing Unit shall include in the TOR that the contractor/supplier
shall provide the Operation and/or Maintenance Service Manual, including
all supplier warranties, for projects including various building systems (e.g.
mechanical, electrical, electronics, etc.), and building equipment.

15. The Implementing Unit shall explicitly indicate in the contract the
appropriate duration in calendar days of the project specified by HFEP MO
and pursuant to existing GPPB rules. The duration of the project with a
contract cost of up to Php50 Million shall be in accordance with Annex B:
Duration of the project.

16. For projects with a costof more than PhpS0 Million, the duration shall be
based on the Construction Schedule considering the use of optimum
additional resources. The schedule shall be approved by the respective
CHDs
orImplementing Units.

17. The Implementing Unit shall verify that the contractors participating in the
bidding for the infrastructure projects are not included in the current
Construction Industry Authority of the Philippines (CIAP) list of blacklisted
contractors and GPPB’s list of blacklisted entities. The Implementing Unit
may verify with the HFEP MO the contractors’ performance evaluation
report of participating bidders for the infrastructure projects.
Construction Stage

18. If the LGU shall implement the infrastructure project, the CHDsshall enter
into MOA with the concerned LGU for the implementation of infrastructure
project/s pursuant to Section 96 of the General Provisions of the GAA FY
2023, provided that the LGU has:
a. Capability to implement the project by administration or contract and in
accordance with the design, plan, specifications, and such other
standards and policies of the DOH;
b. To commit to the cost of maintenance and repairs thereof;
c. To ensure that the funds appropriated to them shall be released during
the fiscal year to be deposited in a trust fund and shall be made available
for disbursement for the purpose specified until December 31, 2024.

The sample template for MOA is provided in Annex C: Sample template for
the Memorandum of Agreement (MOA) between CHDs and LGUs

d. In addition, the LGU shail secure the following:

i, Submit to the CHD the documentary requirements for the Commission
on Audit (COA) inspection and assessment;
ii. Good track record in implementing infrastructure projects as
evidenced by full liquidation documents; and
iii. Seal of Good Local Governance or Seal of Good Financial
Housekeeping —

19. For the infrastructure projects for LGU health facilities, the CHD may
transfer the fund to other Government Agency (GA). In such case, the CHD
shall determine the capability of the GA to implement the projects in terms
of:
a. Historical accomplishments on the implementation of DOH and non-
DOH funded projects
b. The technical, physical, and financial capacity to administer the project
in accordance with the design, plan, specifications, and such other
standards and policies of the DOH.

19.1. The necessary Memorandum of Agreement (MOA) shall be executed by

the CHD and GA. The MOA shall clearly stipulate among others, the
following:
a) That the GA with the assistance of the CHD, shall comply with the
DOH Rules and Regulations on the construction and/or renovation
of health facilities such as the application and approval of the Permit
to Construct.

b) That the procurement shall be in accordance with the pertinent

provisions for infrastructure projects under the RA. No. 9184,
otherwise known asthe “Government Procurement Reform Act” and
its Revised Implementing Rules and Regulations (IRR).

dy ow
}
F
c) That the GA shall comply with all the provisions of this Guidelines
and other pertinent rules covering government contracts for
infrastructure.

is
The sample template for MOAprovided in Annex D: Sample template
Sor the Memorandum of Agreement (MOA) between CHDs and GA.

19.2. The CHD shall continuously monitor the status of the project and shall
include it in the monthly submission of PAFPRR.

20. The Implementing Units shall comply with Section 103 of the General
Provisions of GAA FY 2023: Transparency of Infrastructure Projects.

21. The Implementing Unit shall include the COA signboard requirement in
the
program of works/bill of quantities as specified in COA C.O. 2013-004:
Information and Publicity on Programs/Projects/Activities of
Government Agencies.

22. The Implementing Unit shall conduct Preconstruction Conference prior to

the commencement of the project to ensure that all issues are discussed and
agreed upon by the Implementing Unit, end-user/s or project owner, and the
contractor.

23. The Implementing Unit shall ensure that a Construction Progress

Conference is held at an agreed interval and milestones to properly monitor
the progressof the project.

24. The Implementing Unit shall conduct a weekly/bi-weekly/monthly

inspection to properly monitor the progress of the project and prepare
regular reports.

25. The Implementing Unit and the contractor shall conduct a pre-installation
and coordination meeting prior to the installation of any
equipment/assemblies/machines required for the project, especially by a
separate contractor/supplier.

26. The Implementing Unit shall ensure the Work Schedule, Bar chart, S-Curve,
Performance Evaluation Review Technique - Critical Path Method (PERT-
CPM) shall be submitted by the contractor and approved by thehead of the
Implementing Unit prior to start of construction and whenever there are
revisions in the time/work schedule. Refer to Annex E for the template of
Work Schedule, Bar Chart, and S-Curve.

27. For any implementation concerns incurred during the construction, the
Implementing Unit shall issue the necessary Field Orders. Refer to Annex
for the template on Field Orders.

28. For the computation and issuance of Time Suspension, Work Suspension,
Time Extension, and Work Resumption use the template in Annex G: Time
Suspension, Work Suspension, Time Extension, and Work Resumption.
 29. For the computation and issuance of Statement of Time Elapsed and
Liquidated Damages use the template shown in Annex H: Statement of
Time Elapsed and Liquidated Damages.

30. Upon request for payment of works accomplished by the contractor, the
Implementing Unit shall review the completeness of the documentary
requirements, assess and verify the submitted Statement of Work
Accomplished (SWA).

31. The Implementing Unit shall ensure that the variation order has a
corresponding justification and be approved by the Head of Procurement
Entity/ Headof Office. Itshall also ensure that any variation order or change
in the specifications of materials shall be permitted only if the alternative
material is stronger or more durable than the originally specified one with
approval from the concerned trade professional. Furthermore, the funds for
any additional cost shall be available and certified by the institution’s budget
officer. See Annex I: Variation Order Template.

32. In case of Negative Slippage, the Implementing Unit shall perform the
Calibrated Actions in accordance with the GPPB Resolution 05-2019
Guidance on contract termination due to
fifteen percent negative slippage
by the contractor in infrastructure projects.

33. The Implementing Unit shall immediately inform the HFEP MO in

coordination with the FICT (copy furnished) in writing, on the above-
mentioned status or percentages of delay of the projects, and the actions
taken in notifying the Contractor for each stage of negative slippage outlined
above. The DOH Central Offices (Legal Service, HFEP MO, FICT) shall
provide any Legal and Technical assistance to these units, when necessary.

Project Completion Phase.

34. The Implementing Unit shall use the Forms in Annex J: Punch List Forms
as a tool in conducting the preliminary inspection when the project has
reached ninety-five percent (95%) accomplishment of the total contract
amount. A copy of the report shall be provided to the Contractor for the
preparation of the final tumover of the project. The report shall contain,
among others, the remaining works, work deficiencies for necessary
corrections, and the specific duration/time to fully complete the project
considering the approved remaining contract time. However, this shall not
preclude the claim of the Implementing Unit for any liquidated damages.
The Punch-listing shall be conducted with the presence of the Contractor
and the end-users or their duly authorized representatives.

35. Furthermore, the Certificate of Completion, together with the Certificate

of Final Inspection shall be issued by the Implementing Unit and End Users
upon the actual date of Completion. See Annex K: Certificate of
Completion Template.
36. Upon completion of the project or request of the contractor for final billing,
the end user/Implementing Unit shall issue the final billing
checklist/requirements specified in Annex L: Final Billing Checklist.
1

Ks}
Post-Construction Stage

37. The Implementing Unit shall inspect the project three (3) months prior to
the expiration of the Defects Liability Period. See Annex M: Defects
Liability Certificate.

38. The Implementing Unit shall accomplish the Form in Annex N: Post-
Construction Inspection Report Form and provide a copy to the Contractor
to
to undertake the repair of any damage the Works. The expenses that will
be incurred due to the repair of the damages shall be covered by the
Contractor.

39. The Certificate of Final Acceptance shall be issued after One (1) year
from the issuance of the Certificate of Completion of the project. This
shall include the details that are prepared by the Implementing
Unit/Technical Personnel representative/s of the End User and approved by
the Head of the Procuring Entity (HoPE). See Annex O: Certificate of Final
Acceptance Template.

40. The Implementing Unit/End Users shall submit a copy of the Certificate of
Completion and Certificate of Final Acceptance to HFEP MO upon issuance
to the contractor.

C. Implementation of Medical Transport Vehicle Projects

1. The procurement and implementation of medical transport vehicle projects shall

be delegated to the respective CHDs. The procurement and implementation
including the
processing and signing of needed documents such as the Deeds of
Donation shall be under the legal supervision of the CHD Directors and
officials. Any Savings incurred upon the completion of the procurement
shall be returned to the DOH Central Office.

2. The Terms of Reference (TOR) to be used for the procurement of the Type I
land ambulances shall be issued by HFEP MO. The TOR shall be updated by
the technical staff of HFEP MO and shall be reviewed and concurred by the
delineated TWG from identified CHDs and selected DOH Hospitals.

3. The TOR for all land

ambulances and sea ambulances shall include all medical
equipment listed in Annex C of AO No. 2018-0001: Revised Rules and
Regulations Governing the Licensure of Land Ambulances and Ambulance
Service Providers.

4. The body color of all medical transport vehicles shall comply with AO No.
2020-0011: Guidelines in the Implementation of the Unified Color, Signage
Features, and Design of Identified Interior Spaces for Health Facilities
Enhancement Program (HFEP)- funded and coordinated Health Facilities and
Medical Transport Vehicles, The logo of Sulong Kalusugan shall be included
as an additional markings in the body of the medical transport vehicles. Annex
P showsthe Sulong Kalusugan Logo.
 5. The requirements and procedures on the turnover of the medical transport
vehicle to the respective recipients shall be in accordance with DOH
Department Order No. 2018-0338: Guidelines on the Distribution of Medical
Transport Procured Under HFEP to the Respective Recipients. All medical
transport vehicles that are turned over to the designated recipients under the
LGU
shallbe accompanied with the corresponding Deed of Donation (DOD)
and shall be in accordance with the GAAM. Annex Q: Sample template for
Deed of Donation (Medical Transport).

D. Implementation of Foreign-Assisted Projects

1, The implementation of the foreign-assisted projects funded under the World

Bank loan such as the construction of isolation facilities and reference
laboratories shall strictly follow the DOH Department Circular 2020-0398 or
the “Guidelines on Civil Works Implementation of the World Bank - Philippines
COVID-19 Emergency Response Project”.

2. The implementation of the foreign-assisted projects funded under the Asian

Development Bank loan such as the construction of isolation facilities and
reference laboratories shall strictly follow the DOH Department Circular 2021-
0216 A or the “Implementation Arrangement for the Asian Development Bank
Funded Project-Health System Enhancement to Address and Limit (HEAL)
COVID-19 under Loan No, 3961-PHI”.

Mi HE PROJECT MODIFICATION

Project modification shall be in accordance with NBC No. 590 Guidelines on

the Release of Funds for Fiscal Year 2023.

fart
Vil.
4. USE OF SAVINGS

Use
of savings shall be pursuant to NBC No. 590 Guidelines on the Release of
Funds for Fiscal Year 2023.

it ¥""" ROLES AND RESPONSIBILITIES

1. Health Facilities Enhancement Program Management Office (HFEP-MO)

a. Shall prepare the corresponding Guidelines on the sub-allotment, utilization of

funds, and transfer of funds or MOA forthe projects appropriated in the GAA
for the DOH hospitals, MOH-BARMM and/or other DOH health facilities
operated by other NGAs and for the CHDs for the implementation of the
projects for LGU health facilities.

y oe
 The HFEP-MO Infrastructure Unit shall provide oversight functions and
technical assistance, when necessary, to CHDs, MOH-BARMM, DOH
Hospitals, LGUs and other health facilities in preparation of terms of reference,
technical designs and building plan development and project implementation
and may provide Technical Assistance as Technical Working Group in the
procurement of infrastructure projects.

The HFEP-MO shall establish and facilitate the implementation of the

Contractors’ Performance Evaluation System (CPES) for HFEP funded
infrastructure projects.

The HFEP-MO technical staff (architects and/or engineers) and the

Development Management Officers (DMOs) assigned to a particular Region
may conduct on-site inspections to validate the reported project status, including
MYOA projects in coordination with CHDs/DOH Hospitals.

The HFEP-MO Performance Management Unit (PMU) shall provide a copy of

the monthly Physical and Financial accomplishment report to the FICT and
Health Policy and Infrastructure Development Team (HPIDT) every 15th day
of the month and shall maintain the PAFPRR via Google Sheets. Likewise, the
unit shall ensure a transparent database that can be accessed within the DOH to
see the movement of projects. (http://hfep-rpmu.com) Also, the unit should
submit the quarterly, yearly, and year-end reports of the Physical and
Financial accomplishment report to the DOH Executive Committee (DOH
ExeCom).

Field Implementation and Coordination Team (FICT)

Shall be the lead office in the imposition of appropriate actions on the reported
project delays, and/or endorsed complaints/ COA AOMs.

Centers for Health Development (CHDs)

a. Shall be the regional managers, implementing arms, and procuring entities of

HFEP-MO for the implementation of LGU- HFEP funded projects.

Shall monitor all HFEP funded projects in their respective regions, maintain and
regularly update the physical and financial performance real-time reporting in
coordination with the HEEP-MO PMU.

Shall coordinate and provide technical assistance with HFEP-MO in the

evaluation of the readiness of the recipient health facilities.

The legal units/officers of CHDs shall aid the CHD Director in the
implementation of calibrated actions in Section VI-B, No.32 of this Order to
ensure promptness in instances of slippage and termination of contracts.

pe
Shall attend and actively participate in the meetings regarding physical and
financial performance organized and required by the Central Office.
 f. The CHDs, as the Implementing Unit, shall conduct on-site inspections to
assess the actual project status and verify the Construction Progress/Delivery
and Installation Report submitted by the contractor/supplier.

In case there are discrepancies between the assessment report of the

contractors/suppliers and the CHDs, the CHDs shall require the
contractors/suppliers to make the necessary corrections/rectifications.

4. DOH Hospitals and Other Health Care Facilities

a. Shall be the implementing arms, and procuring entities for the implementation
of HFEP funded projects in the respective DOH-retained hospitals.

Shall monitor all HFEP funded projects in their respective hospitals, maintain
and regularly update the physical and financial performance real-time reporting,
in coordination with the HFEP-MO PMU.

Shall attend and actively participate in the meetings regarding physical and
financial performance organized and required by the Central Office.

The DOH Hospital, as the Implementing Unit, shall conduct on-site inspections
to assess the actual project status and verify the Construction Progress/Delivery
and Installation Report submitted by the contractor/supplier.

In case there are discrepancies between the assessment report of the

contractors/suppliers and the DOH Hospital, the DOH Hospital shall require
the contractors/suppliers to make the necessary corrections/rectifications.

5. DOH Financial and Management Service (DOH-FMS)

Shall facilitate and process the release of the Sub-Allotment Advice (SAA) upon
the approval of the Department Order on the Sub-allotment and Disbursement
of Funds.

kos,
xX.
ME SEPARABILITY CLAUSE

If any clause, sentence, or provision of this Order shall be declared invalid or

unconstitutional, the other provisions not affected thereby shall remain valid and
effective.
 ioe
Xt VE. PENALTY CLAUSE

The concerned Implementing Unit shall ensure that these Guidelines are strictly
enforced. Failure or refusal of the responsible official/s and/or employee/s without just
cause to comply with and enforce this Order shall be a ground for disciplinary action
against the said official/s and/or employee/s. This is without prejudice to the “threefold
liability rule” which holds that a public officer may be held liable, thus the Revised
Administrative Code of 1987, Chapter 9-General Principles Governing Public Officer.

Upon receipt of any external complaints or reports such as COA Audit

Observation Memorandum (AOM), the HFEP MO shall endorse these complaints and
AOMs to the concemed FICT for the imposition of necessary disciplinary actions.

vA

xi. WEE EFFECTIVITY

This Order shall take effect after fifteen (15) days following its complete publication
in the Official Gazette or in a newspaper of general circulation and filing three (3) certified
copies before the Office of the National Administrative Register, University of the
Philippines Law Center, pursuant to Section 3, Book VII of Executive Order No. 292 or
the Administrative Code of 1987.”

MARIA ROSARIO S. VERGEIRE, MD, MPH, CESO Ik

Officer-{n-Charge
Department of Health
 Annex A: Sample Template for Deed of Donation (Equipment)

DEED OF DONATION
Director/HMO

Director/HMO
KNOWN ALL MEN
BY THESE PRESENTS:
This Deed of Donation is entered into on the _[date]__ day of [month] [year] __in

a
Hospital __,__

Manila, Philippines, by the DEPARTMENT OF HEALTH, National Government Entity

of Hospital

duly organized and existing under the laws of the Republic of the Philippines, hereinafter
lame referred to as “DOH”, with office address at San Lazaro Compound, Rizal Avenue, Sta. Cruz,

___,
Manila, Philippines, herein represented by Name of the director of the center for Health
Development, Director IV, as the DONOR;

In favor of

IV-CHD
The [name] [MHO/CHO/PHO/LGU]
a local government unit duly organized and
existing under the laws of the Republic of the Philippines, hereinafter referred to as [name
[MHO/CHO/PHO/LGU]_ with office address at the address , herein
represented by [name , as the DONEE.
Director

In this Agreement, DOH and the {name] [MHO/CHO/PHO/LGU]___ are individually

Regional
referred to as “Party” and collectively as “Parties”.

WITNESSETH

WHEREAS, the State recognizes its mandate to provide equitable and accessible quality
for all Filipinos;
healthcare

WHEREAS, one the

of four strategic outcomes that the DOH aims to achieve in the Health
Sector Strategy for 2023-2028 is to improve the Filipinos’ access to quality and efficient health
Representative
care which can be achieved by ensuring the availability of functional health care facilities;

WHEREAS, the Health Facilities

Enhancement Program (HFEP) aims to
improve the delivery
of health services through the upgrading of health facilities and provision of /name of
Authorized
equipment] in order to make them more responsive to
the health needs of the population;
LGU

WHEREAS, the provision of a {name of equipment] shall contribute to the functionality of the
of health system and the delivery of quality health care;
ame

WHEREAS, local government units are partners of the DOH in implementing health programs
and in delivering quality health services;

NOW, THEREFORE, in consideration of the foregoing premises and subject to the conditions
stipulated hereunder, the Department of Health hereby donates to the _[Donee]_, [description
of the equipment, brand, model and quantity] including the accessories therein amounting to
[cost of the equipment, in words and in numerical figures] to the [|MHO/CHO/PHO/LGU] as
per hereto attached Property Transfer Receipt as Annex “A”.

if po“4
The Donee accepts the donation and undertakes to:

1, Ensure that the equipment is utilized in accordance with its purpose.

2. Ensure the availability of technically trained trained health personnel who will use the
equipment, supplies and other operational expenses needed for the equipment.
3. Ensure the proper maintenance of the equipment with its own resources.
4. Ensure that the equipment is properly classified and recorded in the books of assets of
the health facility.

The Donor reserves the right to revoke this Deed of Donation in case any of the aforesaid
conditions are not faithfully complied with by the Donee. In case this Deed of Donation is
revoked, the Donee shall surrender the possession of the [name of equipment], including all
its
accessories, to the Donor within fifteen (15) working days from receipt of the Notice of
Revocation. Ownership of the said equipment shall then vest to the Donor effective upon
receipt by the Donee ofthe Notice of Revocation.

IN WITNESS WHEREOF, the Parties here under set their hands on the date and place above
mentioned.

DONOR: DONEE:

DEPARTMENT OF HEALTH

By: By:

Name of CHD Director

Director IV
Name
of Autorized
LGU
Representative

WITNESSES

Nameof Hospital Director/HMO

[Hospital Director/HMO]

Representative

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES)

Manila )S8.S.

BEFORE ME, personally appeared the following persons:

2
 Name Valid ID issued by the Date/Place Issued
° Government

: NAME OF CHD Director

Department of Health- Center for
3 Health Development
=
A
Director/HMO

#
23
fan
ee
S
Hospital

oO}

—
ss

Personally known to me be the same persons who executed the foregoing Deed of Donation
for and on behalf of the entities represented herein, and they acknowledged to me that the same
is their free and voluntary act and deed as well as that on the principals represented herein.

IV-CHD

I hereby certify that this document, consisting of four (4) pages including this page on which
this acknowledgment is
written, has been signed by the Parties and their instrumental witnesses
Director
at the foot thereof and on each and every page of this Deed of Donation.

Regional
IN WITNESS WHEREOF,
day of
I have hereunto set my hand and affixed my notarial seal this
at Manila, Philippines.

Doc. No. 5

Page No. ;

Book No. 5

Series of 20__ ;

Representative

Authorized
LGU

of
lame
1
Annex B: Duration of the Project

Standard Construction Duration per Project Construction Cost & Estimated Monthly Percentage of
Accomplishment of HFEP Infrastructure Projects
Contra Day Day Day
Project Day Day Day Day Day Day Day
ct
Construction 121- 151- 181- 214- 241- 271-
Duratio 31- 61- 91-
Cost 1-30 150 180 210 240 270 300
n 60 90 120
Pi0M&below |120CD 20% 50% 80% 100%
P11-P25M 480 CD 10% 20% 56% 70% 80% 100%
P26M-P40M 240CD 8% 16% 40% 56% 67% 75% 92% 100%
P41M-P50M 300CD 7% 14% 21% 43% 56% 74% 81% 88% 95% 100%

Notes:

1. For projects P51M & above, computation shall be based on the Construction Schedule (Bar
Chart/S-Curve), considering the use of optimum additional resources. The Construction
Schedule are to be prepared by the CHD/DOH Hospitals Engineers. Provide approved copies
to HFEP Performance Management Unit (PMU) on or before 10 day of the month for proper
monitoring and evaluation.

2. The above duration is applicable for New Construction Projects, provide additional 20% for
projects with existing facilities for Repair/Renovation/Rehabilitation/Improvement.

3. For existing
a
facilities, the end-user should submit Plan for Patient Transfer before submitting
of the site to the Procuring Entity should be accomplished during
proposals, Turn-over the Pre-
procurement of the project.

4, The Start Date, is the date when the Contractoris obliged to commence execution of the Works.
The contractor should be granted possession of the site upon issuance
of
the Notice to Proceed,
 Annex C: Sample Template for the Memorandum of Agreement (MOA) between CHDs
and LGUs

ITI MEMORANDUM OF AGREEMENT

Accountant

KNOW ALL MEN BY THESE PRESENTS:

This agreement is entered into by and between:

PDO
The CENTER FOR HEALTH DEVELOPMENT
office address at represented by
for »
with
MD MPH,
CESO
IU,
in her capacity as Director IV, herein after referred to as “CHD-_”
and
Director

The
{MUNICIPALITY/PROVINCE} OF with office address at
Regional
herein represented by {MAYOR/GOVERNOR} his
capacity as {Municipal Mayor/Provincial Governor}, herein after referred to as “LGU”

WITNESSETH

WHEREAS, Department of Health thru the Health Facilities Enhancement Program

Mayor/Governor
for CY has appropriated the amount of (
Php ) intended for the
Project Title to be implemented and procured
by the Local Government Unit of thru transfer of fund.

NOW, THEREFORE, inconsideration of the foregoing premises and stipulations

herein set forth, the Parties hereto agree and do hereby agree as follows:

A. FUND UTILIZATION

1. The funds shall be chargeable against the General Appropriations Act (GAA) CY
or Republic Act under the Health Facilities Enhancement Program of the Department
of Health for Comprehensive Release (FCR) and shall be obligated On or before , .
M/PHO

2. CHD- shall transfer the fund according to the scheme or mode of project
___
implementation/procurement adopted by the Local Government Unit as set forth in
Section C of this Memorandum of Agreement.

3. In the event that the GA fails to execute the project within calendar days

Treasurer
CHD- ___, unless otherwise with justifiable reasons.
to
from the date of receipt of the First (1) Tranche, the funds shall be reverted back the

B. RESPONSIBILITIES OF THE LGU

Mun./Prov.

1. Submit a Sangguniang Bayan Resolution authorizing the {Municipal

Mayor/Provincial Governor}, to enter into an agreement with the CHD-___;
 Ensure that the Schematic Plan for the infrastructure project complies with the existing
DOH standards for licensing and accreditation;

Prepare complete Detailed Architecture and Engineering Drawing (DAED) Plans,

Technical Specifications, Scope of Work, Bill of Quantities, Detailed Cost Estimates,
Approved Budget of the Contract and all other Documents for Bidding Purposes
following provisions of the National Building Code, Structural, Electrical, Sanitary
III and Mechanical Codes, Fire Code, Accessibility Law, and all
other pertinent laws and
regulations;
Accountant

Bid and awardthe infrastructure project in conformity to the provisions of R.A. 9184
and its Revised IRR and allow CHD-____ personnel to act as observer in
the bidding
process and as member in
the Technical Working Group for prequalification and bid
evaluation;
PDO

Supervise the implementation of the project following the highest standards for
materials control, safety, and quality assurance and hire or assign a quality control
Director
engineer for such purpose and secure the necessary local permits;

Attend monitoring meetings called for by CHD- and immediately act on the
Regional
__
observations made by the agency which would require corrections and revisions on
the implementation of the project;

Raise to CHD-___ for arbitration, any issues on the project implementation and must
seek first the clearance and approval of
the agency for any proposed Variation Orders;

Ensure immediate implementation and completion of the Project within the specified
duration;
Mayor/Governor

Together with CHD- , conduct final inspection of the project prior to the issuance
of the Certificate of Completion;

10. Regularly submit the Fund Utilization Report (FUR) of

the infrastructure project to
CHD-___ and submit the documentary requirements enumerated in Section C herein,
corresponding to the chosen scheme/mode of
project implementation;

11. Ensure that the health facility shall be functional within three (3) months after the
turnover and acceptance of
the project and should be utilized according to
its purpose;

12. Ensure that funds shall be provided and reflected in the {Municipal/Provincial}
M/PHO Annual Operational Plan for the continuing maintenance and operations of the
facility/infrastructure project and acquisition of equipment;

13. Book-up the cost of the infrastructure project in the Book of Accounts and furnish
CHD-___ a copy of the Journal Entry Voucher EV) within six (6) months after
completion of the said project;

Treasurer
14, Ensure that the health facility will be accredited by PhilHealth in its Maternity Care
Package.

(+
Mun./Prov,
 C. RESPONSIBILITIES OF THE CHD-____

1. Release/ transfer the funds to the LGU after receipt of the documentary requirements
_
that corresponds to the scheme or mode of project implementation/procurement
III
adopted by the LGU as
set forth herein, to wit:
Accountant
A. Project Implemented by Contract
1. First (1”) Tranche - Twenty percent (20%) of the Total Project Allocation
upon execution of this MOA and submission of the following documentary
requirements by the LGU - to be accomplished in three (3) sets;
a. Fund Utilization Report (FUR) showing One Hundred Percent (100%)
PDO
utilization of previous HFEP Infra Projects with full release of funds and
completed projects
Detailed Architectural and Engineering Drawings (DAED) approved by
the CHD-_ Regional Director
Director

29
Approved and notarized Memorandum of Agreement (MOA)
Regional Program of Work (POW) approved by the LCE
Colored pictures of the existing health facility BEFORE the
implementation of the current Project, if applicable.

2. Second (2“) Tranche - Fifty percent (50%) of the Project’s Total Contract
Price (PTCP), after submission of the following documentary requirements
by the GA - to be accomplished in three (3) sets:
a. Letter request of the LGU for the release of the Second (2nd) Tranche
b. Fund Utilization Report (FUR) showing utilization of at least Sixty
Mayor/Governor

percent (60%) of the amount released in

the First (1) Tranche
Pictures with caption of the ON-GOING implementation
Minimum of:
of
the Project.

i. 4- Angles Exteriors and

ii. 5 - Angles Interior

3. Final Release - The remaining balance of the Project’s Total Contract Price
(PTCP) including Extra Work/Variation Order if any, provided that the
project has reachedat least fifty percent (50%) completion and the GA has
submitted the following requirements to CHD-__ - to be accomplished in
three (3) sets:
a. Letter request of the GA for the release of the remaining fund.
M/PHO

b. Fund Utilization Report ( FUR ) equivalent to at least sixty percent

(60%) of the total amount previously released for the 1St and 2nd
Tranche.
Statement of Work Accomplished (SWA) equivalent toat least 50% of
the PTCP.
As-Built Plan, if there are any changes in the plan or Variation order
Pictures with caption of the ON-GOING implementation of the project
Treasurer
Minimum of:
i. 4 - Angles Exterior and
ii. 5 - Angles Interior
Mun//Prov.

ol
 e. Copy of Journal Entry Voucher (JEV) of completed HFEP Infra Projects
that were previously implemented by the {Municipal/Provincial}
Government through a MOA with CHD-__, if applicable.

III
B. Project Implemented by Administration
Accountant

1. First (1)
Tranche - Twenty percent (20%) of the Total Project Allocation
upon execution of this MOA and submission of the following documentary
requirements by the LGU - to be accomplished in three (3) sets:
a. Fund Utilization Report (FUR) showing One Hundred Percent (100%)
utilization of previous HFEP infra projects with full release of funds
PDO
and completed projects, if applicable
Detailed Architectural and Engineering Drawings (DAED) approved
by the CHD-_ Regional Director
Director

Approved and notarized Memorandum of Agreement (MOA)

a9
Program of Work (POW) approved by the LCE
Colored pictures of the existing health facility BEFORE the
of
the current Project, if applicable
Regional

implementation

2. Second (2") Release - Equivalent to 100% of the cost of Materials upon

submission by the LGU of
the following documentary requirements in three
(3) sets:
a. Approved Purchase Order (PO)
b. Notice of Award

Mayor/Governor
3. Final Release - The remaining balance
total amount of the 157 and 2NP
of
the Project cost after deducting the
Tranche releases to cover the Labor Cost
based on the approved Program of Work and upon submission by the LGU
of the following requirements in three (3) sets:
a. Letter request of the LGU for the release of remaining balance
b. Fund Utilization Report (FUR) showing utilization of at least sixty
percent (60%) of the total amount released in the 1St and 2nd Tranche
Copy
of Journal Entry Voucher (JEV) of previous HFEP Infra Projects
completed and implemented by the {Municipal/Provincial}
Government through MOA with CHD-____, if applicable.

. Provide technical assistance to the {Municipal/Provincial} Engineering Office in the

M/PHO
preparation of schematic plans for infrastructure;

. Evaluate and approve the Detailed Architecture and Engineering Plans, Technical
Specifications, Scope of Work and the Approved Budget for the Contract prior to
bidding and award ofthe infrastructure project;

. Attend all meetings called for by the LGU-BAC in the conduct of infrastructure
Treasurer
procurement as
observer;

. Monitor progress of infrastructure project and act promptly on any requests for
Mun./Prov.
arbitration or for Variation Orders;
 6. Together with the LGU, conduct final inspection of the project prior to issuance of the
Certificate of Completion;

7. Ensure that the LGU/contractor complete the infrastructure project within the specified
project duration;

8. Ensure that utilization of funds shall follow the usual budgeting, accounting and
auditing rules and regulations;

9. Submit a Monthly Fund Utilization report with all the pertinent supporting documents
to DOH Finance Service (cc: HFEP) on or
before the 7th day of the following month.

C. AMENDMENTS
This MOA may be amended or revoked only upon mutual consent the parties
provided that all amendments shall be covered by Supplemental Provisions signed by both
of
parties which shall be incorporated by way of
reference as an integral part of this MOA.

IN WITNESS WHEREOF, the Parties have affixed their hands this

at : _ day of

For the CHD- : For the {Municipality/Province} of

DIRECTOR IV {MAYOR/GOVERNOR}
Signed in the Presence of

PDO, {M/PHO}

Accountant IIT {Municipal/Provincial} Treasurer

ACKNOWLEDGEMENT
Republic of the Philippines )
Province of ) SS.

Xora nn nner enn ene nn nn en nnn en ee nee X

BEFORE ME,
of
a Notary Public for atand in the Province and City of Philippines, personally appeared
>
,
this

the following:

Type of Government
Name
Issued ID/No.
Place/Date of Issue
 II All personally known to me, upon, competent proof of identity indicated below their respective
name and signature, to be the same persons who executed the foregoing document and
Accountant
acknowledged to me that the same istheir free and voluntary act and deed.

This instrument consists of 5 pages, including this page on which the acknowledgment is
written and signed on each and every page thereof by the parties and their instrumental
witnesses.
PDO

WITNESS MY HAND AND SEAL on the place and at the date first abovewritten:

Director

Notary Public
Doc No.
Regional
Page No.
Book No.
Seriesof_

Mayor/Governor

M/PHO

Treasurer

Mun./Prov.

V
 Annex D: Sample Template for the Memorandum of Agreement (MOA) between CHDs and
Other Government Agency (GA)

MEMORANDUM OF AGREEMENT

KNOW ALL MEN BY THESE PRESENTS:

Accountant
This agreement is entered into by and between:
The CENTER FOR HEALTH DEVELOPMENT (CHD) for with
CHD office address at represented by {Name of CHD Director}, MD, MPH,
CESO , in her capacity as Director IV, herein after referred to as “CHD-__”

And

The {GOVERNMENT AGENCY} with office address at herein

represented by {DEPARTMENT SECRETARY/REGIONAL DIRECTOR}
Director his capacity as { Department Secretary/Regional Director}, herein after
referred to as “GA”
CHD
WITNESSETH

WHEREAS, Department of Health thru the Health Facilities Enhancement Program for
CY has appropriated the amount of ( Php
) intended for the Project Title to be implemented and procured by the
Representative
Local Government Unit of thru transfer of fund.

NOW, THEREFORE, in consideration of the foregoing premises and stipulations herein

set forth, the Parties hereto agree and do hereby agree as follows:
GA

A. FUND UTILIZATION
Director

1. The funds shall be chargeable against the General Appropriations Act (GAA) CY
or Republic Act under the Health Facilities Enhancement Program of the Department
of Health for Comprehensive Release (FCR) and shall be obligated On or before , :

2, CHD- shall transfer the fund according to the scheme or mode of project
Secretary/Regional

___
implementation/procurement as set forth in Section C of this Memorandum of
Agreement.

Department
3. In the event that the GA fails to execute the project within calendar days
from the date of receipt of the First (1°) Tranche, the funds shall be reverted back to
GA
the CHD- ___, unless otherwise with justifiable reasons.
 B. RESPONSIBILITIES OF THE GA

1. With the assistance of the CHD, the GA shall comply with the DOH Rules and
Regulations on the construction and/or renovation of health facilities such as the
Accountant

application and approval of the Permit to Construct.

CHD

Comply with the applicable all the provisions of HFEP Guidelines on Project
Implementation and other pertinent rules covering government contracts for
infrastructure.

Ensure that the Schematic Plan for the infrastructure project complies with the existing
DOHstandards for licensing and accreditation;

Prepare complete Detailed Architecture and Engineering Drawing (DAED) Plans,

Director

Technical Specifications, Scope of Work, Bill of Quantities, Detailed Cost Estimates,

Approved Budget of the Contract and all other Documents for Bidding Purposes
CHD

following provisions of the National Building Code, Structural, Electrical, Sanitary and
Mechanical Codes, Fire Code, Accessibility Law, and all other pertinent laws and
regulations;

Bid and award the infrastructure project in conformity to the provisions of R.A. 9184
Representative

and its Revised IRR and allow CHD-____ personnel to

act as observer in the bidding
GA process and as member in the Technical Working Group for prequalification and bid
evaluation;

Director
Supervise the implementation of the project following the highest standards for
materials control, safety, and quality assurance and hire or assign a quality control
engineer for such purpose and secure the necessary local permits;

Secretary/Regional
Attend monitoring meetings called for by CHD-
andimmediately act on the
observations made by the agency which would require corrections and revisions on the
implementation of the project;

Raise to CHD- for arbitration, any issues on the project implementation and must
___
Department
seek first the clearance and approval of the agency for any proposed Variation Orders;

Ensure immediate implementation and completion of the Project within the specified
GA
duration;

10. Together with CHD- , conduct final inspection of the project prior to the issuance
of the Certificate of Completion;

11. Regularly submit the Fund Utilization Report (FUR) of the infrastructure project to
CHD-___ and submit the documentary requirements enumerated in Section C herein,
corresponding to the chosen scheme/mode of
project implementation;
 12. Ensure that the health facility shall be functional within three (3) months after the
turnover and acceptance of the project and should be utilized according to its purpose;
Accountant

CHD

C. RESPONSIBILITIES OF THE CHD-____

1. Release / transfer the funds to the GA after receipt of the documentary requirements
_
that corresponds to the scheme or mode of project implementation/procurement
adopted by the GA as
set forth herein, to wit:
Director
2. Scheme or
by Contract)
mode of project implementation/procurement (Project Implemented

A. First (1”) Tranche - Twenty percent (20%) of the Total Project Allocation upon
CHD

execution of this MOA and submission of the following documentary

requirements by the GA - to be accomplished in three (3) sets;
a. Fund Utilization Report (FUR) showing One Hundred Percent (100%)
Representative
utilization of previous HFEP Infra Projects with full release of funds and
completed projects.
Detailed Architectural and Engineering Drawings (DAED) approved by
GA the CHD-_ Regional Director.
Approved and notarized Memorandum of Agreement (MOA).
Program of Work (POW) approved by the GA Department
Director
Secretary/Regional Director.
Colored pictures of the existing health facility BEFORE the
implementation of the current Project, if applicable.

B. Second (2") Tranche - Fifty percent (50%) of the Project’s Total Contract Price
(PTCP), after submission of
the following documentary requirements by the GA
Secretary/Regional

- to be accomplished in three (3) sets:

a. Letter request of the GA for the
release of the Second (2nd) Tranche
b. Fund Utilization Report (FUR) showing utilization of at
least Sixty percent
Department (60%) of the amount released in the First (1“ Tranche
Pictures with caption of the ON-GOING implementation of the Project.
Minimum of:
4- Angles Exterior and
GA
i.
ii. 5- Angles Interior
C. Final Release - The remaining balance of the Project’s Total Contract Price
(PTCP) if
including Extra Work/Variation Order any, provided that the project
has reached at least fifty percent (50%) completion and the GA has submitted
the following requirements to CHD-__ - to be accomplished
a. Letter request of the GA for the
in
release of the remaining
three (3) sets:
fund.
b. Fund Utilization Report (FUR) equivalent to at least sixty percent (60%)
of the total amount previously released for the 1St and 2nd Tranche.
 c. Statement of Work Accomplished (SWA) equivalent to at least 50% of
the PTCP.
d. As-Built Plan, if there are any changes in the plan or Variation order
Pictures with caption of the ON-GOING implementation of the project
Minimum of:
i. 4- Angles Exterior and
ii. 5 - Angles Interior

D. AMENDMENTS

This MOA be
may amended or revoked only upon mutual consent of the parties provided
that all amendments shall be covered by Supplemental Provisions signed by both parties which
shall be incorporated by way of reference as an integral part of this MOA.

IN WITNESS WHEREOF, the Parties have affixed their hands this

at _ day of

For the CHD- : For the {Department Secretary/Regional Director} of

DIRECTOR IV Department Secretary/Regional Director

a
Signed in the Presence of

Accountant IIT GA Representative

ACKNOWLEDGEMENT

Republic of the Philippines )

Province of ) SS.
x

BEFORE ME,
a Notary Public forat and in the Province and City ofPhilippines, personally appeared
; ,
this
,
the
of

following:

Name Type of Government

Place/Date of Issue
Issued ID/No.
 All personally known to me, upon, competent proof of identity indicated below their respective
name and signature, to be the same persons who executed the foregoing document and

Accountant
acknowledged to me that the same is
their free and voluntary act and deed.

This instrument consists of 5 pages, including this page on which the acknowledgment is written
and signed on each and every page thereof by the parties and their instrumental witnesses.
CHD

at
WITNESS MY HAND AND SEAL on the place and the date first abovewritten:

Notary Public
Doc No.
Page No.
Book No.

Director
Seriesof
CHD

Representative

GA

Director

Secretary/Regional

Department

GA
Annex E: Sample Work Schedule, Bar Chart, and S-curve

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Annex F; Field Orders Template

DEPARTMENT OF HEALTH

{AGENCY NAME]

PROJECT : PROJECT NAME FIELD ORDER

LOCATION: Field Order : 01

Date
03,2022
“rOet.

TO : CONTRACTOR’S NAME Trade Concemed:

Architectural

Structural

Sanitary

Electrical

“~~ Mechanical

Others
v

Kindly provide the following items below:

For your immediate compliance.

Prepared by: Checked by:

NAME NAME
Architect H Architect IV

Approved by:

NAME
Director I]

ACKNOWLEDGEMENT RECEIPT

Contractor's Representative
Annex G: Time Suspension, Work Suspension, Time Extension, and Work Resumption

Republic of the Philippines

Department of Health
AGENCY NAME

TIME EXTENSION NO.

PROJECT TITLE Exwe Work Onder No

LOCATION Change Onder Ne

CONTRACTOR:

You are hereby directed to make the following variation orders in the contract
REASON FOR TIME [SUSPENSION/EXTENSION] DATE CONSIDERED
c
a,
1.
Time Suspension Time Extension duc to. November 20, 2020
of plans/drawing and documents (199 Calendar Days) July 29,2021] 282 CD
and DENR Tree Cutting Permit Application and Approval
May 15, 2021
to July 6, 2021 ($3 Calendar Days)
2. TimeExtension duc to Work Stoppage and Nightshift Work Schedule during concrete breaking September 11, 2021
land excavation and hauling October 10, 2 30 CD.
July 30, 2021 to October 11, 2021 (74 Calendar Days)

TOTAL 282 C.D.

Original Contract Duration 365 CD Original Start Date November 20, 2020
Revised Contract Duration: Revised Start Date:

New Contract Duration Original Target Date: November 19, 2021

for this Time Extension 647 CD. Revised Target Date August 28, 2022
New Target Date for
this Time Extension: August 28, 2022

PREPARED BY

NAME NAME
Architect Engincer

CONCURRED BY:

NAME
Designation, Office

APPROVED BY

NAME
Director IV, Office
Annex H: Sample of Statement of Time Elapsed and Liquidated Damages

Repuliic of the Philippines

Departmces of Health
AGENCY NAME

PROJECT TITLE
LOCATION
CONTRACTOR =

COMPUTATION OF LIQUIDATED DAMAGES

Notice to Proceed Fetwuary 10, 2028

wwe
Oniginal date of stoet Feteuary 10, 2015 $0
Original Duce of Compiction August 2, 2016 Calendar Days
Tame Sunprrion Applicsten aad Retour Feteuary 10, 201s
of Building Peerat SepiemBer 16.2015 219 Colendar Deys
Revived Actual Due of Sturt Sepieniber 17, 2015 $0
> Revived Due of Completion March 9 2017 Calendar Days
Work sesponsioe duc to revewon of OPD Octader 17, 2016
Jane 4. 2017 230 Calendar Deys

Total dans of tree extern aeape 409 Calendar Days

Romuainag Days dsc to sapenon Octaber 17. 2016
Murch 09, 2017 144 Cellondar Deys
Rosumption of work (revised OPD) Jeane OS, 2017
New Date of Completion Oxtuber 26, 2017 144 Calloedar Deys

Revised Target Date of Compiction Octuder 26, 2017

Actsal Date of Completion Augast 15, 2018

Unperfoemad portion as of Octaber 26, 2017

Actsal Desc of Completion Aupest 15, 2018 26 Colondar Deys
ce waperioemad portice 3,019,870 20

(I Cost
Laguiduted Demages (LD)
110s of unperioemad portion per day 3.119 87
O.001% « 3,119,870 70 x days of delay (29400)
WIM rar
TOTAL LIQUIDATED DAMAGES
Te rr
Prepaved and verified by

NAME NAME
Dexignation, Office Designation Ontfice

NAME NAME NAME

Dewtgration, Office Designation Office Designation, Omtice

Rovormendaag Appeor al Approved by

NAME NAME
Designation, Office Designation, Ofhee

Avcepacd by

Designation, Office
(Contractor Suppl

NI
ft
et
Annex I: Variation Order Template

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Annex J: Punch List Forms

Republic of the Philippines

Department ofHealth
HEALTH FACILITIES ENHANCEMENT PROGRAM
3° Floor Bidg. No. 4, San Lazaro Compound. Rizal Avenue. Sta. Cruz. Manila 1003
Telephone Nos. 6517800 local 1409, 1453 - 1454
Website hitp’/: www.doh.gov.ph

PUNCHLIST FORM HFEP FORM NO

FINDINGS
Ae ee

Name &
T 7 E
Note
1.
Use additional page when necessary and attached actual photos (with date & time stamps) taken during the site visit
2. Provide 1 copy of the accomplished and signed form to the contractor and 1 copy
to the end-user
Annex K: Certificate of Completion Template

Republic of the Philippines

Department of Health
AGENCY LETTER HEAD

CERTIFICATE OF ACCEPTANCE AND TURNOVER

UWe the undersigned hereby issued this Certificate of Acceptance and Turnover of the hereunder
specified health infrastructure which has been inspected and found to have been 100% completed in
accordance with the plans, specifications and program of works as of [Date of Completion] per hereto attached
documents supporting complction of the project

Name of Projcet
Location
Date Started
Onginal Target Date
Revised Target Date
Actual Date of Completion
Remarks
Contract Amount
Additional Work Amount
Revised Contract Amount
Contractor

See
Item

a
1.
WORK DESCRIPTION

GENERAL REQUIREMENTS
My

a
é i

lek—— petadaie Rutile

03599 toons ozssonas

Temporary Facihtues, Ware bouse, Bunkhouse 0.1833 100% © IS333873
Temporary Fence oosl7 100% 003167507
Utihties (Power, Water and Communications) 0.4561 100" 0 45612096
Secunty 04561 1o0% 045612096
Permsts and Insurance 0 5068 1oo*%~ 0 50680107

i. CIVILSSTRUCTURAL WORKS
A Earthworks Demolition 26335 100% 263346416
B Concrete and Reber works 33 6905 100%. 33 6905449
c Equipment 1.5082 100% 150823998

In. SANITARY / PLUMBING WORKS

A Ground Floor OS619 100% OS86191278
Second Floor 06700 100% 066997201
c Third Floor 06227 100% 062265706
D Fourth Floor 06265 oor. 0 626455807
E__|
Finth Floor O617i 100% 061712026
' Sixth Floor oe74as 100% 067450027
G Potable Water System 0.1257 100% 012572974
u Storm Draimage 01346 oo. 0 13464564
1
Site Sewerage Network System oos2 oo. 001818402
J Others o0oos4 100% 0 00836222
wv. ARCHITECTURAL WORKS
Masonry Works 1.9402 100% 194021694
ayes
Topping
12680 100% 12680112
Damp proofing & Water Proofing Works 04093 100% 0 40934626

FINISHES
Plaster and
Gypsum Board
-

Acoustic Ceiling
- , 2562 0%
Hoe
Tiles
Drywall
Parton
Plastermg
22
O8132
3233 —a
100" m
a

081324543
s13245
Works
Skim coating 20148 100% 201480032
Straight to finish with power Moat O2134 100% 0 21335869
Painting Works O 3886 100%. O 38858313
Shorting O33 100% 03341088
Doors and Windows 0.4227 100% 042268476
Metal Doors & Frames 00991 100% 0.09911 762
Miscellancous 00994 100% 0 09937355

v MECHANICAL WORKS
Az-conditioning Unit with refrigerant, piping. drain,
duct works, diffusers sir register, etc $4962 100% $.49622591

Ventilating Fans with duct works, aa grilles, diffusers

air registers, ete 07299 100% 07298949
Fan filters with ductwoeks, air diffusers, etc O414s 100% 041447458
Fire Protection System 1.1625 100% 116247419

Viv ELECTRICAL WORKS

Lights
2 =
Fixtures 0.1048 100%. © 10478365
Wining Devices 0.0938 100% 009384942
Roughing-In O3743 100". 037425919
Wires and
35.5402 ' 00% 35 S401815
40181
Cables
Panel Boards and Circuit Breakers 100%
Loghtmng
ction and © 1328 100% 0
13276921
ground system
Miscellaneous (consumables) 0.0360 100% 003598034

Vi. AUNILLARY SYSTEM

Fire Alarm and Detection System 0.1073 100% O.10734173
Publee Address
Background 02147 100% 0.214686
Muste
Telephone and
Dass 02309
230% 100° “s 230868 16
0 23086816

Ane
Closed Circuit
Television 02032 100% 020316388
Access Control and Monitoring 0.1784 100% O.17S3S317
Master Clock 0.0641 100% 006412554

reeeURLTos Tana
bnp
©
www dob gov
tte Tincest-
ph.
sot loca
e-mail:
Tres TTT
fiduquesidoh gov
Tr tis
 Nurse Call
Master Antenna Television oos28 0.08281129
Building Management System 0.0443 0.04434509
Wires and
Cables o0386 003858023
Roughing-In 0.0897 0 OS968S67

TOTAL 100.00 100.00

Turnover by:
NAME NAME
Engineer IV, DOH-HFEP Architect 1V, DOH-HFEP

NAME
Director IV, DOH-HFPEP

Accepted by:

NAME NAME NAME.

Engineer IILOMce Engineer I, Office Engineer IV, Office

NAME
Medical Center Chief I, Office

“Humons
t
1. San Pacare Coe
ine. 711.9. 2.
Sone Firat Aveo
711-9503 Fax:
See

743-1829 ¢
Piet Pee
URL:
Mae tee Pane
wwwdoh gov
hip: ph:
eet
eee
email: fiduqu
Thit,
Joh gow
ttle, tees
ph
 Annex L: Final Billing Checklist

Republic of the Philippines

OF
Department of Health

[__
AGENCY NAME

Project:
Location:

PROCESSING
Contractor:

THE
FOR
The Contractor shall submit (aside from those provided in the Contract Document) the following
before progress billing/final billing payment is made. (/-complied, x-not complied, N/A —not
applicable)

Copy of the Obligation Request (OBR) for General Fund (GF) of Budget Utilization
Request (BUR) for Trust Funds *TF) approved by the signing suthoritics - c/o DOH
Disbursement Voucher (2 copies) — c/o DOH
BIR Disbursement Voucher (2 copies) — c/o DOH

BICUINGS
PROGRESS
CRECRUST
wee
Letter Request from Contractor for progress payment/billing
asof the of billing. (documents showing

DOCUMENTS
Statement of Work accomplishment

SITLINGIFINAL
percentage of work accomplishment and cost equivalent)
som Inspection Report by the Agency’s Authorized Engincer - c/o DOH
Result of Test Analysis (if applicable) :
(Please note the type of Test Analysis conducted in the blank)
Statement of Time Elapsed
Contractor's Affidavit on payment of Laborer and Materials
10. Pictorial progress - 3R for progress billing and SR for final billing with c-file
(CD/DVD), full description of the works, which have been accomplished form the
previous accomplishment up for the period covered, shall be made on cach
photograph of cach item work. (Before, during and after construction of items of work
especially the embedded items)
Certified Truc Copy of Contract — c/o DOH
12 Certified Truc Copy (CTC) of the recciving copy of submission of BAC‘COBAC
the basic requirements and additional documentary requirements pertaining to the of
contract to the Office of the Auditor (for 1* payment) — c/o DOH
. List/status of main items consulted and discussed — (attach minutes of weekly
mectings).

. Daily weather condition report

. PERT/CPM. overall progress Chart’ Bart Chart. The S-Curve shall be reflected for
both the projected and actual accomplished work.

16. General plans reflecting the work donc. These plans shal! be color codcd to indicate
the portions alrcady completed for the current period.
17. Daily accomplishment reports for the period covered.

18, Detailed computation of the accomplished item of works.

19. Pouring request. approved by implementing agency for the period covered for
concreting work including key plan indicating the data’s of pouring (include test
result for concrete. steel and other materials when necessary.)

Bidg. No. 4, 3° flove, San Lazaro Compound, Rizal Avenuc. Sta. Crux, Manila 1003
Tel. Nos, 6§1-78-00 loc. L453 and 1454
 -Additional Requirements for Final Billing-

. All inspection reports from the implementing agency for Architectural, Structural,
Sanitary, Electrical, and Mechanical items for the period.

. Certificate of Final Building Occupancy unless such certificate cannot be obtained

through fault of the Contractor.
no

. Certificate of Final Inspection of clectrical, telephone. sanitary, mechanical, water,

gas. safety and other utilities unless such certificate can not be obtained through no
fault of the Contractor.

. As Built Drawings - Electronic (E-file), Original and four (4) scts of white/bluc prints
of Architectural, Structural. Sanitary. within the scope of conwact. ‘As-Built
Drawings” are the working drawings showing the system and deviation from the
original plan and actual locations of outlets, fixtures, services, and
approved
equipment that were installed.

24. Photocopy of vouchers ofall previous payments - c/o DOH

25, Three (3) copies of Directory of Pancl Boards and List of Circuits.

. Three (3) copies of Instructions and Manual for operating and maintaining of fixtures
and equipment.

. Three (3) copies of keying schedule.

. Warranty Security as defined and required per RA 9184

Note: All of the above to be submitted in three (3) ORIGINAL COPIES

otherwise indicated.
in scparate folder unless
Certified True Copy of the contract documents required for the first billing only (contract
agrecment, Notice of Award. Notice to Proceed, BAC Resolution. ABC, Performance Bond. ete.)
For Contractor’s Compliance

Prepared by: Noted by:

Hospital‘ HFEP Architect/Engineer Hospital Chief Administrative Officer’Division Chief

Received and Complied By:

PM/PE/AMO
of Contractor
DOIN balling CL
=
Annex M: Defects Liabili Certificate

Republic of the Philippines

Department of Health
{AGENCY LETTER HEAD}

Defects Liability Certificate

We, the undersigned hereby certify and accept the hereunder specified Health Infrastructure
project which has been inspected and defects have been corrected per hereto attached documents
supporting final acceptance of the project.

Name of Facility: Specify Name of Health Facility

Location: Specify exact address of the facility (Building No., Street Name, Brgy.
Municipality/City, Province, Region)
Project Description: State Project Description and Program of Works
Actual Date of Completion: Specify Actual Date of Completion
Remarks Choose one of
the following:
©
Completed with no defects
© Completed with corrected defects
Work Done by: Choose one
©
of
the following:
By Administration
e By Contract
If through contract,
Contract Amount: Specifv Amount
Contractor & Address Specify Name and Address of Contractor
Certified by: Accepted by:

Head of Procuring Entity End-User

Date: Date:

Acknowledge by:

Contractor
Date:
Annex N: Post Construction Inspection Form

Republic of the Philippines

Department of Health
HEALTH FACILITIES ENHANCEMENT PROGRAM
3° Floor Bldg. No. 4, San Lazaro Compound, Rizal Avenue, Sta. Cruz, Manila 1003
Telephone Nos. 6517800 local 1409, 1453 - 1454
Website

OF
hito’/: www.doh.gov.ph

POST-CONSTRUCTION HFEP FORM NO

INSPECTION REPORT
NAME F. ITY
PRI T TH

LU

TRACT
CONTRACTOR
IMPLEMENTING AGENCY DATE OF
CERTIFCATE OF ACCEPTANCE & TURN-OVER (REF. NO & DAT!
OEFECT LIABILITY PERIOD.

ACTION TO BE TAKEN &

Room/Area FINDINGS
DURATION

INSPECTED BY
CERTIFIED BY
END-USER ‘OR COMPL
T T

E ; :
DATE:
Note
1.

Use additional page when necessary and attached actual photos (with date & time stamps) taken during the site visit
2. Provide 1 copy of
the accomplished and signed form to the contractor and 1 copy to the end-user
Annex O: Certificate of Final Acceptance

Republic of the Philippines

Department of Health
AGENCY NAME

CERTIFICATE OF ACCEPTANCE

{We the undersigned hereby issued this Certificate of Acceptance of the hereunder specified
health infrastructure which has been inspected and found to have been 100% completed in accordance with
the plans, specifications and program of works as of [Date of Completion} per hereto attached documents
supporting completion of the project.

This Certification relieves the Contractor of his obligations and responsibilities under the
provisions of R.A. 9184 in undertaking repair works on any defect or failure that may occur in any part and
section of the project.

The Certificate of Acceptance shall be issued after the expiration of one (1) year Defects Liability
Period.

Prepared and verified by:

NAME NAME NAME

Designation, Office Designation, Office Designation, Office

NAME NAME NAME

Designation, Office Designation, Office Designation, Office

Recommending Approval: Approved by:

NAME NAME
Medical Center Chief lf, Office Director FV, DOH-HFEP.

eR Name of Project
Location
RYH
Date Started
Original Target Date
EM
Revised Target Date
Actual Date of Completion
N Remarks
Contract Amount
EOP
Additional Work Amount
Revised Contract Amount
-o
=
Contractor
nnex P; Sulong Kalusugan Logo

~
= Sulong Kalusugan
Gt
 Annex Q: Sample Template for Deed of Donation (Medical Transport)

DEED OF DONATION

KNOWN ALL MEN BY THESE PRESENTS:

This Deed of Donation is entered into on the _[date]__ day of [month] ,__[year]
in Manila, Philippines, by the DEPARTMENT OF HEALTH,
a
National Government
Director/HMO

Entity duly orLGUnized and existing under the laws of the Republic of the Philippines,
hereinafter referred to as “DOH”, with office address at San Lazaro Compound, Rizal
Hospital Avenue, Sta. Cruz, Manila, Philippines, herein represented by Name of the director of the
center for Health Development, Director IV, as the DONOR;

In favor of

The [name] [MHO/CHO/PHO/LGU]___,

a
local government unit duly orLGUnized
and existing under the laws of the Republic of the Philippines, hereinafter referred to as
name] [MHO/CHO/PHO/LGU]__ with office address at the address]
IV-CHD
, herein represented by name , as the DONEE.

In this Agreement, DOH and the [name] [MHO/CHO/PHO/LGU] are

Director
individually referred to as “Party” and collectively as “Parties”.

WITNESSETH
Regional

WHEREAS, the State recognizes its mandate to provide equitable and accessible quality
healthcare for all Filipinos;
WHEREAS, one of the four strategic outcomes that the DOH aims to achieve in the Health
Sector Strategy for 2023-2028 is to improve the Filipinos’ access to quality and efficient
health care which can be achieved by ensuring the availability of functional health care
facilities;

Representative
WHEREAS, the Health Facilities Enhancement Program (HFEP) aims to improve the
delivery of health services through the upgrading of health facilities and provision of
[name of equipment] in order to make them more responsive to the health needs of the
population;
Authorized

LGU
WHEREAS, theprovision of a {name of equipment] shall contribute to the functionality
of of the health system and the delivery of quality health care;
ame

WHEREAS, local government units are partners of the DOH in implementing health
programs and in delivering quality health services;

NOW, THEREFORE, in consideration of the foregoing premises and subject to the

conditions stipulated hereunder, the Department of Health hereby donates to the
Donee]_, [description of the equipment, brand, model and quantity] including the
accessories therein amounting to cost of the equipment, in words and in numerical
figures] to the [|MHO/CHO/PHO/LGU] as per hereto attached Property Transfer Receipt
as Annex “A”.
 NOW, THEREFORE, in consideration of the foregoing premises and subject to the
conditions stipulated hereunder, the Department of Health hereby donates to the
Donee quantity in words] unit (Medical Transport Vehicle) including the
equipment therein amounting to (procured cost, in words and numerical figures in Php)
Director/HMO

with the following specifications:

Chassis No.
Director/HMO

Engine No.
:
Hospital

Official Receipt (OR) No.

of Hospital Certificate of Registration (CR) No.:
lame Property Transfer Receipt (PTR) /
Invoice Receipt for Property (IRP) No.:

The Donee accepts the donation and undertakes to:

1. Ensure that the Medical Transport Vehicle is properly classified and recorded in
the books of assets of the LGU or health facility;
TV-CHD

2. Ensure that within six (6) months upon receipt of the Medical Transport Vehicle,

Director
said Medical Transport Vehicle is licensed in its name and at
its own expense, in
accordance with the DOH Administrative Order regarding the Rules and
Regulations Governing the Licensure of Land Medical Transport Vehicles and
Medical Transport Vehicle Service Providers;
Regional

3. Ensure the availability of technical trained health personnel, supplies, and other
operational expenses necessary for the operation and maintenance of the Medical
Transport Vehicle and the equipment therein;

4. Ensure that the Medical Transport Vehicle is utilized in accordance with the
definition and standards provided in the abovementioned DOH Administrative
Order;

5. Ensure the rational use of the Medical Transport Vehicle within the municipality
or locality to maximize its benefit to the residents needing Medical Transport
Vehicle service;

LGU
6. Apply for the renewal of the Medical Transport Vehicle registration with the Land
Transportation Office (LTO) after three years (3) using its own resources. The
Donee may transfer the vehicle registration under its name;

7. Designate the MHO/CHO/PHO/LGU as the focal person who will be coordinating

with the DOH Regional Office for purposes of program monitoring and evaluation;

The Donor reserves the right to revoke this Deed of Donation in case any of the aforesaid
is
conditions are not faithfully complied with by the Donee. In case this Deed of Donation
revoked, the Donee shall surrender the possession of the Medical Transport Vehicle,
including all its accessories and the equipment, to the Donor within fifteen (15) working
days from receipt of the Notice of Revocation. Ownership of the said Medical Transport
Vehicle and equipment shall then vest to the Donor effective upon receipt by the Donee
of the Notice of Revocation.

IN WITNESS WHEREOF, the Parties here under set their hands on the date and place
above mentioned.

DONOR: DONEE:

DEPARTMENT OF HEALTH
By: By:

Name of CHD Director Name of Autorized

Representative
Director IV LGU

WITNESSES

Name of Hospital Director/HMO

[Hospital Director/HMO]

Representative

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES)

Manila )S.S.

BEFORE ME, personally appeared the following persons:

Name Competent Proof of Identity Date/Place Issued

NAME OF CHD Director
Department of Health- Center
for Health Development
 Personally known to me be the same persons who executed the foregoing Deed of
Donation for and on behalf of the entities represented herein, and they acknowledged to
me that the same is their free and voluntary act and deed as well as that on the principals

represented herein.
°
z I hereby certify that this document, consisting of four (4) pages including this page on
£ which this acknowledgment is written, has been signed by the Parties and their
z instrumental witnesses at the foot thereof and on each and every page of this Deed of
=z Donation.

a IN WITNESS WHEREOF,
day of
I have Manila,
at
hereunto set my hand and affixed
Philippines.
my notarial seal this

Doc. No. ;

Page No. 3

Book No. 5

IV-CHD
Series of 20___;

Director

Regional

Representative

Authorized

LGU

of
ame