CONTRACTOR ACCOMPLISHMENT REPORT (CAR)

CONTRACTOR’S NAME: DATE: MM/DD/YYYY

TO: (COMPANY) END-USER/DEPARTMENT: CAR CONTROL NO: SRN-"PO NO"
PO/CONTRACT No: START DATE: MM/DD/YYYY
PROJECT DESCRIPTION: TARGET COMPLETION DATE : MM/DD/YYYY
ACTUAL COMPLETION DATE: MM/DD/YYYY
FINAL REPORT? Yes No

PROJECT STATUS (for Service with progress billing only, otherwise, leave it blank):
Previous Current Period to Date Current Period
Remarks
Accomplishment Accomplishment Accomplishment Coverage
% % % mm/dd/yy - mm/dd/yy

REQUIRED DOCUMENT/S (for submission as applicable):

Copy of PO Copy of Contract Timesheet Summary
3 hard copies of reports Soft copies of reports in CD format
Others documents required in the PO/Contract, please specify:
Note: For submission to Finance: proof of mandated Government remittances (SSS, Philhealth, Pag-ibig & BIR), proof of payment to
subcontractors or any third party and other related documents as stated in the Contract and/or Purchase Order.

NAME OF CONTRACTOR

Signature Over Printed Name Position Title

Authorized Representative

TEAM'S ACKNOWLEDGMENT & APPROVAL:

The undersigned hereby certifies that the above-named Contractor has satisfactorily completed the
Services as specified in this document and in accordance with the terms and conditions of the PO and/or
Contract.

SRN1 No. Concurred by:

No. of days delay chargeable to Contractor: No. of days
LD Amount: CONTRACTOR (Authorized
Approver)
Offense (attached copy of SCMCOP-001 FORM 9: SUPPLIER OFFENSE REPORT (SOR))

Remarks:

Reviewed by: Recommended/Endorsed by: Approved by:

End-user Section Head HOD/Authorized Approver

1
This document will be considered incomplete without the SRN reference number and signed by the authorized approver.
Original: End-user Copy 1: Supplier Copy 2: SCM

This document is being approved without prejudice to subsequent adjustments necessary to arrive at the true and valid cost of the completed
Services. Such adjustments shall be made in accordance with the terms and conditions of the PO and/or Contract.

Approval of the document shall not be construed as an acceptance or waiver of defective work/goods or Contractor's other obligations in the PO
and/or Contract. The Company shall not be considered to have waived, nor shall it be considered in estoppel, in respect of any claims it may
have against the Contractor by the approval of this document.