Annex PSA-CTCO-SS-SPPD-1602-01-04 MEMORANDUM OF AGREEMENT FINANCIAL REQUIREMENTS FOR THE ACTIVITIES OF THE 27th NATIONAL STATISTICS MONTH (NSM) KNOW ALL MEN BY THESE PRESENTS: This Memorandum of Agreement entered into by and between the following parties: The PHILIPPINE STATISTICS AUTHORITY (PSA), with principal address at 3rdFloor, CVEA Building, East Avenue, Diliman, Quezon City, and represented by its National Statistician, LISA GRACE S. BERSALES; and The (NAME OF AGENCY), with principal address at (agency address) and represented by its (Designation), (NAME OF AGENCY HEAD); WHEREAS, under Presidential Proclamation No. 647, the National Statistics Month (NSM) shall be held every October with the following two-fold objectives: (a) to promote, enhance and instill nationwide awareness and appreciation of the importance and value of statistics to the different sectors of the society; and (b) to elicit the cooperation and support of the general public in upgrading the quality and standard of statistics in the country; WHEREAS, PSA Memorandum Circular No. 01-2016 dated 29January 2016enjoins all agencies of the government, local government units, academic institutions, and the private sector at the national and subnational levels to actively participate in and support the celebration of the 27th National Statistics Month in October 2016; WHEREAS, the 27thNSM celebration shall have for its theme “Sustainable Development: Making Statistics Count” WHEREAS, the above Memorandum Circular provides that the participating agencies shall earmark funds for their respective agencies as well as common activities for the 27thNSM; WHEREAS, the Memorandum Circular provides among others, that participating agencies shall be requested to contribute at leastFifteenThousand Pesos (P15,000.00) each, payable toPhilippine Statistics Authority (PSA), to fund all NSM inter-agency activities from preparatory work, celebration proper, to post evaluation. 1 of 3 Annex PSA-CTCO-SS-SPPD-1602-01-04 NOW, THEREFORE, for and in consideration of the foregoing premises, the contracting parties hereby agree to the following: 1. The (Name of Agency) shall contribute at least FIFTEEN THOUSAND PESOS (PhP 15,000.00) to cover the expenses for the 27thNSM activities which shall be made payable toPSAwithin 30 days from the signing of contract;and 2. The PSA shall acknowledge receipt of funds, deposit the same with the Bureau of Treasury in accordance with E. O. 338, series of 1996, and utilize the funds for the purpose of the 27th NSM celebration and subject to existing accounting and auditing rules and regulations; This Agreement shall take effect upon signing by the contracting parties. Modifications may be made upon written consent of all parties. IN WITNESS WHEREOF, the parties have hereto set their hands at the City of ______________ this ____ day of __________ 2016. LISA GRACE S. BERSALES National Statistician and Civil Registrar General Philippine Statistics Authority NAME OF AGENCY HEAD Designation Name of Agency Signed in the presence of CANDIDO J. ASTROLOGO, JR. _______________________Witness Witness 2 of 3 Annex PSA-CTCO-SS-SPPD-1602-01-04 ACKNOWLEDGMENT Republic of the Philippines Makati City ) ) ss BEFORE ME, this ____ day of _________ at ___________________, Philippines, personally appeared Lisa Grace S. Bersales of Philippine Statistics Authority (PSA)with ID No.___________issued on24 June 2014at Manila and _____________ of _____________ with ID No. ______________________ issued on ______________________at _____________________, known to me to be the same persons who executed the foregoing instruments and acknowledged to me that the same is their free act and deed. This instrument, consisting of (3) pages including this one on which the acknowledgment is written, has been signed on the left hand margin of each page thereof by said parties and their instrumentals, and sealed with my notarial seal. IN WITNESS WHEREOF, I have hereunto set my hand and seal on the day, in the year and place above written. Doc. no. Page no. Book no. Series of ______________ ______________ ______________ ______________ 3 of 3