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Road Clearing Form

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Annex “B”

Monthly Cumulative Monitoring Report on Barangay Road Clearing Operations


(Pursuant to PRRD’s Directive and DILG Memorandum Circular No. 2019-121; DILG MC No. 2019-167; DILG MC No. 2020-027; MC Number-2020-036)

Region V
Province of Albay
Municipality of DARAGA
Barangay __________________________
(for the month of ______________________________ CY ___________)

Conducted Road Clearing Status of Barangay Roads/Turned REMARKS


Operations/Maintenance of Inventory of Barangay Roads/ Over Cleared Roads
(May include date of road clearing operations or
Cleared Roads Pathways/Sidewalk/Alleys /Turned-over Cleared Roads [put “/” to appropriate column] initiatives conducted by the barangay, other related
[Check appropriate [Location/Street name/Landmarks] undertakings)
column] On-going Cleared/Maintained
Road Clearing
YES NO
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
TOTAL
Prepared by:

I hereby CERTIFY and DECLARE that the above information


__________________________________________________________________ and activities are true and accurate to the best of my knowledge.
Name/Position of Designated Barangay Official

_________________________________________
Punong Barangays
Page ___ of ___

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