NWRB-WUD-09-r3
Republic of the Philippines
NATIONAL WATER RESOURCES BOARD
8th Floor NIA Building, EDSA, Quezon City
Telefax (02) 8920-2714
APPLICATION FOR
INCREASE OF WATER RATES AND
EXTENSION OF SERVICE AREA
Accomplish this form in six (6) copies.
Attach separate sheet if more space is required.
Water Service
Provider (WSP)
Category¹ {{$application->cat_id ?? 'N/A'}}
Case Number
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Name of Applicant
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Mailing Address
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Email Address
{{ $application->email_address ?? 'N/A' }}
Contact No.
{{ $application->contact_number ?? 'N/A' }}
Citizenship
{{ $application->citizenship ?? 'N/A' }}
TIN
{{ $application->tin ?? 'N/A' }}
Year Operations Started
{{ $application->year_operation ?? 'N/A' }}


Filing Fee Amount
OR No.
Date Paid
Location of Service Area
@if ($totalBarangays >= 3 || $totalBarangaysExt >= 3)
Existing Service Area (NWRB Resolution No. ) Extended Service Area
Subdivision

See the Checklist Location of Service Area Below
Barangay
Municipality
Province
@else @php $colspan = ($totalBarangays >= 2) ? 2 : 1; $colspan2 = ($totalBarangaysExt >= 2) ? 2 : 1; @endphp @foreach ($newGrouped as $col) @endforeach @foreach ($newGroupedExt as $col) @endforeach @foreach ($newGrouped as $col) @endforeach @foreach ($newGroupedExt as $col) @endforeach @foreach ($municipalityGroups as $group) @endforeach @foreach ($municipalityGroupsExt as $group) @endforeach @foreach ($municipalityGroups as $group) @endforeach @foreach ($municipalityGroupsExt as $group) @endforeach
Existing Service Area (NWRB Resolution No. ) Extended Service Area
Subdivision{{ $col['subdivisions'] }}{{ $col['subdivisions'] }}
Barangay{{ $col['barangay'] }}{{ $col['barangay'] }}
Municipality {{ $group['value'] }} {{ $group['value'] }}
Province {{ $group['province'] }} {{ $group['province'] }}
@endif
Type of Water Service Provider
Meters tested?
Kind of Water System
For Bulk Water Seller/Peddler,
Average volume of water delivered per day
(in cu. m.)
Water Permit Information
@if ($rowPermit <= 4) @php $totalRows = 4; $countRows = count($rowsData); @endphp @foreach ($rowsData as $row) @endforeach @for ($i = $countRows; $i < $totalRows; $i++) @endfor @else {{-- additional empty rows if needed --}} @for ($j = 0; $j < 3; $j++) @endfor @endif
CWP/Water Permit No. Source Latitude Longitude Barangay Location of Source
Deg.Min.Sec. Deg.Min.Sec.
{{ $row['permit_no'] }} {{ $row['source'] }} {{ $row['deg_latitude'] }} {{ $row['min_latitude'] }} {{ $row['sec_latitude'] }} {{ $row['deg_longitude'] }} {{ $row['min_longitude'] }} {{ $row['sec_longitude'] }} {{ $row['barangay_source'] }}
See the Checklist Water Permit below.
If water is bulk supplied, copy of agreement/contract/receipt
See back page for pertinent requirements
I hereby certify that the information given above and the documents submitted are true and correct to the best of my knowledge and belief.
Signature over printed name of Water Utility Representative
Subscribed and sworn to before me on this date:
Notary Public / Administering Officer
Date
¹ How to Determine the Water Service Provider Category
Category A
Category B
Category C

Water utilities operating for profit:

  1. Privately-owned or privately run WUs; or
  2. Government-owned and government-run WUs
    that opted to be classified or NWRB has classified as Category A; or
  3. Community-based WUs that:
    1. Have expanded/ are expanding outside original area of jurisdiction, or
    2. Opted to be classified or NWRB has classified it as Category A
Government-owned or controlled, and government-run WUs that do not opt to be classified as Category “A” or NWRB has classified as Category B

Community-based WUs that:

  1. Are not operating for profit;
  2. Have not expanded/ are not expanding outside their original area of jurisdiction; or
  3. Do not opt to be classified as Category “A”/”B” or NWRB has classified as Category “A”
National Water Resources Board
APPLICATION FOR INCREASE OF WATER
RATES AND EXTENSION OF SERVICE AREA
Name of Applicant
{{ $application->applicant_name ?? 'N/A' }}
Water Service Provider Category
{{$application->cat_id ?? 'N/A'}}
Case Number
{{ $application->docket_code ?? '' }}
Documentary Requirements Cat. A Cat. B Cat. C
Articles of Incorporation/Partnership or DTI/CDA Registration
 cat_id == 'A' && $hasDocument1 ? 'checked' : '' }}> cat_id == 'C' && $hasDocument1 ? 'checked' : '' }}>
Authority to sign and file the application
  • Board Resolution for corporations and partnerships, or Board Secretary’s Certificate
  • For single proprietorship, signed by owner or Special Power of Attorney
 cat_id == 'A' && $hasDocument2 ? 'checked' : '' }}> cat_id == 'B' && $hasDocument2 ? 'checked' : '' }}> cat_id == 'C' && $hasDocument2 ? 'checked' : '' }}>
Copy of approved Conditional / Water Permit/s If water is bulk-supplied, copy of agreement/contract/receipt cat_id == 'A' && $hasDocument3 ? 'checked' : '' }}> cat_id == 'B' && $hasDocument3 ? 'checked' : '' }}> cat_id == 'C' && $hasDocument3 ? 'checked' : '' }}>
Copy of latest Official Receipts of Annual Water Charges cat_id == 'A' && $hasDocument4 ? 'checked' : '' }}> cat_id == 'B' && $hasDocument4 ? 'checked' : '' }}> cat_id == 'C' && $hasDocument4 ? 'checked' : '' }}>
Copy of latest Official Receipts of Supervision and Regulation Fee cat_id == 'A' && $hasDocument5 ? 'checked' : '' }}> cat_id == 'B' && $hasDocument5 ? 'checked' : '' }}> cat_id == 'C' && $hasDocument5 ? 'checked' : '' }}>
    Copy of recent Certificate of Potability (within 6 months) issued by the City/Municipal Health Officer where the source is located, with results of bacteriological (within 3 months), physical and chemical (at least one year) impurity tests conducted by a Department of Health accredited laboratory
cat_id == 'A' && $hasDocument6 ? 'checked' : '' }}> cat_id == 'B' && $hasDocument6 ? 'checked' : '' }}> cat_id == 'C' && $hasDocument6 ? 'checked' : '' }}>
Plan duly signed by a licensed Engineer
  • Water distribution system
  • Elevation and cross-sectional views of tank/reservoi
  • Elevation and cross-sectional views of pump house, machinery and equipmen

For Category C, only sketch plan is required

cat_id == 'A' && $hasDocument7 ? 'checked' : '' }}> cat_id == 'B' && $hasDocument7 ? 'checked' : '' }}> cat_id == 'C' && $hasDocument7 ? 'checked' : '' }}>
Copy of latest Annual Report cat_id == 'A' && $hasDocument8 ? 'checked' : '' }}> cat_id == 'B' && $hasDocument8 ? 'checked' : '' }}> cat_id == 'C' && $hasDocument8 ? 'checked' : '' }}>
Latest audited financial statements cat_id == 'A' && $hasDocument9 ? 'checked' : '' }}> cat_id == 'B' && $hasDocument9 ? 'checked' : '' }}> cat_id == 'C' && $hasDocument9 ? 'checked' : '' }}>
Business Plan containing
  • List of existing/required investment consistent with the 10-year business plan
  • Proposed Tariff Schedule
  • Levels of service (e.g. water quality, water pressure, non-revenue water, number of hours of water supply per day)
cat_id == 'A' && $hasDocument10 ? 'checked' : '' }}> cat_id == 'B' && $hasDocument10 ? 'checked' : '' }}>
Proposed Tariff (Downloadable form under Supplemental Guidelines in the Preparation of the Tariff Proposal) cat_id == 'A' && $hasDocument11 ? 'checked' : '' }}> cat_id == 'B' && $hasDocument11 ? 'checked' : '' }}> cat_id == 'C' && $hasDocument11 ? 'checked' : '' }}>
Financial Projections Model for Category A/Category B (hard and soft copy) cat_id == 'A' && $hasDocument12 ? 'checked' : '' }}> cat_id == 'B' && $hasDocument12 ? 'checked' : '' }}>
Tariff schedule being implemented (please attach NWRB Board Resolution) cat_id == 'A' && $hasDocument13 ? 'checked' : '' }}> cat_id == 'B' && $hasDocument13 ? 'checked' : '' }}> cat_id == 'C' && $hasDocument13 ? 'checked' : '' }}>
Proof or brief description stating, among others, the need to extend/expand service area cat_id == 'A' && $hasDocument14 ? 'checked' : '' }}> cat_id == 'B' && $hasDocument14 ? 'checked' : '' }}>
Copy of CPC Certificate cat_id == 'A' && $hasDocument15 ? 'checked' : '' }}> cat_id == 'C' && $hasDocument15 ? 'checked' : '' }}>
{{-- 3rd PAGE Checklist Location of Service Area --}} @if ($totalBarangays >= 3 || $totalBarangaysExt >= 3)
Checklist Location of Service Area
APPLICATION FOR INCREASE OF WATER RATES AND EXTENSION OF SERVICE AREA - {{ strtoupper($application->applicant_name) }}
Existing Service Area
@php $lastProvince = null; @endphp @foreach ($tables as $table) @if ($table['province'] !== $lastProvince)

PROVINCE : {{ $table['province'] }}

@php $lastProvince = $table['province']; @endphp @endif @foreach ($table['columns'] as $col) @endforeach @foreach ($table['columns'] as $col) @endforeach @foreach ($table['municipalities'] as $m) @endforeach
Subdivision{{ $col['subdivisions'] }}
Barangay{{ $col['barangay'] }}
Municipality{{ $m['value'] }}
Province {{ $table['provinceCell']['value'] }}
@endforeach
Extended Service Area
@php $lastProvinceExt = null; @endphp @foreach ($tablesExt as $tableExt) @if ($tableExt['province'] !== $lastProvinceExt)

PROVINCE : {{ $tableExt['province'] }}

@php $lastProvinceExt = $tableExt['province']; @endphp @endif @foreach ($tableExt['columns'] as $col) @endforeach @foreach ($tableExt['columns'] as $col) @endforeach @foreach ($tableExt['municipalities'] as $m) @endforeach
Subdivision{{ $col['subdivisions'] }}
Barangay{{ $col['barangay'] }}
Municipality{{ $m['value'] }}
Province {{ $tableExt['provinceCell']['value'] }}
@endforeach
@endif @if ($rowPermit > 4)
Checklist Water Permit
APPLICATION FOR INCREASE OF WATER RATES AND EXTENSION OF SERVICE AREA - {{ strtoupper($application->applicant_name) }}
@foreach ($rowsData as $row) @endforeach
CWP/Water Permit No. Source Latitude Longitude Barangay Location of Source
Deg.Min.Sec. Deg.Min.Sec.
{{ $row['permit_no'] }} {{ $row['source'] }} {{ $row['deg_latitude'] }} {{ $row['min_latitude'] }} {{ $row['sec_latitude'] }} {{ $row['deg_longitude'] }} {{ $row['min_longitude'] }} {{ $row['sec_longitude'] }} {{ $row['barangay_source'] }}
@endif