REPORT OF CHECKS ISSUED

Period Covered: MAY 1- 31, 2018

Entity Name : ZAMBOANGA DEL NORTE NHS

Fund Cluster : 101 Report No.: 2018-05
Bank Name/Account No. : 2-00020-815-7 (PS) Sheet No. : 01

Check DV/Payroll Responsibility UACS Object

No.
ORS/BURS No. Center Code Payee Code Nature of Payment Amount
Date Serial No.
5/3/2018 10521924 2018-05-175 100-2018-05-136 ORIENT CABLE & TELECOMMUNICATIONS, INC. 5020504000 cablle subscription 500.00
5/3/2018 10521925 2018-05-176 100-2018-05-137 SUREACT SECURITY & INVESTIGATION CO., INC. 5021203000 security services 30,375.00
5/3/2018 10521926 2018-05-177 100-2018-05-138 POWERTEK GAS STATION 5020309000 fuel and oil 11,248.24
5/3/2018 10521927 2018-05-178 100-2018-05-139 VANNIX COMPUTER CENTER & ENTERPRISES 1040502000 computer equipments 30,285.71
10521928 CANCELLED
5/16/2018 10521929 2018-05-194 RURAL BANK OF KATIPUNAN 2999999000 loan remittance 546,341.50
5/16/2018 10521930 2018-05-195 FIRST VALLEY BANK 2999999000 loan remittance 99,827.43
5/16/2018 10521931 2018-05-196 CEBU CFI 2999999000 loan remittance 411,082.22
5/16/2018 10521932 2018-05-197 UCPB 2999999000 loan remittance 38,116.08
5/16/2018 10521933 2018-05-198 FIRST CONSOLIDATED BANK 2999999000 loan remittance 5,651.47
5/16/2018 10521934 2018-05-200 UNISTAR CREDIT & FINANCE CORPORATION 2999999000 loan remittance 12,980.01
5/16/2018 10521935 2018-05-201 BUREAU OF TREASURY 2999999000 service charge remittance 11,252.52
5/16/2018 10521936 2018-05-202 100-2018-05-155 BETTER LIVING APPLIANCE CENTER 5020321000 aircon unit for clinic 12,028.16
5/16/2018 10521937 2018-05-203 100-2018-05-156 MA. FATIMA Y. ACOSTA 5021304000 reimbursement of supplies 2,175.00
5/16/2018 10521938 2018-05-204 100-2018-05-157 PETRONILO G. LACAYA JR. 5020399000 reimbursement of materials for repair 3,220.00
5/16/2018 10521939 2018-05-205 100-2018-05-158 ROSARIO SHARON S. ORTEGA 5020399000 reimbursement of supplies 1,314.73
5/16/2018 10521940 2018-05-206 100-2018-05-159 VIRGINIA E. TAGAB 5020399000 reimbursement of supplies 1,303.50
5/16/2018 10521941 2018-05-207 100-2018-05-160 VICENTE S. GALLEMIT JR. 5020399000 reimbursement of expenses 1,500.00
5/29/2018 10521942 2018-05-212 100-2018-05-165 HOME DEVELOPMENT MUTUAL FUND 2020103000 PAG-IBIG remittance 346,232.27
5/29/2018 10521943 2018-05-213 100-2018-05-166 HOME DEVELOPMENT MUTUAL FUND 2020103000 PAG-IBIG remittance 1,240.80
5/29/2018 10521944 2018-05-216 100-2018-05-169 THEA COMPUTER SALES, SERVICES & ENTERPRISES 5021305000 labor for biometric software repair 26,250.00
1,216,398.07
C E R T I F I CAT I O N
I hereby certify on my official oath that this Report of Checks Issued in One (1) sheet(s) is a full, true and correct
statement of all checks issued by me during the period stated above for which Check Nos. 10521924 to 10521944 to inclusive,
were actually issued by me in payment for obligations shown in the attached disbursement vouchers/payroll

JOSEPHINE S. ADRAINCEM
Name and Signature of Disbursing Officer/Cashier
Cashier May 1-31, 2018
 Official Designation Date

REPORT OF CHECKS ISSUED

Period Covered: MAY 1- 31, 2018

Entity Name : ZAMBOANGA DEL NORTE NHS

Fund Cluster : 101 Report No.: 2018-05
Bank Name/Account No. : 2-00020-815-7 (PS) Sheet No. : 02

Check DV/Payroll Responsibility UACS Object

No.
ORS/BURS No. Center Code Payee Code Nature of Payment Amount
Date Serial No.
TOTAL FORWARDED 1,216,398.07
5/16/2018 10521940 2018-05-206 100-2018-05-159 VIRGINIA E. TAGAB 5020399000 reimbursement of supplies 1,303.50
5/16/2018 10521941 2018-05-207 100-2018-05-160 VICENTE S. GALLEMIT JR. 5020399000 reimbursement of expenses 1,500.00
5/29/2018 10521942 2018-05-212 100-2018-05-165 HOME DEVELOPMENT MUTUAL FUND 2020103000 PAG-IBIG remittance 346,232.27
5/29/2018 10521943 2018-05-213 100-2018-05-166 HOME DEVELOPMENT MUTUAL FUND 2020103000 PAG-IBIG remittance 1,240.80
5/29/2018 10521944 2018-05-216 100-2018-05-169 THEA COMPUTER SALES, SERVICES & ENTERPRISES 5021305000 labor for biometric software repair 26,250.00

1,592,924.64
yhc
I hereby certify on my official oath that this Report of Checks Issued in Two (2) sheet(s) is a full, true and correct
statement of all checks issued by me during the period stated above for which Check Nos. 10521924 to 10521944 to inclusive,
were actually issued by me in payment for obligations shown in the attached disbursement vouchers/payroll
JOSEPHINE S. ADRAINCEM
Name and Signature of Disbursing Officer/Cashier
Cashier May 1-31, 2018
Official Designation Date
 REPORT OF CHECKS ISSUED
Period Covered: SEPTEMBER 1- 30, 2017

Entity Name : ZAMBOANGA DEL NORTE NHS

Fund Cluster : 101 Report No. 2017-09
Bank Name/Account No. : 2-00031-815-9 (MOOE) Sheet No. 1

Check DV/Payroll ORS/BURS Responsibility UACS Object

Payee Nature of Payment
Date Serial No. No. No. Center Code Code

09/04/17 10291695 2017-09-202 172-2017-09-172 30205003 SUREACT SECURITY AND INVESTIGATION 5021203000 Security Services
09/04/17 2017 09 13 2017-09-203 173-2017-09-173 30205003 PRISCILLA T. ANOTADO 5020101000 Traveling Expenses - Local
09/04/17 2017 09 13 2017-09-204 174-2017-09-174 30205003 RESIN O. LACLAC 5020101000 Traveling Expenses - Local
09/04/17 2017 09 13 2017-09-205 175-2017-09-175 30205003 JEOANN V. ABIAN 5020101000 Traveling Expenses - Local
09/04/17 2017 09 13 2017-09-206 176-2017-09-176 30205003 JONAH D. PABALAY 5020101000 Traveling Expenses - Local
09/04/17 2017 09 13 2017-09-207 177-2017-09-177 30205003 JONALD L. NOLI 5020101000 Traveling Expenses - Local
09/04/17 10291696 2017-09-208 200-2017-09-178 30205003 EDGARDO S CABALIDA 1990104000 Advances to Officers and Employees
09/04/17 2017 09 14 2017-09-209 200-2017-09-179 30205003 ZNHHS 5021202000 Janitorial Services
09/04/17 10291697 2017-09-210 200-2017-09-180 30205003 COPYLANDIA 1040401000 Office Supplies Inventory
09/04/17 10291698 2017-09-211 200-2017-09-181 30205003 POWERTEK GAS STATIION 5020309000 Fuel, Oil and Lubricants Expenses
09/04/17 10291699 2017-09-212 200-2017-09-182 30205003 GLORIPER MARKETING CENTER 1040499000 Other Supplies and Materials Inventory
09/04/17 2017 09 15 2017-09-213 200-2017-09-183 30205003 ACORIN NEWSTAND 5029907000 Subscription Expenses
09/04/17 102916700 2017-09-214 200-2017-09-184 30205003 JOSEPHINE S. ADRAINCEM 5030104000 Bank charges
09/11/17 2017 09 16 2017-09-215 200-2017-09-185 30205003 JOSE ERIC S. YANGCO 1990104000 Advances to Officers and Employees
09/11/17 2017 09 16 2017-09-216 200-2017-09-186 30205003 JOSEPHINE S. ADRAINCEM 1990104000 Advances to Officers and Employees
09/11/17 2017 09 16 2017-09-217 200-2017-09-187 30205003 JO ANNE A. ABAD 1990104000 Advances to Officers and Employees
09/14/17 10368001 2017-09-218 200-2017-09-188 30205003 ROSARIO G. GONZALES 1990104000 Advances to Officers and Employees
09/14/17 10368002 2017-09-219 200-2017-09-189 30205003 MARIA DORIS R. BITON 1990104000 Advances to Officers and Employees
09/14/17 10368003 2017-09-220 200-2017-09-190 30205003 JUNE RITCHAR M. ABULON 1990104000 Advances to Officers and Employees
09/14/17 10368004 2017-09-221 200-2017-09-191 30205003 JOSE ERIC S. YANGCO 1990104000 Advances to Officers and Employees
TOTAL
C E R T I FI CAT I O N
I hereby certify on my official oath that this Report of Checks Issued in __1__ sheet(s) is a full, true and correct
statement of all checks issued by me during the period stated above for which Check Nos. _10291695 to _10368004_ inclusive,
were actually issued by me in payment for obligations shown in the attached disbursement vouchers/payroll.
 JOSEPHINE S. ADRAINCEM
Name and Signature of Disbursing Officer/Cashier
Cashier SEPT 1- 30, 2017
Official Designation Date
 REPORT OF CHECKS ISSUED
Period Covered: SEPTEMBER 1- 30, 2017

Entity Name : ZAMBOANGA DEL NORTE NHS

Fund Cluster : 101 Report No. 2017-09
Bank Name/Account No. : 2-00031-815-9 (MOOE) Sheet No. 2

Check DV/Payroll ORS/BURS Responsibility UACS Object

Payee Nature of Payment
Date Serial No. No. No. Center Code Code
TOTAL FORWARDED
09/14/17 10368005 2017-09-222 200-2017-09-192 30205003 EDGARDO S. CABALIDA 5020399000 Other Supplies and Materials Expenses
09/15/17 10368010 2017-09-223 200-2017-09-193 30205003 JO ANNE A. ABAD 1990104000 Advances to Officers and Employees
09/25/17 10368023 2017-09-224 200-2017-09-194 30205003 CRUZTELCO 5020502000 Telephone Expenses
09/25/17 10368024 2017-09-224 200-2017-09-194 30205003 CRUZTELCO 5020502000 Telephone Expenses
09/25/17 10368012 2017-09-225 200-2017-09-195 30205003 ORIENT CABLE & TELECOMMUNICATIONS,5020504000 Cable, Satellite, Telegraph and Radio Expenses
09/25/17 10368013 2017-09-226 200-2017-09-196 30205003 JOSEPHINE S. ADRAINCEM 5020101000 Traveling Expenses - Local
09/25/17 10368014 2017-09-227 200-2017-09-197 30205003 JOSE ERIC S. YANGCO 5020101000 Traveling Expenses - Local
09/25/17 10368015 2017-09-228 200-2017-09-198 30205003 JO ANNE A. ABAD 5020301000 Office Supplies Expenses
09/25/17 10368016 2017-09-229 200-2017-09-199 30205003 DIPOLOG CITY WATER DISTRICT 5020401000 Water Expenses
09/25/17 10368022 2017-09-230 200-2017-09-200 30205003 ZANECO 5020402000 Electricity Expenses
09/25/17 10368018 2017-09-231 200-2017-09-201 30205003 MERLINA T. TOMALES 5020101000 Traveling Expenses - Local
09/25/17 10368019 2017-09-232 200-2017-09-202 30205003 ROEL V. CARPIO 5020201000 Traveling Expenses - Local
09/25/17 10368020 2017-09-233 200-2017-09-203 30205003 SUSAN S. ALCAZAR 5020101000 Traveling Expenses - Local
09/25/17 10368025 2017-09-231 200-2017-09-201 30205003 JACLINE MEG F. SON 5020301000 Office Supplies Expenses

TOTAL
C E R T I FI CAT I O N
I hereby certify on my official oath that this Report of Checks Issued in __2__ sheet(s) is a full, true and correct
statement of all checks issued by me during the period stated above for which Check Nos. _10368005_ to _10368025 inclusive,
were actually issued by me in payment for obligations shown in the attached disbursement vouchers/payroll.
 JOSEPHINE S. ADRAINCEM
Name and Signature of Disbursing Officer/Cashier
Cashier SEPT 1- 30, 2017
Official Designation Date
 Amount
30,375.00
9,233.50
12,960.00
12,940.00
12,940.00
12,940.00
14,734.00
50,723.41 1
30,866.82
10,643.31
20,111.61
2,207.08
750.00
1,070.00
1,070.00
1,140.00
4,820.00
9,640.00
4,820.00
2,560.00
246,544.73

ursement vouchers/payroll.
 Amount
246,544.73
450.00
4,800.00
3,665.64
1,727.50
500.00
400.00
400.00
271.85
39,471.46
35,374.36
3,770.00
3,770.00
3,770.00
766.54

345,682.08 2

ursement vouchers/payroll.
 REPORT OF CHECKS ISSUED
Period Covered: OCTOBER 1- 30, 2017

Entity Name : ZAMBOANGA DEL NORTE NHS

Fund Cluster : 101 Report No.: 2017-10
Bank Name/Account No. : 2-00031-815-9 (MOOE) Sheet No. : 01

Check DV/Payroll Responsibilit

UACS Object
No.
ORS/BURS No. y Center Payee Code Nature of Payment
Date Serial No. Code
04-Oct-17 10368026 2017-10-235 200-2017-10-205 30205003 SUREACT SECURITY AND INVEESTIGATIO5021203000 Security Services
04-Oct-17 2017-10-18 2017-10-236 200-2017-10-206 30205003 ZNNHS 5021202000 Janitorial Services
09-Oct-17 10368028 2017-10-237 200-2017-10-207 30205003 MARISTEL A. BAOY 5029902000 Printing and Publication Expenses
05-Oct-17 10368027 2017-10-238 200-2017-10-208 30205003 JOSE ERIC S. YANGCO 5020101000 Traveling Expenses - Local
30205003 5020309000 Fuel, Oil and Lubricants Expenses
30205003 5021306000 Repairs and Maintenance - Transpor
09-Oct-17 10368029 2017-10-239 200-2017-10-209 30205003 PLDT INC. 5020503000 Internet Subscription Expenses
11-Oct-17 10368030 2017-10-240 200-2017-10-210 30205003 NONOY COYA AUTO SERVICE CENTER 5021306000 Repairs and Maintenance - Transpor
11-Oct-17 10368031 2017-10-241 200-2017-10-211 30205003 ROSEL P. PATANGAN 5021305000 Repairs and Maintenance - Machine
11-Oct-17 2017-10-19 2017-10-242 200-2017-10-212 30205003 MA. FATIMA Y. ACOSTA 5020101000 Traveling Expenses - Local
11-Oct-17 2017-10-19 2017-10-243 200-2017-10-213 30205003 GAIL JOSEPHINE P. BUSTILLO 5020101000 Traveling Expenses - Local
11-Oct-17 2017-10-19 2017-10-244 200-2017-10-214 30205003 GREATYL JEAN C. WAPELLE 5020101000 Traveling Expenses - Local
11-Oct-17 2017-10-19 2017-10-245 200-2017-10-215 30205003 ARNOLD G. RUBIATO 5020101000 Traveling Expenses - Local
11-Oct-17 2017-10-19 2017-10-246 200-2017-10-216 30205003 JANICE J. MANGINSAY 5020101000 Traveling Expenses - Local
11-Oct-17 2017-10-19 2017-10-247 200-2017-10-217 JOMAR M. OMISOL 5020101000 Traveling Expenses - Local
11-Oct-17 10368032 2017-10-248 200-2017-10-218 30205003 CRUZTELCO 5020502000 Telephone Expenses
11-Oct-17 10368033 2017-10-249 200-2017-10-219 30205003 ORIENT CABLE & TELECOMMUNICATIONS 5020504000 Cable, Satellite, Telegraph and Radi

C E R T I F I CAT I O N
I hereby certify on my official oath that this Report of Checks Issued in Three (3) sheet(s) is a full, true and correct
statement of all checks issued by me during the period stated above for which Check Nos. 10368033 to LDDAP 2017-10-24 to inclusive,
were actually issued by me in payment for obligations shown in the attached disburse

JOSEPHINE S. ADRAINCEM
 OCT 1- 31, 2017
Cashier OCT 1- 31, 2017
Official Designation Date

REPORT OF CHECKS ISSUED

Period Covered: OCTOBER 1- 30, 2017

Entity Name : ZAMBOANGA DEL NORTE NHS

Fund Cluster : 101 Report No.: 2017-11
Bank Name/Account No. : 2-00031-815-9 (MOOE) Sheet No. : 02

Check DV/Payroll Responsibilit

UACS Object
No.
ORS/BURS No. y Center Payee Code Nature of Payment
Date Serial No. Code
TOTAL FORWARDED
11-Oct-17 10368034 2017-10-250 200-2017-10-220 30205003 JACLINE MEG F. SON 5020399000 Other Supplies and Materials Expenses
11-Oct-17 10368035 2017-10-251 200-2017-10-221 30205003 VERONICA E. TUASTUMBAN 5020201000 Training Expenses
12-Oct-17 10368036 2017-10-252 200-2017-10-222 30205003 BUREAU OF TREASURY 5021502000 Fidelity Bond Premiums
12-Oct-17 10368037 2017-10-253 200-2017-10-223 30205003 MA. FATIMA Y. ACOSTA 5029904000 Transportation and Delivery Expenses
12-Oct-17 2017-10-20 2017-10-254 200-2017-10-224 30205003 RANELL I. MAGALLANES 5020201000 Training Expenses
12-Oct-17 2017-10-20 2017-10-255 200-2017-10-225 30205003 CECILIO P. SIANO 5020201000 Training Expenses
12-Oct-17 2017-10-20 2017-10-256 200-2017-10-226 30205003 LEO TAMAN 5020201000 Training Expenses
12-Oct-17 2017-10-20 2017-10-257 200-2017-10-227 30205003 ENRIQUE L. VILLANUEVA 5020201000 Training Expenses
12-Oct-17 2017-10-20 2017-10-258 200-2017-10-228 30205003 MA. KRISTINA S. AJERO 5020201000 Training Expenses
12-Oct-17 2017-10-20 2017-10-259 200-2017-10-229 30205003 JONAH D. PABALAY 5020201000 Training Expenses
12-Oct-17 2017-10-21 2017-10-260 200-2017-10-230 30205003 SARAH MAE B. DANDA 5020101000 Traveling Expenses - Local
12-Oct-17 2017-10-21 2017-10-261 200-2017-10-231 30205003 EDITHA M. ACABAL 5020101000 Traveling Expenses - Local
12-Oct-17 2017-10-21 2017-10-262 200-2017-10-232 30205003 MA. ELSA S. CABASAN 5020101000 Traveling Expenses - Local
18-Oct-17 10368038 2017-10-263 200-2017-10-233 30205003 JACLINE MEG F. SON 1990104000 Advances to Officers and Employees
18-Oct-17 10368039 2017-10-264 200-2017-10-234 30205003 JO ANNE A. ABAD 1990104000 Advances to Officers and Employees

C E R T I F I CAT I O N
 I hereby certify on my official oath that this Report of Checks Issued in Three (3) sheet(s) is a full, true and correct
statement of all checks issued by me during the period stated above for which Check Nos. 10368039 to LDDAP 2017-10-26 to inclusive,
were actually issued by me in payment for obligations shown in the attached disburse
JOSEPHINE S. ADRAINCEM
OCT 1- 31, 2017
Cashier OCT 1- 31, 2017
Official Designation Date

REPORT OF CHECKS ISSUED

Period Covered: OCTOBER 1- 30, 2017

Entity Name : ZAMBOANGA DEL NORTE NHS

Fund Cluster : 101 Report No.: 2017-11
Bank Name/Account No. : 2-00031-815-9 (MOOE) Sheet No. : 03

Check DV/Payroll Responsibilit

UACS Object
No.
ORS/BURS No. y Center Payee Code Nature of Payment
Date Serial No. Code
TOTAL FORWARDED
18-Oct-17 10368040 2017-10-265 200-2017-10-235 JOSEPHINE S. ADRAINCEM 1990104000 Advances to Officers and Employees
18-Oct-17 10368041 2017-10-266 200-2017-10-236 JOSE ERIC S. YANGCO 1990104000 Advances to Officers and Employees
20-Oct-17 10368042 2017-10-267 200-2017-10-237 JOSEPHINE S. ADRAINCEM 1990101000 Advances for Operating Expenses
20-Oct-17 10368043 2017-10-268 200-2017-10-238 NEW CLS FOOD PLAZA 5020201000 Training Expenses
27-Oct-17 10368044 2017-10-269 200-2017-10-239 EDGARDO S. CABALIDA 5020101000 Traveling Expenses - Local
27-Oct-17 10368045 2017-10-270 200-2017-10-240 DBP-DIPOLOG BRANCH 1040402000 Accountable Forms, Plates and Stick
30-Oct-17 2017-10-22 2017-10-271 200-2017-10-241 VIRGINIA E. TAGAB 5020101000 Traveling Expenses - Local
30-Oct-17 2017-10-22 2017-10-272 200-2017-10-242 ZNNHS 5020101000 Traveling Expenses - Local
30-Oct-17 10368046 2017-10-273 200-2017-10-243 ZANECO 5020402000 Electricity Expenses
 C E R T I F I CAT I O N
I hereby certify on my official oath that this Report of Checks Issued in Three (3) sheet(s) is a full, true and correct
statement of all checks issued by me during the period stated above for which Check Nos. 10368046 to LDDAP 2017-10-27 to inclusive,
were actually issued by me in payment for obligations shown in the attached disburse
JOSEPHINE S. ADRAINCEM
OCT 1- 31, 2017
Cashier OCT 1- 31, 2017
Official Designation Date
 Amount
30,375.00
45,402.73
2,600.00
3,440.00
965.21
240.00
7,976.57
11,225.00
3,000.00
3,440.00
3,440.00
3,440.00
3,440.00
3,440.00
3,440.00
5,557.61
500.00
131,922.12

s) is a full, true and correct

33 to LDDAP 2017-10-24 to inclusive,
payment for obligations shown in the attached disbursement vou
Amount
131,922.12
221.16
1,200.00
22,500.00
21,000.00
500.00
500.00
500.00
500.00
500.00
500.00
2,020.00
2,020.00
2,020.00
1,895.00
1,965.00
189,763.28
s) is a full, true and correct
39 to LDDAP 2017-10-26 to inclusive,
payment for obligations shown in the attached disbursement vou

Amount
189,763.28
1,040.00
1,040.00
33,000.00
37,125.00
150.00
760.00
1,200.00
8,540.00
71,157.37
 343,775.65

s) is a full, true and correct

46 to LDDAP 2017-10-27 to inclusive,
payment for obligations shown in the attached disbursement vou
 REPORT OF CHECKS ISSUED
Period Covered: NOVEMBER 1- 30, 2017

Entity Name : ZAMBOANGA DEL NORTE NHS

Fund Cluster : 101 Report No.: 2017-11
Bank Name/Account No. : 2-00031-815-9 (MOOE) Sheet No. : 01

Check DV/Payroll Responsibility UACS Object

No.
ORS/BURS No. Center Code Payee Code Nature of Payment
Date Serial No.
06-Nov-17 2017-11-23 2017-11-274 200-2017-11-244 30205003 EDGARDO S. CABALIDA 1990104000 Advances to Officers and Employees
06-Nov-17 10368047 2017-11-275 200-2017-11-245 30205003 GERRY A. OZARAGA 1990104000 Advances to Officers and Employees
06-Nov-17 10368048 2017-11-276 200-2017-11-246 30205003 RUEL C. JEBONE 1990104000 Advances to Officers and Employees
06-Nov-17 2017-11-23 2017-11-277 200-2017-11-247 30205003 JO ANNE A. ABAD 5020101000 Traveling Expenses - Local
06-Nov-17 10368049 2017-11-278 200-2017-11-248 30205003 JOSE ERIC S. YANGCO 5020101000 Traveling Expenses - Local
06-Nov-17 2017-11-23 2017-11-279 200-2017-11-249 30205003 GLIROD JANE T. TINDUGAN 5020101000 Traveling Expenses - Local
06-Nov-17 10368050 2017-11-280 200-2017-11-250 30205003 5021203000
SUREACT SECURITY AND INVESTIGATION Security Services
06-Nov-17 2017-11-24 2017-11-281 200-2017-11-251 30205003 ZNNHS 5020101000 Traveling Expenses - Local
10-Nov-17 2017-11-24 2017-11-282 200-2017-11-252 30205003 ZNNHS 5021202000 Janitorial Services
10-Nov-17 2017-11-24 2017-11-283 200-2017-11-253 30205003 ZANECO 5020402000 Electricity Expenses
10-Nov-17 2017-11-24 2017-11-284 200-2017-11-254 30205003 ACORIN NEWSTAND 5029907000 Subscription Expenses
10-Nov-17 2017-11-25 2017-11-285 200-2017-11-255 30205003 ISRAELI M. CUIZON 5020101000 Traveling Expenses - Local
10-Nov-17 2017-11-25 2017-11-286 200-2017-11-256 30205003 MA. FATIMA Y. ACOSTA 5020101000 Traveling Expenses - Local
14-Nov-17 2017-11-26 2017-11-287 200-2017-11-257 30205003 ZNNHS 1990104000 Advances to Officers and Employees
5020101000 Traveling Expenses - Local
19-Nov-17 2017-11-27 2017-11-288 200-2017-11-258 30205003 ZNNHS 5020101000 Traveling Expenses - Local
27-Nov-17 2017-11-27 2017-11-289 200-2017-11-259 30205003 JESSE P. SAMANIEGO 5020101000 Traveling Expenses - Local

C E R T I F I CAT I O N
I hereby certify on my official oath that this Report of Checks Issued in Two (2) sheet(s) is a full, true and correct
statement of all checks issued by me during the period stated above for which Check Nos. 10368050 to LDDAP 2017-11-27 to inclusive,
were actually issued by me in payment for obligations shown in the attached disburse

JOSEPHINE S. ADRAINCEM
 NOV 1- 31, 2017
Cashier NOV 1- 31, 2017
Official Designation Date

REPORT OF CHECKS ISSUED

Period Covered: NOVEMBER 1- 30, 2017

Entity Name : ZAMBOANGA DEL NORTE NHS

Fund Cluster : 101 Report No.: 2017-11
Bank Name/Account No. : 2-00031-815-9 (MOOE) Sheet No. : 02

Check DV/Payroll Responsibility UACS Object

No.
ORS/BURS No. Center Code Payee Code Nature of Payment
Date Serial No.
TOTAL FORWARDED
16-Nov-17 2017-11-27 2017-11-290 200-2017-11-260 30205003 JOSEPHINE S. ADRAINCEM 5021306000 Repairs and Maintenance - Transportation Equip
19-Nov-17 2017-11-27 2017-11-291 200-2017-11-261 30205003 ACORIN NEWSTAND 5029907000 Subscription Expenses
19-Nov-17 2017-11-27 2017-11-292 200-2017-11-262 30205003 ELSA S. CABASAN 5020101000 Traveling Expenses - Local
27-Nov-17 2017-11-27 2017-11-293 200-2017-11-263 30205003 JONAH D. PABALAY 5020101000 Traveling Expenses - Local

C E R T I F I CAT I O N
 I hereby certify on my official oath that this Report of Checks Issued in Two (2) sheet(s) is a full, true and correct
statement of all checks issued by me during the period stated above for which Check Nos. LDDAP 2017-11-27 to inclusive,
were actually issued by me in payment for obligations shown in the attached disburse
JOSEPHINE S. ADRAINCEM
Name and Signature of Disbursing Officer/Cashier
Cashier NOV 1- 31, 2017
Official Designation Date
 Amount
2,640.00
2,640.00
2,640.00
1,240.00
2,240.00
2,640.00
30,375.00
3,355.00
26,430.25
164,942.76
2,398.25
7,680.00
26,537.00
43,840.00
15,691.70
3,200.00
2,410.00
340,899.96

a full, true and correct

to LDDAP 2017-11-27 to inclusive,
ent for obligations shown in the attached disbursement vouche
Amount
340,899.96
520.00
975.00
1,040.00
789.39

344,224.35
 a full, true and correct
DAP 2017-11-27 to inclusive,
ent for obligations shown in the attached disbursement vouche
 REPORT OF CHECKS ISSUED
Period Covered: OCTOBER 1- 30, 2017

Entity Name : ZAMBOANGA DEL NORTE NHS

Fund Cluster : 101 Report No. 2017-10
Bank Name/Account No. : 2-00031-815-9 (MOOE) Sheet No. 1

Check DV/Payroll ORS/BURS Responsibility UACS Object

Payee Nature of Payment
Date Serial No. No. No. Center Code Code

09/04/17 10291695 2017-09-202 172-2017-09-172 30205003 SUREACT SECURITY AND INVESTIGATION 5021203000 Security Services
09/04/17 2017 09 13 2017-09-203 173-2017-09-173 30205003 PRISCILLA T. ANOTADO 5020101000 Traveling Expenses - Local
09/04/17 2017 09 13 2017-09-204 174-2017-09-174 30205003 RESIN O. LACLAC 5020101000 Traveling Expenses - Local
09/04/17 2017 09 13 2017-09-205 175-2017-09-175 30205003 JEOANN V. ABIAN 5020101000 Traveling Expenses - Local
09/04/17 2017 09 13 2017-09-206 176-2017-09-176 30205003 JONAH D. PABALAY 5020101000 Traveling Expenses - Local
09/04/17 2017 09 13 2017-09-207 177-2017-09-177 30205003 JONALD L. NOLI 5020101000 Traveling Expenses - Local
09/04/17 10291696 2017-09-208 200-2017-09-178 30205003 EDGARDO S CABALIDA 1990104000 Advances to Officers and Employees
09/04/17 2017 09 14 2017-09-209 200-2017-09-179 30205003 ZNHHS 5021202000 Janitorial Services
09/04/17 10291697 2017-09-210 200-2017-09-180 30205003 COPYLANDIA 1040401000 Office Supplies Inventory
09/04/17 10291698 2017-09-211 200-2017-09-181 30205003 POWERTEK GAS STATIION 5020309000 Fuel, Oil and Lubricants Expenses
09/04/17 10291699 2017-09-212 200-2017-09-182 30205003 GLORIPER MARKETING CENTER 1040499000 Other Supplies and Materials Inventory
09/04/17 2017 09 15 2017-09-213 200-2017-09-183 30205003 ACORIN NEWSTAND 5029907000 Subscription Expenses
09/04/17 102916700 2017-09-214 200-2017-09-184 30205003 JOSEPHINE S. ADRAINCEM 5030104000 Bank charges
09/11/17 2017 09 16 2017-09-215 200-2017-09-185 30205003 JOSE ERIC S. YANGCO 1990104000 Advances to Officers and Employees
09/11/17 2017 09 16 2017-09-216 200-2017-09-186 30205003 JOSEPHINE S. ADRAINCEM 1990104000 Advances to Officers and Employees
09/11/17 2017 09 16 2017-09-217 200-2017-09-187 30205003 JO ANNE A. ABAD 1990104000 Advances to Officers and Employees
09/14/17 10368001 2017-09-218 200-2017-09-188 30205003 ROSARIO G. GONZALES 1990104000 Advances to Officers and Employees
09/14/17 10368002 2017-09-219 200-2017-09-189 30205003 MARIA DORIS R. BITON 1990104000 Advances to Officers and Employees
09/14/17 10368003 2017-09-220 200-2017-09-190 30205003 JUNE RITCHAR M. ABULON 1990104000 Advances to Officers and Employees
09/14/17 10368004 2017-09-221 200-2017-09-191 30205003 JOSE ERIC S. YANGCO 1990104000 Advances to Officers and Employees
TOTAL
C E R T I FI CAT I O N
I hereby certify on my official oath that this Report of Checks Issued in __1__ sheet(s) is a full, true and correct
statement of all checks issued by me during the period stated above for which Check Nos. _10291695 to _10368004_ inclusive,
were actually issued by me in payment for obligations shown in the attached disbursement vouchers/payroll.
 JOSEPHINE S. ADRAINCEM
Name and Signature of Disbursing Officer/Cashier
Cashier SEPT 1- 30, 2017
Official Designation Date
 REPORT OF CHECKS ISSUED
Period Covered: OCTOBER 1- 30, 2017

Entity Name : ZAMBOANGA DEL NORTE NHS

Fund Cluster : 101 Report No. 2017-10
Bank Name/Account No. : 2-00031-815-9 (MOOE) Sheet No. 2

Check DV/Payroll ORS/BURS Responsibility UACS Object

Payee Nature of Payment
Date Serial No. No. No. Center Code Code
TOTAL FORWARDED
09/14/17 10368005 2017-09-222 200-2017-09-192 30205003 EDGARDO S. CABALIDA 5020399000 Other Supplies and Materials Expenses
09/15/17 10368010 2017-09-223 200-2017-09-193 30205003 JO ANNE A. ABAD 1990104000 Advances to Officers and Employees
09/25/17 10368023 2017-09-224 200-2017-09-194 30205003 CRUZTELCO 5020502000 Telephone Expenses
09/25/17 10368024 2017-09-224 200-2017-09-194 30205003 CRUZTELCO 5020502000 Telephone Expenses
09/25/17 10368012 2017-09-225 200-2017-09-195 30205003 ORIENT CABLE & TELECOMMUNICATIONS,5020504000 Cable, Satellite, Telegraph and Radio Expenses
09/25/17 10368013 2017-09-226 200-2017-09-196 30205003 JOSEPHINE S. ADRAINCEM 5020101000 Traveling Expenses - Local
09/25/17 10368014 2017-09-227 200-2017-09-197 30205003 JOSE ERIC S. YANGCO 5020101000 Traveling Expenses - Local
09/25/17 10368015 2017-09-228 200-2017-09-198 30205003 JO ANNE A. ABAD 5020301000 Office Supplies Expenses
09/25/17 10368016 2017-09-229 200-2017-09-199 30205003 DIPOLOG CITY WATER DISTRICT 5020401000 Water Expenses
09/25/17 10368022 2017-09-230 200-2017-09-200 30205003 ZANECO 5020402000 Electricity Expenses
09/25/17 10368018 2017-09-231 200-2017-09-201 30205003 MERLINA T. TOMALES 5020101000 Traveling Expenses - Local
09/25/17 10368019 2017-09-232 200-2017-09-202 30205003 ROEL V. CARPIO 5020201000 Traveling Expenses - Local
09/25/17 10368020 2017-09-233 200-2017-09-203 30205003 SUSAN S. ALCAZAR 5020101000 Traveling Expenses - Local
09/25/17 10368025 2017-09-231 200-2017-09-201 30205003 JACLINE MEG F. SON 5020301000 Office Supplies Expenses

TOTAL
C E R T I FI CAT I O N
I hereby certify on my official oath that this Report of Checks Issued in __2__ sheet(s) is a full, true and correct
statement of all checks issued by me during the period stated above for which Check Nos. _10368005_ to _10368025 inclusive,
were actually issued by me in payment for obligations shown in the attached disbursement vouchers/payroll.
 JOSEPHINE S. ADRAINCEM
Name and Signature of Disbursing Officer/Cashier
Cashier SEPT 1- 30, 2017
Official Designation Date
 Amount
30,375.00
9,233.50
12,960.00
12,940.00
12,940.00
12,940.00
14,734.00
50,723.41 1
30,866.82
10,643.31
20,111.61
2,207.08
750.00
1,070.00
1,070.00
1,140.00
4,820.00
9,640.00
4,820.00
2,560.00
246,544.73

ursement vouchers/payroll.
 Amount
246,544.73
450.00
4,800.00
3,665.64
1,727.50
500.00
400.00
400.00
271.85
39,471.46
35,374.36
3,770.00
3,770.00
3,770.00
766.54

345,682.08 2

ursement vouchers/payroll.
 REPORT OF CHECKS ISSUED
Period Covered: OCTOBER 1- 31, 2017

Entity Name : ZAMBOANGA DEL NORTE NHS

Fund Cluster : 101 Report No.: 2017-10
Bank Name/Account No. : 2-00020-815-7 (PS) Sheet No. : 01

Check DV/Payroll ORS/BURS Responsibility Center UACS Object

No. No. Code Payee Code Nature of Payment
Date Serial No.
10/12/2017 2017-10-50 2017-10-259 100-2017-10-163 ZNNHS 5010101000 Salaries and Wages - Regular
10/18/2017 10367970 2017-10-260 100-2017-10-164 JOSE ERIC S. YANGCO 5010102000 Salaries and Wages - Casual/Contractual
10/18/2017 10367971 2017-10-261 KATIPUNAN BANK 2999999000 Other Payables
10/18/2017 10367972 2017-10-262 1ST VALLEY BANK 2999999000 Other Payables
10/18/2017 10367973 2017-10-263 CEBU CFI 2999999000 Other Payables
10/18/2017 10367974 2017-10-264 UCPB 2999999000 Other Payables
10/18/2017 10367975 2017-10-265 UNISTAR 2999999000 Other Payables
10/18/2017 10367976 2017-10-266 FIRST CONSOLIDATED BANK 2999999000 Other Payables
10/18/2017 10367977 2017-10-267 ZNNHSTEA 2999999000 Other Payables
10/18/2017 2017-10-51 2017-10-268 DEP ED 2999999000 Other Payables
10/18/2017 10367978 2017-10-269 BUREAU OF TREASURY 2999999000 Other Payables
10/18/2017 2017-10-51 2017-10-270 100-2017-10-165 PHILIPPINE HEALTH INSURANCE INC. 5010303000 PhilHealth Contributions
10/18/2017 10367979 2017-10-271 100-2017-10-166 HOME DEVELOPMENT MUTUAL FUND 5010302000 Pag-IBIG Contributions
10/18/2017 2017-10-51 2017-10-272 100-2017-10-167 GSIS 2020102000 Due to GSIS
10/18/2017 10367980 2017-10-273 100-2017-10-168 GINA C. BANGCAL 2999999000 Other Payables
10/27/2017 10367981 2017-10-274 100-2017-10-169 MARIVIC P.TOME 5010102000 Salaries and Wages - Casual/Contractual

C E R T I F I CAT I O N
I hereby certify on my official oath that this Report of Checks Issued in Two (2) sheet(s) is a full, true and correct
statement of all checks issued by me during the period stated above for which Check Nos. 10367970 to 81 & LDDAP 2017-10-50 to 51 to inclusive,
were actually issued by me in payment for obligations shown in the attached disburse

JOSEPHINE S. ADRAINCEM
Name and Signature of Disbursing Officer/Cashier
Cashier OCT 1- 31, 2017
 Official Designation Date

REPORT OF CHECKS ISSUED

Period Covered: OCTOBER 1- 31, 2017

Entity Name : ZAMBOANGA DEL NORTE NHS

Fund Cluster : 101 Report No.: 2017-10
Bank Name/Account No. : 2-00020-815-7 (PS) Sheet No. : 02

Check DV/Payroll ORS/BURS Responsibility Center UACS Object

No. No. Code Payee Code Nature of Payment
Date Serial No.
TOTAL FORWARDED
10/27/2017 10367982 2017-10-275 100-2017-10-170 MIRALUNA F. LAGORRA 5010102000 Salaries and Wages - Casual/Contractual
10/27/2017 10367983 2017-10-276 100-2017-10-171 JILLEAN N. OCAY 5010102000 Salaries and Wages - Casual/Contractual
10/30/2017 10367984 2017-10-2277 100-2017-10-172 JHONNA P. BAS 5010102000 Salaries and Wages - Casual/Contractual
10/30/2017 10367985 2017-10-278 100-2017-10-173 HDMF 2020103000 Due to Pag-IBIG
10/30/2017 2017-10-52 2017-10-279 100-2017-10-174 GSIS 2020102000 Due to GSIS
10/30/2017 2017-10-52 2017-10-280 100-2017-10-175 PHILIPPINE HEALTH INSURANCE CORP. 5010303000 PhilHealth Contributions
10/30/2017 10367986 2017-10-281 100-2017-10-176 REYNALDO A. MACOL 5010102000Salaries and Wages - Casual/Contractual
10/30/2017 10367987 2017-10-282 100-2017-10-177 RANULFO L. MAHOMAS 5010102000Salaries and Wages - Casual/Contractual

C E R T I F I CAT I O N
I hereby certify on my official oath that this Report of Checks Issued in One (1) sheet(s) is a full, true and correct
statement of all checks issued by me during the period stated above for which Check Nos. 10367982 to 87 & LDDAP 2017-10-52 to inclusive,
were actually issued by me in payment for obligations shown in the attached disburse
JOSEPHINE S. ADRAINCEM
Name and Signature of Disbursing Officer/Cashier
Cashier OCT 1- 31, 2017
Official Designation Date
 Amount
1,633,903.55
10,710.26
554,590.19
82,988.69
393,617.76
40,509.29 1
13,475.01
6,590.84
7,650.00
87,854.58
11,027.99
103,825.00
330,619.58
1,496,568.10
866.68
22,602.73
4,797,400.25

is a full, true and correct

81 & LDDAP 2017-10-50 to 51 to inclusive,
payment for obligations shown in the attached disbursement vou
 Amount
4,797,400.25
12,775.45
17,902.50
10,770.59
1,198.48
12,809.83
900.00
10,770.59
10,770.59

4,875,298.28

is a full, true and correct

 o 87 & LDDAP 2017-10-52 to inclusive,
payment for obligations shown in the attached disbursement vou
 REPORT OF CHECKS ISSUED
Period Covered: NOVEMBER 1- 31, 2017

Entity Name : ZAMBOANGA DEL NORTE NHS

Fund Cluster : 101 Report No.: 2017-11
Bank Name/Account No. : 2-00020-815-7 (PS) Sheet No. : 01

Check DV/Payroll ORS/BURS Responsibility Center UACS Object

No. No. Code Payee Code Nature of Payment
Date Serial No.
11/6/2017 2017-11-53 2017-11-283 100-2017-11-178 ZNNHS 5010215000 Cash Gift
11/6/2017 2017-11-54 2017-11-284 100-2017-11-179 ZNNHS 5010101000 Salaries and Wages - Regular
11/12/2017 2017-11-55 2017-11-285 100-2017-11-180 MYRA ANN . ALFORQUE 5010101000 Salaries and Wages - Regular
11/12/2017 2017-11-55 2017-11-286 100-2017-11-181 MARIA DORIS P. WALLIN 5010101000 Salaries and Wages - Regular
11/12/2017 2017-11-55 2017-11-287 100-2017-11-182 GERALDINE V. ALIT 5010101000 Salaries and Wages - Regular
11/12/2017 2017-11-55 2017-11-288 100-2017-11-183 ZNNHS 5010214000 Year End Bonus
11/13/2017 10367988 2017-11-289 100-2017-11-184 CARLO JOSE G. JANOLINO 5010214000 Year End Bonus
11/13/2017 2017-11-55 2017-11-290 100-2017-11-185 ANN FRANCE K. BUHISAN 5010101000 Salaries and Wages - Regular
11/13/2017 10367989 2017-11-291 100-2017-11-186 MARIA EMMA J. ROCAMORA 5010211000 Hazard Pay (HP)
11/13/2017 2017-11-56 2017-11-292 100-2017-11-187 GSIS 2020102000 Due to GSIS
11/13/2017 2017-11-56 2017-11-293 100-2017-11-188 PHILIPPINE HEALTH INSURANCE INC. 5010303000 PhilHealth Contributions
11/13/2017 2017-11-56 2017-11-294 DEP ED DIPOLOG 2999999000 Other Payables
11/13/2017 10367990 2017-11-295 100-2017-11-189 HDMF 2020103000 Due to Pag-IBIG
11/13/2017 10367991 2017-11-296 ZNNHSTEA 2999999000 Other Payables
11/13/2017 10367992 2017-11-297 RURAL BANK OF KATIPUNAN ZN 2999999000 Other Payables
11/13/2017 10367993 2017-11-298 CEBU CFI 2999999000 Other Payables

C E R T I F I CAT I O N
I hereby certify on my official oath that this Report of Checks Issued in Two (2) sheet(s) is a full, true and correct
statement of all checks issued by me during the period stated above for which Check Nos. 10367988 to 93 & LDDAP 2017-10-53 to 56 to inclusive,
were actually issued by me in payment for obligations shown in the attached disburse

JOSEPHINE S. ADRAINCEM
Name and Signature of Disbursing Officer/Cashier
Cashier NOV 1- 30, 2017
 Official Designation Date

REPORT OF CHECKS ISSUED

Period Covered: NOVEMBER 1- 31, 2017

Entity Name : ZAMBOANGA DEL NORTE NHS

Fund Cluster : 101 Report No.: 2017-11
Bank Name/Account No. : 2-00020-815-7 (PS) Sheet No. : 02

Check DV/Payroll ORS/BURS Responsibility Center UACS Object

No. No. Code Payee Code Nature of Payment
Date Serial No.
TOTAL FORWARDED
13-Nov-17 10367994 2017-11-299 1ST VALLEY BANK 2999999000 Other Payables
13-Nov-17 10367995 2017-11-300 UCPB 2999999000 Other Payables
13-Nov-17 10367996 2017-11-301 FIRST CONSOLIDATED BANK 2999999000 Other Payables
13-Nov-17 10367997 2017-11-302 UNISTAR CREDIT & FINANCING CORP. 2999999000 Other Payables
13-Nov-17 10367998 2017-11-303 BUREAU OF TREASURY 2999999000 Other Payables
19-Nov-17 2017-11-57 2017-11-304 100-2017-11-190 ZNNHS 5010102000 Salaries and Wages - Casual/Contractua
28-Nov-17 2017-11-58 2017-11-305 100-2017-11-191 HELEN M. OGOC 5010101000 Salaries and Wages - Regular
28-Nov-17 10367999 2017-11-306 100-2017-11-192 HDMF 2020103000 Due to Pag-IBIG
28-Nov-17 2017-11-59 2017-11-307 100-2017-11-193 GSIS 2020102000 Due to GSIS
28-Nov-17 2017-11-59 2017-11-308 100-2017-11-194 PHILIPPINE HEALTH INSURANCE INC. 2020104000 Due to PhilHealth

C E R T I F I CAT I O N
I hereby certify on my official oath that this Report of Checks Issued in Two (2) sheet(s) is a full, true and correct
statement of all checks issued by me during the period stated above for which Check Nos. 10367994 to 99 & LDDAP 2017-10-57 to 59 to inclusive,
were actually issued by me in payment for obligations shown in the attached disburse
JOSEPHINE S. ADRAINCEM
Name and Signature of Disbursing Officer/Cashier
Cashier NOV 1- 30, 2017
Official Designation Date
 Amount
5,289,574.77
1,710,234.11
9,691.74
3,747.51
6,110.65
19,481.00
65,652.22
6,110.65
16,157.00
1,532,296.40
105,025.00
83,588.46
336,564.22
5,790.00
504,485.66
391,465.23
10,085,974.62

s) is a full, true and correct

93 & LDDAP 2017-10-53 to 56 to inclusive,
n payment for obligations shown in the attached disbursement v
 Amount
10,085,974.62
84,717.05
41,002.23
5,334.84
13,475.01
10,509.89
43,022.02
51,184.63
3,118.25
28,161.20
2,975.00

10,369,474.74

s) is a full, true and correct

 99 & LDDAP 2017-10-57 to 59 to inclusive,
n payment for obligations shown in the attached disbursement v