REPUBLIC OF THE PHILIPPINES )

CITY OF BATANGAS ) SS

AFFIDAVIT

I, ADELAIDA U. UNTALAN, of legal age, married,

Filipino and a resident of Rizal Avenue, Batangas City
after having been duly sworn to in accordance with law
hereby depose and state:

That I am the duly appointed Supply

Officer/Administrative Officer V of the Batangas
Regional Hospital, Batangas City;

That I am responsible for the recording in the

ledger card and preparation of documents relative to
the materials, equipments and other supplies
necessary for the operation of the hospital and
inventory thereof;

That sometime on January, 2009 at around 9:00

in the morning, it was reported that a robbery incident
happened at the Batangas Regional Hospital wherein
five cardiac monitors were involved which amounted to
One Million Three Hundred Twenty Five Thousand
Pesos ( P 1,325,000.00);

That relative to such incident, investigation was

conducted by the members of National Bureau of
Investigation and Philippine National Police – Batangas
City;

That said cardiac monitors were installed by the

personnel of International Worksbell Incorporated, the
company that sold to Batangas Regional Hospital, at
the General Intensive Care Unit of the hospital as per
Equipment Ledger Card prepared by the undersigned
hereto attached as Annex “A”;

That the General Intensive Care Unit of the

hospital during that time when the robbery incident
occurred was not yet operational thus under the
supervision of the Office of the Chief of Hospital,
reason why the keys of said unit was in possession of
the Office of the Chief of Hospital;

That after the installation of cardiac monitors at

the said Unit, I inspected the same and made sure
that all of the units were safely installed and secured
at the said area;

That since the keys of the General Intensive Care

Unit are under the custody and safekeeping of the
Office of the Chief of Hospital, I am assured that the
cardiac monitors installed at the said unit would be
secured;

That I have no reason to believe or suspect that

the five cardiac monitors installed and secured therein
will be subject of any thievery or similar acts;

That I am executing this affidavit to attest to the

truth of the foregoing facts and for whatever legal
purpose this may serve.

IN TRUTH HEREOF, I have hereunto set my hand

this ____ day of March, 2010 in Batangas City,
Philippines.

ADELAIDA U. UNTALAN
Affiant

SUBSCRIBED AND SWORN to before me this

_____ day of March, 2010 in Batangas City,
Philippines. Affiant exhibited to me her Batangas
Regional Hospital Identification Card Numbered 08-
120 as proof of identity.