NWRB Application Form

NWRB-WUD-17-r3

Republic of the Philippines

NATIONAL WATER RESOURCES BOARD

8th Floor NIA Building, EDSA, Quezon City

Telefax (02) 8920-2714

APPLICATION FOR

RENEWAL OF CPC WITH EXTENSION OF SERVICE AREA

Accomplish this form in six (6) copies.

Attach separate sheet if more space is required.

Water Service
Provider (WSP)
Category¹

Case Number
{{ $application->docket_code ?? 'N/A' }}

Name of Applicant
{{ $application->applicant_name ?? 'N/A' }}

Mailing Address
{{ $application->mailing_address ?? 'N/A' }}

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' }}

Provisional Authority Required?

provisional_ar) == 'yes' ? 'checked' : '' }}> Yes provisional_ar) == 'no' ? 'checked' : '' }}> No

Filing Fee Amount
{{ $application->filing_fee ?? 'N/A' }}

OR No.
{{ $application->or_no ?? 'N/A' }}

Date Paid
{{ $application->date_paid ?? 'N/A' }}

Location of Service Area

{{-- Subdivision @php $subdivisions = $application->subdivision ?? []; @endphp @php $maxRows = collect($subdivisions)->map(fn($d) => count($d))->max() ?? 1; @endphp @foreach ($subdivisions as $division) @endforeach @for ($i = 1; $i < $maxRows; $i++) @foreach ($subdivisions as $division) @endforeach @endfor Barangay @php $barangays = $application->barangay ?? []; @endphp @php $maxRows = collect($barangays)->map(fn($r) => count($r))->max() ?? 1; @endphp @foreach ($barangays as $barangay) @endforeach @for ($i = 1; $i < $maxRows; $i++) @foreach ($barangays as $barangay) @endforeach @endfor Municipality @php $municipalities = $application->municipality ?? []; @endphp @php $maxRows = collect($municipalities)->map(fn($p) => count($p))->max() ?? 1; @endphp @foreach ($municipalities as $municipality) @endforeach @for ($i = 1; $i < $maxRows; $i++) @foreach ($municipalities as $municipality) @endforeach @endfor Province @php $provinces = $application->province ?? []; @endphp @php $maxRows = collect($provinces)->map(fn($p) => count($p))->max() ?? 1; @endphp @foreach ($provinces as $province) @endforeach @for ($i = 1; $i < $maxRows; $i++) @foreach ($provinces as $province) @endforeach @endfor --}} {{-- Subdivision --}} @php $subdivisions = $application->subdivision ?? []; $allSubs = collect($subdivisions) ->flatMap(fn($division) => $division) ->filter() ->values() ->all(); @endphp @foreach ($allSubs as $sub) @endforeach {{-- Barangay --}} @php $barangays = $application->barangay ?? []; $allBarangays = collect($barangays) ->flatMap(fn($group) => $group) ->filter() ->values() ->all(); $mergedCellsBrgy = []; $countBrgy = count($allBarangays); for ($i = 0; $i < $countBrgy; $i++) { if (isset($mergedCellsBrgy[$i])) { continue; } $colspanBrgy = 1; for ($j = $i + 1; $j < $countBrgy; $j++) { if ($allBarangays[$j] === $allBarangays[$i]) { $colspanBrgy++; $mergedCellsBrgy[$j] = true; } else { break; } } $mergedCellsBrgy[$i] = $colspanBrgy; } @endphp @foreach ($allBarangays as $index => $brgy) @if (is_int($mergedCellsBrgy[$index]) && $mergedCellsBrgy[$index] > 0) @endif @endforeach {{-- Municipality --}} @php $municipalities = $application->municipality ?? []; $flatMunicipalities = collect($municipalities)->flatten()->toArray(); $mergedCellsMun = []; $countMun = count($flatMunicipalities); for ($i = 0; $i < $countMun; $i++) { if (isset($mergedCellsMun[$i])) { continue; } $colspanMun = 1; for ($j = $i + 1; $j < $countMun; $j++) { if ($flatMunicipalities[$j] === $flatMunicipalities[$i]) { $colspanMun++; $mergedCellsMun[$j] = true; } else { break; } } $mergedCellsMun[$i] = $colspanMun; } @endphp @foreach ($flatMunicipalities as $index => $mun) @if (is_int($mergedCellsMun[$index]) && $mergedCellsMun[$index] > 0) @endif @endforeach {{-- Province --}} @php $provinces = $application->province ?? []; $flat = collect($provinces)->flatten()->toArray(); $mergedCells = []; $count = count($flat); for ($i = 0; $i < $count; $i++) { if (isset($mergedCells[$i])) { continue; } $colspan = 1; for ($j = $i + 1; $j < $count; $j++) { if ($flat[$j] === $flat[$i]) { $colspan++; $mergedCells[$j] = true; } else { break; } } $mergedCells[$i] = $colspan; } @endphp @foreach ($flat as $index => $prov) @if (is_int($mergedCells[$index]) && $mergedCells[$index] > 0) @endif @endforeach

Subdivision	{{ $division[0] ?? '-' }}
{{ $division[$i] ?? '-' }}
Barangay	{{ $barangay[0] ?? '-' }}
{{ $barangay[$i] ?? '-' }}
Municipality	{{ $municipality[0] ?? '-' }}
{{ $municipality[$i] ?? '-' }}
Province	{{ $province[0] ?? '-' }}
{{ $province[$i] ?? '-' }}
Subdivision	{{ $sub }}
Barangay	{{ $brgy }}
Municipality	{{ $mun }}
Province	{{ $prov }}

Type of Water Service Provider

serv_id == 1 ? 'checked' : '' }}> Subdivision / Homeowners’ Association serv_id == 2 ? 'checked' : '' }}> Rural Waterworks and Sanitation Association serv_id == 3 ? 'checked' : '' }}> Cooperative serv_id == 4 ? 'checked' : '' }}> Bulk Water Seller / Peddler serv_id == 5 ? 'checked' : '' }}> Others, specify:

Number of Connections
With water meters
Without water meters

Meters tested?
{{-- @dd($application->meters_tested) --}} meters_tested == 'yes' ? 'checked' : '' }}> Yes meters_tested == 'no' ? 'checked' : '' }}> No

If tested, Tested by Date tested

Kind of Water System

kind_of_water == 1 ? 'checked' : '' }}> Draw and Fill kind_of_water == 2 ? 'checked' : '' }}> Float kind_of_water == 3 ? 'checked' : '' }}> Direct Pumping

For Bulk Water Seller/Peddler,
Average volume of water delivered per day
(in cu. m.)

Water Permit Information

@php // Group all columns into one array for easy looping $rows = max( count($application->permit_no ?? []), count($application->source ?? []), count($application->deg_latitude ?? []), count($application->min_latitude ?? []), count($application->sec_latitude ?? []), count($application->deg_longitude ?? []), count($application->min_longitude ?? []), count($application->sec_longitude ?? []), count($application->barangay_source ?? []) ); @endphp {{-- Generate N rows dynamically --}} @for ($i = 0; $i < $rows; $i++) {{-- Latitude --}} {{-- Longitude --}} @endfor {{-- Extra empty row --}} {{-- Bulk supply row --}}

CWP/Water Permit No.	Source	Latitude			Longitude			Barangay Location of Source
CWP/Water Permit No.	Source	Deg.	Min.	Sec.	Deg.	Min.	Sec.	Barangay Location of Source
{{ $application->permit_no[$i] ?? '' }}	{{ $application->source[$i] ?? '' }}	{{ $application->deg_latitude[$i] ?? '' }}	{{ $application->min_latitude[$i] ?? '' }}	{{ $application->sec_latitude[$i] ?? '' }}	{{ $application->deg_longitude[$i] ?? '' }}	{{ $application->min_longitude[$i] ?? '' }}	{{ $application->sec_longitude[$i] ?? '' }}	{{ $application->barangay_source[$i] ?? '' }}

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:

Privately-owned or privately run WUs; or
Government-owned and government-run WUs
that opted to be classified or NWRB has classified as Category A; or
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:

Are not operating for profit;
Have not expanded/ are not expanding outside their original area of jurisdiction; or
Do not opt to be classified as Category “A”/”B” or NWRB has classified as Category “A”

National Water Resources Board

APPLICATION FOR RENEWAL OF CPC

WITH EXTENSION OF SERVICE AREA

Name of Applicant

Water Service Provider Category

Case Number

Documentary Requirements	Cat. A	Cat. B	Cat. C
Articles of Incorporation/Partnership or DTI/CDA Registration
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
Copy of approved Conditional / Water Permit/s If water is bulk supplied, copy of agreement/contract/receipt
Copy of latest Official Receipts of Annual Water Charges Not required when procuring bulk
Copy of latest Official Receipts of Supervision and Regulation Fees
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
Plan duly signed by a licensed Engineer Water distribution system Elevation and cross-sectional views of tank/reservoir Elevation and cross-sectional views of pump house, machinery and equipment For Category C, only a sketch plan is required
Latest audited financial statements For Category C: Income Statement and Balance Sheet
Simplified Financial Projections Model for Category C (hard/soft copy) with the following data: Revenue requirements for one year, composed of: Operating expenses, with breakdown Depreciation Loan amortization (interest and principal) per year Estimated total consumption for one year in cu.m
Business Plan containing: List of existing/required investments 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)
Financial Projections Model for Category A/Category B (hard and soft copy)
Copy of latest Annual Report with NWRB received stamp
Tariff schedule to be implemented (please attach NWRB Board Resolution)
Proof or brief description stating, among others, the need to extend/expand service area
Copy of latest filled-out Survey Form with the data uploaded/encoded in the Listahang Tubig website (http://[email protected]/) or (http://listahangtubig.southeast.cloudapp.azure.com/)
Copy of CPC Certificate