Republic of the Philippines
PHILIPPINE HEALTH INSURANCE CORPORATION
                                                                         www.philhealth.gov.ph
                                                                                                                                Date/Time Generated :           07/19/2022 05:53:41
                                                                                                                                            SPA No :             SPA100029818499
                                                                                                                                   Applicable Period :                      06-2022
                                                                                                                                        Report Type :                       Regular
                                                           EMPLOYEES PREMIUM REMITTANCE LIST
PhilHealth Number : 021000012719
Employer Name : I.F. CLEMENTE CONSTRUCTION CORPORATION
Employer Address : BALIUAG BULACAN
Employer TIN :      009435767000
Employer Type :     Private
  No.       PhilHealth No.              Surname             Given Name                Middle Name              PS              ES                Status | Remarks
   1        022538129120     ALQUIROZ             MA LORAINE               INANOD                                     240.00          240.00 A
   2        212500896105     CAO                  JANINA MAE               CLEMENTE                                   300.00          300.00 A
   3        212500896091     CAO                  JOCEL                    CLEMENTE                                   300.00          300.00 A
   4        210501899776     CAO                  JUDITH                   CLEMENTE                                   300.00          300.00 A
   5        212005257287     CAO                  JULIE ANN                CLEMENTE                                   300.00          300.00 A
   6        212500862715     CLEMENTE             KRISTINE KATE            GIRON                                      300.00          300.00 A
   7        070253003233     CLEMENTE             MELISA                   VENERACION                                 280.00          280.00 A
   8        210000161254     DE GUZMAN            MARIA FRANCHESCA         ALBANIA                                    300.00          300.00 A
   9        080507341857     MARIANO              REYNANTE                 CAYANAN                                    260.00          260.00 A
   10       030502565555     TORRES               MARIBEL                  CABRAL                                     260.00          260.00 A
                                                                                                    Subtotal        2,840.00        2,840.00
                                                                                             GRAND TOTAL                            5,680.00
Prepared by :                                                              Certified True and Correct by :
Signature over Printed Name and Designation                                Signature over Printed Name and Designation