2013 PBB Forms

8/12/2019 2013 PBB Forms

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GOCC Letterhead Interim PES Form 3

Performance MeasuresBaseline Data

(if available) CY 2013Targets

CY 2013Accomplishment

RatingDescription Formula eight

Data Pro!i"er if applicable

2010 2011 2012

MF# 1 $ [Insert MFO Name]

Quantity

Quality

Timeliness

Financial

Subtotal of Weights:

MF# 2 $ [Insert MFO Name]

Quantity

Quality

Timeliness

Financial

Subtotal of Weights:

T#TA% #F &'()T*$ 100+

Certified Correct:

Head of Planning Date Head of Finance Date

Approved by:

Chief Eecutive !fficer Chairperson" #oard of Directors Date

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GOCC Letterhead 2013 PBB Form 1

B#ARD R&*#%,T'#- -#. $$$$$$$$

AD#PT'-( T)& CY 2013 P&RF#RMA-C&/BA*&D B#-,* * Y*T&M F#R -AM& #F T)&

(#CC '- ACC#RDA-C& 'T) &&C,T'& #RD&R -#. 405 *. 2012 A-D (C(M&M#RA-D,M C'RC,%AR -#. 2013/06%

)&R&A*" on &' (uly &')&" President #E*+,*! -% AQ.+*! +++ issuedEecutive !rder /E%!%0 *o% 1'" s% &')&" 2hich directed the ,overnance Commissionfor ,!CCs /,C,0 to issue the necessary guidelines for the Performance3#ased+ncentive/P#+0-ystem of ,!CCs under ,C,4s 5urisdiction6

)&R&A*" ,C, 7emorandum Circular /7%C%0 *o% &')83'9 established therules and regulations for the +nterim Performance3#ased #onus /P##0 -ystem forQualified !fficers and Employees of ,!CCs covered by ,C, pursuant to the

GOCC Governance Act of 2011; /<%A% *o% )')=>06

)&R&A*" sub5ect to further evaluation by ,C," ?,!CC Acronym@ hasattained a 2eighted3average of $ based on its Performance Agreement for &')8"and has complied 2ith all ,ood ,overnance Conditions" pursuant to ,C, 7C *o%&')83'& and ,C, 7C *o% &')83'96

)&R&A*" based on the guidelines in ,C, 7C *o% &')83'9" ?,!CC Acronym@ is a ?Profitable B osing@,!CC6

)&R&A*" E%!% *o% 1' reuires that the funds for the grant of P## in ,!CCsshall be charged against their respective corporate funds" sub5ect to the approval oftheir respective governing boards6 and

)&R&A*" no other performance3based incentive or its euivalent has beengranted to the !fficers and Employees for C &')8%

B& 'T 7

R&*#%&D" the #oard herebyAPPR#&* the follo2ing:

)% Application for authoriation from ,C, to grant the &')8 P##" 2hich

consists of:/a0 Productivity Enhancement +ncentive /PE+0amounting to P9"'''"

2hich shall be granted across3the3board6 and

/b0 P## for Qualified !fficers and Employees based on their Percentile<anGing 2ithin their respective levels" and the applicable?multipleBfied rate@%

&% Allocation of an amount not eceeding ?AM#,-T '- #RD* BA*&D #- 2013PBB F#RM 3@ /P$0" chargeable against corporate funds" for the grant of theC &')8P## to ualified!fficers and Employees6Provided " the grant of theC &')8P## is sub5ect to the approval andBor ad5ustment by the ,C,%

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8% Authoriation of the Chairperson of the ,overning #oard" the ChiefEecutive !fficer"Heads of Finance and Planning or their euivalent inauthority and area of responsibility" Chairperson of the #ids and A2ardsCommittee and other !fficers concerned" to certify and attest under oath tothe veracity of all information disclosed in the submitted documents reuired

in ,C, 7C *o% &')83'9 and such other documents that may be reuired by,C,%

D#-&5 this $$$ day of ?month@ &')=" in ?city@" Philippines%

To be signed by all 7embers of the ,overning #oard

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#M-'B,* C&RT'F'CAT'#-

This is to certify to the follo2ing:

)% The ?F,%% -AM& #F (#CC@ achieved a 2eighted3average score of $ on its&')8 Performance -corecard%

&% Complied 2ith all ,ood ,overnance Conditions" to 2it:

/a0 Transparency -eal6

/b0 Phil,EP- Posting6

/c0 Cash Advance iuidation6

/d0 Citien4s Charter or its euivalent6

/e0 ?select one" delete the other@ -ubmission of statement of compliance 2ith

the ,overnment Quality 7anagement -ystem -tandards /,Q7--0pursuant to E%!% *o% '9" s% &''I ?!<@-ubmission of concrete andtimebound plan and actions taGen to2ards complying 2ith the ,overnmentQuality 7anagement -ystem -tandards /,Q7--0 pursuant to E%!% *o%'9" s% &''I6

/f0 Compliance 2ith the submission and revie2 reuirements covering-tatement of Assets" iabilities and *et2orth /-A*06

/g0 Paid in full all statutory liabilities" namely:

i% All taes due to the ,overnment6

ii% Declaration and payment of all dividends to the -tate due for C &')86

iii% Payment of mandatory premiums due for C &')8 to the ,overnment-ervice +nsurance -ystem /,-+-0" -ocial -ecurity -ystem /---0"Home Development 7utual Fund /Pag3+#+,0" Philippine Health+nsurance Corporation /PhilHealth0 and the Employees CompensationCommission /ECC06

/h0 -ubmission to ,C, and C!A of concrete and time bound action plans foraddressing *otices of Disallo2ances and Audit !bservation 7emorandafrom the Commission on Audit /C!A0" if any" and the timely eecution ofall such plans that 2ere possible as of the time of the issuance of thisCertification%

/i0 .ploading of the follo2ing on the official 2ebsite of ?,!CC Acronym@ forunrestricted public access" to 2it:

i% Manual of Corporate Governanceapproved by ,C, pursuant to -ection=& of the C#D& #F C#RP#RAT& (#&R-A-C& F#R (#CC* (C( MC-#. 2012/08%

ii% Disclosure reuirements enumerated under -ection =8 of ,C, 7C *o%&')&3'I%

iii% No Gift Polic as approved by ,C,pursuant to -ection &> of ,C,7C *o% &')&3'I%

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8% Pursuant to -ection 9/b0 of E%!% 1' and ,C, 7C *o% &')83'9" the fundingallocated for the &')8 Performance3#ased #onus /P##0and approved by the,overning #oard has been sourced from corporate funds" 2hich have notbeen sourced from any of the follo2ing:

/a0 oans6/b0 -ubsidy from the *, for the ,!CCJs operations" ecept for

subsidy income or subsidy given by D#7 precisely for thepayment of the P##6 and

/c0 -ale of the ,!CCJs asset/s0 for the sole purpose of paying theP## and is other2ise not in the ordinary course of business%

Furthermore" the allocation of the budget for the P## is in accordance 2ith allother applicable la2s" rules and regulations%

=% That ?AM#,-T '- #RD* BA*&D #- 2013 PBB F#RM 3@ /P$0 is available for the

grant of the P## for C &')8" as approved under #oard <esolution *o% $" s% $ and confirmed by ?)ea" of Finance@%

This certification is being issued to attest the truth and accuracy of all theinformation contained herein based on our personal Gno2ledge" available recordsand information that can be easily verified 2ith ?,!CC Acronym@%

D#-&" this $$$$$ day of $$$$$$$$$$$$$ &')= at ?CityB7unicipality" Province@"Philippines%

Chairperson5 Boar" of Directors Chief &9ecuti!e #fficer

Compliance #fficer : Corporate*ecretar;

)ea" of Finance

)ea" of Bu"get )ea" of Planning

Chairman5 Bi"s an" A<ar"sCommittee

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*,MMARY = *C)&D,%& #F T)& RA->'-( #F&%'('B%& #FF'C&R* A-D &MP%#Y&&*

[ Notes on the Form: Belo i! an illu!tration of the PBB di!tribution of e"plo#ee!$ %he!ub"i!!ion "u!t co"pl# ith the folloin& for"at provided on thi! Anne'$ %he reuired

infor"ation fro" the GOCC !hall con!i!t of to table! (1) A !u""ar# !hoin& the ran* anddi!tribution for each per!onnel &roup+ ith corre!pondin& PBB a"ount ba!ed on the percentile ran*, and (2) a !chedule of the actual and applicable PBB di!tribution on a per-e"plo#ee ba!i!$ .or profitable GOCC!+ indicate the ba!ic !alar# of the e"plo#ee$/eletenote! before printin&$

M,%T'P%& : F'&D AM#,-T D'*TR'B,T'#--#. #F

P&R*#--&%PBB AM#,-TP

Personnel Grou!: *&-'#R MA-A(&M&-T

&%9' B &9"''' $

)%9' B )9"''' $

)%'' B I"9'' $

#elo2 -atisfactory $

Total$ *enior Management

Personnel Grou!: M'DD%& MA-A(&M&-T

&%9' B &9"''' $

)%9' B )9"''' $

)%'' B I"9'' $


Total$ Mi""le Management

Personnel Grou!: PR#F&**'#-A% A-D *,P&R'*#RY

&%9' B &9"''' $

)%9' B )9"''' $

)%'' B I"9'' $


Total$ Professional an" *uper!isor;

Personnel Grou!: C%&R'CA%:(&-&RA% *TAFF

&%9' B &9"''' $

)%9' B )9"''' $

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M,%T'P%& : F'&D AM#,-T D'*TR'B,T'#--#. #F

P&R*#--&%PBB AM#,-TP

)%'' B I"9'' $


Total$ Clerical:(eneral *taff

(RA-D T#TA%

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*C)&D,%& #F PBB D'*TR'B,T'#- F#R PR#F'TAB%&(#CCs/values indicated are for illustration only0

<anGEmployee

code7ultiplier

#asic-alary /P0

P## Amount/P0

SENIO" M#N#GEMEN$

Top2.60 ) &%9 )9"'''%'' 8I"9''%''

& &%9 8'"'''%'' I9"'''%''

8 &%9 9'"'''%'' )&9"'''%''

-ub3total 2385600.00

-e9t 1.60 ) )%9 )9"'''%'' &&"9''%''

& )%9 8'"'''%'' =9"'''%''

8 )%9 9'"'''%'' I9"'''%''

-ub3total 1?25600.00

Remaining 1.00 ) )%' )9"'''%'' )9"'''%''

& )%' 8'"'''%'' 8'"'''%''

8 )%' 9'"'''%'' 9'"'''%''

-ub3total @65000.00

Belo< *atisfactor; $

Total$ *enior Management ?865000.00

MI%%&E M#N#GEMEN$

Top 2.60 ) &%9 )9"'''%'' 8I"9''%''

& &%9 8'"'''%'' I9"'''%''

8 &%9 9'"'''%'' )&9"'''%''

-ub3total 2385600.00

-e9t 1.60 ) )%9 )9"'''%'' &&"9''%''

& )%9 8'"'''%'' =9"'''%''

8 )%9 9'"'''%'' I9"'''%''

-ub3total 1?25600.00

Remaining 1.00 ) )%' )9"'''%'' )9"'''%''

& )%' 8'"'''%'' 8'"'''%''

8 )%' 9'"'''%'' 9'"'''%''

-ub3total @65000.00


Total$ Mi""le Management ?865000.00

PR#F&**'#-A% A-D *,P&R'*#RY

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Top 2.60 ) &%9 )9"'''%'' 8I"9''%''

& &%9 8'"'''%'' I9"'''%''

8 &%9 9'"'''%'' )&9"'''%''

-ub3total 2385600.00

-e9t 1.60 ) )%9 )9"'''%'' &&"9''%''

& )%9 8'"'''%'' =9"'''%''

8 )%9 9'"'''%'' I9"'''%''

-ub3total 1?25600.00

Remaining 1.00 ) )%' )9"'''%'' )9"'''%''

& )%' 8'"'''%'' 8'"'''%''

8 )%' 9'"'''%'' 9'"'''%''

-ub3total @65000.00


Total$ Professional an"*uper!isor;

?865000.00

C%&R'CA%:(&-&RA% *TAFF

Top 2.60 ) &%9 )9"'''%'' 8I"9''%''

& &%9 8'"'''%'' I9"'''%''

8 &%9 9'"'''%'' )&9"'''%''

-ub3total 2385600.00

-e9t 1.60 ) )%9 )9"'''%'' &&"9''%''

& )%9 8'"'''%'' =9"'''%''

8 )%9 9'"'''%'' I9"'''%''

-ub3total 1?25600.00

Remaining 1.00 ) )%' )9"'''%'' )9"'''%''

& )%' 8'"'''%'' 8'"'''%''

8 )%' 9'"'''%'' 9'"'''%''

-ub3total @65000.00


Total$ Clerical:(eneral *taff ?865000.00

(RA-D T#TA% [email protected]

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*C)&D,%& #F PBB D'*TR'B,T'#- F#R %#*'-((#CCs/values indicated are for illustration only0

<anGEmployee

code Amount

/P0

*&-'#R MA-A(&M&-T

Top ) &9"'''%''

& &9"'''%''

8 &9"'''%''

-ub3total 865000.00

-e9t ) )9"'''%''

& )9"'''%''

8 )9"'''%''

-ub3total ?65000.00

Remaining ) I"9''%''

& I"9''%''

8 I"9''%''

-ub3total 225600.00


Total$ *enior Management 1?25600.00

M'DD%& MA-A(&M&-T

Top ) &9"'''%''

& &9"'''%''

8 &9"'''%''

-ub3total 865000.00

-e9t ) )9"'''%''

& )9"'''%''

8 )9"'''%''

-ub3total ?65000.00


& I"9''%''

8 I"9''%''

-ub3total 225600.00


Total$ Mi""le Management 1?25600.00

PR#F&**'#-A% A-D *,P&R'*#RY

Top ) &9"'''%''

& &9"'''%''

8 &9"'''%''

-ub3total 865000.00

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<anGEmployee

code Amount

/P0

-e9t ) )9"'''%''

& )9"'''%''

8 )9"'''%''

-ub3total ?65000.00


& I"9''%''

8 I"9''%''

-ub3total 225600.00


Total$ Professional an" *uper!isor; 1?25600.00

C%&R'CA%:(&-&RA% *TAFF

Top ) &9"'''%''& &9"'''%''

8 &9"'''%''

-ub3total 865000.00

-e9t ) )9"'''%''

& )9"'''%''

8 )9"'''%''

-ub3total ?65000.00

Remaining ) I"9''%''& I"9''%''

8 I"9''%''

-ub3total 225600.00


Total$ Clerical:(eneral *taff 1?25600.00

(ran" total 6805000.00

2013 PBB Forms

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