PHILIPPINE HEALTH INSURANCE CORPORATION a ec a STATEMENT OF PREMIUM ACCOUNT (SPA) - FORMAL SECTOR PEN ‘11000002418 ‘SPA No. : SPA100009511352 Employer Type Private Date Generated : May 10,2017. BusinessiAgency Name: SAN MATEO CATHOLIC ACADEMY OF BACOLOD INC Premium Due Date Group Account Name: Please Pay immediately CURRENT CHARGES: lApplicable Month ‘Apel 2017 No. of Employees 10 JAmount of Premium: Employee Share 900.00 Employer Share 900.00 Premium Due forthe Current Applicable Period 1,300.00 [TOTAL AMOUNT DUE 7,800.00 IMPORTANT REMINDER: Per available records, it appears that you may have missed paying andlor reporting your payments forthe following applicable periods SPA Number Applicable Month's Premium/Report Due SPA1000083¢6388 ‘Jan 2017) 2,000.00 SPA100008730"18 Feb 2017 2'900.00 SPA100008154062 Mar 2017 2'000.00 Please settle the above accounts immediately and coordinate with your PAIMS (or visit the nearest PhilHealth Office) to assist you in posting these payments. Thank you. PHILHEALTH EPRS PREMIUM PAYMENT SLIP Remittance Due Date ; Please Pay Immediately SPA No. : SPA100009511352 Date Generated : “May 10, 2017 PEN 11000002618 Employer Type > Priva Business/Agency Name: SAN MATEO CATHOLIC ACADEMY OF BACOLOD INC JApplicable Month ‘Apel 2017 No, of Employees : 10 Principal Grouping No: Principal Name: JAmount of Premium: Employes Share ‘900.00 Employer Share 900.00 Premium Due for the Curent Applicable Period 1,800.00 [TOTAL AMOUNT DUE 7,800.00