1

Honda Philippines, Inc.WARRANTY CLAIM REPORT

DU EK SAM, INC. MONTH YEAR

FEB. 2012 10110-12-047

PRODUCT LINE: MOTORCYCLE POWER PRODUCTSERVICING DEALER CODE NO. MODEL NAME

306035 CB110SERVICING DEALER NAME AND ADDRESS MODEL CODE

DU EK SAM, INC. June 24,2011 KWS

ATABAY, SAN JOSE, ANTIQUE FRAME NO.

TEL. NO. (036)5407118 Feb.24,2012 KWS00014631CUSTOMER NAME AND ADDRESS ENGINE NO.

ROBERT M. YEE II KWS00E014637Turko st.San jose,Antique 0001 DAYS DISTANCE

TEL. NO. N/A 2,020 KMMC / PP MAIN USAGE AND EQUIPMENT DEFECT COLOR TECHNICAL REPORT NO. IF ATTACHED

solo Silver

DESCRIPTION OF CUSTOMER (SYMPTOM) ILLUSTRATION / SKETCH / PICTURE / DRAWING

MECHANIC DIAGNOSIS AND COMPLETED REPAIR

REPAIRED PART / REPLACED PART LABORPART DESCRIPTION PART NO. Q.TY PRICE FLAT RATE TIME

MAIN CAUSAL PART

1 Mainshaft(11T) 23221-KWS-900 1 611.10 3.60

RELATED PART

2 Drum,Gearshift 24301-KWS-900 1 427.00 3.403 Gear,Mainshaft Fourth(24T) 23471-KWS-900 1 452.904 Gasket,l.crankcase cover 11395-KWS-900 1 59.505 Gasket,R.Crankcase 11394-KWS-901 1 82.606 Gasket,Cylinder 12191-KWS-900 1 9.107 0.008 0.009 0.00

10 0.0011 0.0012 0.00

REMARKS: MONTH DAY YEAR PARTS AMOUNT TOTAL FRT.

FILING DATE March 15, 2006 1,642.20 7.00

ARNOLD PALLER RALPH ABARIO 15% 314.20 200.00

1,956.40 1,400.00

ROBERT M. YEE II MARY GRACE ESPARAR

3,356.40 PHP

( HONDA PHILIPPINES USE ONLY )CHECKED BY:

APPROVED WRONG DATA

DISAPPROVED INCOMPLETE

REMARKS: Signature / DateAPPROVED BY:

Signature / Date

Hindi maayos ang takbo ng motor sa tuwing naka fourth gear ito.

Hindi match ang fourth gear sa Mainshaft transmission at shifting drum nito.

SHIPMENT FROMHONDA

MM - DD - YR

DEFECT CODE&COLOR

MALFUNCTIONEDDATE

PURCHASED DATE

REPAIRED DATE

PERIOD

DEALER NAME

LANDING COST ALLOWANCE

TOTAL PART COST

PARTS AND LABOUR COST

LABOR RATE

TOTAL LABOR COST

CURRENCY

BRANCH MANAGER NAME & SIGNATURE

DLR. MONTH SERIAL

PRINT

DRIVER/CUSTOMER NAME & SIGNATURE

MECHANIC NAME & SIGNATURE

MM - DD - YR

MM - DD - YR

MM - DD - YR

Prepared by:

NAME & SIGNATURE

ENGINE NO. FRAME NO. M. NAME M. CODE DISTANCE PUR. DATE MAL. DATE REPAIR DATE DAYS COLOR DEALER NAME DEALER ADDRESS CUSTOMER NAME CUSTOMER ADDRESS DESCRIPTION OF CUSTOMER (SYMPTOM) MECHANIC DIAGNOSIS AND COMPLETED REPAIR MAIN PART PART NUMBER 1 Q'TY 1 FRT 1 RELATED PART 2 PART NUMBER 2 FRT 2 RELATED PART 3 PART NUMBER 3 FRT 3 RELATED PART 4 PART NUMBER 4 Q'TY 4 FRT 4 RELATED PART 5 PART NUMBER 5 FRT 5 RELATED PART 6 PART NUMBER 6 Q'TY 6 FRT 6 RELATED PART 7 PART NUMBER 7 Q'TY 7 FRT 7 RELATED PART 8 PART NUMBER 8 FRT 8 RELATED PART 9 PART NUMBER 9 FRT 9 PART NUMBER 10 FRT 10 RELATED PART 11 PART NUMBER 11 FRT 11 RELATED PART 12 PART NUMBER 12 FRT 12

0.30

100110-05-001 XRM110ME-7055581E XRM12054-055581 XRM110 KPY 509 5/6/2005 5/13/2005 5/13/2005 1 51 RED 100110 L.G.K. GUANZON PEREZ BLVD., DAGUPAN CITY (02) 5335014 Richard Baclig Laoac Alcala Pang. (049) 742 3456 solo Maingay ang makina. May lumalagutok. Primary Clutch Assy 60046900030 1 1,254.00 1.3 Outer Comp Clutch 1111222222 01 250.00 piston 1231231231 01 300.00 2.3

100110-05-002 KB506054020850E KB506054020850 TMX155 KB5 611 5/9/2005 5/16/2005 5/16/2005 1 99 BLACK 100110 L.G.K. GUANZON PEREZ BLVD., DAGUPAN CITY (02) 7211050 Rosario Capitle JP Laurel St. Malasiqui Pang. (078) 635 6784 tricycl Umuusok ng puti ang tambutso. Piston Set 88 1 523.00 0.4 Cylinder Comp. 1234566777 1,289.00

100110-07-004 GCAET-1259857 GXMEGA 0 May 5,2007 July 19,2007 July 20,2007 1 RED 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)540-7118 RUSTICO DOMINGO LAPAZ, HAMTIC, ANTIQUE N/A BANGKA Ignition Coil 30500-ZF6-WO2 1 2316.16 0.2

100110-07-005 KB508E-022749 KB508022749 TMX155 KB5 391 July 6,2007 July 11,2007 July 12,2007 1 BLUE 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)540-7118 Ronald Colondes Igbobon,Patnongon,Antique N/A Solo Camshaft Comp. 14100-KCS-650 1 2,440.00 2.2 Valve exhaust 14721-KCS-650 01 634.00 Cotter,Valve 14781-HAO-770 02 110.00 Shaft,Cam gear 14423-KYO-890 01 588.00 O-ring 29x20 91318-590-000 01 67.00 Wash B Trust 14 90428-958-000 01 66.00

100110-07-006 KB58E045428 KB508045428 TMX155 KB5 JAN.16,2008 JAN.17,2008 JAN.17,2008 1 RED 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)540-7118 CARLO GALONO Pis-anan,Sibalom,Antique N/A solo Umuusok at tumatagos ang oil sa Exhaust Muffler Ring set,Piston S 13011-KRC-921 1 906.08 1.9

100110-07-007 KB508E047939 KB508047938 TMX155 KB5 0 FEB.7,2008 FEB.7,2008 FEB.12.2008 1 BLACK 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)540-7118 JOVELITO ROQUERO Ilaures,Bugasong,Antique N/A Solo Maingay ang loob ng makina Gear Comp.Starter 23520-KB5-000 1 1,481.76 3.8 Gear only,Idle Starter 23531-KB5-000 01 748.00

100110-08-008 KB508E048260 KB508048267 TMX155 KB5 3,000 Jan.31,2008 MAY.10,2008 MAY.10,2008 1 RED 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)540-7118 ROSENIO A.MAGBANUA Buhang,Hamtic,Antique N/A Solo Bumaluktot ang exhaust valve sanhi ng pagkawalan ng Exhaust Valve 14721-KCS-650 1 634.00 1.8

100110-08-009 XRM14E096363 XRM14096356 XRM125 KPY 506 MAY 10,2008 JUNE 17,2008 MAY 17,2008 1 BLACK 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)540-7118 ROMULO REGINIO Igbobon,Patnongon,Antique N/A solo Tumatagos ang oil sa Rear Cushion Cushion Assy.Rear 52400-KPG-902 1 3,116.24 0.4

100110-08-010 XRM14E075130 XRM14075129 XRM125 KPY 1,627 APRIL 29,2008 AUG.13,2008 AUG.14,2008 1 BLUE 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)540-7118 JESUS C. TALANTOR San Roque,Anini-y,Antique N/A solo Harness,Wire 32100-KPY-710 1 1,070.72 1.2 BOX,LUGGAGE 81250-KPG-900 01 698.88 COVER SET,L.BODY 64600-KPY-710ZB 01 294.56 COVER,CENTER 64330-KPG-900 01 108.64 STATOR COMP. 31120-KPY-711 01 1,601.60 SWITCH SET,CHANGE 35750-KPH-900 01 585.76

100110-09-013 KRZ03E004499 KRZ03004496 TMX125 KRZ 657 MAY 4,2009 MAY 26,2009 MAY 26,2009 1 BLACK 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)540-7118 Corner Real - Sang Dios ST.San N/A Solo Tumatagos ang oil sa Front Fork May leakage ang oil seal Seal Set,Front Fork 51490-469-305 2 696.64 1.2

100110-09-014 KPG00E016482 KPG00016469 XRM125RS KPG 2,418 APRIL 7,2009 MAY 26,2009 MAY 26,2009 1 BLACK 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)540-7118 MARK ANTHONY J. MAG Badiang,San Jose,Antique N/A solo Tumatagos ang oil sa Front Fork May leakage ang oil seal Seal Set,Front Fork 51490-KGH-901 01 211.68 0.8

100110-09-015 KB508E078126 KB5508078116 TMX155 KB5 7,394 JAN.23,2009 JUNE 30,2009 JULY 01,2009 1 RED 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)540-7118 JOSE RENE G.EVANGELI N/A Tricycle May Tumatagos na oil sa Cylinder Head Comp. Head Comp.Cylinder 12200-KB5-920 01 4,415.04 2.4

100110-09-017 XRM15E046193 XRM15046195 XRM125 KPY 8,095 FEB.04,2009 JULY 23,2009 JULY 23,2009 1 BLACK 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)540-7118 MOISES P. PASAQUIAN Igbical,Hamtic,Antique N/A solo Biglang Nasunog ang motor habang tumatakbo ito Harness,Wire 32100-KPY-710 01 1,114.40 1.2

100110-09-018 KB509E036008 KB509036004 TMX155 KB5 4,600 April 28,2009 Sept.11,2009 Sept.11,2009 1 Black 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)540-7118 ALFREDO Y. ENILA Egaña,Sibalom,Antique N/A Tricycle May Tumatagos na oil sa Cylinder Head Comp. Head Comp.Cylinder 12200-KB5-920 01 4,415.04 2.4

100110-09-019 KCN05E008751 KCN05008751 XR200 KCN 8,902 Dec.02,2009 Sept.30,2009 Oct.01,2009 1 Black 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (0360540-7118 Antique Electric Cooperati San Jose,Antique N/A solo May Tumatagos na gasolina sa Fuel Tank. Set,Fuel Tank 17520-KCN-D30ZA 01 5,216.96 0.3

100110-09-020 KVL11E122157 KVL11022150 WAVE125 KVL 5,881 APRIL.2,2009 Oct.11,2009 Oct.13,2009 1 BLACK 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)540-7118 BALDEV SINGH Capadocia st.San Jose,Antique N/A Solo May Tumatagos na oil sa Rear Cushion Cushion Assy,Rear 52400-KPH-E21 01 1,743.84 0.4

100110-09-021 KWY00E010814 KWY10010843 WAVE100 KWY 116 Oct.22,2009 Nov.05,2009 Nov.05,2009 1 RED 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)540-7119 FOTUNATO M. GASPAR Culasi,Antique N/A solo Damage oil Pump Assy. Pump Assy,oil 15100-KFJ-910 01 837.76 1.2 Head Comp.Cyl.Head 12200-KPG-900 01 3,696.00 Shaft,Valve Rocker Arm 14451-035-000 02 99.68 Arm,Valve Rocker 14431-GN5-911 02 433.44 Camshaft Comp. 14100-KFM-900 01 1,664.32 Cyl.Head Comp. 12100-KFM-900 01 3,376.80 Ring set,Piston 13011-KFL-851 01 304.64 Piston 13101-KFV-950 01 275.52 1.5 Pin,Piston 13111-087-000 01 68.32 Gasket,Cylinder 12191-KFL-850 01 39.20 Gasket,Carb.Insulator 16201-KCW-851 01 39.20 Gasket,L.Cyl Head 12395-KFL-850 01 4.48

100110-09-022 KB509E034230 KB509034225 TMX155 KB5 8,011 April 14,2009 Nov.25,2009 Nov.25,2009 1 Black 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)540-7118 ALEXANDER L. CRUZ N/A solo Biglang namatay ang Makina habang Tumatakbo ito Nasira ang C.D.I unit C.D.I unit 30410-KB5-921 01 1,402.24

100110-09-023 KWY00E040176 KWY00040171 Wave 100 KWY 123 Dec.11,2009 Dec.22,2009 Dec.22,2009 1 BLACK 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)540-7118 TEDDY B. SILVESTRE Centro sur,Culasi,Antique N/A solo May Tumatagos na oil sa Makina Oil Seal,30x42x4.5 91201-GB4-691 01 42.56 0.9 Oil Seal 91202--GB4-692 01 104.16

100110-10-024 GCADT-1134995 GX270 TQP Feb.26,2009 Feb.02,2010 Feb.02,2010 1 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)5407118 GEMIMA ARMILLA N/A Bangka Coil Assy.Ignition 30500-Z1C-023 01 838.00 0.2

100110-10-025 KWY00E000964 Wave100 KWY 0 July 02,2010 July 02,2010 1 Black 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)5407118 DU EK SAM, INC. Atabay,San Jose,Antique N/A Hindi ito mai-Shift sa Fourth gear Kulang ang Gearshift Drum Pin Pin,Gearshift Drum 24421-200-000 01 9.00 1.1 Gasket,R.Crankcase 11394-KFL-850 01 113.00

100110-10-026 KB509E134769 KB509134768 TMX155 KB5 71 June 26,2010 July 03,2010 July 20,2010 1 Black 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)5407118 SONNY P. ESCARLAN Villaflor,Tobias Fornier,Antique N/A solo Damage oil Pump Assy. Pump Assy,oil 15100-KB5-721 01 3131.00 0.7 Gasket,R.Crankcase 11393-KTO-710 01 335.00 Cylinder head comp. 12100-KB5-720 01 1,903.00 Piston 13101-KB5-920 01 1,216.00 1.9 Ring set,Piston 13011-KRC-921 01 990.00 Cyl.head Gasket 12191-KY0-600 01 142.00 Follower,Cam 14421-KCS-650 02 2,480.00 2.2 Shaft,Cam follower 14422-397-000 01 665.00 Shaft,Cam gear 14423-KY0-890 01 645.00 O-ring 91333-KE5-003 01 70.00 O-ring 91318-590-000 01 65.00 Push Rod 14440-KB5-000 02 1,330.00

100110-10-027 KB509E134769 KB509134768 TMX155 KB5 71 June 26,2010 July 03,2010 July 20,2010 1 Black 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)5407118 SONNY P. ESCARLAN Atabay,San Jose,Antique N/A solo Additional to WCR #100110-10-026 Camshaft Comp. 14100-KCS-650 01 3858.00 2.2 Holder Comp.Valve Rocker Arm 14400-KCS-650 01 2,772.00 Head comp.Cylinder 12200-KB5-920 01 4,416.00

100110-10-028 KB509E136369 KB509136364 TMX155 KB5 5,050 June 2,2010 July 29,2010 July 29,2010 1 Blue 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)5407118 LEO R. NANLABI Nueva St.Patnongon,Antique N/A solo May tumatagos na oil sa Right Crankcase cover May damage ang Right crankcase gasket Gasket R.Cover 11393-KTO-710 01 335.00 0.6

10110-10-029 KB509E128504 KB50918502 TMX155 KB5 2,928.04 Jan.14,2010 Aug.17,2010 Aug. 17,2010 1 Red 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)5407118 EDSEL T. MANTAC Ilaud,Bugasong,Antique N/A solo Tumatagos ang oil sa Right crankcase cover Damage ang right crankcase Gasket Gasket R.Cover 11393-KTO-710 01 335.00 0.6

10110-10-030 KB509E143753 KB509143749 TMX155 KB5 3,713 June 28,2010 Aug.24,2010 Aug.24,2010 1 Red 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)5407118 HERNANI A. EBOSIO Delima,Belison,Antique N/A solo Tumatagos ang oil sa Right crankcase cover Damage ang right crankcase Gasket Gasket R.Cover 11393-KTO-710 01 335.00 0.6

10110-10-031 TM155 KB5 Black 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)5407118 N/A Tricycle May Tumatagos na oil sa Rear Cushion May damage ang Rear cushion Cushion Assy.RR 52400-402-013ZA 01 4038.00 0.1

10110-11-031 KB509E177222 KB509177218 TMX155 KB5 7,886 NOV.13,2010 MARCH 03,2010 MARCH 03,2010 1 RED 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)5407118 PEUZY M. ELIZAN Buhang,Hamtic,Antique N/A Tricycle Tumatagos ang oil sa Right crankcase cover Damage ang right crankcase Gasket Gasket R.Cover 11393-KVC-901 01 527.00 0.6

10110-11-032 KSW00E002072 KSW00002066 CB110 KSW 2,446 OCT.07,10 March 20,2011 March 21,2011 1 Black 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)5407118 PRIM ROSE C. ELGUIRA Pob.2,Hamtic,Antique N/A solo Mainshaft(11T) 23211-KWS-900 873.00 3.6 Drum,Gearshift 24301-KWS-900 01 610.00 3.4 Gear,Mainshaft Fourth(24T) 23471-KWS-900 01 647.00 Gasket,L.Crankcase cover 11395-KWS-900 01 85.00 Gasket,R.Crankcase 11394-KWS-901 01 118.00 Gasket,Cylinder 12191-KWS-900 01 13.00

10110-11-033 KWS00E002866 KWS00002889 CB110 KSW 9,050 OCT.28,2010 April 30,2011 May 02,2011 1 Silver 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)5407118 JOSERITO G.CHECA N/A solo Mainshaft(11T) 23211-KWS-900 01 873.00 3.6 Drum,Gearshift 24301-KWS-900 01 610.00 3.4 Gear,Mainshaft Fourth(24T) 23471-KWS-900 01 647.00 Gasket,L.Crankcase cover 11395-KWS-900 01 85.00 Gasket,R.Crankcase 11394-KWS-901 01 118.00 Gasket,Cylinder 12191-KWS-900 01 13.00

10110-11-034 KWS00E009423 KWS00009418 CB110 KWY 4,227 March 08,2011 May 21,2011 May 23,2011 1 Black 303035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)5407118 BJORN DENFIELD L. HUD Pob.Patnongon,Antique N/A solo Mainshaft(11T) 23211-KWS-900 01 873.00 3.6 Drum,Gearshift 24301-KWS-900 01 610.00 3.4 Gear,Mainshaft Fourth(24T) 23471-KWS-900 01 647.00 Gasket,L.Crankcase cover 11395-KWS-900 01 85.00 Gasket,R.Crankcase 11394-KWS-901 01 118.00 Gasket,Cylinder 12191-KWS-900 01 13.00

10110-11-035 KWS00E014059 KWS00014053 CB110 KWY 1,333 May 26,2011 June 24,2011 June 24,2011 1 RED 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)5407118 KNEEPOLL B. TONOG Lacayon,Bugasong,Antique N/A solo Tumatagos ang oil sa Cover comp.cyl.head May leakage ang cover comp.cyl.head Cover comp.Cyl.head 12310-kws-900 01 581.00 0.3

10110-11-036 KWS00E007827 KWS00007824 CB110 KWY 8,450 May 21,2011 July 06,2011 July 06,2011 1 Red 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)5407118 SHAUN V. ARDEñA Buhang,Hamtic,Antique N/A solo Mainshaft(11T) 23211-KWS-900 01 873.00 3.6 Drum,Gearshift 24301-KWS-900 01 610.00 3.4 Gear,Mainshaft Fourth(24T) 23471-KWS-900 01 647.00 Gasket,L.crankcase cover 11395-KWS-900 01 85.00 Gasket,R.Crankcase 11394-Kws-901 01 118.00 Gasket,Cylinder 12191-KWS-900 01 13.00

10110-11-037 KB509E218992 KB509218988 TMX155 KB5 8,050 March 19,2011 July 26,2011 July 26,2011 1 Red 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)5407118 DEXTER B. NIEVES Badiang,San jose,Antique N/A Tricycle Tumatagos ang oil sa Right crankcase cover May damage ang Right crankcase gasket Gascket R. Cover 11393-KVC-901 01 527.00 0.6

10110-11-038 KB509E207888 KB509207891 TMX155 KB5 4,986 Feb.08,2011 Sep.08,2011 Sep.8,2011 1 Blue 303036 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)5407118 NOEL GORDON Cabariuan,Sibalom,Antique N/A tricycle Tumatagos ang oil sa Right crankcase cover May damage ang Right crankcase gasket Gasket R.Cover 11393-KVC-901 01 527.00 0.6

10110-11-039 KB509E245318 KB509245332 TMX155 KB5 3,806 July 09,2011 Nov.17,2011 Nov.17,2011 1 Red 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)407118 CASIANO SANCHEZ N/A solo Tumatagos ang oil sa Right crankcase cover May damage ang Right crankcase gasket Gasket R.Cover 11393-KVC-901 01 527.00 0.6

10110-11-040 KB509E246802 KB509246899 TMX155 KB5 300 NOV.07,2011 Nov.17,2011 1 Black 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)5407118 TEODORA P. SEVILLENO Siwaragan,San Joaquin,Iloilo N/A solo Wheel Sub Assy.Fr. 44650-KB5-305 01 3795.00 1.0 Cam,Fr.Brake 43141-KB4-000 01 716.00 Arm,Fr.Brake 43410-402-000 01 542.00 Tank set,Fuel 17500-kb5-950ZA 01 2,937.00 0.2

10110-11-041 GCABT-3875175 GX160 0 APRIL 28,2011 DEC.12,2011 DEC.12,2011 1 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)5407118 VIRGINIA RUBIO San Pedro,San Jose,Antique N/A solo Caburetor Assy. 16100-ZOV-821 01 1442.00 0.2

10110-11-042 KB509E246802 KB509246899 TMX KB5 NOV.07,2011 DEC.19,2011 DEC,19,2011 1 Black 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)5407118 TEODORA P. SEVILLENO Siwaragan,San Joaquin,Iloilo N/A solo Tank set,Fuel 17500-KB5-950ZA 01 2937.00 0.2

10110-11-043 KWS00E004895 KWS00004893 CB110 KWS 5,420 Dec.28,2010 Dec.21,2011 1 Silver 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)5407118 AMPARADOS S.SEMENIA N/A solo Mainshaft(11T) 23221-KWS-900 01 873.00 3.6 Drum,Gearshift 24301-KWS-900 01 610.00 3.4 Gear,Mainshaft Fourth(24T) 23471-KWS-900 01 647.00 Gasket,L.Crankcase cover 11395-KWS-900 01 85.00 Gasket,R.Crankcase 11394-KWS-901 01 118.00 Gasket,Cylinder 12191-KWS-900 01 13.00

10110-11-044 GCABT-3875175 GX160 0 APRIIL 28,2011 DEC.29,2011 DEC.29,2011 1 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)5407118 VIRGINIA RUBIO San Pedro,San Jose,Antique N/A Bangka Carburetor Assy. 16100-ZOV-821 01 1442.00 0.2

10110-11-045 KB509E246802 KB509246899 TMX KB5 134 NOV.07,2011 JAN.11,2012 1 Black 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)5407118 TEODORA P. SEVILLENO Siwaragan,San Joaquin,Iloilo N/A solo Wheel Sub Assy.Fr. 44650-KB5-305 01 3795.00 1.0 Cam,Fr.Brake 43141-KB4-000 01 716.00 Arm.Fr.Brake 43410-402-000 01 542.00 Tank set,Fuel. 17500-KB5-950ZA 01 2,937.00 0.2

10110-12-046 XRM17E033215 XRM17033210 XRM125(Motard) KPY 725 DEC.27,2011 1 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)5407118 GRACIANO V. VILLASIS N/A solo May sira ang Meter comp.Fuel METER COMP.FUEL. 37350--KPY-A01 01 0.3

10110-12-047 KWS00E014637 KWS00014631 CB110 KWS 2,020 June 24,2011 Feb.24,2012 1 Silver 306035 DU EK SAM, INC. ATABAY, SAN JOSE, ANTIQUE (036)5407118 ROBERT M. YEE II Turko st.San jose,Antique N/A solo Mainshaft(11T) 23221-KWS-900 01 873.00 3.6 Drum,Gearshift 24301-KWS-900 01 610.00 3.4 Gear,Mainshaft Fourth(24T) 23471-KWS-900 01 647.00 Gasket,l.crankcase cover 11395-KWS-900 01 85.00 Gasket,R.Crankcase 11394-KWS-901 01 118.00 Gasket,Cylinder 12191-KWS-900 01 13.00

DEALER CLAIMS NUMBER

D. CODE

D'LER. CODE

DEALER CONTACT NUMBER

CUSTOMER CONTACT NUMBER

MC / PP USAGE(SOLO, TRI, BANGKA,

ETC)

CURRENT SRP

Q'TY 2

CURRENT SRP

Q'TY 3

CURRENT SRP

CURRENT SRP

Q'TY 5

CURRENT SRP

CURRENT SRP

CURRENT SRP

Q'TY 8

CURRENT SRP

Q'TY 9

CURRENT SRP

RELATED PART 10

Q'TY 10

CURRENT SRP

Q'TY 11

CURRENT SRP

Q'TY 12

CURRENT SRP

Standard lahat ang rpm, valve clearance pati oil level. Pero may kalog ang clutch weight. Pinalitan ang primary clutch pati outer comp. Saka palang nag-ok.

Nagasgas ang cylinder bore dahil walang piston pin lock.

Biglang namatay ang makina sa kalagitnaan ng kanilang paggamit.

Mahina ang supply ng kuryente galing sa ignition coil kaya namamatay pag mainit na ang makina. Pinalitan ang ignition coil at saka nag ok.

Biglang namatay ang makina at nawalan ng kompresyon,Biglang umingay ang makina

Ok ang oil level at clearance ng valve,maingay at biglang namatay ang makina.Pinalitan ang exhaust valve at camshaft comp.kaya ok na ang motor

Kulang ang Oil Ring kaya tumatagos ang oil at umuusok sa tuwing tumatakbo ang motorHindi match ang Gear Comp.Starter sa Gear only,Idle Starter.kaya ito umiingay sa tuwing tumatakbo ang motor.

Biglang namatay ang makina at nawalan ng kompresyon

May leakage ang oil seal ng Rear cushion kaya tumatagos angoil

Biglang umusok at nasunog ang Harness Wire habang tumatakbo ang motor

Nagkashort circuit ang electrical mula sa socket ng source coil

REY JAMES E.MOSCOSO

Crossing Villa Hermosa,Sibalom,Antique

May Leakage ang Cylinder Head Comp.Kaya dapat itong Palitan

Nagkaroon ng short Circuit sa Harness,Wire dahilan ng pagkasunog nito

May Leakage ang Cylinder Head Comp.Kaya dapat itong Palitan

May maliit na butas sa Fuel Tank Dahilan ng may tumatagos na gasolina,Kaya dapat itong palitan

May Leakage ang oil sa Rear Cushion,Kaya dapat itong palitan.

Na Overheat ang Motor dahilan ng Pagkasira ng iba pang pyiesa

Brgy.Mabini,San Jose Occ.Mindoro

May Leakage ang oil seal at O-Ring Sa Flywheel Comp.kaya dapat iton palitan

Maybato North,San Jose,Antique

Biglang Namatay ang makina at Nawalan ito ng kompresyon.

Mahina ang supply ng kuryente galing sa ignition coil kaya namamatay pag mainit na ang makina. Pinalitan ang ignition coil at saka nag ok.

Na Overheat ang Motor dahilan ng Pagkasira ng iba pang pyiesa

Hindi maayos ang takbo ng motor sa tuwing naka fourth gear ito.

Hindi match ang fourth gear sa Mainshaft transmission at shifting drum nito.

Sunset sub.Dalipe,San jose,Antique

Hindi maayos ang takbo ng motor sa tuwing naka fourth gear ito.

Hindi match ang fourth gear sa Mainshaft transmission at shifting drum nito.

Hindi maayos ang takbo ng motor sa tuwing naka fourth gear ito.

Hindi match ang fourth gear sa Mainshaft transmission at shifting drum nito.

Hindi maayos ang takbo ng motor sa tuwing naka fourth gear ito.

Hindi match ang fourth gear sa Mainshaft transmission at shifting drum nito.

Ipayo St.Pob.Patnongon,Antique

Customer complaint of her unit that during cleaning of her unit she found out that the front Wheel sub assy.have rusty

Mechanic checked the unit he found out that the Fr.Wheel hub assy.rusty

Mataas palagi ang tunog ng makina,Namamatay sa tuwing nkaminor ito.

Nilinis ng mikaniko ang carburetor at inadjust ang valve clearance pero ganon parin.Pinalitan ang carburetor assy at saka ng ok.

The customer complain that the paint on fuel tank was bubbling and there is a trace of gasoline from the fuel cap that causes the paint to melt and become damaged.

The mechanic checked the unit and said that maybe the mixture of paint is not fine.

Guibongan Bayunan,San Joaquin,Iloilo

Hindi maayos ang takbo ng motor sa tuwing naka fourth gear ito.

Hindi match ang fourth gear sa Mainshaft transmission at shifting drum nito.

Mataas palagi ang tunog ng makina,Namamatay sa tuwing nkaminor ito.

Nilinis ng mikaniko ang carburetor at inadjust ang valve clearance pero ganon parin.Pinalitan ang carburetor assy at saka ng ok.

Customer complaint of her unit that during cleaning of her unit she found out that the front Wheel sub assy.have rusty and also the paint of Fuel tank was bubbling and there is a trace of gasoline from the fuel cap that causes the paint to melt and become damage

Mechanic checked the unit he found out that the Fr.Wheel hub assy.rusty.And also mechanic said that maybe the mixture of paint is not fine.

Bagumbayan,Tobias fornier,Antique

Hindi gumagana ang Meter comp.Fuel.hindi ito gumagalaw khit puno ang tanke ng motor.

Hindi maayos ang takbo ng motor sa tuwing naka fourth gear ito.

Hindi match ang fourth gear sa Mainshaft transmission at shifting drum nito.

Please type your discount here.Ex. 30%, you may type 0.3

SELLING DEALER NAME MONTH YEAR PREPARED BY FILING DATE

Guanzon, Malolos Bulacan May 2005 Juan dela Cruz Rudy Fernandez Robert Arebalo Leon Guerrero May 26, 2005

ABC, Canlubang, Laguna May 2005 Noel Santos Leo Martinez Jerry Castro Danny Cruz May 29, 2005

DU EK SAM, INC. JULY 2007 RUSTICO DOMINGO RALPH ABARIO RODOLFO BINOBO ARNOLD PALLER AUGUST 29,2007

DU EK SAM, INC. JULY 2007 RONALD S. COLONDESRALPH ABARIO RODOLFO BINOBO ARNOLD PALLER July 12,2007

DU EK SAM, INC. JAN. 2008 CARLO GALONO RALPH ABARIO RODOLFO BINOBO ARNOLD PALLER JAN.17,2008

DU EK SAM, INC. FEB. 2008 JOVELITO ROQUERO RALPH ABARIO RODOLFO BINOBO ARNOLD PALLER FEB.12,2008

DU EK SAM, INC. May 2008 ROSENIO A. MAGBANUADINDO ALTEJOSRODOLFO BINOBO ARNOLD PALLER May.10,2008

DU EK SAM, INC. JUNE 2008 ROMULO REGINIO RALPH ABARIO RODOLFO BINOBO ARNOLD PALLER JUNE,17,2008

DU EK SAM, INC. AUG. 2008 JESUS C. TALANTORDINDO ALTEJOSRODOLFO BINOBO ARNOLD PALLER AUG.13,2008

DU EK SAM, INC. May 2009 REY JAMES E. MOSCOSORALPH ABARIO RODOLFO BINOBO ARNOLD PALLER May 26,2009

DU EK SAM, INC. May 2009MARK ANTHONY J. MAGBANUARALPH ABARIO RODOLFO BINOBO ARNOLD PALLER May 26,2009

DU EK SAM, INC. JULY 2009JOSE RENE G. EVANGELISTARALPH ABARIO RODOLFO BINOBO ARNOLD PALLER JULY 01,2009

DU EK SAM, INC. JULY 2009 MOISES P. PASAQUIANRALPH ABARIO RODOLFO BINOBO ARNOLD PALLER JULY 23,2009

DU EK SAM, INC. july 2009 ALFREDO Y. ENILA RALPH ABARIO RODOLFO BINOBO ARNOLD PALLER SEPT.11,2009

DU EK SAM, INC. Oct. 2009 Antique Electric CooperativeRALPH ABARIO RODOLFO BINOBO ARNOLD PALLER Oct.01,2009

DU EK SAM, INC. Oct. 2009 BALDEV SINGH RALPH ABARIO RODOLFO BINOBO ARNOLD PALLER Oct.13,2009

DU EK SAM, INC. Oct. 2009 FORTUNATO M. GASPARRALPH ABARIO RODOLFO BINOBO ARNOLD PALLER Nov.05,2009

DU EK SAM, INC. Nov. 2009 ALEXANDER L. CRUZ RALPH ABARIO RODOLFO BINOBO ARNOLD PALLER Nov.25,2009

DU EK SAM, INC. Dec. 2009 TEDDY B. SILVESTRE RALPH ABARIO RODOLFO BINOBO ARNOLD PALLER DEC.22,2009

DU EK SAM, INC. JAN. 2010 GEMIMA ARMILLA RALPH ABARIO RODOLFO BINOBO ARNOLD PALLER Feb.2010

DU EK SAM, INC. JULY 2010 DU EK SAM,INC RALPH ABARIO RODOLFO BINOBO ARNOLD PALLER July 1, 2010

DU EK SAM, INC. JULY 2010 SONNY P.ESCARLAN RALPH ABARIO RODOLFO BINOBO ARNOLD PALLER July 20,2010

DU EK SAM, INC. JULY 2010 SONY P. ESCARLAN RALPH ABARIO RODOLFO BINOBO ARNOLD PALLER July 20,2010

DU EK SAM, INC. JULY 2010 LEO R. NANLABI RALPH ABARIO RODOLFO BINOBO ARNOLD PALLER July 29,2010

DU EK SAM, INC. AUG. 2010 EDSEL T. MANTAC RALPH ABARIOMARY GRACE SAN PEDROARNOLD PALLER AUG.17,2010

DU EK SAM, INC. AUG. 2010 HERNANI A. EBOSIO RALPH ABARIOMARY GRACE SAN PEDROARNOLD PALLER AUG.24,2010

DU EK SAM, INC. Nov. 2010 RALPH ABARIOMARY GRACE SAN PEDROARNOLD PALLER Nov.24

DU EK SAM, INC. MARCH 2011 PEUZY M. ELIZAN DINDO ALTEJOSMARY GRACE SAN PEDROARNOLD PALLER MARCH 03,2011

DU EK SAM, INC. MARCH 2011 PRIM ROSE C. ELGUIRARALPH ABARIOMARY GRACE SAN PEDROARNOLD PALLER

DU EK SAM, INC. May 2011 JOSERITO G. CHECA RALPH ABARIOMARY GRACE SAN PEDROARNOLD PALLER May 02,2011

DU EK SAM, INC. May 2011BJORN DENFIELD L. HUDIEREZRALPH ABARIOMARY GRACE SAN PEDROARNOLD PALLER May 23,2011

DU EK SAM, INC. June 2011 KNEEPOLL B. TONOG RALPH ABARIOMARY GRACE SAN PEDROARNOLD PALLER June,24 2011

DU EK SAM, INC. July 2011 SHUAN V. ARDEñA RALPH ABARIOMARY GRACE SAN PEDROARNOLD PALLER July 06,2011

DU EK SAM, INC. JULY 2011 DEXTER B. NIEVES RALPH ABARIOMARY GRACE SAN PEDROARNOLD PALLER July 26,2011

DU EK SAM, INC. Sept. 2011 NOEL GORDON RALPH ABARIOGRACE SAN PEDRO ARNOLD PALLER SEPT.08,2011

DU EK SAM, INC. Nov. 2011 CASIANO SANCHEZ RALPH ABARIOMARY GRACE ESPARARARNOLD PALLER Nov.17,2011

DU EK SAM, INC. Nov. 2011 TOEDORA P. SEVILLENORALPH ABARIOMARY GRACE ESPARARARNOLD PALLER Nov.17,2011

DU EK SAM, INC. Dec. 2011 VIRGINIA RUBIO RALPH ABARIOMARY GRACE ESPARARARNOLD PALLER DEC 12,2011

DU EK SAM, INC. Dec. 2011 TEODORA P. SEVILLENARALPH ABARIOMARY GRACE ESPARARARNOLD PALLER DEC.19,2011

DU EK SAM, INC. Dec. 2011AMPARADOS S. SEMENIANORALPH ABARIOMARY GRACE ESPARARARNOLD PALLER DEC.21,2011

DU EK SAM, INC. Dec. 2011 VIRGINIA RUBIO RALPH ABARIOMARY GRACE ESPARARARNOLD PALLER DEC.29,2011

DU EK SAM, INC. JAN. 2012 TEODORA P. SEVILLENARALPH ABARIOMARY GRACE ESPARARARNOLD PALLER JAN.09,2012

DU EK SAM, INC. JAN. 2012 GRACIANO V. VILLASISRALPH ABARIOMARY GRACE ESPARARARNOLD PALLER JAN.25,2012

DU EK SAM, INC. FEB. 2012 ROBERT M. YEE II RALPH ABARIOMARY GRACE ESPARARARNOLD PALLER Feb.24,2012

DRIVER /CUSTOMER'S

NAME

MECHANIC NAME

BRANCH MANAGER'S

NAME