'OFFICIAL

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QOM Iasi* Mike

REPUBLIC OF THE PHILIPPINES

Q4NANG
DEPARTMENT OF BUDGET AND MANAGEMENT
BONCODIN HALL, GENERAL SOLANO STREET, SAN MIGUEL, MANILA

LOCAL BUDGET CIRCULAR NO. 116-A Date: March 26, 2018

To CITY MAYORS, MEMBERS OF THE SANGGUNIANG PANLUNGSOD, CITY

BUDGET OFFICERS, CITY TREASURERS, CITY PLANNING AND
DEVELOPMENT COORDINATORS, CITY ACCOUNTANTS, AND ALL OTHERS
CONCERNED

Subject : SUPPLEMENTAL GUIDELINES ON THE IMPLEMENTATION OF THE LOCAL

GOVERNMENT SUPPORT FUND-ASSISTANCE TO CITIES (LGSF-AC) IN THE
FY 2018 GENERAL APPROPRIATIONS ACT (GAA), REPUBLIC ACT (RA) NO.
10964

1.0 BACKGROUND

An amount of Two Billion Five Hundred Eighty Nine Million Eight Hundred Thousand Pesos
(P2,589,800,000.00) was appropriated for the LGSF-AC in the FY 2018 GAA, RA No. 10964.
The said amount shall be used to support the cities in the development of their respective
open spaces.

To prescribe the initial guidelines on the implementation of the LGSF-AC, particularly on the
submission of the city mayors' expression of interest and initial conceptual design(s) of their
proposed project(s) and the policies to be observed in the identification of projects, the
Department of Budget and Management (DBM) issued Local Budget Circular (LBC) No. 116
dated January 29, 2018.

As provided under item 4.0 of LBC No. 116, a separate circular shall be issued by the DBM
to prescribe the guidelines and procedures on the final submission and approval of project
proposals, and release of the fund to the cities concerned.

2.0 PURPOSE

This Circular is being issued to prescribe the supplemental guidelines and procedures on the
final submission and approval of project proposals, and release of the fund to the cities
concerned.

3.0 GENERAL GUIDELINES

3.1 The proposed projects of the cities shall be in accordance with the following:

3.1.1 Enrichment of open space creating sustainable and livable urban

environment through turfing, landscaping, and green space architecture;

3.1.2 Establishment of forest parks, arboretum and botanical gardens;

Page 1 of 5
 3.1.3 Transformation of streetscape, such as installation of eco-friendly street
furniture and fixtures, and shading;

3.1.4 Augmentation of connectivity and accessibility, such as construction of eco-

friendly bike lanes and walkways; and

3.1.5 Green infrastructure enhancements, such as tree planting, construction of

bioswales and pervious surfaces.

3.2 The deadline of submission by the cities concerned of their expression of interest to
avail of the fund, together with the corresponding conceptual designs of their
proposed projects, consistent with the templates prescribed under item 3.3 of LBC
No. 116, is hereby extended until April 13, 2018.

3.3 All conceptual designs submitted by the cities shall be subject to evaluation and
approval by the DBM.

3.4 Upon the approval by the DBM of the conceptual designs of the proposed projects of
the cities, the following technical requirements shall be submitted by the cities to the
DBM:

3.4.1 Program of Works, as approved by the city mayor;

3.4.2 Detailed Estimates, as approved by the city mayor;

3.4.3 Project Brief (details provided in Annex A hereof);

3.4.4 Vicinity Map (details provided in Annex A hereof);

3.4.5 As-built Plan (details provided in Annex A hereof);

3.4.6 Site Development Plan (details provided in Annex A hereof);

3.4.7 Utilities Plan (details provided in Annex A hereof);

3.4.8 Planting Plan (details provided in Annex A hereof);

3.4.9 General Sections (details provided in Annex A hereof); and

3.4.10 Certification under oath from the city mayor attesting that:

3.4.10.1 There is a Sanggunian Resolution endorsing the proposed

project(s), and that the same is/are part of the duly approved Local
Development Investment Program and Annual Investment
Program of the city;

3.4.10.2 The city has the capability to implement the proposed project(s)
either by administration or contract;

3.4.10.3 The proposed project(s) is/are readily implementable within the

prescribed timelines and that there are no issues related to the
site/land title, including informal settlers thereon, and right-of-way
acquisition;

3.4.10.4 The city has complied with the standards prescribed by the
appropriate government agencies and has secured all the
necessary clearances or Certification from same agencies before
the implementation of the eligible project(s), e.g., Environmental
Clearance, Zonal Clearance, among others;

Page 2 of 5
 3.4.10.5 The location, area or site of the project(s) is/are located in suitable
area, that is, (i) open space; (ii) public land; and MO land that is
accessible and free to the public;
_
3.4.10.6 The location, area or site of the project(s) is/are not: (i) privately-
owned land/lot; and (h) included in the critical geo-hazard areas or
no build zones identified and/or certified by the Mines and Geo-
sciences Bureau hazard map;

3.4.10.7 The city commits to fund the cost of maintenance and repairs of
the project(s); and

3.4.10.8 The project is not fully funded from other sources.

The template for the said certification is provided in Annex B hereof.

3.5 In addition to the documentary requirements prescribed above, the DBM, if

necessary, may require the cities concerned to submit other pertinent details or
information relative to their proposed project(s).

3.6 The cities that previously received funding support from the LGSF-Financial
Assistance to LGUs in FYs 2016 and 2017 shall submit a report following the
prescribed template provided in Annex C hereof.

3.7 The fund shall be released upon approval by the DBM of the cities' submission of the
technical requirements prescribed under items 3.4, 3.5 and 3.6 hereof.

3.8 Consistent with Section 90 of the General Provisions and Special Provision No. 7 of
the LGSF under the Allocations to LGUs in the FY 2018 GAA, RA No. 10964, the
LGSF-AC shall be:

3.8.1 Released directly by the Bureau of the Treasury (BTr) to the beneficiary cities,
through authorized government servicing banks, upon receipt of and
consistent with the purposes indicated in the corresponding Special Allotment
Release Order and Advice of Notice of Cash Allocation Issued to be released
by the DBM to the BTr.

3.8.2 Recorded as Trust Funds by the cities for the specified purpose(s). Funds
which remain unutilized as of December 31, 2019 shall be reverted to the
National Treasury by the recipient cities. However, if at any point before
December 31, 2019, the city determines that the funds cannot be utilized,
e.g., when the project(s) cannot be implemented for any reason or when the
same has/have been funded from other sources, the amount received by the
same city from the LGSF-AC shall be immediately reverted to the National
Treasury.

For this purpose, unutilized funds refer to the balances of the amount
received from the LGSF-AC, which were not disbursed by the recipient
city.

3.9 Prohibitions on the Use of the LGSF-AC

The LGSF-AC shall not be used:

3.9.1 For any purpose other than the project(s), including the location thereof, for
which the fund was released;

Page 3 of 5
 3.9.2 To fund projects already fully covered by other funds under the LGSF in the
FY 2018 GM;

3.9.3 For consultation fees and other related or incidental expenses for the
development of the design of the proposed-project(s); and

3.9.4 For the payment of Personnel Services 1 expenditures (i.e., payment of

salaries, including honoraria, allowances, bonuses, and similar forms of
compensation).

3.10 Disbursement and utilization by the cities shall be subject to pertinent provisions of the
Government Procurement Reform Act (RA No. 9184) and its 2016 Revised
Implementing Rules and Regulations (IRR), and any relevant policies released by the
Government Procurement Policy Board (GPPB), as well as the applicable budgeting,
accounting, and auditing rules and regulations.

4.0 POSTING AND REPORTING REQUIREMENTS

The cities shall:

4.1 Comply with the posting requirements prescribed under RA No. 9184 and its 2016
Revised IRR, and any relevant policies issued by the GPPB;

4.2 Prepare quarterly reports on fund utilization and status of project implementation using
the prescribed format (Annex C) until such time that the Unified Reporting System for
LGUs has been developed and can be used by the LGUs;

4.3 Consistent with the Full Disclosure Policy of the DILG, the said reports shall be posted
on the cities' respective websites, and in at least three (3) conspicuous public places
in the locality within twenty (20) days from the end of each quarter; and

4.4 The city mayors shall send a written notice to the Speaker of the House of
Representatives, President of the Senate of the Philippines, House Committee on
Appropriations, and Senate Committee on Finance upon posting of the reports on their
cities' respective websites. The said written notice of the city mayors shall be
considered the date of submission to the said offices.

5.0 RESPONSIBILITY AND ACCOUNTABILITY

The responsibility and accountability in the implementation of projects and proper utilization
and disbursement of the LGSF-AC shall rest upon the city mayors and other city officials
concerned. It is also the responsibility of the said local officials to ensure that the funds
released to their respective cities are utilized strictly in accordance with applicable budgeting,
accounting, and auditing rules and regulations, and pertinent provisions of RA No. 9184.

Moreover, it shall be the responsibility of the city officials concerned to ensure that no
duplication and/or overlapping of funding will occur. As such, the city mayors shall immediately
inform the DBM if their city has received funding from other sources for the same project(s).

6.0 DISSEMINATION OF THIS CIRCULAR

The DBM Regional Offices shall disseminate a copy of this Circular to all the cities within their
respective regional jurisdictions.

' Sec. 306(k) of the Local Government Code of 1991

Page 4 of 5
7.0 ISSUES FOR RESOLUTION

Interpretation of the provisions of this Circular, including cases not covered therein, shall be
referred to the DBM for resolution.

8.0 EFFECTIVITY

This Circular shall take effect immediately.

BENJAMIN E. DIOKNO
Secretary j41
(

Page 5 of 5
 Annex A

PROJECT PROPOSAL CONSIDERATIONS AND DELIVERABLES

- _
SITE SELECTION CONSIDERATIONS DELIVERABLE

Type of Public Open Space

Consider one type of public open space
-Park Vicinity Map
-Plaza Vicinity Map
-Waterfront Vicinity Map
-Streets Vicinity Map
-Other types of public open space (for example: river easements, Vicinity Map
city boundary buffer zone as required by the CLUP HLURB
Guidelines)
Type of Development
Consider all that apply
-New Development . Vicinity Map
-Repair Vicinity Map
-Rehabilitation Vicinity Map
-Improvement Vicinity Map
Justification (Why the site is a priority?)
Consider all that apply
-Addressing an environmental concern in the locality Project Brief
-Addressing a social concern in the locality (for example: Project Brief
heritage preservation)
-Addressing other concerns in the locality (for example: Project Brief
connectivity, accessibility)
Scalability
Consider all that apply
-Proposed project can be linked to developed public open space Vicinity Map
types nearby
-Proposed project will instigate potential public open space Vicinity Map
development nearby
Accessibility
Consider all that apply
-Linked to a public road Vicinity Map
-Linked to public transportation stop Vicinity Map
-Linked to a public/government facility Vicinity Map
-Linked to communities Vicinity Map
Project Feasibility
Consider all that apply
-New public open space development Vicinity Map
-First phase of a proposed public open space development Vicinity Map
-Continuation of an existing public open space development Vicinity Map
-Part of a future public development that is currently under Vicinity Map
construction
-Part of a future public development Vicinity Map
Readiness of the Site for Construction
Consider all that apply
-No structures on site As-built Plan
-Structures on site needs to be demolished or relocated for site As-built Plan
to be ready for construction
-Site requires legal process to be ready for construction As-built Plan
Support Utilities
Consider all that apply
-Availability of Clean Water Connection/Tapping Point on Site As-built Plan
-Availability of Power Connection/Tapping Point on Site As-built Plan
-Proximity to Drainage Line As-built Plan

Page 1 of 11
 PHYSICAL DESIGN CONSIDERATIONS DELIVERABLE

On-site Accessibility (Proposed Circulation)

Consider all that apply .
-Location of access (entry/exit) points linked to public road/transport Site Development Plan
stop
-Clear delineation between pedestrian and vehicular circulation Site Development Plan
-Pedestrian circulation spaces are comfortable for walking (for Site Development Plan
example: provision of shade, width of walkway)
-Vehicular circulation spaces facilitate ease of traffic flow in and out Site Development Plan
of the site (for example: layout of parking area, drop-off/pick-up
points)
-Compliance to the Accessibility Law, B.P. 344, pp 12-30 Site Development Plan
Security
Consider all that apply
-Design/layout of entry/exit points to site facilitate control of people Site Development Plan
to and from site
-Layout of activity spaces and design of spatial elements facilitate General Sections
ease of surveillance of users on site
-Design of fence is a combination of hardscape and softscape General Sections
materials
Use of Spaces (Proposed Activity Spaces)
Consider all that apply
-Relevance of proposed activity spaces to type of public open space Project Brief
development
-Inclusive to all people groups Site Development Plan
Sustainable Site Maintenance Strategies
Consider all that apply
-Strategies to reduce dependence on non-renewable resourced Utilities Plan
power for site lighting
-Strategies to reduce dependence on clean water supply for Utilities Plan
landscape irrigation (for example: rainwater harvesting)
-Strategies for ease of maintenance such as use of materials and Site Development Plan,
finishes that last for 3 years or more and use of endemic plant Planting Plan
species or species indigenous to the tropics

ENVIRONMENTAL DESIGN CONSIDERATIONS DELIVERABLE

Reduce Urban Heat Island Effect/Microclimate Management

-Minimum requirement: Green space designed to shade and/or Planting Plan
absorb heat from the sun
Capture Stormwater Run-off
-Minimum requirement: Providing drainage lines Site Development Plan,
Utilities Plan
-Best Practice: Green strategies (for example: detention ponds, rain Site Development Plan,
garden) Utilities Plan
Capture Carbon Emissions
-Minimum requirement: Providing more tree cover than gray space Site Development Plan,
Planting Plan
Increase Biodiversity
-Minimum requirement: Providing variety of plant types, which are Planting Plan
trees, palms, shrubs, groundcovers
Improve Air Quality
-Minimum requirement: Providing small-leaved plant species of Planting Plan
different plant types

Page 2 of 11
 BUDGET CONSIDERATIONS DELIVERABLE
Construction Cost Considerations
Minimum Requirements
-Site Preparation _ Program of Works and Detailed
Cost Estimate
-Hardscape Program of Works and Detailed
Cost Estimate
-Softscape Program of Works and Detailed
Cost Estimate
-Utilities (Lighting, Irrigation/Water Supply, Drainage Strategy) Program of Works and Detailed
Cost Estimate
-Labor Program of Works and Detailed
Cost Estimate
-Contractor's Warranty for Materials and Workmanship (1 year Program of Works and Detailed
for softscape; 2 years for hardscape, utilities, structures, Cost Estimate
accessories)
-Applicable Taxes Program of Works and Detailed
, Copt Estimate

DEFINITION OF TERMS

Project Brief

The project brief is a written overview providing insight of the project objectives, desired
impact, and main components. The project brief serves as the narrative support of the
proposed design and includes:

SWOT Analysis

This narrative shall provide analysis on why the project is the best site for a
public open space development in the city.

Justification for the Project

This narrative shall provide basis on what the proposed project addresses for
the city such as environmental and social issues. The narrative shall specify the total
land area of the proposed public open space development project. It shall also define
the total land area that the funding assistance can cover, if the funding is not sufficient
to cover the total construction cost of the proposed project as well as other funding
sources that will supplement the total cost. Lastly, the narrative will describe the
intended uses of the site as well as the users of the proposed project.

Vicinity Map

The Vicinity Map is a scaled drawing or satellite map (to fit A4-size paper) of the
proposed public open space project site and its surrounding area of at least 100 meters from
all boundary lines of the site.

The map shall include the following details:

Title of Map
Scaled Map or Drawing of Project Site and Its Surrounding Area
Boundary lines of Proposed Project Site and indication of boundary lines for future
phases, if applicable
Graphic Scale of Map or Drawing
North Symbol

Page 3 of 11
Location (proposed site and surrounding area) and corresponding Label of
important land uses including landmarks, institutions, commercial centers,
residential areas, and points of Public Access to or at Project Site such as Public
Road and Public Transport Stop

Indication if the proposed public open space project is a new development, first
phase of a proposed public open space de-velopment, improvement or
continuation of a proposed public open space development, or a repair or
rehabilitation development

Map Source (for example: Google Map Hybrid)

Thunderbird Resort
Vegas

Miffs
Beach

PROPOSED BAYWALK DEVF.LOPMENT I

Map data ©2018 Google Imagery ©2018 , CNES / Airbus, DigitalGlobe 100 m
InrANWZIFA 'Iriii:.:X111111111Gri.Liesi 'MOE_
Image 1: An example on how a proposed site for public open space development with no existing
development can be defined and labeled on Google Map Hybrid.
an ernan ()-
the Oity M aypr4

South Lion's Park

Oebuana Lhuillier
Pawnshop nion
a 4 iA E1US 1110 LION'S PARK
(NEWLY RENOVATED)
hnst the r,
.gg Oollege /
atm ...Way
CrEArtmelit;, s

Baptist

Parish
Waiting

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Image 2: An example on how a proposed site for public open space development that is
continuation or improvement of an existing public open space development can be defined and J.
labeled on Google Map Hybrid.

Page 4 of 11
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Image 3: An example on how a proposed site for public open space development that has existing
structures can be defined and labeled on Google Map Hybrid

POSSIBLE EXPANSION
OF THE BAYWALK
DEVELOPMENTIV
toii's Par k

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Map data ..:,2012, Gcmgle imagery, D2018, CUES / Airbus, DigitalGlobe L200 m
It
Image 4: An example on how a proposed site for the first phase of a public open space development
can be defined and labeled on Google Map Hybrid

Page 5 of 11
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1 FOAM
Image 5: An Example of a Vicinity Map

As-built Plan

The As-built Plan is a scaled drawing (on A3-size paper) of the proposed public open
space project site showing all existing conditions. The drawing shall include the following
details:

Title of Drawing
Boundary lines of Proposed Project Site
Graphic Scale of Drawing
North Symbol
Standard Title Block showing logo and name of LGU, name of the local chief
executive and project lead of the proposed public open space project
Location (on-site) and corresponding label of existing hardscape elements.
Hardscape is defined as the gray spatial elements in an open space development.
These elements include floors or pavements, walls and fences, roof or shade
structures, water feature, artwork, and outdoor furniture.
Location (on-site) and corresponding label of existing utilities such as lighting fixtures,
drainage fixtures and line, waterline and tapping points, power line and tapping
points.
Location (on-site) and corresponding label of existing softscape. Softscape is defined
as the green spatial elements in an open space development. These elements
include plants and the surface area (soil or planting area) of which they are
established on.
Basic measurements to illustrate size of the site. (For example: providing typical
length and width of the site or providing grid-system measurement)

6.32-

Page 6 of 11
 Image 6: An Example of an As-built Plan

Site Development Plan

The Site Development Plan is a scaled drawing (on A3-size paper) of the proposed
public open space project site showing the proposed new development or scope of
rehabilitation, repair, or improvement works. The drawing shall include the following details:

Title of Drawing
Boundary lines of Proposed Project Site
Graphic Scale of Drawing
North Symbol
Standard Title Block showing logo and name of LGU, name of the local chief executive
and designer of the proposed public open space project
Location (on-site) and corresponding label of proposed hardscape elements, as
applicable. Hardscape is defined as the gray spatial elements in an open space
development. These elements include floors or pavements, walls and fences, roof or
shade structures, water feature, artwork, and outdoor furniture.
Location (on-site) and corresponding label as applicable of proposed trees, palms and
softscape areas. Softscape is defined as the green spatial elements in an open space
development. These elements include plants and the surface area (soil or planting
area) of which they are established on.
Location (on-site) and corresponding label of proposed pedestrian access (entry/exit)
points to site
Location (on-site) and corresponding label of proposed vehicular access
(loading/unloading) points on site.
Location and corresponding amenity and label of proposed activities on-site, as
applicable
Location and corresponding label of pedestrian circulation on site such as walkways
and accessibility ramps.
Location and corresponding label of vehicular circulation on site such as driveway and
parking area as applicable
Indicate proposed materials and finishes for all hardscape elements
Basic measurements to illustrate size of the site. (For example: providing typical length
and width of the site or providing grid-system measurement)

Page 7 of 11
 Boo JOLIBEE CAF BLDG. I

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EVELOFMLNI PLAN

Image 7: An Example of a Site Development Plan

Utilities Plan

The Utilities Plan is a scaled drawing (on A3-size paper) of the proposed public open
space project site showing the proposed new utility works. The drawing shall include the
following details as applicable:

Title of Drawing
Boundary lines of Proposed Project Site
Graphic Scale of Drawing
North Symbol
Standard Title Block showing logo and name of LGU, name of the local chief executive
and designer of the proposed public open space project
Key Plan (if site development plan shows typical design that is repeating throughout
the extent of the site)
Location (on-site) and corresponding label of proposed lighting strategy such as
lighting fixtures types, specifications (such as lumens, wattage and voltage), type of
assembly of lighting fixture (such as pole-mounted, in-ground or above-ground), and
quantity of proposed lighting fixture types.
If conventional drainage strategy is proposed, provide location (on-site) and
corresponding label of proposed conventional drainage strategy such as drainage
fixtures types, specifications (such as typical dimensions of fixtures), and quantity of
proposed drainage fixture types. If green strategy is proposed, provide detailsas to
how surface water run-off is collected, drained and re-used on-site.
If conventional irrigation strategy is proposed, provide location (on-site) and
corresponding label of proposed conventional irrigation strategy such as type of
irrigation system, specifications (such as size and irrigation coverage of fixtures), and
quantity of proposed irrigation fixture types. If green strategy is proposed, provide
details as to how irrigation water is sourced and used on-site.
Basic measurements to illustrate location of proposed utilities on the site. (For
example: providing typical spacing for each utility)

Page 8 of 11
 - --

y --------
- -

Image 8: Example of a Utilities Plan

Planting Plan

The Planting Plan is a scaled drawing (on A3-size paper) of the proposed public open
space project site showing the proposed new softscape. The drawing shall include the
following details as applicable:

Title of Drawing
Boundary lines of Proposed Project Site
Graphic Scale of Drawing
North Symbol
Standard Title Block showing logo and name of LGU, name of the local chief executive
and designer of the proposed public open space project
Location (on-site) and corresponding specifications of proposed tree and palm such
as scientific name, common name, proposed height of tree/palm at the time of planting,
proposed typical distance of one species of tree/palm to another tree/palm of the same
species in one area at the time of planting, and quantity of proposed tree/palm per
species.
Location (on-site) and corresponding specifications of proposed shrubs, vines and
other groundcovers except for grass such as scientific name, common name,
proposed height of shrub/vine/groundcover at the time of planting, proposed typical
distance of one species of shrub/vine/groundcover to another shrub/vine/groundcover
of the same species in one area at the time of planting, and quantity of proposed
tree/palm per species.
Location (on-site) and corresponding specifications of proposed grass such as
scientific name, common name, method of planting of grass (such as sodded or
seeding), and quantity (in square meters) of each grass species.
eJ.

Page 9 of 11
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Image 9: Example of a Planting Plan

General Sections

The General Section is a scaled drawing (on A3-size paper) of the proposed public
open space project site showing the proposed design in elevation and section views through
selected length and width of the site that best illustrate the proposed design. The drawing
shall include the following details as applicable:

Title of Drawing
Boundary lines of Proposed Project Site
Graphic Scale of Drawing
North Symbol
Standard Title Block showing logo and name of LGU, name of the local chief executive
and designer of the proposed public open space project
Key Plan showing where section lines have been cut through on plan
Scaled section-elevation drawing of the length of the site that provides the best view
of the proposed design including corresponding labels (proposed activity spaces,
circulation spaces, hardscape elements, softscape elements, utilities) and basic
measurements (typical height and width of proposed activity spaces, circulation
spaces, hardscape elements, softscape elements, utilities)
Scaled section-elevation drawing of the width of the site that provides the best view of
the proposed design including corresponding labels (proposed activity spaces,
circulation spaces, hardscape elements, softscape elements, utilities) and basic
measurements (typical height and width of proposed activity spaces, circulation
spaces, hardscape elements, softscape elements, utilities)
4,9P

Page 10 of 11
 1.4

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Image 10: Example of General Sections

Program of Works and Detailed Cost Estimate

The Program of Works and Detailed Cost Estimate shall follow the standard format for
infrastructure project but shall include the cost considerations in the project proposal criteria.

Page 11 of 11
 Annex B

REPUBLIC OF THE PHILIPPINES)

CITY OF ) S.S.

OMNIBUS SWORN STATEMENT

I, the undersigned, attest to the veracity of the following:

There is a Sanggunian Resolution endorging the proposed project(s), and that the
same is/are part of the duly approved Local Development Investment Program and
Annual Investment Program of the City of

The City of has the capability to implement the proposed project(s) either by
administration or contract;

The proposed project(s) of the City of is/are readily implementable within the
prescribed timelines and that there are no issues related to the site/land title,
including informal settlers thereon, and right-of-way acquisition;

The City of has complied with the standards prescribed by the appropriate
government agencies and has secured all the necessary clearances or Certification
from same agencies before the implementation of the eligible project(s), e.g.,
Environmental Clearance, Zonal Clearance, among others;

The location, area or site of the project(s) is/are located in suitable area, that is,
(i) open space; (ii) public land; and (iii) land that is accessible and free to the public;

The location, area or site of the proposed project(s) of the City of is/are not:
(i) privately-owned land/lot; and (ii) included in the critical geo-hazard areas or no
build zones identified and/or certified by the Mines and Geo-sciences Bureau hazard
map;

The City of commits to fund the cost of maintenance and repairs of the
project(s); and

The proposed project(s) of the City of is/are not fully funded from other
sources.

Page 1 of 2
 IN WITNESS WHEREOF, I have hereunto set my hand this day of [month] [year]
at [place of execution].

[Insert NAME OF LOCAL CHIEF EXECUTIVE]

[Insert Signatory's Legal Capacity]
Affiant

SUBSCRIBED AND SWORN to before me this day of [month] [year] at [place of

execution], Philippines. Affiant is personally known to me and was identified by me through
competent evidence of identity as defined in the 2004 Rules on, Notarial Practice (A.M. No. 02-
8-13-Sa). Affiant exhibited to me his/her [insert type of government identification card used],
with his/her photograph and signature appearing thereon, with no. issued on at

Witness my hand and seal this day of [month] [year].

NAME OF NOTARY PUBLIC

Serial No. of Commission
Notary Public for until
Roll of Attorneys No.
PTR No. [date issued], [place issued]
IBP No. [date issued], [place issued]

Doc. No.
Page No.
Book No.
Series of

Page 2 of 2
 Annex C

LOCAL GOVERNMENT SUPPORT FUND — ASSISTANCE TO CITIES (LGSF-AC)

Report on Fund Utilization and Status of Project Implementation
For the Quarter Ended

Date of Amount
Notice of _ Estimated
Authority Name/ Mechanism/ Estimated Period of
Fund Type of Specific Project
to Debit Title of Mode of Number of Completion
Source Project Location Received Obligation Disbursement Status
Account Project Implementation Beneficiaries (month and
Issued year)
(NADAI)

Prepared by: The Local Finance Committee (LFC) Attested by:

City Budget Officer City Mayor

City Treasurer

City Planning and Development Coordinator

Instructions:
The report shall be prepared by the LFC, in coordination with the other city officials concerned (e.g. city accountant on the
allotment, obligation and disbursements; city engineer on the status of infrastructure projects, as may be applicable).
The fund source shall be based on the NADAI issued to the city.
The type of project shall be identified consistent with the Project Menu of the LGSF-AC.
Amount received refers to the amount received by the city as its allocation. It is the amount indicated in the NADAI. Obligation
refers to the total amount obligated by the city as of reporting period. Disbursement refers to the total amount paid by the city as
of reporting period.
The status of project(s) refers to the percentage of physical completion as of reporting period.