Department of Public Works and Highways Contract ID: Contract Name: Location of the Contract: ------------------------------------------------------------------------------------------ ---------------------------------------------------------------------------------------------------------------------- DPWH-INFR-20-2016 Page 1 of 1 BIDDER’S CHECKLIST OF REQUIREMENTS FOR ITS BID, INCLUDING TECHNICAL AND FINANCIAL COMPONENTS OF THE BID The Technical Component shall contain the following: PhilGEPS Certificate of Registration and Membership a. If not yet enrolled in the CWR o PCAB License and Registration o Statement of All Ongoing Government and Private Contracts o SLCC o NFCC Computation and Statement of Total Assets and Total Liabilities o JVA, if applicable b. If already enrolled in the CWR but wishes to update Eligibility Documents o Documents to be updated: ________________________________________ Bid Security (Form DPWH-INFR-09, 10, or 11, as applicable) Project Requirements: o Duly initialed Organizational Chart for the Contract (Form DPWH-INFR-12) o Duly initialed Contractor’s List of Key Personnel for the Contract (Form DPWH- INFR-13) o Duly initialed List of Contractor’s Major Equipment (Form DPWH-INFR-14) o Sworn statement under RA9184-IRR Sec. 25.2b)iv) (Form DPWH-INFR-15) Signatory is proprietor/duly authorized representative of bidder. Full power and authority to perform acts or represent bidder. Not “blacklisted” or barred from bidding. Each document is authentic copy of original, complete, and correct. Authorizing Head of Procuring Entity to verify all documents submitted. Not related to HOPE, BAC, TWG, Secretariat, PMO/IU, within 3 rd civil degree. Complies with existing labor laws and standards. Aware of and undertaken responsibilities as a bidder. Did not give any commission, amount, fee, or consideration. The Financial Component shall contain the following: Duly signed Bid Form Duly signed Bid Prices in the Bill of Quantities (Forms DPWH-INFR-16 and 17) Duly initialed Detailed Estimates Duly initialed Cash Flow by Quarter (Form DPWH-INFR-18)
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Department of Public Works and Highways
Contract ID:
Contract Name:
Location of the Contract: ------------------------------------------------------------------------------------------
----------------------------------------------------------------------------------------------------------------------DPWH-INFR-20-2016 Page 1 of 1
BIDDER’S CHECKLIST OF REQUIREMENTS FOR ITS BID, INCLUDING
TECHNICAL AND FINANCIAL COMPONENTS OF THE BID
The Technical Component shall contain the following:
PhilGEPS Certificate of Registration and Membership
a. If not yet enrolled in the CWR
o PCAB License and Registration
o Statement of All Ongoing Government and Private Contracts
o SLCC
o NFCC Computation and Statement of Total Assets and Total Liabilities
o JVA, if applicable
b. If already enrolled in the CWR but wishes to update Eligibility Documents
o Documents to be updated: ________________________________________
Bid Security (Form DPWH-INFR-09, 10, or 11, as applicable)
Project Requirements:
o Duly initialed Organizational Chart for the Contract (Form DPWH-INFR-12)
o Duly initialed Contractor’s List of Key Personnel for the Contract (Form DPWH-
INFR-13)
o Duly initialed List of Contractor’s Major Equipment (Form DPWH-INFR-14)
o Sworn statement under RA9184-IRR Sec. 25.2b)iv) (Form DPWH-INFR-15)
Signatory is proprietor/duly authorized representative of bidder.
Full power and authority to perform acts or represent bidder.
Not “blacklisted” or barred from bidding.
Each document is authentic copy of original, complete, and correct.
Authorizing Head of Procuring Entity to verify all documents submitted.
Not related to HOPE, BAC, TWG, Secretariat, PMO/IU, within 3rd civil degree.
Complies with existing labor laws and standards.
Aware of and undertaken responsibilities as a bidder.
Did not give any commission, amount, fee, or consideration.
The Financial Component shall contain the following:
Duly signed Bid Form
Duly signed Bid Prices in the Bill of Quantities (Forms DPWH-INFR-16 and 17)
Duly initialed Detailed Estimates
Duly initialed Cash Flow by Quarter (Form DPWH-INFR-18)
Department of Public Works and Highways
Contract ID:
Contract Name:
Location of the Contract: ----------------------------------------------------------------------------------------
DPWH-INFR-09-2016 Page 1 of 2
BID FORM
Date:
To: Name of Procuring Entity
Address
We, the undersigned, declare that:
a. we have examined and have no reservation on the Bidding Documents (BDs), including
Supplemental/Bid Bulletins, for the above stated Contract;
b. we offer to execute the Works for this Contract in accordance with the said BDs, including
the Bid Data Sheet, General and Special Conditions of Contract, Specifications and Drawings
therein;
c. we present our Bid to execute the Works, consisting of our Technical Proposal (Annex “A”)
and our Financial Proposal (Annex “B”);
d. our Technical Proposal includes the following required documents:
(1) Bid Security in the required form, amount and validity period, using Form DPWH-INFR-
09, 10, or 11, as applicable (Annex “A-1”)
(2) Organizational Chart for the Contract, using Form DPWH-INFR-13 (Annex “A-3”)
(3) Contractor’s Certification on Key Personnel for the Contract, with the Key Personnel’s
Affidavits of Commitment to Work on the Contract, using Form DPWH-INFR-14
(Annex “A-4”)
(4) List of Contractor’s Major Equipment Pledged for the Contract, using Form DPWH-
INFR-15 (Annex “A-5)
(5) Omnibus Sworn Statement required under RA 9184-IRR Sec. 25.2b)iv), using Form
DPWH-INFR-16 (Annex “A-6”);
e. our Financial Proposal includes the following required documents:
(1) This Bid Form (Annex “B-1”)
(2) Bid prices in the Bill of Quantities Form, using Forms DPWH-INFR-17 and 18 (Annex
“B-2”)
(3) Detailed estimates (Annex “B-3”)
(4) Cash flow by quarter, using Form DPWH-INFR-19 (Annex “B-4”);
f. the total price of our Bid for this Contract based on the unit prices in the said Bill of
Quantities, excluding any discounts offered in item (g) below, is: total Bid price in words
and in figures;
g. the discounts we offer and the methodology for their application for this Contract are: N/A;
Department of Public Works and Highways
Contract ID:
Contract Name:
Location of the Contract: ----------------------------------------------------------------------------------------
DPWH-INFR-09-2016 Page 2 of 2
h. our Bid shall be valid for a period of _______________________ days from the date fixed
for the opening of bids in accordance with the Bidding Documents, and it shall remain
binding upon us and may be accepted by you at any time before the expiration of that
period;
i. if our Bid is accepted and we receive from you a Notice of Award, we commit, within ten
(10) calendar days from our receipt of the said Notice, (1) to submit to you the required
Performance Security and other documents prescribed in the Bidding Documents, and (2)
to sign the Contract Agreement;
j. we understand that, if the contract is awarded to us, this Bid, together with your written
acceptance thereof through your Notice of Award, shall constitute a binding contract
between us, until a formal Contract Agreement is prepared and executed;
k. we understand that you are not bound to accept the Lowest Calculated Bid or any other Bid
that you may receive;
l. we acknowledge that failure to sign each page of this Form of Bid and the accomplished
Bill of Quantities shall be a ground for the rejection of our Bid; and
m. we likewise certify/confirm that the undersigned is the duly authorized representative of the
Bidder, and granted full power and authority to do, execute and perform any and all acts
necessary to participate, submit the Bid, and to sign and execute the appropriate contract
documents for the abovementioned Contract.
Name: ______________________________
In the capacity of:
Signed:
Duly authorized to sign the Bid for and on behalf of:
Date:
Department of Public Works and Highways
Contract ID:
Contract Name:
Location of the Contract: ------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- DPWH-INFR-13-2016 Page 1 of 1
LIST OF THE CONTRACTOR’S MAJOR CONSTRUCTION AND LABORATORY EQUIPMENT UNITS TO BE ASSIGNED TO THE CONTRACT, SUPPORTED BY
CERTIFICATIONS OF AVAILABILITY
Business Name : __________________________________
Business Address : __________________________________
__________________________________
Description Model/Year Capacity /
Performance / Size
Plate No. Motor No. / Body
No.
Location Condition Proof of Ownership /
Lease/Purchase
A. Owned1
i.
ii.
iii.
iv.
v.
B. Leased2
i.
ii.
iii.
iv.
v.
C. Under Purchase Agreements3
i.
ii.
iii.
iv.
v.
1 Attached are copies of sales invoices / Registration Certificates from LTO.
2 Attached are the certifications from the lessors that the equipment units under B (Leased) shall be available for this contract.
3 Attached are the certifications from the vendors that the equipment units under C (Purchase Agreements) shall be available for this contract.
Minimum major constructions equipment requirement as prescribed in the Bid Data Sheet: Minimum major laboratory equipment requirements as prescribed in Bid Data Sheer:
-------------------------------------------------------------------------------------------------------------------------------------- DPWH-INFR-16-2016 Page 3 of 3
SUBSCRIBED AND SWORD to before me this __ day of [month] [year] at [place of
execution], Philippines. Affiant/s is personally known to me and was identifies by me through
competent evidence of identity as defined in the 2004 Rules on Notarial Practice (A.M. No.
02-8-13-SC). Affiant exhibited to me his/her. [Insert type of government identification card
used] with his/her photograph and signature appearing thereon, with no. ______.
Witness my hand and seal this __ day of [month] [year].
NAME OF NOTARY PUBLIC
Serial No. of Commission _________
Notary Public for _____ until ______
Rolls of Attorneys No. ______
PTR No. __, [date issued], [place issued]
IBP No. __, [date issued], [place issued]
Doc. No. ___
Page No. ___
Book No.___
Series of ___,
INTEGRITY PLEDGE For DPWH Constructor
Contract ID No.: _____________ Contract Name: __________________________________________________________________
_________________________________________________________________ Location of Contract: _______________________________________________________________
We believe that the corruption detracts from the contribution of infrastructure projects to national development.
We recognize that the national executive government, in particular the DPWH leadership, is taking
initiatives to reduce corruption and promote integrity.
We realize that such initiatives cannot be successful without our full cooperation.
As professionals, business owners and development partners, we are fully aware of our responsibility
to our stakeholders and to society to conduct our business with the highest degree of professionalism and ethical standards.
In view of the following, we pledge the following:
• We will promote healthy competition and will not engage in collusion and rigging that make a
mockery of the biding process.
• We will provide value-for-money services by including in our bid offers only the cost that go
directly to the project and reasonable profit, and by executing projects in accordance with
engineering standards.
• We will not engage in bribery in cash or in any other form and we will not offer or yield to any
demand or request for payoff money.
• We will maintain only one book of accounts and we will ensure that our financial reports are
accurate and transparent.
• We will install internal controls and systems for good governance and accountability.
• We will ensure that our employees embrace our commitment to integrity by developing or enhancing our inter Code of Conduct.
• We will continue to participate di dialogues with DPWH and fellow contractors to address any
concerns in a fair transparent manner.
____________________________________
Name and signature ____________________________________ Chief Executive Officer/Managing Owner ____________________________________ Company ____________________________________ Date Signed
Department of Public Works and Highways
Contract ID No.: _____________ Contract Name: ____________________________________________________________________
Location of Contract: _________________________________________________________________
Additional Technical Requirement
(DEPARTMENT ORDER NO. 09 DATED FEBRUARY 27, 2012)
I, _____________________, Filipino, of legal age with postal and business address at ____________ _______________________________________________, hereby state that:
1. That I am the Authorized Managing Officer Manager/President of ______________________ __________________firm duly licensed, organized and existing by virtue of the laws of the
Republic of the Philippines with postal and business address at ________________________ __________________________.
2. That the Equipment we have pledge in the project to be bid will be available for inspection during the post qualification period in the office compound ___________________________
_________________________________________ in compliance with Department Order No. 09 series of 2012 (dated February 27, 2017) and Department Order No. 58 series of 2012.
3. That the Technical Personnel I have submitted in the bidding documents is an employee of
my firm and if working on another project at the time of the bidding, I certify that: (1) the
personnel will be pulled out form the on-going project once the contract is awarded and (2) he/she will be replaced with another person with equal or better qualification.
4. That I am making this statement is part of the requirement for the Technical Proposal of the
Republic of the Philippines ) ______________________ ) S.S.
SUBSCRIBED AND SWORD TO before this ____ day of __________________________ 2017
at ________________________________________, Philippines, affiant exhibiting this Community Tax Certificate No. ____________________issued at_____________________ on ___________________.
Notary Public
Doc. No.______
Page No.______
Book No.______ Series 2018
-------------------------------------------------------------------------------------------------------------------------------------------- DPWH-INFR-05-1015 Page 4 of 15
2. List of all contracts completed by the contractor both in government and in private sector: Attach Annex “I”
Contract ID
Contract Name
Owner
Contractor’s Role &
Participation %
Contract Date
Major Categories of
Work Code Refer to
Attachment A
Dimensions
Refer to Attachment A
Total As Built Cost per Major Work Category
(PhP) Start
mm/dd/yy
Actual Completion mm/dd/yy
-------------------------------------------------------------------------------------------------------------------------------------------- DPWH-INFR-05-1015 Page 5 of 15
3. List of all on-going contracts including those already awarded but not yet started, both government and in the private sector: Attach Annex “J”
Note: Cost must be in Philippine Peso computed on the date of the signing of the Contract.