Department of Agrarian Reform

Pang-agraryong Tulay para sa Bagong Bayanihan ng mga Magsasaka

(PBBM Bridge)

Initial Validation Form

Rationale

The PBBM Bridge Data Gathering Form was developed to gather important data needed for the development of the
PBBM Bridge project proposal and supporting documents that are required by the NEDA Investment Coordination
Committee for the approval of the proposal.

The data gathering form serves as an initial validation for all bridge requests. It has two components, 1) Technical
Survey, and 2) Socio-economic Survey. The data gathering form may be a streamlined version of DAR’s Initial
Validation Form. The data gathered will provide sufficient information to help the FASPO in 1) profiling the condition
of the bridge and its proposed location, 2) generating a priority list of bridges for project proposal development, 3)
developing the Resettlement Action Plan and Budget, and 4) conducting a socio-economic analysis to determine the
impact of a new or replacement bridge as well as its viability for the subsequent approval by the NEDA Investment
Coordination Committee (NEDA ICC).

How to fill-up the Form

1. The Initial Validation form is required for all bridge requests received by the DAR;
2. The Form will be administered by a DAR Officer in coordination with the Municipal LGU;
3. All items should be filled-up with actual data and accurate estimates as required in specific items (e.g. projected
data after the new bridge);
4. The Technical Survey form will be filled-up by an engineer or equivalent. This is to be submitted together with a
copy of a Municipal Road Map showing the proposed site of the bridge linked to the nearest main road and
photographs requested in the form;
5. The Socio-economic Survey will be filled-up by LGU official/technical officer (ie. Municipal Planning and
Development Officer (MPDO); During the Initial validation conducted by the DAR personnel, the role of the LGU to
take on the implementation of the Reseettlement Action Plan will have to be discussed and clarified with the Mayor.
6. For any questions or clarifications, please get in touch with FASPO.

Contact Person:

Submission of the Form

The duly filled-up form will be submitted to the Office of the Undersecretary for Foreign-Assisted and Special Projects
Office either in hard copy or electronic form. For e-copy, please send to a FASPO email, to be supplied later.

Confidentiality Clause

All data provided will be properly managed by the DAR-FASPO and only be used for its intended purpose.
 PANG-AGRARYONG TULAY PARA SA BAGONG BAYANIHAN NG Important reminders in filling-up the form
MGA MAGSASAKA (Instructions below correspond to the items on the left side)
(PBBM BRIDGES)

INITIAL VALIDATION FORM

TECHNICAL SURVEY* Form No.

PROFILE Date filled-up

1 0 1 0 2 0 2 4
1 BRIDGE NAME PANGDAN BRIDGE M M D D Y Y Y Y

2 PROPOSED LENGTH in linear meter Name of Contact Person/Field Validator

ENGR. LUCY D. FRANCISCO
3 REGION VIII
Office / Designation
4 PROVINCE SAMAR ACTING CITY ENGINEER
CEO
5 CONG. DISTRICT II
Contact Number & Email Address
6 CITY / MUNICIPALITY CATBALOGAN CITY 0917-500-1485
[email protected]
7 INCOME CLASS 3RD

8 BARANGAY 1 PANGDAN ENGR. LUCY FRANCISCO

9 BARANGAY 2 Signature over printed name

ACTUAL SITE DATA L = Pre-filled

"A" "W" "B"

NAME OF RIVER/WATERWAY CANTONGTONG RIVER
S
WIDTH OF RIVER (W) 7.00 m DEPTH OF RIVER (W) 22.00 m

COORDINATES @ POINT "A" COORDINATES @ POINT "B" > Fill-up the coordinates using the Geotagging App of DA
N 11°47'16.05"' N 11°47'16.45"' Validator should go to the location of the bridge and take a screenshot with the coordinates
E 124°58'5.22"'' E 124°58'5.57"

ELEVATION @ POINT "A" (MASL) ELEVATION @ POINT "B" (MASL)

75.00 m 75.00 m

SOIL TYPE @ POINT "A" SOIL TYPE @ POINT "B"

Sandy / Clay Rocky Sandy / Clay Rocky
/ Silt / Loamy (Combination) Boulders / Silt / Loamy (Combination) Boulders

FLOOD RISK FLOOD LEVEL FLOOD RISK FLOOD LEVEL

/ YES 10 m / YES 10 m
NO NO

VEGETATION VEGETATION HT. VEGETATION VEGETATION HT.

YES 0 m YES 0 m
/ NO / NO

ROAD WIDTH @ POINT "A" ROAD WIDTH @ POINT "B"

6 . 1 m 6 . 1 m

ROAD CONDITION @ POINT "A" ROAD CONDITION @ POINT "B"

NO ROAD Gravel Surface NO ROAD Gravel Surface
Rough / Paved Rough / Paved

*To be filled-up by the Municipal Engineer or equivalent

Page 2 of Technical Data Form

SITE PHOTOGRAPHS > Attach the screenshot photos taken from this side using the DA Geotagging App

Va
VA

"A" "B"

Photos from VA (Approach) Photos from Va

Vb > Attach the screenshot photos taken from this side using the DA Geotagging App

VB

"A" "B"

Photos from VB (Approach) Photos from Vb

ENVIRONMENT-RELATED DATA Additional Requirements

1 Is this a replacement of existing bridge? Please provide a Location map (with

electronic copy) showing bridge location
(If YES, proceed to next question) YES NO linked to the road networks

2 Is the bridge passable during rainy season?

YES NO

3 Is the project site within or very near a

National Park and/or protected area?
YES NO

4 Is the project site within an indigenous

people's (IP) community?
YES NO

5 Is there any quarrying activity within the area?

YES NO

6 Is the project site accessible to a 40-footer

van /delivery truck? YES NO

Page 3 of Technical Data Form

Page 3 of Technical Data Form
FOR RESETTLEMENT ACTION PLANNING

> Attach the screenshot photos taken from each side using the DA Geotagging App

"Approach A" "Approach B"

Estimated length of 'Approach A' Estimated length of 'Approach B'

(in LM) >3M (In LM) >3M

Are there households currently living within YES NO Are there households currently living within the YES NO
the construction site of Approach A? construction site of Approach A?
(within 5 meters from the center of the road aproach for barangay
(within 5 meters from the center of the road aproach for barangay roads) roads)

Actual number of affected households Actual number of affected households

NONE NONE

Type of land ownership / private owned Type of land ownership private owned
government property / government property

Please provide photograph 'Approach A' construction site Please provide photograph 'Approach B' construction site
USAGE AND TIME OF TRAVEL FROM AREA SERVICED BY THE BRIDGE TO POBLACION/MARKET

Number trips per week Length of Time from Travel Distance from ARC Transportation Cost
using the bridge Bridge to Poblacion (in to the Market/Poblacion or Fare
minutes) (in kilometers) >
TYPE OF VEHICLE

Before new After new Before new After new Before new After new Before new Unit After new >
bridge bridge bridge bridge bridge bridge bridge bridge
per person
Motorcycle 40 60 35 25 13.39 13.39 150.00 per trip 50.00
>
per person
Tricycle 0 10 35 25 13.39 13.39 0.00 per trip 30.00

Handtractors With
Trailers/ trucks/hauling N/A N/A N/A N/A N/A N/A N/A N/A N/A
trucks

Public jeepney/bus/van N/A N/A N/A N/A N/A N/A N/A N/A N/A

gas exp. per

Private cars/jeep/van 5 15 30 15 13.39 13.39 9.00 trip 8.00

Others, please specify per kilo per

(i.e. bangka, animal N/A N/A N/A N/A N/A N/A N/A trip N/A
trasport, etc.)

NUMBER OF PEOPLE CROSSING/USING THE BRIDGE PER WEEK

USERS OF THE BRIDGE Before After Daily Wage Rate
New Bridge New Bridge
SKILLED WORKERS (e.g. professionals, veterinarian, agriculturist, driver, farm 11 20 Php 700.00
machine operators, mason, carpenter, plumber, electrician, etc.)
> % of WOMEN to total SKILLED WORKERS 27.27% 40% Php 700.00
UNSKILLED WORKERS (e.g. landless farm laborers, construction workers) 25 38 Php 400.00
> % of WOMEN to total UNSKILLED WORKERS 25.00% 0.17 Php 400.00
OTHER PEOPLE N/A N/A N/A
> % of WOMEN to total N/A N/A N/A

MAJOR CROPS PLANTED/ECONOMIC ACTIVITIES IN THE INFLUENCE AREAS (covering ARBs)

Area Planted* Yield* % of Total Volume of Transportati

NAME OF MAJOR CROPS Number of per Hectare Production Hauled to the
Cropping (in Hectares) (in kilograms) Market per kilog
(e.g. palay, corn, pinapple, banana, Cycle per
vegetables, etc. year
Before new After new Before new After new Before new After new Before new
bridge bridge bridge bridge bridge bridge bridge
1 Rice 2 41.9 46.3 1.68 M 1.86 M 60 90 2
2 Coconut 4 37.2 41.06 117.84 K 123.192 K 60 90 2
3 Corn 2 4.8 5.66 20.40 K 24.05 K 60 90 2
4 Vegetables 2 2.3 4 34.38 K 59.80 K 60 90 1.00
5 Food Staple 2 20.1 28.6 438 K 623 K 60 90 2
 Republic of the Philippines
Province of Samar
Municipality of Pinabacdao

MUNICIPAL ENGINEERING OFFICE

PROGRAM OF WORK
(For all Types of Project)

NAME OF PROJECT : Appropriation : 0.00

Source of Funds :
INSTALLATION OF BRGY.CATIGAWAN SOLAR STREET LIGHT
Issued Obligated Authority :
LOCATION : Brgy.Catigawan Pinabacdao, Samar Released :
: Cal. Days to Complete : 30 C.D
PROJECT DESCRIPTION : Desirable Starting Date :
Installation of 14 Units Solar Street Light Mode of Implementation : Public Bidding

MINIMUM EQUIPMENT REQUIRED TECHNICAL PERSONNEL REQUIRED

Description No. Description No. Description No.
Foreman 1
Mason 1
Carpenter 1
Electrician 1
Laborer 6

ESTIMATED COST OF PROPOSED WORK

Unit of Direct Cost
Item No. Pay Item/Description % Wt. Measure Quantity Total Cost Unit Cost
130 Structural Excavation #DIV/0! cu.m 1.50 0.00 -
900(2) Structural Concrete #DIV/0! cu.m 3.00 0.00 -
624(8) Installation of Electrical Wirings, LED Streetlights and other accessories #DIV/0! units 10.00 0.00 -
Post
1032(1) Hauling of Materials #DIV/0! L.S 1.00 0.00 -
B.5 Project Billboard/Signboard #DIV/0! Lot 1.00 0.00 -

Total Direct Cost #DIV/0!

TOTAL 0.00
 BREAKDOWN OF ESTIMATED PROJECT COST % OF TOTAL AMOUNT

1. ESTIMATED COST
A. DIRECT COST
A.1. Labor #DIV/0! 0.00
A.2. Equipment Expenses #DIV/0!
A.3. Materials #DIV/0! 0.00

SUB-TOTAL (DIRECT COST) #DIV/0! 0.00

B. INDIRECT COST (Per D.O. # 197, s. 2016)

B.1. Overhead, Cotengency & Mis . #DIV/0! 0.00
(9% OF Max. of D.C)
B.2. Profit (10% of Max. of D.C) #DIV/0! 0.00

C. VAT (5% OF D.C. and I.C. Per D.O. # 197,s, 2016 #DIV/0! 0.00

SUB-TOTAL (CONTRACT COST) #DIV/0! 0.00

1. ESTIMATED GOVERNMENT EXPENDITURES

1. Engineering and Administrative Overhead(3.5%)

2. Detailed Engineering (1%)
3. Reserved for the Payment of RROW
4. Physical Reserved

TOTAL ESTIMATED PROJECT COST #DIV/0! -

Prepared by: Approved by:

ENGR. ZALDY R. PACAYRA HON.ENGR. TEODORICO A. MABAG
Municipal Engineer Municipal Mayor
 DETAILED UNIT PRICE ANALYSIS (DUPA)

Item No./Description : 803(1) STRUCTURAL EXCAVATION

Unit of Measurement : Cu.m
Output per Day : 0.67 cu.m
Quantity : 2.00 cu.m

No. of
Designation No. of DaysDaily Rate Amount
Person
A. Labor

a. Foreman 1 3.00 500.00 1,500.00

b. Laborer 5 3.00 300.00 4,500.00

Sub - Total for A 6,000.00

Name and Capacity No. UnitsNo. of Days
Hourly Rate Amount
B. Equipment

Sub - Total for B 0.00

C. Total (A+B) 6,000.00
D. Output per Day = 0.67 cu.m.
Name and Specification Unit Quantity Unit Cost Amount
E. Materials

Sub - Total for F 0.00

F. Direct Unit Cost (E+F) 6,000.00
G. Overhead, Contingencies & Mis 9% of F per D.O. 197, s. 2016 540.00
H. Contractor's Profit (CP) 10% of F per D.O. 197, s. 2016 600.00
I. Value Added Tax (VAT) 5% of (F+G+H) per D.O. 197, s. 2016357.00
J. Total Unit Cost (F+G.+H+I) 7,497.00
 DETAILED UNIT PRICE ANALYSIS (DUPA)

Item No./Description : 900(2) STRUCTURAL CONCRETE

Unit of Measurement : cu.m.
Output per hour : 1.05 cu.m
Quantity : 4.20 cu.m

No. of
Designation No. of DaysDaily Rate Amount
Person
A. Labor

a. Foreman 1 4.00 500.00 2,000.00

b. Mason 1 4.00 400.00 1,600.00
c. Carpenter 1 4.00 400.00 1,600.00
d. Laborer 3 4.00 300.00 3,600.00

Sub - Total fo A 8,800.00

Name and Capacity No. UnitsNo. of Days
Daily Rate Amount
B. Equipment

Sub - Total for B 0.00

C. Total (A+B) 8,800.00
D. Output per Day = 1.05 cu.m.
Name and Specification Unit Quantity Unit Cost Amount
E. Materials
Portland Cement bags 35.00 310.00 10,850.00
Gravel cu.m 3.00 1,600.00 4,800.00
C. Sand cu.m 2.00 1,300.00 2,600.00
Coco. Form Lumbers Bdft 80.00 20.00 1,600.00
1/4" Ord. Plywood sheets 3.00 380.00 1,140.00
CWN Assorted kgs 6.00 95.00 570.00
10 MM Rsb pcs 12.00 220.00 2,640.00

Sub - Total for F 24,200.00

F. Direct Unit Cost (C+E) 33,000.00
G. Overhead, Contingencies & Mis 9% of F per D.O. 197, s. 2016 2,970.00
H. Contractor's Profit (CP) 10% of F per D.O. 197, s. 2016 3,300.00
I. Value Added Tax (VAT) 5% of (F+G+H) per D.O. 197, s. 20161,963.50
J. Total Unit Cost (F+G+H+I) 41,233.50
 DETAILED UNIT PRICE ANALYSIS (DUPA)

Item No./Description : 624(8) INSTALLATION OF LED STREET LIGHT,

Unit of Measurement : units
Output per Day : 3.50
Quantity : 14.00 units

No. of
Designation No. of DaysDaily Rate Amount
Person
A. Labor

a.Foreman 1 4.00 500.00 2,000.00

b. Electrician 1 4.00 400.00 1,600.00
c. Laborer 3 4.00 300.00 3,600.00

Sub - Total fo A 7,200.00

Name and Capacity No. UnitsNo. of Days
Daily Rate Amount
B. Equipment

Sub - Total for B 0.00

C. Total (A+B) 7,200.00
D. Output per Day = 3.50 units
Name and Specification Unit Quantity Unit Cost Amount
E. Materials
LED Solar Street Light sets 14.00 8,000.00 112,000.0
2" G.I Pipe S1000 pcs. 14.00 2,900.00 40,600.00
Red Oxide Gal. 1.00 680.00 680.00
Paint Brush pcs. 4.00 65.00 260.00
Welding Rod kgs. 5.00 110.00 550.00

Sub - Total for F 154,090.0

F. Direct Unit Cost (C+E) 161,290.0
G. Overhead, Contingencies & Mis 9% of F per D.O. 197, s. 2016 14,516.10
H. Contractor's Profit (CP) 10% of F per D.O. 197, s. 2016 16,129.00
I. Value Added Tax (VAT) 5% of (F+G+H) per D.O. 197, s. 20169,596.76
J. Total Unit Cost (F+G+H+I) ###
 DETAILED UNIT PRICE ANALYSIS (DUPA)

Item No./Description : 1032(1) HAULING OF MATERIALS

Unit of Measurement : L.S
Output per Day :
Quantity : 1.00 L.S

No. of
Designation No. of DaysDaily Rate Amount
Person
A. Labor

Sub - Total fo A 0.00

Name and Capacity No. UnitsNo. of Days
Daily Rate Amount
B. Equipment

Sub - Total for B 0.00

C. Total (A+B) 0.00
D. Output per Day = 0.00 sq.m
Name and Specification Unit Quantity Unit Cost Amount
E. Materials
Portland Cement Bagss 35.00 100.00 3,500.00
Sand Can 78.00 100.00 7,800.00
Gravel Can 156.00 100.00 15,600.00
2" G.I Pipe Pcs. 10.00 100.00 1,000.00
10 mm RSB pcs. 12.00 20.00 240.00

Sub - Total for F 28,140.00

F. Direct Unit Cost (C+E) 28,140.00
G. Overhead, Contingencies & Mis 9% of F per D.O. 197, s. 2016 2,532.60
H. Contractor's Profit (CP) 10% of F per D.O. 197, s. 2016 2,814.00
I. Value Added Tax (VAT) 5% of (F+G+H) per D.O. 197, s. 20161,674.33
J. Total Unit Cost (F+G+H+I) 35,160.93
 DETAILED UNIT PRICE ANALYSIS (DUPA)

Item No./Description : B.5 PROJECT BILLBOARD/ SIGNBOARD

Unit of Measurement : Lot
Output per Day : 1.00 Lot.
Quantity : 1.00 Lot.

No. of
Designation No. of DaysDaily Rate Amount
Person
A. Labor

a. Project Engineer 1 1.00 500.00 500.00

b. Carpenter 1 1.00 400.00 400.00
c. Laborer 1 1.00 300.00 300.00

Sub - Total fo A 1,200.00

Name and Capacity No. UnitsNo. of Days
Daily Rate Amount
B. Equipment

Sub - Total for B 0.00

C. Total (A+B) 1,200.00
D. Output per Day = 1.00 Lot.
Name and Specification Unit Quantity Unit Cost Amount
E. Materials
Tarpaulin pcs. 4 500.00 2,000.00
2x3x12 Coco Lumber pcs. 14.00 95.00 1,330.00
Assoarted Nail kgs. 4.00 92.56 370.24

Sub - Total for F 3,700.24

F. Direct Unit Cost (C+E) 4,900.24
G. Overhead, Contingencies & Mis 9% of F per D.O. 197, s. 2016 441.02
H. Contractor's Profit (CP) 10% of F per D.O. 197, s. 2016 490.02
I. Value Added Tax (VAT) 5% of (F+G+H) per D.O. 197, s. 2016 291.56
J. Total Unit Cost (F+G+H+I) 6,122.85

TOTAL PROJECT COST 221,574.1

Prepared by: Approved by:

HON. ENGR. ZALDY R. PACAYRA HON. ARGIE M. LABRO

Municipal Engineer Punong Baranggay