INDIVIDUAL PERFORMANCE COMMITMENT & REVIEW (IPCR)

I, DONDON T. AMPALO of the Office of the Municipal Treasurer's Office Division of Treasury Operation commit to deliver and agree to be rated on the attainment
of the folllowing targets in accordance with the indicated measures for the period of Jan 1 to June 31, 2018.
DONDON T. AMPALO
Admin. Aide II
Reviewed By: Approved By:
MIGUELA B. ARNOCO MIGUELA B. ARNOCO
Municipal Treasurer Date Municipal Treasurer Date:
SUCCESS INDICATOR RATING
MAJOR FINAL OUTPUT (MFO) ACTUAL ACCOMPLISHMENT REMARKS
(target + measure) Q1 E2 T3 A4
Strategic Priority No.

1. To Prepare Print out of Bus. Application 1. To Prepare Print out of Bus. Application Printed 680 Bus. Application Form 5 5 5 5
Form, Motorized Tricycle & Sicad. Form, Motorized Tricycle & Sicad. Motorized Tricycle & Sicad

750 Application 650 Application

2. To print Real Property Tax Bills for 28brgys. To print Real Property Tax Bills 14 brgys. Printed 1,200 RPT bills 4 4 4 4
Target 2000 Tax Bills Target 1000 Tax Bills

3. Encode Official Receipt 100% official receipt encoded 100% official receipt encoded 3 3 3 3
(Abstract of Collection Monthly) (Abstract of Collection Monthly)

Total Rating:
Final Average Rating: 12.00
Adjectival Rating 4.00
Assessed by: Final Rating by: Date
Date: I CERTIFY, that I discussed my Assessment of performance with the employees.

DONDON T. AMPALO MIGUELA B. ARNOCO, MBA LEONARDO L. BABASA, JR. CPA, MBA
Employee Supervisor Date MUNICIPAL MAYOR
 INDIVIDUAL PERFORMANCE COMMITMENT & REVIEW (IPCR)

I, DONDON T. AMPALO of the Office of the Municipal Treasurer's Office Division of Treasury Operation commit to deliver and agree to be rated on the attainment
of the folllowing targets in accordance with the indicated measures for the period of Jan 1 to July 31, 2019.
DONDON T. AMPALO
Admin. Aide II
Reviewed By: Approved By:
MIGUELA B. ARNOCO MIGUELA B. ARNOCO
Municipal Treasurer Date Municipal Treasurer Date:
SUCCESS INDICATOR RATING
MAJOR FINAL OUTPUT (MFO) ACTUAL ACCOMPLISHMENT REMARKS
(target + measure) Q1 E2 T3 A4
Strategic Priority No.

1. To Prepare Print out of Bus. Application 1. To Prepare Print out of Bus. Application Printed 680 Bus. Application Form 5 5 5 5
Form, Motorized Tricycle & Sicad. Form, Motorized Tricycle & Sicad. Motorized Tricycle & Sicad

750 Application 650 Application 900 Application

2. To Collect Fees & Other charges Collected Fees & Other charges All Collected Fees & Other charges 3 3 3 3
Target Php./ 100,000 Target 50% Php./ 100,000 Actual Php. / 56,658.42

3. Encode Official Receipt 100% official receipt encoded 100% official receipt encoded 3 3 3 3
(Abstract of Collection Monthly) (Abstract of Collection Monthly)

4. To prapare RCD's in all collections and To prapare RCD's in all collections and To prapare RCD's in all collections and 3 3 3 3
remitt allcollection. To liq. Offcr. remitt allcollection. To liq. Offcr. remitt allcollection. To liq. Offcr.
Target-30 RCD's Target-15 RCD's Actual Target-18 RCD's
Total Rating:
Final Average Rating: 14.00
Adjectival Rating 3.50
Assessed by: Final Rating by: Date
Date: I CERTIFY, that I discussed my Assessment of performance with the employees.
DONDON T. AMPALO MIGUELA B. ARNOCO, MBA CELSO A. MATIAS
Employee Supervisor Date MUNICIPAL MAYOR
HUMAN RESOURCE MANAGEMENT SERVICES
INDIVIDUAL PERFORMANCE COMMITMENT & REVIEW (IPCR)
MAJOR FINAL OUTPUT (MFO) SUCCESS INDICATOR OFFICE INDIVIDUAL ACCOUNTABLE ESTIMATED/EXPECTED ACCOMPLISHMENT

1. Established & Updates employees service

records
2. Leave Administration of Personnel
a. Received/computed/dissiminated
applications for leave

3. Review thoroughly and check the completeness

of all requirements papers in connections
with all cases of appointment before
submission to CSC
4. Appointment preparations

5. Prepared/issued :
a. Vouchers with supporting papers
b. Plantilla of Personnel
c. Notice of Salary Adjustment
d. Notice of Step Increment of Personnel
e. Publication of Vacant Position
f. Certificate of Employment
g. Service Records
h. Payrolls
HUMAN RESOURCE MANAGEMENT SERVICES
INDIVIDUAL PERFORMANCE COMMITMENT & REVIEW (IPCR)
MAJOR FINAL OUTPUT (MFO)
1. Leave Application Processed
2. Service Records Issued
3. Certificate of Employment Issued
4. Appointment Preparation -Regular,
Casual & Job Orders
5. Prepared Terminal Leaved Benefits:
Vouchers, Monetization & all other
Documents.
6. Prepared Plantilla of Personnel, Notice
Notice of Salary Adjustments
Notice of Step Increments
Publication of Vacant Positions
7. Prepared Payroll casuals, Job Orders
& Local Paid Teachers
8. Established & Updates employees:
1. Service records
2. Leave Credits Earned
9. Dessiminate Approved Leave Appli-
cations & Orders
SUCCESS INDICATOR OFFICE INDIVIDUAL ACCOUNTABLE ESTIMATED/EXPECTED ACCOMPLISHMENT
Within 5 minutes upon receipt, leave appli- Office Concerned 660 clients/leave application, 100% acted and
cation endorsed to the Approving Officer/ approved.
Municipal Mayor or his duly authorized
Officer.
Within 10 minutes upon receipt, request Personnel Concerned 132 Clients, 100% acted & issued
acted/issued.
Within 10 minutes upon receipt, request Personnel Concerned 150 Clients, 100% acted & issued
with Official Receipt (O.R.)
Within 45 minutes upon receipt of the com- HRMO 100 Appointment, acted, issued & approved ready
pleteness of the supporting papers, appoint- for CSC submission.
ments papers to be sign by the MBO then
to the Municipal Mayor for approval.
Within 15 minutes every papers, upon HRMO TLB, Clearance, Form 6, Leave Credits Certification
receipt of the request. & OVR acted & issued.
15 minutes per plantilla HRMO 22 pcs - ready for signatures
10 minutes per adjustments 130 Noticed issued
10 minutes per Increments 40 Noticed issued
15 minutes 6 Publication
20 minutes per payroll with OVR HRMO 11 Payrolls /month for signature then forwarded to
MBO
First month of the Year & followed by the HRMO 130 personnel acted
Notice of Step Inrements
10 minutes every personnel HRMO 130 Personnel acted
10 minutes by office HRMO Weekly
COMPLISHMENT
 COMPLISHMENT
% acted and

& approved ready

Credits Certification

hen forwarded to
 Republic of the Philippines
Province of Zamboanga del Sur
Municipality of Bayog

PERFORMANCE EVALUATION FORM

For the rating period July 1, 2011 to December 31, 2011.

EMPLOYEE: ELENA A. BELZA OFFICE: OFFICE OF THE MUNICIPAL MAYOR

POSITION: ADMINISTRATIVE OFFICER II UNIT: HUMAN RESOURCE MANAGEMENT SERVICES
PART I PERFPRMANCE (75%)
TARGETS AND ACCOMPLISHMENTS RATING
DUTIES AND RESPONSIBILITIES QUANTITY QUALITY TIME RE- QUAN- QUA-
TIME
Planned Actual Planned Actual Planned Actual MARK TITY LITY
1. Leave application processed. 300 320 95% 100% EO12/11 EO12/11 8 8 8
2. Established & updated employees Service Record Cards. 150 160 95% 100% EO12/11 EO11/11 8 8 8

3. Reviewed thoroughly and check the completeness of all requirement 50 60 95% 100% EO12/11 EO10/11 8 8 8
papers in connections with all cases of appointment before
submission to CSC
4. Appointment preparation of regular, casual & Job Order. 50 60 95% 100% EO12/11 EO10/11 8 8 8

5. Prepared terminal leave vouchers & Monetization & other supporting 3 6 95% 100% EO12/11 EO12/11 8 8 8
documents.
6. Received/computed/dissiminated application for leave of the LGU 300 320 95% 100% EO12/11 EO12/11 8 8 8

7. Prepared Plantilla of Personnel, Notice of Salary Adjustmenst, Notice 30 40 95% 100% EO12/11 EO10/11 8 8 8
of Step Incremenst of LGU Personnel and Publication of vacant
positions.
8. Payroll preparation of Job Order, Casual personnel & Local Paid 60 80 95% 100% EO12/11 EO12/11 8 8 8
teachers.
9. Issued Certificate of employment, service records 35 40 95% 100% EO12/11 EO12/11 8 8 8
& orders.
10. Print forms; Philhealth, Form 6, PDS, AR & others 60 70 90% 100% EO12/11 EO12/11 8 8 8

I agree to achieve these targets for the period of July to December I agree to assist the employee achieve Total 80 + 80 + 80
his/her targets for the said period. Grand Total 240
Average Point Score_ 8
ELENA A. BELZA 1/10/2012 LEONARDO L. BABASA, JR., CPA 1/13/2012 Equivalent Point 6
NAME & SIGNATURE OF EMPLOYEE DATE NAME & SIGNATURE OF RATER DATE Score
PART II (25%) POINT SCORE

A. Courtesy 8
B. Human Relations 10
C. Punctuality & Attendance 10
D. Initiative 8
E. Leadership (For Supervisor only)
F. Stress Tolerance (For Supervisor only)

EMPLOYEE'S COMMENTS REMARKS TOTAL 36

Average Point Score 9
Equivalent Point Score 2.25
OVERALL POINT 6.00 + 2.25
SCORE (Part 1 & 11 EQUIVALENT 8.25
NUMERAL RATING EQUIVALENT 8
RATER'S COMMENTS/REMARKS ADJECTIVAL RATING VS

DISCUSSED RATING WITH:

ELENA A. BELZA January 10, 2012

SIGNATURE OF RATEE Date

LEONARDO L. BABASA, JR, CPA January 13, 2012

SIGNATURE OF RATER Date

LEONARDO L. BABASA, JR., CPA January 13, 2012

SIGNATURE OF RATER SUPERVISOR Date
 Republic of the Philippines
Province of Zamboanga del Sur
Municipality of Bayog

PERFORMANCE EVALUATION REPORT

For the rating period January to June 30, 2012

EMPLOYEE: ELENA A. BELZA OFFICE: OFFICE OF THE MUNICIPAL MAYOR

POSITION: ADMINISTRATIVE OFFICER II UNIT: HUMAN RESOURCE MANAGEMENT SERVICES
PART I PERFPRMANCE (75%)
TARGETS AND ACCOMPLISHMENTS RATING
REMARK
DUTIES AND RESPONSIBILITIES QUANTITY QUALITY TIME S
Planned Actual Planned Actual Planned Actual Quantity QUALITY TIME
1. Leave application processed 300 350 95% 100% EO 6/12 EO 6/12 8 8 8
2. Established & updated employees Service Record Card. 120 150 95% 100% EO 6/12 EO 6/12 8 8 8

3. Review thoroughly and check the completeness of all requirement 50 60 95% 100% EO 6/12 EO 6/12 8 8 8
papers in connections with all cases of appointment before
submission to CSC
4. Appointment preparation of regular, casual & Job Order. 50 60 95% 100% EO 6/12 EO 6/12 8 8 8

5. Prepare terminal leave vouchers & Monetization & other supporting 4 6 95% 100% EO 6/12 EO 6/12 8 8 8
documents.
6. Received/computed/dissiminated application for leave of the LGU 300 350 95% 100% EO 6/12 EO 6/12 8 8 8

7. Prepared Plantilla of Personnel, Notice of Salary Adjustment, Notice 50 60 95% 100% EO 6/12 EO 6/12 8 8 8
of Step Increment of LGU Personnel & Publication of vacant
positions.
8. Payroll preparation of Job Order, Casual personnel & Local Paid 60 78 95% 100% EO 6/12 EO 6/12 8 8 8
Teacher.
teachers.
9. Issue Certificate of employment, service record 30 40 95% 100% EO 6/12 EO 6/12 8 8 8
& orders.
10. Print forms; Philhealth, Form 6, PDS, AR & others 150 200 90% 100% EO 6/12 EO 6/12 8 8 6

I agree to achieve these targets for the period of July to December I agree to assist the employee achieve his/her targets Total 80 + 80 + 78
for the
his/her targets for said.
the said period. Grand 238
Total
Average Point Score 7.93
Equivalent Point Score 5.94
ELENA A. BELZA 7/10/2012 LEONARDO L. BABASA, JR., CPA 7/13/12
NAME & SIGNATURE OF EMPLOYEE Date NAME & SIGNATURE OF RATER DATE
 PART II (25%) POINT SCORE

A. Courtesy 8
B. Human Relations 10
C. Punctuality & Attendance 10
D. Initiative 8
E. Leadership (For Supervisor only)
F. Stress Tolerance (For Supervisor only)

EMPLOYEE'S COMMENTS REMARKS TOTAL 36

Average Point Score 9
Equivalent Point Score 2.25
OVERALL POINT 5.94 + 2.25
SCORE (Part 1 & 11 EQUIVALENT 8.19
NUMERAL RATING EQUIVALENT 8
RATER'S COMMENTS/REMARKS ADJECTIVAL RATING VS

DISCUSSED RATING WITH:

ELENA A. BELZA July 11, 2012

SIGNATURE OF RATEE Date

LEONARDO L. BABASA, JR., CPA July 12, 2012

SIGNATURE OF RATER Date

LEONARDO L. BABASA, JR., CPA July 13, 2012

SIGNATURE OF RATER SUPERVISOR Date

Republic of the Philippines

Province of Zamboanga del Sur
Municipality of Bayog
 PERFORMANCE EVALUATION REPORT
For the rating period January to June 30, 2012

EMPLOYEE: ELENA A. BELZA OFFICE: OFFICE OF THE MUNICIPAL MAYOR

POSITION: ADMINISTRATIVE OFFICER II UNIT: HUMAN RESOURCE MANAGEMENT SERVICES
PART I PERFPRMANCE (75%)
TARGETS AND ACCOMPLISHMENTS RATING
REMARK
DUTIES AND RESPONSIBILITIES QUANTITY QUALITY TIME S
Planned Actual Planned Actual Planned Actual Quantity QUALITY TIME
1. Leave Application Processed 200 95% EO 6/12 8
2. Established & updated employees Service Record Card. 100 95% EO 6/12 8

3. Review thoroughly and check the completeness of all requirement 50 95% EO 6/12 8
papers in connections with all cases of appointment before
submission to CSC
4. Appointment preparation of regular, casual & Job Order. 50 95% EO 6/12 8

5. Prepare terminal leave vouchers & Monetization & other supporting 2 95% EO 6/12 8
documents.
6. Received/computed/dissiminated application for leave of the LGU 200 95% EO 6/12 8

7. Prepared Plantilla of Personnel, Notice of Salary Adjustment, Notice 100 95% EO 6/12 8
of Step Increment of LGU Personnel & Publication of vacant
positions.
8. Payroll preparation of Job Order, Casual personnel & Local Paid 60 95% EO 6/12 8
Teacher.
teachers.
9. Issue Certificate of employment, service record 20 95% EO 6/12 8
& orders.
10. Print forms; Philhealth, Form 6, Form 212, Form 211, SALN, & others 50 90% EO 6/12 8
others.
I agree to achieve these targets for the period of July to December I agree to assist the employee achieve Total
his/her targets for the said period. Grand Total
Average Point Score
Equivalent Point Score
ELENA A. BELZA 1/12/2012 LEONARDO L. BABASA, JR., CPA 1/12/12
NAME & SIGNATURE OF EMPLOYEE DATE NAME & SIGNATURE OF RATER DATE
 Republic of the Philippines
Province of Zamboanga del Sur
Municipality of Bayog

PERFORMANCE EVALUATION REPORT

For the rating period January to June 30, 2012

EMPLOYEE: JOHN LINO N. TINGCANG OFFICE: OFFICE OF THE MUNICIPAL MAYOR

POSITION: ADMINISTRATIVE AIDE 1 UNIT: DEPUTY AREA COORDINATOR/KALAHI-CIDSS
PART I PERFPRMANCE (75%)
TARGETS AND ACCOMPLISHMENTS RATING
REMARK
DUTIES AND RESPONSIBILITIES QUANTITY QUALITY TIME S
Planned Actual Planned Actual Planned Actual Quantity QUALITY TIME
1. Conduct Procurement training 1 2 95% 150% EO 6/12 EO 6/12 8 8 8

2.Resource person for the pre-procurement conference 20 26 95% 98% EO 6/12 EO 6/12 8 9 8

3.Contractors Conference 20 28 95% 105% EO 6/12 EO 6/12 8 9 8

4. Bidding/ Opening of Canvass 20 32 95% 120% EO 6/12 EO 6/12 9 9 8

5.Supervised project implementation 20 28 95% 105% EO 6/12 EO 6/12 9 9 8

6.Prepared Progress Accomplishment Report 100 200 95% 150% EO 6/12 EO 6/12 9 8 8

7.Procurement Tracking Benchmark 4 6 95% 113% EO 6/12 EO 6/12 9 8 8

8.Prepared Joint Inspection Report 40 60 95% 113% EO 6/12 EO 6/12 9 9 8

I agree to achieve these targets for the period of July to December I agree to assist the employee achieve Total
his/her targets for the said period. Grand Total 202
Average Point Score 8.4
Equivalent Point Score 6.3
JOHN LINO N. TING 1/12/2012 LEONARDO L. BABASA, JR., CPA 1/12/12
NAME & SIGNATURE OF EMPLOYEE DATE NAME & SIGNATURE OF RATER DATE
 PART II (25%) POINT SCORE

A. Courtesy 8
B. Human Relations 9
C. Punctuality & Attendance 8
D. Initiative 9
E. Leadership (For Supervisor only)
F. Stress Tolerance (For Supervisor only)

EMPLOYEE'S COMMENTS REMARKS TOTAL 34

Average Point Score 8.5
Equivalent Point Score 2.13
OVERALL POINT 6.3+2.13
SCORE (Part 1 & 11 EQUIVALENT 8.43
NUMERAL RATING EQUIVALENT 8.43
RATER'S COMMENTS/REMARKS ADJECTIVAL RATING VS

DISCUSSED RATING WITH:

JOHN LINO N. TINGCANG July 11, 2011

SIGNATURE OF RATEE Date

LEONARDO L. BABASA, JR., CPA July 12, 2011

SIGNATURE OF RATER Date

LEONARDO L. BABASA, JR., CPA July 13, 2011

SIGNATURE OF RATER SUPERVISOR Date
 Republic of the Philippines
Province of Zamboanga del Sur
Municipality of Bayog

PERFORMANCE EVALUATION REPORT

For the rating period June 30 to December 31, 2012

EMPLOYEE: JOHN LINO N. TINGCANG OFFICE: OFFICE OF THE MUNICIPAL MAYOR

POSITION: ADMINISTRATIVE AIDE 1 UNIT: DEPUTY AREA COORDINATOR/KALAHI-CIDSS
PART I PERFPRMANCE (75%)
TARGETS AND ACCOMPLISHMENTS RATING
REMARK
DUTIES AND RESPONSIBILITIES QUANTITY QUALITY TIME S
Planned Actual Planned Actual Planned Actual Quantity QUALITY TIME
1.Prepared Program of Works 22 28 95% 95% EO 6/12 EO 6/12 8 8 8

2.Conduct Site Validation 28 36 95% 96% EO 6/12 EO 6/12 8 9 8

3. Conduct Kalahi-Cidss Trainings and Workshop 10 24 95% 180% EO 6/12 EO 6/12 8 9 8

4. Conduct Risk Assessment for the proposed Sub-Project 28 40 95% 107% EO 6/12 EO 6/12 9 9 8

I agree to achieve these targets for the period of July to December I agree to assist the employee achieve Total
his/her targets for the said period. Grand Total 100
Average Point Score 8.33
Equivalent Point Score 6.25
JOHN LINO N. TING 1/12/2012 LEONARDO L. BABASA, JR., CPA 1/12/12
NAME & SIGNATURE OF EMPLOYEE DATE NAME & SIGNATURE OF RATER DATE
 PART II (25%) POINT SCORE

A. Courtesy 8
B. Human Relations 9
C. Punctuality & Attendance 8
D. Initiative 8
E. Leadership (For Supervisor only)
F. Stress Tolerance (For Supervisor only)

EMPLOYEE'S COMMENTS REMARKS TOTAL 33

Average Point Score 8.25
Equivalent Point Score 2.06
OVERALL POINT 6.25+2.06
SCORE (Part 1 & 11 EQUIVALENT 8.31
NUMERAL RATING EQUIVALENT 8.31
RATER'S COMMENTS/REMARKS ADJECTIVAL RATING VS

DISCUSSED RATING WITH:

JOHN LINO N. TINGCANG January 12,2012

SIGNATURE OF RATEE Date

LEONARDO L. BABASA, JR., CPA January 12,2012

SIGNATURE OF RATER Date

LEONARDO L. BABASA, JR., CPA January 12,2012

SIGNATURE OF RATER SUPERVISOR Date
RVICES
RVICES
PERSONAL BACKGROUND:

NAME: ELENA I. ALCAZARIN - BELZA

POSITION ADMINISTRATIVE OFFICER II (HRMO)

EDUCATION: BEED Graduate

ELIGIBILITY: CS-Sub Professional

CS- Professional

EXPERIENCE: May 16, 1985 to Nov. 10, 1986 - Casual

Nov. 11, 1986 to July 1, 1990 - Personnel Aide
July 2, 1990 to Nov. 3, 1991 - Community Affairs Asst. I
Nov. 4, 1991 February 28, 2001 - Market Inspector II
March 1, 2001 to Dec. 31, 2005 - HRMO I
Jan. 1, 2006 to date - Administrative Officer II (HRMO)

TRAINING: March 16-17, 1999 - CSC Local Furon on Personnel Administration

Dec. 4 - 7, 1992 - CSC Seminar Workshop on Work Improvement Scheme for
Effectiveness (WISE)
March 27 - 28, 1993 - Seminar Workshop on Public Ethics and value and
peformance educ. System.
May 9 - 13, 1984 - Training on Appointment Preparation
April 15 - 16, 1999 - Local forum on Personnel Administration
July 26-27, 2001 - Seminar on Personnel Records Administrtation Management
March 1, 2005 - Training on Pre-Accreditation orientation seminar for
Liaison Officer
July 25 - 26, 2006 Public Service Excellence seminar Workshop
Dec. 9 - 10, 2009 - Harmonization Workshop Towards Synergy: Integrating
DILG Intervention for LGU's
Feb. 22 - 23, 2007 - Compentency Based Trainings

SKILLS: Playing volley ball

Computer literate

PDF: Human Resourse Management Services

1 Leave Administration of personnel

2 Established & updated employees service record card
3 Review thoroughly and check the completeness of all requirement papers
in connections with all cases of appointment before submission to CSC.
4 Appointment preparation of regular, casual & Job Order.
5 Prepared terminal leave vouchers, monetization & other supporting documents.
6 Received/computed/dissiminated application for leave of LGU
7 Prepared Plantilla of Personnel, Notice of Salary Adjustment, Notice of Step
Increment of Personnel & Publication of vacant positions.
8 Payroll perparation of Job Order personnel & local paid teacher.
9 Issue Certificate of employment, service record & orders.
10 Print forms; Philhealth, Form 6, Accomplishment report & others
11 Do other works as maybe directed.
 Human Resourse Management Services

1 Leave Administration of personnel

2 Established & updated employees service record card

3 Review thoroughly and check the completeness of all requirement papers

in connections with all cases of appointment before submission to CSC.

4 Appointment preparation of regular, casual & Job Order.

5 Prepared terminal leave vouchers & other supporting documents.

6 Received/computed/dissiminated application for leave of LGU

7 Prepared Plantilla of Personnel, Notice of Salary Adjustment, Notice of Step

Increment of Personnel & Publication of vacant positions.

8 Payroll perparation of Job Order personnel & local paid teacher.

9 Issue Certificate of employment, service record & orders.

10 Attend quarterly conferences, trainings of CSC.

11 Perform other duties as maybe directed by competent authorities.

Management

documents.