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DEED OF USUFRUCT

KNOW ALL MEN BY THESE PRESENTS:

This DEED OF USUFRUCT is entered into this _____day of


__________________________ 2015, by and between:

The DEPARTMENT OF HEALTH, Regional Office No.2 , a national


government entity organized and existing under the laws of the Philippines
with principal office address at Maharlika Highway, Carig Norte, Tuguegarao City,
Cagayan, represented by VALERIANO JESUS V. LOPEZ, MD, MPH, MHA,
CESO IV in his capacity as Director IV, hereinafter referred to as “OWNER”

-and-

____________________________________________,of legal age,


Filipino and with address at
___________________________________________________, hereinafter
referred to as the “USUFRUCTUARY”

WITNESSETH

WHEREAS, the OWNER, has procured Remote Monitoring Device for use
to pursue its thrust;

WHEREAS, OWNER, by these presents offers for the use of the


Usufructuary a Remote Monitoring Device to be utilized exclusively by the latter
for the monitoring of Programs assigned to them;

WHEREAS, the USUFRUCTUARY accepts the above-stated offer of the


OWNER with gratitude and deep appreciation;

NOW THEREFORE, for and in consideration of the following premises,


the parties have agreed to the following:

1. DOH ROII is the registered owner of the Remote Monitoring


Device described below:
Make/Model : ________________________
Serial No. : ________________________
Unit Price : ________________________
________ : ________________________

2. DOH ROII shall deliver and make available to the Malaria under
Job Order Service , for the duration of their Contract of Service of
six (6) months that can be renewed based on a very satisfactory
performances, the said Program Remote Monitoring Device for the
latter’s use in the pursuit of its activities covering the said Project.

3. DOH ROII shall register and maintain a Masterlist of Recipients of


the Program Remote Monitoring Device thru its Senior Health
Program Officer incharged of the Program ;

4. The Original Official copy of the Property Acknowledgment


Receipt shall at all times be with the Senior Health Program
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Officer of the Local Health Support Division for safekeeping. The
Senior Health Program Officer shall provide the Malaria Personnel
under the Job Order Service a duplicate copy of said Property
Acknowledgment Receipt and Memorandum of Agreement;

5. Malaria Personnel under the Job Order Service shall be


accountable to the program Remote Monitoring Device against
loss through accident, theft, and vandalism, equivalent to the
acquisition cost of the device

6. The appointed Malaria Personnel under the Job Order Service


shall use the program Remote Monitoring Device for official
functions only. Official functions shall mean to be used for the
pruposes of delivering services, implementation, monitoring and
supervisión of projects of the DOH RO2 as contained in the
Malaria Personnel under the Job Order Service resposnisbilites.
The program Remote Monitoring Device shall NOT be used for
personal transactions at any time.

7. Only the designated Malaria Personnel under the Job Order


Service maybe issued and use the Program Remote Monitoring
Device , a copy of the Property Acknowledgment Receipt and the
MOA must be submitted to Supply Section of the DOH RO2 for
safekeeping and reference.

8. The designated Malaria Personnel under the Job Order Service


shall be oriented on the proper use and handling of the Program
Remote Monitoring Device;

9. The designated Malaria Personnel under the Job Order Service


agrees to take care of the Program Remote Monitoring Device with
proper diligence

10. The designated Malaria Personnel under the Job Order Service
agrees to shoulder repair/replacement of parts of the Program
Remote Monitoring Device ;

11. Malaria Personnel under the Job Order Service agrees/commits


to hold DOH RO2 free and harmless from any and all claims,
causes of action of whatever kind and nature arising from, related
to or connectred with the use or operation of said Program Remote
Monitoring Device through its officials, employees or agents.

12. Upon the expiration of their Contract of Service with DOH ROII,
the Malaria Personnel under the Job Order Service should return
the Remote Monitoring Devise to the Senior Health Program
Officer.

13. The Owner shall issue a Clearance over the said device upon
receipt by the Senior Health Program Officer to entitle them of
their compensation for their last month of service.

III. Duration, Termination and Modification of Agreement

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This agreement shall take effect upon signing by the PARTIES.

Upon full or partial termination of this Agreement for any reason or the
expiry of the Project Term, Malaria Personnel under the Job Order Service
among other procedures which may be requested by DOH RO2 shall
immediately return the Program Remote Monitoring Device as of the date of the
termination notice or the expiry date of the Program Term (as applicable).

In the event that DOH RO2 determines that the Program Remote
Monitoring Device is not being used in pursuit of the purposes for which it was
made available, DOH RO2 shall have the absolute prerogative to reclaim and
repossess the Program Remote Monitoring Device from Malaria Personnel
under the Job Order Service, and pre-terminate this agreement after giving ten
(10) days notice.

No modification of this Agreement shall be valid unless in writing and


signed . Any change to the terms of this Agreement shall be made in an
implementation letter signed by the parties to this Agreement.

Should circumstances arise beyond the control of any PARTY that makes
it imposible to proceed with or fulfil its obligations under the Agreement, such
PARTY shall notify the other PARTY in writing within two (2) weeks from the
occurence of the unforeseen circumstances.

The PARTIES shall there upon mutually agree on the actions to be taken
and the date when the unfulfilled obligations be undertaken.

IN WITNESS WHEREOF, the parties herein executed this Agreement and


hereunto set their hands this _____day of 2015, _______________, Philippines.

DEPARTMENT OF HEALTH
Regional Office 2

OWNER: USUFRUCTUARY:

VALERIANO JESUS V. LOPEZ, MD, MPH, MHA, CESO IV ________________

Director IV

WITNESS:

JOSE T. GUMPAL, CPA ENGR. MARISSA S. MANINGAS


Accountant III Senior Health Program Officer

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ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES)


)S.S.

BEFORE ME, a Notary Public for and in the City of


______________________personally, appeared:

Name Government ID Number Date Issued

VALERIANO JESUS V. LOPEZ ________________ ____________

________________________ ________________ ____________

Known to me and to me known to be the same persons who executed the


foregoing instrument and acknowledged to me that the same are their free act and
voluntary deed.

This instrument, consisting of 4 pages, including the page on which this


acknowledgement is written, has been signed on the left margin of each and every page
thereof by the concerned parties and their witnesses, and sealed with my notarial seal.

WITNESS MY HAND AND SEAL on this ____day of 2015 at ____________.

_____________________________
Notary Public

Doc. No. __________


Page No. __________
Book No. __________
Series of __________

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