Biomed Engineer: PATRICK BRIAN S.

BELEN
Territory: QUEZON CITY
Date: March 18, 2019
Week: 2

Follow Up Completion Supporting Service

Date Time In Time Out Location Task Results Next Actions Contact Person Date Date Documents SR # DR # SI # Amount

11-Mar-19 8:37 17:41RBGM Training Echo Training KS

12-Mar-19 8:31 17:36 Chinese General Preventive Maintenance of Force All measured parameters Service Report 6705
Hospital FX are in range. Safe and
ready for patient use.

13-Mar-19 8:30 11:00 St. Luke's Medical Inspection of Force Fx Functioning and working Service Report
Center- Global City properly
6706
11:42 17:33 Maklati Medical Preventive Maintenance of FT10 All measured parameters Service Report
Center are in range. Safe and
ready for patient use.

6706
14-Mar-19 8:22 17:38RBGM Biomed On-Duty
15-Mar-19 8:20 8:50RBGM Biomed On-Duty
9:12 17:46 East Avenue Repair Ventillators Defective Q2 Flow Sensor Request for spare 6988,6989
Medical Center and Safety Valve parts

Prepared by: PATRICK BRIAN S. BELEN Reviewed by: Noted by:

 BIOMED: PATRICK BRIAN S. BELEN
MONTH: MARCH

Date Day AM/PM Hospital/Location Purpose Equipment

18 MON AM/PM RBGM Training KS scopes

Inspect Force Fx(CGH) and apply for

Chinese General Supplier's ID(JRMMC)
Hospital and Jose
Reyes Memorial
19 Tue AM/PM Medical Center

20 Wed AM/PM RBGM STAND BY FOR ON CALL SERVICE

21 Thu AM/PM RBGM STAND BY FOR ON CALL SERVICE

22 Fri AM/PM RBGM STAND BY FOR ON CALL SERVICE

Prepared By:
PATRICK BRIAN S. BELEN
 q EXPENSE REPORT q CA LIQUIDATION
NAME: PATRICK BRIAN S. BELEN PERIOD COVERED: Mar11-Mar15, 2019 DATE: March 18, 2019

AREA: QUEZON CITY CAR PLATE No.

RBGM01 RBGM02 RBGM03 RBGM04 RBGM05 RBGM06 RBGM07 RBGM08 RBGM09 RBGM10 RBGM11 RBGM12: OTHERS

FUEL & OIL

(Refer to ER-B ENTERTAINMEN
T/ MEETINGS / COURIER (LBC /
DATE LOCATION HOUSING & TRAVEL & TRANSPORTATION PARKING & for Odometer REPRESENTATIO REPAIRS & COMMUNICATI OFFICE CONFERENCES TOTAL AMOUNT (per day)
MEALS LODGING (Refer to ER-A for Details) TOLL Details - Out- MAINTENANCE ONS SUPPLIES (Refer to ER-C CARGO DETAILS AMOUNT
N (Refer to ER-C CHARGES)
based Travels for Details) for Details)
Only)

RBGM - -

11-Mar

-
Chinese General 100.00 200.00
12-Mar
Hospital
300.00
St. Luke's Medical 100.00 200.00

Center- Global City/

13-Mar Makati Medeical
Center
300.00
14-Mar RBGM - -
-
East Avenue Medical 100.00 100.00
13-Mar
Center
200.00
16-Mar
Load For March 300.00 300.00
TOTAL AMOUNT (per Account Code)
300.00 - 500.00 - - - - - - - - 300.00 1,100.00
NOTES: SUM MARY OF ACCO UNT
DISTRIBUTION ACCOUNT CODE AMOUNT
(A) Approving officials are accountable for compliance to company policies on
travel and entertainment and company cars when when approving E.R.s CASH ADVANCE RBGM01: Meals 300.00

(B) Please report within seven (7) days from arrival date / date expense is (ER/CA #: ____________________) RBGM02: Housing & Lodging -
incurred and attached supporting documents
LESS: Total Expenses 1,100.00 RBGM03: Travel & Transportation 500.00

GUIDELINES: RBGM04: Parking & Toll -

1. Meals should be for business travel only. If more than one employee dined, DUE COMPANY RBGM05: Fuel & Oil -
indicate companions on the receipt. Highest ranked employee should pay.
(EMPLOYEE) RBGM06: Entertainment / Representation -

2. Non-lodging expenses (e.g. meals etc.) on hotel bills should be classified RBGM07: Repairs & Maintenance -
separately in the appropriate expense columns.
RBGM08: Communications -

3. For meetings and conferences, highest-ranked employee should pay and RBGM09: Office Supplies -
reimburse except if he is an invited guest.
RBGM10: Meetings / Conferences -

RBGM11: Courier (LBC / Cargo Charges) -

RBGM12: Others 300.00

EMPLOYEE SIGNATURE: APPROVED BY:
TOTAL EXPENSES PhP 1,100.00
Signature over Printed Name / Date
 q EXPENSE REPORT q CA LIQUIDATION
NAME: Roger Caldito PERIOD COVERED: 8-Jan-19

ER-A: TRAVEL & TRANSPORTATION DETAIL

LOCATION
DATE MODE OF TRANSPORTATION
FROM TO
7-Feb-2019 House SM North Edsa Bus Bay UV
SM North Edsa Bus Bay Cabanatuan Bus terminal BUS
Wesleyan University Philippines
Cabanatuan Bus terminal Hosiptal TRICYCLE
Wesleyan University Philippines
Hosiptal Cabanatuan Bus terminal TRICYCLE
Cabanatuan Bus terminal SM North Edsa Bus Bay BUS
SM North Edsa Bus Bay House UV

8-Feb-2019 RBGM The Medical City-Ortigas Grab

The Medical City-Ortigas Legarda BUS
Legarda House JEEPNEY
EMPLOYEE SIGNATURE: APPROVED BY:

Signature over Printed Name / Date

CA LIQUIDATION
8-Jan-19

REMARKS AMOUNT

30.00
202.00

60.00

60.00
202.00
30.00
TOTAL 584.00

226.00
30.00
15.00
TOTAL 271.00
TOTAL AMOUNT:

PhP 855.00
 q EXPENSE REPORT q CA LIQUIDATION
NAME: PERIOD COVERED:
AREA: CAR PLATE No.

ER-B: ODOMETER DETAIL (OUT-BASED TRAVELS ONLY)

LOCATION
DATE MODE OF TRANSPORTATION REMARKS
FROM TO
EMPLOYEE SIGNATURE: APPROVED BY:

Signature over Printed Name / Date

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2
3
4
5
6
7
8
9

10

11

12
13
14
15
16
17
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19
20
 q EXPENSE REPORT q CA LIQUIDATION
NAME: PERIOD COVERED:

ER-C: ENTERTAINMENT / REPRESENTATION DETAIL

DATE GUEST NAME (s) NAME OF ESTABLISHMENT BUSINESS PURPOSE

ER-C: MEETINGS / CONFERENCES DETAIL

DATE PARTICIPANT (s) NAME OF ESTABLISHMENT MEETING PURPOSE
EMPLOYEE SIGNATURE: APPROVED BY: TOTAL AMOUNT:

PhP
Signature over Printed Name / Date
CA LIQUIDATION

AMOUNT
1
2
3
4
5
6
7
8
9
10

AMOUNT
1
2
3
4
5
6
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8
9
10

-
 BUSINESS CASH ADVANCE REQUEST

REQUEST TYPE: c Revolving Fund PAYMENT c Cash

*attach necessary c Travel Request MODE: c Check
documents (i.e.,
quotation, etc.) c Representation Payee:
c Sponsorship c For Pick-up
c Product Demonstration Fund Name:
c Supplies Purchase c For Deposit
c Maintenance (Co. Vehicle, Equipment, Supplies) Bank:
c Others ____________________________ Account #:
Acct. Name:
AMOUNT:
Hospital/Customer: DATE NEEDED:

JUSTIFICATION: SUPERVISORY
* include ROI, NOTES:
Projects, Details of
Expenses, etc.

ACCOUNTING Date Released:

NOTES: Voucher #:
Liquidation Date:

REQUESTED BY: NOTED BY: APPROVED BY:

________________________________ __________________________________________ ____________________________

Signature over Printed Name / DATE Signature over Printed Name / DATE Signature over Printed Name

BUSINESS CASH ADVANCE REQUEST

REQUEST TYPE: c Revolving Fund PAYMENT c Cash

*attach necessary c Travel Request MODE: c Check
documents (i.e.,
quotation, etc.) c Representation Payee:
c Sponsorship c For Pick-up
c Product Demonstration Fund Name:
c Supplies Purchase c For Deposit
c Maintenance (Co. Vehicle, Equipment, Supplies) Bank:
c Others ____________________________ Account #:
Acct. Name:
AMOUNT:
Hospital/Customer: DATE NEEDED:

JUSTIFICATION: SUPERVISORY
* include ROI, NOTES:
Projects, Details of
Expenses, etc.
Projects, Details of
Expenses, etc.

ACCOUNTING Date Released:

NOTES: Voucher #:
Liquidation Date:

REQUESTED BY: NOTED BY: APPROVED BY:

________________________________ __________________________________________ ____________________________

Signature over Printed Name / DATE Signature over Printed Name / DATE Signature over Printed Name
________________________________
Signature over Printed Name / DATE
________________________________
Signature over Printed Name / DATE