Funeral Contract
Funeral Contract
For service rendered to the late: ______ DELFIN PACHECO ANDAYA ________
CONTRACTING PARTY / AUTHORIZED REPRESENTATIVE LIFE PLAN
Name Marta Pacheco Andaya Plan N/A
Address Sitio Maharlika, Alas-asin, Mariveles, Bataan Policy Number N/A
Contact Number 09304014306 Plan Holder Name N/A
Relation to the Balance N/A
Deceased WIFE / MARRIED
Plan Type N/A
Casket: OMS PLAIN (LLP)_______
Mortuary Arrangement: ___HOUSE VIEWING__
Hearse / Van: ______MOON LIGHT FUNERAL VAN and Funeral Chariot______________
Number of Viewing Days: ________5 DAYS_____________
Remarks: ____________________________________________
Others: ________________________________________________________________________________________
SCHEDULE OF INTERMENT ADD ON FREEBIES
Date / Time: January 20, 2022 Water Dispenser, Tarpaulin, Chairs and tables, Candles
STIPULATION:
The undersigned /family hereby agrees to all the terms and conditions herein stipulated and hereby promises to pay Moonlight Funeral Services,
Inc. The cost services and other charges herein itemized ON OR BEFORE interment or cremation. The undersigned /family also agrees to the NO
PAYMENT, NO INTERMENT / NO CREMATION policy.
In case of complaint/s regarding the service rendered, the undersigned /family shall immediately inform the Company in order that appropriate and
expeditious action may be taken to address the complaint. Failure to immediate notify the Company shall be deemed to have performed its services. The
undersigned family also agrees that the Company shall not be liable for any damages, claims or causes of action attributable to the fault or negligence of
the deceased family /the undersigned or third parties. By signing, the undersigned /family agrees to all the stipulations and has read and understood and
conforms to the terms of the Release and Waiver set forth. Payable one (1) day before interment or cremation.
AL STEPHEN M. GULAPA
Contracting Party /Authorized Representative Family Care Representative
(Printed Name over Signature) (Printed Name over Signature)
Moonlight Funeral Services Inc.
Besides Goodspeed Cemetery, Brgy. Alas-asin, Mariveles, Bataan
SEC Reg. No.: 2021120034812-12
TIN No.: 605 – 271 – 458 – 000
“We committed to Serve from ‘Womb to Tomb!”
STIPULATION:
The undersigned /family hereby agrees to all the terms and conditions herein stipulated and hereby promises to pay Moonlight Funeral Services,
Inc. The cost services and other charges herein itemized ON OR BEFORE interment or cremation. The undersigned /family also agrees to the NO
PAYMENT, NO INTERMENT / NO CREMATION policy.
In case of complaint/s regarding the service rendered, the undersigned /family shall immediately inform the Company in order that appropriate and
expeditious action may be taken to address the complaint. Failure to immediate notify the Company shall be deemed to have performed its services. The
undersigned family also agrees that the Company shall not be liable for any damages, claims or causes of action attributable to the fault or negligence of
the deceased family /the undersigned or third parties. By signing, the undersigned /family agrees to all the stipulations and has read and understood and
conforms to the terms of the Release and Waiver set forth. Payable one (1) day before interment or cremation.
AL STEPHEN M. GULAPA
Contracting Party /Authorized Representative Family Care Representative
(Printed Name over Signature) (Printed Name over Signature)
Moonlight Funeral Services Inc.
Besides Goodspeed Cemetery, Brgy. Alas-asin, Mariveles, Bataan
SEC Reg. No.: 2021120034812-12
TIN No.: 605 – 271 – 458 – 000
“We committed to Serve from ‘Womb to Tomb!”
STIPULATION:
The undersigned /family hereby agrees to all the terms and conditions herein stipulated and hereby promises to pay Moonlight Funeral Services,
Inc. The cost services and other charges herein itemized ON OR BEFORE interment or cremation. The undersigned /family also agrees to the NO
PAYMENT, NO INTERMENT / NO CREMATION policy.
In case of complaint/s regarding the service rendered, the undersigned /family shall immediately inform the Company in order that appropriate and
expeditious action may be taken to address the complaint. Failure to immediate notify the Company shall be deemed to have performed its services. The
undersigned family also agrees that the Company shall not be liable for any damages, claims or causes of action attributable to the fault or negligence of
the deceased family /the undersigned or third parties. By signing, the undersigned /family agrees to all the stipulations and has read and understood and
conforms to the terms of the Release and Waiver set forth. Payable one (1) day before interment or cremation.
AL STEPHEN M. GULAPA
Contracting Party /Authorized Representative Family Care Representative
(Printed Name over Signature) (Printed Name over Signature)
Moonlight Funeral Services Inc.
Besides Goodspeed Cemetery, Brgy. Alas-asin, Mariveles, Bataan
SEC Reg. No.: 2021120034812-12
TIN No.: 605 – 271 – 458 – 000
“We committed to Serve from ‘Womb to Tomb!”
STIPULATION:
The undersigned /family hereby agrees to all the terms and conditions herein stipulated and hereby promises to pay Moonlight Funeral Services,
Inc. The cost services and other charges herein itemized ON OR BEFORE interment or cremation. The undersigned /family also agrees to the NO
PAYMENT, NO INTERMENT / NO CREMATION policy.
In case of complaint/s regarding the service rendered, the undersigned /family shall immediately inform the Company in order that appropriate and
expeditious action may be taken to address the complaint. Failure to immediate notify the Company shall be deemed to have performed its services. The
undersigned family also agrees that the Company shall not be liable for any damages, claims or causes of action attributable to the fault or negligence of
the deceased family /the undersigned or third parties. By signing, the undersigned /family agrees to all the stipulations and has read and understood and
conforms to the terms of the Release and Waiver set forth. Payable one (1) day before interment or cremation.
AL STEPHEN M. GULAPA
Contracting Party /Authorized Representative Family Care Representative
(Printed Name over Signature) (Printed Name over Signature)
Moonlight Funeral Services Inc.
Besides Goodspeed Cemetery, Brgy. Alas-asin, Mariveles, Bataan
SEC Reg. No.: 2021120034812-12
TIN No.: 605 – 271 – 458 – 000
“We committed to Serve from ‘Womb to Tomb!”
STIPULATION:
The undersigned /family hereby agrees to all the terms and conditions herein stipulated and hereby promises to pay Moonlight Funeral Services,
Inc. The cost services and other charges herein itemized ON OR BEFORE interment or cremation. The undersigned /family also agrees to the NO
PAYMENT, NO INTERMENT / NO CREMATION policy.
In case of complaint/s regarding the service rendered, the undersigned /family shall immediately inform the Company in order that appropriate and
expeditious action may be taken to address the complaint. Failure to immediate notify the Company shall be deemed to have performed its services. The
undersigned family also agrees that the Company shall not be liable for any damages, claims or causes of action attributable to the fault or negligence of
the deceased family /the undersigned or third parties. By signing, the undersigned /family agrees to all the stipulations and has read and understood and
conforms to the terms of the Release and Waiver set forth. Payable one (1) day before interment or cremation.
AL STEPHEN M. GULAPA
Contracting Party /Authorized Representative Family Care Representative
(Printed Name over Signature) (Printed Name over Signature)
Moonlight Funeral Services Inc.
Besides Goodspeed Cemetery, Brgy. Alas-asin, Mariveles, Bataan
SEC Reg. No.: 2021120034812-12
TIN No.: 605 – 271 – 458 – 000
“We committed to Serve from ‘Womb to Tomb!”
Place:
Additional Service(s): CONTRACT PRICE: 30,000
STIPULATION:
The undersigned /family hereby agrees to all the terms and conditions herein stipulated and hereby promises to pay Moonlight Funeral Services,
Inc. The cost services and other charges herein itemized ON OR BEFORE interment or cremation. The undersigned /family also agrees to the NO
PAYMENT, NO INTERMENT / NO CREMATION policy.
In case of complaint/s regarding the service rendered, the undersigned /family shall immediately inform the Company in order that appropriate and
expeditious action may be taken to address the complaint. Failure to immediate notify the Company shall be deemed to have performed its services. The
undersigned family also agrees that the Company shall not be liable for any damages, claims or causes of action attributable to the fault or negligence of
the deceased family /the undersigned or third parties. By signing, the undersigned /family agrees to all the stipulations and has read and understood and
conforms to the terms of the Release and Waiver set forth. Payable one (1) day before interment or cremation.
AL STEPHEN M. GULAPA
Contracting Party /Authorized Representative Family Care Representative
(Printed Name over Signature) (Printed Name over Signature)
Moonlight Funeral Services Inc.
Besides Goodspeed Cemetery, Brgy. Alas-asin, Mariveles, Bataan
SEC Reg. No.: 2021120034812-12
TIN No.: 605 – 271 – 458 – 000
“We committed to Serve from ‘Womb to Tomb!”
Place:
Additional Service(s): CONTRACT PRICE: 30,000
STIPULATION:
The undersigned /family hereby agrees to all the terms and conditions herein stipulated and hereby promises to pay Moonlight Funeral Services,
Inc. The cost services and other charges herein itemized ON OR BEFORE interment or cremation. The undersigned /family also agrees to the NO
PAYMENT, NO INTERMENT / NO CREMATION policy.
In case of complaint/s regarding the service rendered, the undersigned /family shall immediately inform the Company in order that appropriate and
expeditious action may be taken to address the complaint. Failure to immediate notify the Company shall be deemed to have performed its services. The
undersigned family also agrees that the Company shall not be liable for any damages, claims or causes of action attributable to the fault or negligence of
the deceased family /the undersigned or third parties. By signing, the undersigned /family agrees to all the stipulations and has read and understood and
conforms to the terms of the Release and Waiver set forth. Payable one (1) day before interment or cremation.
AL STEPHEN M. GULAPA
Contracting Party /Authorized Representative Family Care Representative
(Printed Name over Signature) (Printed Name over Signature)
Moonlight Funeral Services Inc.
Besides Goodspeed Cemetery, Brgy. Alas-asin, Mariveles, Bataan
SEC Reg. No.: 2021120034812-12
TIN No.: 605 – 271 – 458 – 000
“We committed to Serve from ‘Womb to Tomb!”
Place:
Additional Service(s): CONTRACT PRICE: 30,000
STIPULATION:
The undersigned /family hereby agrees to all the terms and conditions herein stipulated and hereby promises to pay Moonlight Funeral Services,
Inc. The cost services and other charges herein itemized ON OR BEFORE interment or cremation. The undersigned /family also agrees to the NO
PAYMENT, NO INTERMENT / NO CREMATION policy.
In case of complaint/s regarding the service rendered, the undersigned /family shall immediately inform the Company in order that appropriate and
expeditious action may be taken to address the complaint. Failure to immediate notify the Company shall be deemed to have performed its services. The
undersigned family also agrees that the Company shall not be liable for any damages, claims or causes of action attributable to the fault or negligence of
the deceased family /the undersigned or third parties. By signing, the undersigned /family agrees to all the stipulations and has read and understood and
conforms to the terms of the Release and Waiver set forth. Payable one (1) day before interment or cremation.
AL STEPHEN M. GULAPA
Contracting Party /Authorized Representative Family Care Representative
(Printed Name over Signature) (Printed Name over Signature)
Moonlight Funeral Services Inc.
Besides Goodspeed Cemetery, Brgy. Alas-asin, Mariveles, Bataan
SEC Reg. No.: 2021120034812-12
TIN No.: 605 – 271 – 458 – 000
“We committed to Serve from ‘Womb to Tomb!”
Place:
Additional Service(s): CONTRACT PRICE: 30,000
STIPULATION:
The undersigned /family hereby agrees to all the terms and conditions herein stipulated and hereby promises to pay Moonlight Funeral Services,
Inc. The cost services and other charges herein itemized ON OR BEFORE interment or cremation. The undersigned /family also agrees to the NO
PAYMENT, NO INTERMENT / NO CREMATION policy.
In case of complaint/s regarding the service rendered, the undersigned /family shall immediately inform the Company in order that appropriate and
expeditious action may be taken to address the complaint. Failure to immediate notify the Company shall be deemed to have performed its services. The
undersigned family also agrees that the Company shall not be liable for any damages, claims or causes of action attributable to the fault or negligence of
the deceased family /the undersigned or third parties. By signing, the undersigned /family agrees to all the stipulations and has read and understood and
conforms to the terms of the Release and Waiver set forth. Payable one (1) day before interment or cremation.
AL STEPHEN M. GULAPA
Contracting Party /Authorized Representative Family Care Representative
(Printed Name over Signature) (Printed Name over Signature)
Moonlight Funeral Services Inc.
Besides Goodspeed Cemetery, Brgy. Alas-asin, Mariveles, Bataan
SEC Reg. No.: 2021120034812-12
TIN No.: 605 – 271 – 458 – 000
“We committed to Serve from ‘Womb to Tomb!”
Place:
Additional Service(s): CONTRACT PRICE: 30,000
STIPULATION:
The undersigned /family hereby agrees to all the terms and conditions herein stipulated and hereby promises to pay Moonlight Funeral Services,
Inc. The cost services and other charges herein itemized ON OR BEFORE interment or cremation. The undersigned /family also agrees to the NO
PAYMENT, NO INTERMENT / NO CREMATION policy.
In case of complaint/s regarding the service rendered, the undersigned /family shall immediately inform the Company in order that appropriate and
expeditious action may be taken to address the complaint. Failure to immediate notify the Company shall be deemed to have performed its services. The
undersigned family also agrees that the Company shall not be liable for any damages, claims or causes of action attributable to the fault or negligence of
the deceased family /the undersigned or third parties. By signing, the undersigned /family agrees to all the stipulations and has read and understood and
conforms to the terms of the Release and Waiver set forth. Payable one (1) day before interment or cremation.
AL STEPHEN M. GULAPA
Contracting Party /Authorized Representative Family Care Representative
(Printed Name over Signature) (Printed Name over Signature)
Moonlight Funeral Services Inc.
Besides Goodspeed Cemetery, Brgy. Alas-asin, Mariveles, Bataan
SEC Reg. No.: 2021120034812-12
TIN No.: 605 – 271 – 458 – 000
“We committed to Serve from ‘Womb to Tomb!”
For service rendered to the late: ____ JHEZZA ARTUZ DELA ROSA____
CONTRACTING PARTY / AUTHORIZED REPRESENTATIVE LIFE PLAN
Name Edgardo E. Dela Rosa Plan N/A
Address Sitio Dapdap Alas-asin, Mariveles, Bataan Policy Number N/A
Contact Number 09702397277 Plan Holder Name N/A
Relation to the Balance N/A
Deceased GRAND- MOTHER
Plan Type N/A
Casket: OMS PLAIN (LLP)_______
Mortuary Arrangement: ___HOUSE VIEWING__
Hearse / Van: ______MOON LIGHT FUNERAL VAN and Funeral Chariot______________
Number of Viewing Days: ________5 DAYS_____________
Remarks: ____________________________________________
Others: ________________________________________________________________________________________
SCHEDULE OF INTERMENT ADD ON FREEBIES
Date / Time: May 28, 2022 Water Dispenser, Tarpaulin, Chairs and tables, Candles
STIPULATION:
The undersigned /family hereby agrees to all the terms and conditions herein stipulated and hereby promises to pay Moonlight Funeral Services,
Inc. The cost services and other charges herein itemized ON OR BEFORE interment or cremation. The undersigned /family also agrees to the NO
PAYMENT, NO INTERMENT / NO CREMATION policy.
In case of complaint/s regarding the service rendered, the undersigned /family shall immediately inform the Company in order that appropriate and
expeditious action may be taken to address the complaint. Failure to immediate notify the Company shall be deemed to have performed its services. The
undersigned family also agrees that the Company shall not be liable for any damages, claims or causes of action attributable to the fault or negligence of
the deceased family /the undersigned or third parties. By signing, the undersigned /family agrees to all the stipulations and has read and understood and
conforms to the terms of the Release and Waiver set forth. Payable one (1) day before interment or cremation.
AL STEPHEN M. GULAPA
Contracting Party /Authorized Representative Family Care Representative
(Printed Name over Signature) (Printed Name over Signature)
Moonlight Funeral Services Inc.
Besides Goodspeed Cemetery, Brgy. Alas-asin, Mariveles, Bataan
SEC Reg. No.: 2021120034812-12
TIN No.: 605 – 271 – 458 – 000
“We committed to Serve from ‘Womb to Tomb!”
STIPULATION:
The undersigned /family hereby agrees to all the terms and conditions herein stipulated and hereby promises to pay Moonlight Funeral Services,
Inc. The cost services and other charges herein itemized ON OR BEFORE interment or cremation. The undersigned /family also agrees to the NO
PAYMENT, NO INTERMENT / NO CREMATION policy.
In case of complaint/s regarding the service rendered, the undersigned /family shall immediately inform the Company in order that appropriate and
expeditious action may be taken to address the complaint. Failure to immediate notify the Company shall be deemed to have performed its services. The
undersigned family also agrees that the Company shall not be liable for any damages, claims or causes of action attributable to the fault or negligence of
the deceased family /the undersigned or third parties. By signing, the undersigned /family agrees to all the stipulations and has read and understood and
conforms to the terms of the Release and Waiver set forth. Payable one (1) day before interment or cremation.
AL STEPHEN M. GULAPA
Contracting Party /Authorized Representative Family Care Representative
(Printed Name over Signature) (Printed Name over Signature)
Moonlight Funeral Services Inc.
Besides Goodspeed Cemetery, Brgy. Alas-asin, Mariveles, Bataan
SEC Reg. No.: 2021120034812-12
TIN No.: 605 – 271 – 458 – 000
“We committed to Serve from ‘Womb to Tomb!”
STIPULATION:
The undersigned /family hereby agrees to all the terms and conditions herein stipulated and hereby promises to pay Moonlight Funeral Services,
Inc. The cost services and other charges herein itemized ON OR BEFORE interment or cremation. The undersigned /family also agrees to the NO
PAYMENT, NO INTERMENT / NO CREMATION policy.
In case of complaint/s regarding the service rendered, the undersigned /family shall immediately inform the Company in order that appropriate and
expeditious action may be taken to address the complaint. Failure to immediate notify the Company shall be deemed to have performed its services. The
undersigned family also agrees that the Company shall not be liable for any damages, claims or causes of action attributable to the fault or negligence of
the deceased family /the undersigned or third parties. By signing, the undersigned /family agrees to all the stipulations and has read and understood and
conforms to the terms of the Release and Waiver set forth. Payable one (1) day before interment or cremation.
AL STEPHEN M. GULAPA
Contracting Party /Authorized Representative Family Care Representative
(Printed Name over Signature) (Printed Name over Signature)