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MEMORANDUM OF AGREEMENT

KNOW ALL MEN BY THIS PRESENTS:This Memorandum of Agreement made and____ in the byandbetween: into this

The LOCAL GOVERNMENT OF THE CITY OF BACO R, alocal government unit of the Philippines with office ad ressat Evangelista St. Brgy. Tabing Dagat, Bacoor, C 1 viterepresented herein by its City Mayor, Hon. STRI B.REVILLA, Ph.D., acting pursuant to Sangguniang layanResolution No. 2013-12, dated January 7,2013, herei lafter'referred to as "CITY";' I

IST. DOMINIC MEDICAL CENTER, INC., a corporation \dUlYorganized and existing under the laws of the Republic f thePhilippines, with principal office address at St. Do inicComplex, Aguinaldo Highway, Talaba, Bacoor, Cavite, hi reinrepresented by its President Dr. GREGORIO ANDAMAN JR.and its Hospital Director, Dr. OSCAR D. TINIO, herei laftercalled "SDMC."

and

WITNESSETH that:WHEREAS, numerous indigent resident patients of t e City of

Bacoor requested the CITY for assistance on thei medicalproblems/ conditions;

WHEREAS, the CITY,in its desire to extend freemedi servicesto the marginalized and underprivileged residents, as well a 1 to publicschool teachers, non-teaching personnel and for its Bacoor G vernmentemployees, need to have hospital facilities to fulfill the task; I

WHEREAS, the HOSPITAL, possessing the facilities I eeded byindigent patients requesting for medical assistance from the \CITY,hasmanifested its willingness to serve as retainer hospital to rend r medicalservices and confinement for patients referred by the CITY; I

NOW THEREFORE, for and in consideration' of the I foregoingpremises, and the terms and considerations hereunder enum rated, theParties to this Agreement hereby agree as follows: \1. The HOSPITALshall admit, provide and administer the Inecessarymedical attention and services to all individuals referr d to it bythe CITYas service patients through the Officeof the M or under

the City of Bacoor Hospitalization Program ("CBH). It is. understood, however, that the HOSPITAL shall rend r servicemainly to tertiqry' c~ses and reserves the right 0 refuseentertaining primary cast=;,s.The HOSPITALshall not de and fromthe said patients any deposit or up-front payment as a Iconditionfor their admission, treatment or discharge if they prese t a validGuaranty Letter (GL) from the CITY, but said amoun I shall be~ incorporated in the final hospital bill;

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2. The HOSPITAL, in cases of emergency, shall ad !inister thenecessary medical attention. The Emergency oom andprofessional fees shall however, be. paid by the patient I Provided,that if the patient is admitted to the HOSPITAL,then such roomand professional fees shall be assumed and charged t CBHP andnot by the patient If the patient is to be admitted, he/ he may beI .admitted upon presentation of the "Guaranty Lette I ("GL"). Ifadmitted, a GLmust be presented within 24 hours afte I admissionor on the first working day if the day of emergenc falls on aSaturday, Sunday or official holiday .

3. .The GL shall. bear the signature of the Mayor. In th precedinginstances, the GL bearing the signature of the May Ir, shall besurrendered to the BillingSection of the HOSPITALat I later date.Sample copies of the GL are hereto attached as Anne !es "A" and"B", respectively;If no GL is presented, the HOSPITALshall not consider the patient. to be covered by the CBHP, and shall be discharged ace rdingly;

4. The HOSPITALshall make available to the CITY,at al times andfor the duration of this Agreement, its facilities for con inement ofpatients, at any time, in the department where the p I ients shallbe properly treated. The CITYin-patient accommodatil n shall bestrictly limited to Service Ward facilities. Provided, th It the CITYmay also send to the HOSPITALits service patients for Iut-patientaccommodation and the CITYshall be billed accordingl pursuantto the HOSPITAL'spertinent policies and procedures; IThe professional services of a specified list of c Insultants,specialists, resident physicians, nurses and other perso' nel of theHOSPITAL, including medicines, laboratory examin tions andother diagnostic procedures shall be' made available to the CITY'sservice patients' (hereto attached as Annex "C'];

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6. The HOSPITAL shall give the CITY the right to vi it patient-members and monitor their health conditions subject t I pertinentregulations of the HOSPITAL.The CITYshall coordina Iewith theOffice of the Deputy Director for Health Operations, subject toexisting laws, rules and regulations on disposition of r cords. Allexpenses for accessing such records shall be for the s e accountof the CITY;

7. The HOSPITALshall conduct an initial evaluation on t e patient-member's medical condition for the purpose of esti ating thepossible medical expenses that will be incurred. If ithe initialestimate be more than the amount guaranteed in t e GL, theHOSPITAL shall immediately inform the CITY of suer possiblediscrepancy. The excess shall be charged to the acco I nt of thepatient-member who is personally liable therefore. he CITY,however, shall render assistance to the HOSPITALfor th Icollectionof unpaid hospital bill of the patient;

8. The HOSPITALshall deduct, when applicable, Medicare Imployee'sCompensation and other government-mandated medic I benefitsfrom the hospital bills of a patient-member.

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It shall be solely responsible for ensuring that the pplicationforms and supporting documents for the availmen of thesebenefits are duly accomplished and filed before a patiel t-memberis discharged from the HOSPITAL;The HOSPITALshall remit to the CITYany compensa Ie chargespaid or reimbursed by Philhealth in excess of the amou r deductedby the HOSPITALfromthe account of the patient withi thirty (30)days from receipt of Philhealth's payment. Corre pondingly,should the Philhealth remittance be less than t f amountdeducted by the HOSPITAL,the discrepancy shall be harged tothe account of the CITY;The HOSPITALshall, free of charge, conduct an annu medical,dental and minor surgical mission at an area designat b upon bythe City;

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The HOSPITALshall, free of charge and after medical check-up,issue a medical certificate to all beneficiaries of the onditionalI .cash transfer program (and/or 4Ps) of the City Dep tment ofSocial Welfarewithin the HOSPITAL'sterritorialjurisdict on;. IThe HOSPITAL likewise commits to participate in t eSpecialBacoor Resident (SBR)Card Program of the City and a [ideby therules and regulations to be issued by the City Mayor. n relationthereto;

13. For and in consideration of the foregoing terms and onditions,and for the services to be rendered by the HOSPITAL, the CITYshall allocate the amount of TWO MILLIO PESOS(P2 ,OOO,OOO.OO), herein cited as the FUND,for the dura t o n of thisAgreement, which amount shall be used the Local Gov rnment ofBacoor in settling bills issued to it by the HOSPITAL, ubject toapproval of proper government offices and in accord! ce withexistin!? government accounting and auditing r lIes andregulations. The amount of TWO HUNDREDFIFTYT 'OUSANDPESOS (P250,000.00) shall be deposited to the HOSPIT L as thebond of the CITYto secure treatment of CBHPeligible pa ients andto act as guaranty for the payment of all hospital bills on lime;For recording regular auditing and monitoring purposes, . monthlystatement of actual HOSPITALcharges for CBHP patient I shall beprepared by the HOSPITAL,a copy ofwhich is to be reql ested bythe CITY for its review /perusal in accordance with the 'rocedureof Processing of Hospital Bills (Annex "D" hereof). The : ITYmaycountercheck for erroneous billings or entries to the HO: PITAL,ifany, and shall inform the HOSPITALof such error with r fifteen(15) days from receipt of the billings in question;It is agreed upon by the parties that the City shall not be liable forany damages and/ or liability caused by the negligence an I / or faultof the Hospital, or any of its staff and/ or employee.

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16. DISPUTERESOLUTIONAlldisputes controversies or claims arising out. of or rel ting to thisAgreement, or about its breach, termination or invalid ty shall besettled through negotiation and/or mediation within six1y (60) daysfrom receipt of a notice by the other party from the part I injured.All such conflicts which cannot be decided by negotia ion and/ ormediation shall be decided through P.D. 242 (pres: ribing theProcedures for Administrative Settlement or Adju ication ofDisputes, Claims and Controversies between r amongGovernment Offices and instrumentalities, including G vernment-Owned and Controlled Corporations and other Purpose .

17. This Agreement shall be valid from January 1, 2013 t December31,2013, and may be terminated by either party in th I event thatany provision hereof is violated, by giving a 30-day wr tten noticeto the other, without prejudice to any legal rights 0 the partyterminated. The term of this Agreement shall be a ~omaticallyrenewed for a period of one (1)year unless either party give noticeof intention not to renew this Agreement ..Any amendment to this Agreement shall take effect on y after 'thewritten consent of both parties, which shall be embodi in a dulyexecuted Supplement Agreement.

IN WITNESS WHEREOF. the parties hereto have set theithe date and at the place first above written.

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hands on

THE LOCAL GOVERNMENTOF THE CITY OF BACOOR ST. DOMINIC MEDICAL C

BY:~STRIKE B. REVILLA, p~

. Mayor ~/

By:

'A..M[.Mf0J~'.M.D.

~~RRAB~A

City Legal Officer

.Signed in the Presence oL. &~~

OSCAR D. TINIO, M.D.Director

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ACKNOWLEDGMENT

BEFOREME, a Notary Public for F E B 2 2 2 0 1 3 , person y appeared,the followingpersons, presenting to me their respective Competen Evidence ofIdentity, as indicated below:

known to me and to me known to be the same persons who pcecuted theforegoing instrument denominated as Memorandum ofAgreement ,onsisting offour (4 ) pages, including this page, having acknowledged before I e that it istheir own free and voluntary act and deed, and that of the entity theyrespectively represent in this instance.

Republic of the Philippines)) S.S.

Name Competent Evidence ofIdentity Date of Issue

Jq o t ( , 'Jq Jot). q,W/'?)J q 0 lq '904 JCh./S, WI~

Dr. Gregorio Andaman, Jr.Dr. Oscar D. Tinio, M.D.Mayor Strike B. Revilla, Ph.D.

Place of Issue

\

TO THE TRUTH OF THE FOREGOING, witness now my h d and sealon the date and at the place indicated.

ATTV . iLM E T R A 8 U Y AAPPUCAT lONNO. 011-21N O l M Y U N T l l D~GE I E R 3 1, 20BROUNO 42 58

IS P L i fETIM E NQ ~567P 1R NO. 2'117 64 1; J A M . 22011 C A V ITe

Doc.No.~PageNo.~BookNo.~Series of 2013.