CDD E-34: Form

CBIM Form C-3

Republic of the Philippines
Province of Surigao del Norte
Municipality of Placer
Barangay ___________
Department of Social Welfare and Development
KALAHI CIDSS: Disaster Response Operation Modality/Procedure
COMMUNITY OPERATION AND MAINTENANCE (O& M) PROJECT IMPLEMENTATION PROGRAM
CY: 2022-2023
Name of Sub-Project: CONSTRUCTION OF BARANGAY HEALTH STATION

Physical Target: 100 SQ.M.

Barangay: ______________________

Municipality: Placer
A. Organizational and Financial Aspects

CAPABILITY BUILDING
RESPONSIBLE
ASPECTS ACTION PLAN/ SCHEDULE BUDGET FUND SOURCE
PERSON/UNIT
ACTIVITIES
Organizational  O&M Training  April 13-14, 25,000.00 snack
Aspect/  ODM Training 2023 and meal
O&M president MLGU
Management In-kind -venue &
speaker

Financial  Financial Literacy and  ARPIL 30,2023 3,000.00 snack

Management and meal
O&M president BLGU
 Simple Bookkeeping In-kind -venue &
speaker

B. Physical/Technical Aspect

Resources Needed Source of Fund Expected Output Remarks

Labor Materials Total Cost

Work Item Physical Activity to be No. of Days B M

Frequency
Description Scope Undertaken L L Commun
Qty Rate Cost No. Description Unit Price Cost Others
G G ity

U U

OPERATION:
Pagdis-infect - Na disinfect ang mga
Weekly nga pagdis- Misting
sa collapsible 14 In 1 5,000.00 5,000.00 5,000.00 / pasilidad/Tent, namentinar
infect sa quarantine Weekly 1 48 weeks In kind Machine,
Tent units kind ang kalempyo ug nalikayan ang
facility Disinfectants
pagkuyanap sa maong virus.

-Nahiloan ang palibot sa

Pagpanilhig ug
Pahina In Walis Tambo, / / Collapsible Tent ug nalabay sa
1 lot paglabay sa basura sa Weekly 1 48 weeks In kind 5 In kind In kind In kind
kind Walis Tingting, saktong labayanan ang mga
saktong labayanan
basura

MAINTENANCE:

Pagdajaw sa mga Pipe

Pag-ilis sa nga nangaguba, Ilisan immediately Napulihan na ang mga guba ug

In /
naguba nga 5 units ang nagbara ug upon need 1 1 In kind 5 Faucet In kind In kind 0 / functional na ang handwash
kind
faucet naguba nga mga arises facility

Faucet

Doorknobs Pag-ilis sa naguba immediately

700.0 8,200.0 / Nailisdan na ang naguba nga
easily broken 5 units nga Door knobs upon need 5 1 day 700.00 5 Doorknobs 1,500.00 7,500.00
0 0 door-knobs
arises

TOTAL 32,000.00

BLGU Cash – 13,200.00

BLGU In-kind –

Prepared by: Recommending Approval: Approved by:

_______________________ ________________________________ ____________________________ _______________________________________

BDRRMC Chairperson Municipal Engineer BDC-TWG Chairperson Municipal Mayor