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Republic of the Philippines cp
Department of Agriculture ii
Philippine Center for Postharvest Development and Mechanization p
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Science City of Muñoz, Nueva Ecija, Philippines in
www.philmech.gov.ph
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CHECKLIST OF DOCUMENTARY REQUIREMENTS s
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Name of Organization: CERVANTES BAN-AO IRRIGATORS ASSOCIATION, INC ss
Address: BRGY. BANTOCALING MANGATAREM, PANGASINAN it
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DOCUMENTS Complied Remarks n
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Minimum Requirements for Farmer Organization c
1. Letter of Intent eP
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2. Board from the farmer organization stating the need for the farm machineries and P
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postharvest facilities and willingness to provide shed for the project as counterpart. h
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3. Certificate of Accreditation from the DA iM
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4. Valid CDA certificate/SEC registration/DOLE registration M
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5. Financial statement duly audited or Income Tax Returns for the past 2 years. eh
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6. Farmer Association/Cooperative Profiles h
i. List of farmer members with corresponding rice farm area.
Table ( )
ii. Machineries present and other information related to the coop’s operation.
Table ( )
7. Have at least 50 ha rice farm of regular members.
i.total rice area of members: 200.52 ha
ii. no. of members: 174
8. Have a minimum rice area of 300ha within the peripheral barangays from the
proposed location of the agricultural machineries and postharvest facilities.
Rice Area of nearby barangays
Name of Barangay: Parian Total Area: 125.0 ha
Name of Barangay: Bantay Total Area: 150.0 ha
Name of Barangay: Muelang Total Area: 130.0 ha
9. Presence of personnel for the following:
Manager : Name: LORENZO S. MORENO : CP Number 09635162935
Bookkeeper : Name: NANCY M. VISTRO : CP Number 09102073348
Mechanic : Name: ANTHONY L. CAYOG : CP Number 09460828549
Operator 1 : Name: JHAY-R C. MONDALA : CP Number 09318411411
Operator 2 : Name: ANTHONY L. CAYOG : CP Number 09460828549
10. Machinery shed as counterpart for the project: area ________ sqm
Location: Brgy. Bantocaling, Mangatarem, Pang.
Lot owner:LORENZO S. MORENO CP Number: 09635162935
Owned ______ Donated _________ Lease ____________
Republic of the Philippines
Cluster:____________
Department of Agriculture Region:____________
Philippine Center for Postharvest Development and Mechanization Province:___________
Science City of Muñoz, Nueva Ecija, Philippines Municipality:_________
www.philmech.gov.ph
VALIDATION FORM
Date of Validation: __________
I.Farmer Cooperative/ Association (FCA) PROFILE
Name of FCA: CERVANTES BAN-AO IRRIGATORS ASSOCIATION INC.
Office Address: BANTOCALING, MANGATAREM, PANGASINAN
Geographic Coordinates(optional): ___________________________________________________
Year established and Active Years of Operation: 9 YRS
Name of Chairman/Pres: LORENZO S. MORENO
Contact Number: 09635162935
Email address:
[email protected]II. ABSTRACT OF REQUEST (name atleast 6 technologies)
Rank
Technology Machinery/Facility Type Preferred Machinery/Facility Preferred No. Remarks (labor
(pls. check) of units (according to and cost situation)
priority)
Hand Tractor / 1 6
land preparation Floating Tiller
4 Wheel Tractor / 1 2
Precision Seeder
Transplanter, walk-behind
crop care establishment
Transplanter, riding type / 1 5
Mechanical Weeder
Reaper
harvesting and treshing Tresher
Combine Harvester / 1 1
mechanical drying Mechanical Dryer / 1 4
rice milling Rice Mill / 1 3
III. BASIC REQUIREMENTS
Remarks
Documents Complied Lacking (status of
compliance)
1. Letter of Intent
2. Resolution from the farmer organization stating the need for the farm machineries and
postharvest facilities and willingness to provide shed for the project as counterpart.
3. Certificate of Accreditation from the DA
4. Certificate of registration: ___CDA ____DOLE ____SEC
a) certificate of good standing issued by SEC/CDA
5. Financial statement duly audited or Income Tax Returns for the past 2 years.
6. Farmer Association/Cooperative Profiles
i. List of farmer members with corresponding rice farm area.Table 1
ii. Machineries present and other information related to the FCA’s operation. Table 2
7. Have at least 50 ha rice farm of regular members.
i.total rice area of members: 200.52 ha irrigated: 200.52 ha non-irrig. __ha
ii. no. of members: 174
8. Have a minimum rice area of 300ha within the peripheral barangays from the proposed
location of the agricultural machineries and postharvest facilities.
Rice Area of nearby barangays
Name of Barangay: Parian Total Area: 125.0 ha
Name of Barangay: Bantay Total Area: 150.0 ha
Name of Barangay: Muelang Total Area: 130.0 ha
9. Presence of personnel for the following:
Manager : Name: LORENZO S. MORENO : CP Number 09635162935
Bookkeeper : Name: NANCY M. VISTRO : CP Number 09102073348
Mechanic : Name: ANTHONY L. CAYOG : CP Number 09460828549
Operator 1 : Name: JHAY-R C. MONDALA : CP Number 09318411411
Operator 2 : Name: ANTHONY L. CAYOG : CP Number 09460828549
10. Machinery shed as counterpart for the project: area ________ sqm
Location: Brgy. Bantocaling Mangatarem, Pangasinan
Lot owner: LORENZO S. MORENO CP Number: 09635162935
Owned ______ Donated _________ Lease ____________
11. Available cash for initial operating cost for custom service - Php 50k/unit-technology
requested
IV. OTHER INFORMATIONS
Describe (nature and level of operation, presence of
1 Projects and Services warehouse/storage and capitalization)
( ) Rice Trading
( ) Rice Milling
( ) Rice Seed Growing (for seed purposes)
( / ) Farm Machinery Services (Custom service/service provider)
( ) others (please specify)
2 Trainings attended by the managers and other officers/members:
1.________________________________________________________________________________________
2._______________________________________________________________________________________
3. _______________________________________________________________________________________
4.________________________________________________________________________________________
5. _______________________________________________________________________________________
Validated by:
____________________________
PHilMech Technical Staff DA-RFO Technical Staff/LGU Technical Staff
Noted by: Conformed by:
____________________________ _________________________________________
Cluster Head (PhilMech) FCA Chairman/Representative
OBSERVATIONS, IMPRESSIONS AND RECOMMENDATIONS
(base on the selection/prioritization criteria, comparison of the actual observations with the minimun
requirements,and other factors which will signify if the recipient is feasible or not)
Prepared by: Noted by:
____________________________ ____________________________
PHilMech Technical Staff Immediate Supervisor (PHilMech)
