I.

ADMINISTRATIVE DATA
Name of Permittee/Operator: FELIX T. CHUA, JR.
Official Address : C.V. CONSTRUCTION AND DEVELOPMENT
Location of Quarry: Brgy. Ipil, Surigao City and Brgy. Honrado, San Francisco, Surigao del Norte
Date of First Operation: June 23 , 2017 Permit No.: SGEP-0201 Meridional Block(s) ID:

II.PRODUCTION & SALES/MARKETING DATA (Use additional sheet if necessary)

Construction PRODUCTION SALES ESTIMATED EXTRACTION ESTIMATED EXCISE Buyer Address
Materials Quantity (cu.m.) Value (P) Quantity (cu.m.) Value (P) FEE PAYABLE TAX PAYABLE
1.
Sand 300 60,000 300 72,000 11,250 1,440
S1
S2
2. Gravel
G1 700 154,000 700 189,000 26,250 3,780
G2
3. Others(Pls.
Specify)
Note: If three or more buyers just indicate Various buyers

Reasons for increase or decrease in production this month compared to the previous date: (pls. check appropriate answer below and use additional sheet if necessary
Increase was due to: Decreased was due to:
1. Increased price of 1. Lesser operating days
The mineral being 1.a Equipment breakdown (pls. specify) _________________________________________ 2.d Environmental Problems (pls. specify) ________________________________
Produced 1.b Unfavorable weather condition 9state duration or other information) _____________ 2.e Govt preventive actions such as CDO (pls. specify) ______________________
2. Increased demand 1.c Labor or other strikes (state duration) _______________________________________ 2.f Financial problem (pls. specify) ______________________________________
3. Expansion 2. Suspension due to:
4. More operating days 2.a Low price of the mineral commodity produced (pls. specify) _____________________ 3. Others (pls. specify) ________________________________________________
5. Others (pls. specify) 2.b Market problems (pls. specify) _____________________________________________
_____________________ 2.c Force Majeure (pls. specify) _______________________________________________

III.EMPLOYMENT DATA
Report the number of persons engaged in work at the office and site during this month.
OFFICE QUARRY SITE TOTAL
MALE FEMALE MALE FEMALE MALE FEMALE
- 1 4 - 4 -
IV. CERTIFICATION

I hereby certify that all information in this report are complete, true and correct to the best of my knowledge and belief.

FELIX T. CHUA, JR. PERMITTEE________ July 03, 2017 , __

SIGNATURE OF REPORTING OFFICE OFFICIAL POSITION DATE

REPUBLIC OF THE PHILIPPINES

CITY OF SURIGAO ) S.S

PROVINCE OF SURIGAO DEL NORTE )

Subscribed and sworn to before me this day of , the affiant exhibiting his Community Tax Certificate No. 02753171 issued at Surigao City on the 6th day
of January, 2017.

Doc. No. ______ notary public

Page No. ______
Book No. ______
Series of 2017
I. ADMINISTRATIVE DATA
Name of Permittee/Operator: FELIX VENSON A. CHUA
Official Address : CITY HOMEBASIC CONSTRUCTION SUPPLY
Location of Quarry: Barangay Luna, Surigao City
Date of First Operation: Permit No.: SGEP-0031 Meridional Block(s) ID:

II.PRODUCTION & SALES/MARKETING DATA (Use additional sheet if necessary)

Construction PRODUCTION SALES ESTIMATED EXTRACTION ESTIMATED EXCISE Buyer Address
Materials Quantity (cu.m.) Value (P) Quantity (cu.m.) Value (P) FEE PAYABLE TAX PAYABLE
1. Sand
S1 260 52,000 260 62,400 9,750 1,248
S2
2. Gravel
G1 740 162,800 740 199,800 27,750 3,996
G2
3. Others(Pls.
Specify)
Note: If three or more buyers just indicate Various buyers

Reasons for increase or decrease in production this month compared to the previous date: (pls. check appropriate answer below and use additional sheet if necessary
Increase was due to: Decreased was due to:
4. Increased price of 1. Lesser operating days
The mineral being 1.a Equipment breakdown (pls. specify) _________________________________________ 2.d Environmental Problems (pls. specify) ________________________________
Produced 1.b Unfavorable weather condition 9state duration or other information) _____________ 2.e Govt preventive actions such as CDO (pls. specify) ______________________
5. Increased demand 1.c Labor or other strikes (state duration) _______________________________________ 2.f Financial problem (pls. specify) ______________________________________
6. Expansion 2. Suspension due to:
7. More operating days 2.a Low price of the mineral commodity produced (pls. specify) _____________________ 3. Others (pls. specify) ________________________________________________
8. Others (pls. specify) 2.b Market problems (pls. specify) _____________________________________________
_____________________ 2.c Force Majeure (pls. specify) _______________________________________________

III.EMPLOYMENT DATA
Report the number of persons engaged in work at the office and site during this month.
OFFICE QUARRY SITE TOTAL
MALE FEMALE MALE FEMALE MALE FEMALE
- 1 4 - 4 -
IV. CERTIFICATION

I hereby certify that all information in this report are complete, true and correct to the best of my knowledge and belief.

FELIX VENSON A. CHUA PERMITTEE________ _______

SIGNATURE OF REPORTING OFFICE OFFICIAL POSITION DATE

REPUBLIC OF THE PHILIPPINES

CITY OF SURIGAO ) S.S

PROVINCE OF SURIGAO DEL NORTE )

Subscribed and sworn to before me this ____ day of _________________ 2015, the affiant exhibiting his Community Tax Certificate No. 02753169 issued at Surigao City
on the 6th day of January, 2015.

Doc. No. ______ notary public

Page No. ______
Book No. ______
Series of 2015
I.ADMINISTRATIVE DATA
Name of Permittee/Operator: FELIX VENSON A. CHUA
Official Address : CITY HOMEBASIC CONSTRUCTION SUPPLY
Location of Quarry: Brgy. Luna, Surigao City
Date of First Operation: December 06, 2013 Permit No.: OES-0030 Meridional Block(s) ID:

II.PRODUCTION & SALES/MARKETING DATA (Use additional sheet if necessary)

Construction PRODUCTION SALES ESTIMATED EXTRACTION ESTIMATED EXCISE Buyer Address
Materials Quantity (cu.m.) Value (P) Quantity (cu.m.) Value (P) FEE PAYABLE TAX PAYABLE
1. Sand
S1
S2
2. Gravel
G1
G2
3. Others(Pls. Ordinary earth soil 1050 5,250 4,200.00 84.00 Ciara Kristine C.
Specify) 700 70,000 2,800.00 1,400.00 Gokiangkee/vario
us
Note: If three or more buyers just indicate Various buyers
Reasons for increase or decrease in production this month compared to the previous date: (pls. check appropriate answer below and use additional sheet if necessary
Increase was due to: Decreased was due to:
1. Increased price of 1. Lesser operating days
The mineral being 1.a Equipment breakdown (pls. specify) _________________________________________ 2.d Environmental Problems (pls. specify) ________________________________
Produced 1.b Unfavorable weather condition 9state duration or other information) _____________ 2.e Govt preventive actions such as CDO (pls. specify) ______________________
2. Increased demand 1.c Labor or other strikes (state duration) _______________________________________ 2.f Financial problem (pls. specify)
______________________________________
3. Expansion 2. Suspension due to:
4. More operating days 2.a Low price of the mineral commodity produced (pls. specify) _____________________ 3. Others (pls. specify)
________________________________________________
5. Others (pls. specify) 2.b Market problems (pls. specify) _____________________________________________
_____________________ 2.c Force Majeure (pls. specify) _______________________________________________

III.EMPLOYMENT DATA
Report the number of persons engaged in work at the office and site during this month.
OFFICE QUARRY SITE TOTAL
MALE FEMALE MALE FEMALE MALE FEMALE
- 1 3 - 3 1
 Republic of the Philippines
Department of Environment and Natural Resources
MINES AND GEOSCIENCES BUREAU
Mineral Economics Information & Publications Division
North Avenue, Diliman, Quezon City

MONTHLY REPORT ON PRODUCTION, SALE AND INVENTORY OF COMMERCIAL SAND & GRAVEL AND EMPLOYMENT
REPORT PERIOD: MONTH DECEMBER YEAR _2015_.

INSTRUCTION:
1. This form must be accomplished in duplicate
2. Submit the original copy to the MGB Central Office through the mineral economics, Information & Publication Division. Copy furnished the concerned region within fifteen (15) working
days after the end of each calendar month.
3. Submission of this report is compliance with SECTION 270 CHAPTER XXIX of DENR AO 96-40 or the implementing rules and regulations of REPUBLIC ACT 7942.
4. Information to be supplied by the reporting Operator/Permit Holder should cover the period from the first day to last day of the report month.
5. This report from must be accomplished by a Holder of a Commercial Sand & Gravel Permit or is Operator.
6. Write within the space provided for your answers and do not leave any of the requirements unanswered.
7. If a requirement does not apply to you write NA (Not Applicable). If the question is applicable to you but you have no answer write NONE.
8. This document should be signed by the resident manager or equivalent position.
9. This report should be duly notarized
10. For any comments suggestions or clarifications regarding this form please consult your nearest MB Region Office in your area.

DEFINITION OF TERMS:
Mining Company is composed of one Head Office and one or more Mine Sites.
Head Office undertakes the job overall company administration the mining company may not have a separate headquarters. Rooms or ports which house the personnel charged with the task.
Mine Site refers to the location of mine where mining operations, specifically mineral extraction. Takes place (Barangay, Municipality, and Province)
Production Quantity refers to the total cost of production in pesos including taxes on products except value added-tax (VAT) or any other non-deductible tax and taxes on production paid by the
producers.
Estimated Extraction Fee Payable refers to an estimate of the total extraction fee to be paid by the permittee covering the production during the quarter and based on the prevailing extraction
fee rate in the province/city.
Sales Value refers to the total value of mineral solid during the reporting period. This value includes all costs of production, taxes invoiced to purchasers, transport & trade mark-up.
Estimated Excise Tax Payable refers to an estimate of the total excise tax on mineral to be paid by the permittee to the Bureau of Internal Revenue (BIR) covering the production during the
reporting period and based in the rate prescribed by Section 217 (b) of the Revised IRR of the Mining Act of 1995.