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P'VdMtl "e Republic of the Philippines DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT BUREAU OF JAIL MANAGEMENT AND PENOLOGY NATIONAL HEADQUARTERS 144 Mindanao Avenue, Quezon City Trunklines: (+632)927-6383; 927-5505 Email Address: [email protected] Website: www.bjmp.gov.ph o REQUEST FOR QUOTATION The Bureau of Jail Management and Penology - National Headquarters (BJMP- NHQ), through its Bids and Awards Committee, intends to procure Preventive Maintenance of BJMP National Headquarters Air-conditioning Units, which will be undertaken in accordance with the 2016 Revised Implementing Rules and Regulations of Republic Act No. 9184. Name of the Project Preventive Maintenance of BJMP-National Headquarters Air-conditioning Units ABC Two Hundred Twenty-Three Thousand Two Hundred Pesos (Php 223,200.00) Specifications See Annex ADelivery Location BJMP National Headquarters, 144 Mindanao Avenue Project 8, Quezon City Contract Duration Six (6) months Please quote your best offer for the items/s described herein, subject to the Terms and Conditions provided at the last page of this RFQ. Submit your quotation duly signed by you or your authorized representative not later than______ j J^.N ^ . J________ at 5:00 PM Interested suppliers are required to submit the following documents: a. Valid and current Mayors Permit; b. PhilGEPS Registration Number (Please indicate in the space provided in Annex A); c. Omnibus Sworn Statement together with any documents to prove that the signatory of the quotation is authorized representative of the company or photocopy of ID bearing the picture/signature of the representative issued by the company (to be submitted before issuance of Notice of Award). Quotations may be submitted manually or email at the address and contact numbers indicated below. For further information, please refer to; J/INSP ARTURO R ESPOS JR Directorate for Logistics BJMP National Headquarters, 144 Mindanao Avenue, Project 8, Quezon City Telephone Number: 927-6383 local 202 Email Address; [email protected] DENNIS U RjOCAMORA, CESE Jail Chief Superintendent^i^^^l-^ Deputy Chief for Operations of the Jail Bureau Chairperson, BJMP-NHQ BAC "Cflanging Lives, 'BuiCcCing a Safer fNatum' Page 1 of 10
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DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT Preventive... · a. General cleaning of Air Conditioning Units (ACU’s) (Indoor and Outdoor Units) b. Use detergent or mild chemical

Apr 11, 2020

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Page 1: DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT Preventive... · a. General cleaning of Air Conditioning Units (ACU’s) (Indoor and Outdoor Units) b. Use detergent or mild chemical

P'VdMtl "e

Republic of the PhilippinesDEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT

BUREAU OF JAIL MANAGEMENT AND PENOLOGY NATIONAL HEADQUARTERS

144 Mindanao Avenue, Quezon City Trunklines: (+632)927-6383; 927-5505

Email Address: [email protected] Website: www.bjmp.gov.ph

o

REQUEST FOR QUOTATION

The Bureau of Jail Management and Penology - National Headquarters (BJMP- NHQ), through its Bids and Awards Committee, intends to procure Preventive Maintenance of BJMP National Headquarters Air-conditioning Units, which will be undertaken in accordance with the 2016 Revised Implementing Rules and Regulations of Republic Act No. 9184.

Name of the Project Preventive Maintenance of BJMP-National Headquarters Air-conditioning Units

ABC Two Hundred Twenty-Three Thousand Two Hundred Pesos (Php 223,200.00)

Specifications See Annex “A”Delivery Location BJMP National Headquarters, 144 Mindanao Avenue Project

8, Quezon CityContract Duration Six (6) months

Please quote your best offer for the items/s described herein, subject to the Terms and Conditions provided at the last page of this RFQ. Submit your quotation duly signed by you or your authorized representative not later than______ j J^.N ^ . J________ at5:00 PM

Interested suppliers are required to submit the following documents:

a. Valid and current Mayor’s Permit;b. PhilGEPS Registration Number (Please indicate in the space provided in

Annex “A”);c. Omnibus Sworn Statement together with any documents to prove that the

signatory of the quotation is authorized representative of the company or photocopy of ID bearing the picture/signature of the representative issued by the company (to be submitted before issuance of Notice of Award).

Quotations may be submitted manually or email at the address and contact numbers indicated below.

For further information, please refer to;

J/INSP ARTURO R ESPOS JRDirectorate for LogisticsBJMP National Headquarters, 144 Mindanao Avenue, Project 8, Quezon City Telephone Number: 927-6383 local 202 Email Address; [email protected]

DENNIS U RjOCAMORA, CESEJail Chief Superintendent^i^^^l-^ Deputy Chief for Operations of the Jail BureauChairperson, BJMP-NHQ BAC

"Cflanging Lives, 'BuiCcCing a Safer fNatum' Page 1 of 10

Page 2: DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT Preventive... · a. General cleaning of Air Conditioning Units (ACU’s) (Indoor and Outdoor Units) b. Use detergent or mild chemical

L_

Terms and Conditions

1. Bidders shall provide correct and accurate information required in this form.

2. Price quotations shall be denominated in Philippine Peso and shall include all taxes and/or levies payable.

3. Quotation exceeding the Approved Budget for the Contract shall be rejected.

4. Award of Contract shall be made to the Lowest Quotation (for goods and infrastructure) or, the highest rated offer (for consulting service) which complies with the minimum technical specification and other terms and conditions stated therein.

5. Any interlineations, erasure or overwriting shall be valid only if they are signed or initialed by you or your authorized representative/s.

6. The item/s shall be delivered according to requirement specified in the Technical Specifications.

7. The BJMP-NHQ shall have the right to inspect and/or to test the goods to conform their conformity to the technical specifications.

8. Liquidated damages equivalent to one tenth of one percent of the value of the goods not delivered within the prescribed delivery period shall be imposed per day of delay. The BJMP-NHQ shall rescind the contract once the cumulative amount of liquidated damages reaches ten percent (10%) of the amount of the contract, without prejudice to other course of action and remedies open to it.

I hereby understand and commit to comply all the above requirements in accordance with the above-stated terms and conditions.

Name and Signature of Authorized Representative:

Name of the Company/ Business Name________

Date: _______________________

Page 2 of 10

Page 3: DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT Preventive... · a. General cleaning of Air Conditioning Units (ACU’s) (Indoor and Outdoor Units) b. Use detergent or mild chemical

ANNEX“A”Name of the Company: Address:Business Permit No.:_____PhilGEPS Registration No.:. TIN: ______Telephone/ Cellphone Number: Email Address: ______

Instructions:1. Do not alter the contents of this form in any way.2. All the technical specifications are mandatory. Failure to comply with the

specification shall be a ground for the disqualification of your quotation.3. Failure to follow these instructions will disqualify your entire quotation.

TECHNICAL SPECIFICATIONS

Bidders must state either “Comply” or “Not Comply” or any equivalent term in the column “Statement of Compliance” against each of the individual parameters of each

Technical Specifications STATEMENT OF COMPLIANCE

1. The contractor shall perform regular Quarterly Preventive Maintenance to the One Hundred Three (103) Various Types of Air Conditioning Units (ACU’s) for a period of six (6) months.

2. The Contractor shall ensure that the equipment stays in good operating condition and minimize the possibility of any malfunctions of the equipment, which include the following:

a. General cleaning of Air Conditioning Units (ACU’s)(Indoor and Outdoor Units)

b. Use detergent or mild chemical in cleaning the evaporator and condenser coils to prevent corrosion and moderate pressurized water.

c. Inspect operational and various parts of the unit such as:

o air filters o cooling coils o condenser coils o condenser fan motor alignment o overload protection devices o performance of the compressor unit o fan bladeso blower assembly: and all associated

components of the units.d. Lubrication and maintain the noiselessness of the

ACU’se. Check conditions and performance of the items such as;

o settings of panel controls o operating controls o safety controlso thermostat; and gauges to ensure the optimum

performance.f. Check the proper refrigerant charge for the ideal

operation and performance of the unit.Page 3 of 10

Page 4: DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT Preventive... · a. General cleaning of Air Conditioning Units (ACU’s) (Indoor and Outdoor Units) b. Use detergent or mild chemical

g. Check all terminals and tight connections.h. Check-up the drain and remove partial clogging.i. Checklist for the different parts of the ACU’s

inspected / cleaned.j. Additional remarks, comments and recommendations

regarding the operational status of the ACU’s3. The Contractor shall perform the regular quarterly Preventive

Maintenance (PM) as indicated in the “Annex B”

4. It is the Contractor’s responsibility to assign a qualified technician/s with TESDA training and provide a free of charge items such as: lubricants and cleaning materials in the field of performing the preventive maintenance.

5. The contractor shall abide by and strictly follow all the requirements of security measure in returning the units to their original position after cleaning/checking-up the units to prevent accident and damage the government property.

6. The contractor shall be liable for all penalties, claims, compensations, damages on account of electrical/fire accidents caused if any due to the negligence of the contractors personnel or non-compliance of safety requirement.

7. In case of emergency, the contractor shall provide a “HOTLINE” which is open for 8 hours from Monday toSaturday to be used for emergency calls.

8. The contractor shall conduct the regular preventive maintenance during working hours from Mondays toSaturdays at 8:00 a.m to 5:00 p.m and should be completed within the agreed time and date as scheduled.REPORTING for Preventive Maintenance

9. The contractor shall provide a detailed inspection report after performing the regular quarterly preventive maintenance to Directorate for Logistics, BJMP National Headquarters.

10. The contractor shall provide a logbook and checklist of record for all preventive maintenance activities executed on each Air-Conditioning Units (ACU’s) together with the inspection results conducted and signed by your authorized technician and countersigned by the Directorate for Logistics authorized personnel.

11. The contractor shall provide a detailed report and recommendations for the minor and major conditions of each equipment and particularly on malfunctioning or defective parts of the ACUs to the Directorate for Logistics for appropriate action.Requirement for Repair of Malfunction and unconditional performance of the Units

12. Submit a quotation for minor and major defective parts for unreliable performance of each ACU’s to the Directorate for Logistics for evaluation and action.

13. Refer a highly skilled technician in the installation of the replacement items of each ACU’s to avoid further technical problems.

14. Provide immediate response or action when the procuring entity (BJMP) calls for maintenance service.Purchasing of Parts

15. Expenses for purchasing minor and major defective parts of the ACU’s shall be borne by the BJMP.

Page 4 of 10

Page 5: DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT Preventive... · a. General cleaning of Air Conditioning Units (ACU’s) (Indoor and Outdoor Units) b. Use detergent or mild chemical

16. The contractor shall bear all circumstances of all damaged parts or damaged government property made by its technician due to negligence with out safety precaution.

17. The contractor may claim additional service charge for installation of replaced items subject to agreed terms and conditions between the former and the BJMP.Payment

18. Payment shall be made on monthly basis based from the actual service rendered.

19. The contractor shall submit summary of service rendered and billing statement every month.

Financial OfferPreventive Maintenance of BJMP-National Headquarters Air-conditioning Units

Approved Budget for the Contract: Two Hundred Twenty-Three Thousand Two Hundred Pesos (Php 223,200.00)

Note: The goods are grouped in a single lot and the lot shall not be divided into sub-lots for the purpose of bidding, evaluation, and contract award.

Particulars Quantity Bidder’s Offer per Preventive MaintenanceWindow Type 35Wall Mounted 43Floor Mounted 20Ceiling Mounted 5Computation for Total Bid Amount Quantity x Bidders offer per Preventive

Maintenance x 2 (one per Quarter)TOTAL BID AMOUNT (In words and in figures)Payment Details:

Banking Institution:Account Number:

Account Name:Branch:

Name and Signature of Authorized Representative:

Name of the Company/ Business Name:_________

Date:_____________________ _

Page 5 of 10

Page 6: DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT Preventive... · a. General cleaning of Air Conditioning Units (ACU’s) (Indoor and Outdoor Units) b. Use detergent or mild chemical

ANNEX B (Kind’s/Types of ACU’s and Specification per Office and Schedule for Maintenance per Quarter)

Name of Office

Kind of ACU TotalUnitsACUper

Office

Schedule for Maintenance

Type of ACU/SpecificationsWindowTypesACU

SPLIT TYPE Quarter 1 Q uarter 2Wall

MountedFloor

MountedCeiling

Mounted JAN FEB MAR APR MAY JUN

BATCH 1

Office of the Chief

1

5

/ / Koppel, Floor Mounted, Split Type, 3TR1 / / Kolin, Floor Mounted, Split Type, 3TR1 / / Kolin, Floor Mounted, Split Type, 3TR

1 / / Wall Mounted, Split Type 1.5 HP1 / / Carrier, Window Type, 2.5HP

ChiefDirectorial Staff

1

3

/ / Koppel, Wall Mounted, 1.5HP Split Type

1 / /Arne. Home, Wall Mounted, Split Type,

1.5 HP1 / / Wall Mounted, Split Type 2HP

Deputy Chief for Operations

12

/ / Haier, Floor Mounted, Split Type, 3TR

1 / /Arne. Home, Wall Mounted, Split Type,

1.5 HPDeputy Chief

forAdministration

12

/ / LG, Wall Mounted, Split Type 2.5HP

1 / /Arne. Home, Wall Mounted, Split Type,

2.5 HPCommunity

Relations Serv. Office

1 1 / / Carrier, Floor mounted. Split Type, 3TR

MiniConference

Room1 1 / / Carrier, Floor mounted. Split Type, 3TR

Chaplaincy Service and

Chapel

1

5

/ / Arne. Home, Wall Mounted, 1.5 HP1 / / Arne. Home, Wall Mounted, 1.5 HP1 / / Arne. Home, Wall Mounted, 1.5 HP

1 Panasonic, Window Type, 2.5 HP

Page 6 of 10

Page 7: DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT Preventive... · a. General cleaning of Air Conditioning Units (ACU’s) (Indoor and Outdoor Units) b. Use detergent or mild chemical

1 / / Koppel, Window Type, 2.5 HPMainConferenceRoom

1 4 / / Kolin, Ceiling Mounted, Split Type 5TR

1 / / Kolin, Ceiling Mounted, Split Type 5TR1 / / Kolin, Ceiling Mounted, Split Type 5TR1 / / Daikin, Ceiling Mounted, Split Type, 5TR

JSIOC 1 2 / / Midea, Wall mounted. Split Type, 2.5HP1 / / Carrier, Floor Mounted, Split Type, 3TR

BJMPProvident Fund 1 1 / / Carrier, Window Type, 2.5

BATCH 2

Directorate for Operations

1

6

/ / LG, Window type, 2.5hp1 / / LG, Window type, 2.5hp1 / / LG, Window type, 2.5hp1 / / Condura, Window type, 2.5hp1 / / Condura, Window type, 2.5hp1 / / Condura, Window type, 2.5hp

Office of the NESJO 1 1 Kolin, Window type, 2.5hp

Directorate for Investigation

andProsecution

13

/ / Carrier, Floor Mounted Split type, 3TR1 / / Condura, Wall Mounted Split type, 2.5hp

1 / / Kolin, Window type 2.5hp

Finance Service Office

1

5

/ / Haier, Floor Mounted, 3TR1 / / Carrier, Window type,2.5hp1 / / Carrier, Window type,2.5hp1 Window Type, 2.5HP1 / / Carrier, Window type,1hp

Directorate for Comptrollership

1

6

/ / Arne home. Wall Mounted, Split type,2.5hp

1 / / LG, Floor Mounted, Split type, 3TR1 / / Kolin, Wall Mounted, Split type, 1.5hp1 / / Kolin, Wall Mounted, Split type, 1.5hp

1 / / Arne home. Wall Mounted, Split type,1.5hp

Page 7 of 10

Page 8: DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT Preventive... · a. General cleaning of Air Conditioning Units (ACU’s) (Indoor and Outdoor Units) b. Use detergent or mild chemical

1 / / Koppel, Wall Mounted, 1.5hp

DICTM

1

5

Carrier, Floor Mounted, Split Type, 3 TR

1 / /Arne home. Wall Mounted, Split

type,2.5hp1 Kolin, Window type,2.5hp1 Kolin, Window type,2.5hp1 / / Kolin, Window type,2.5hp

Directorate for Intellegence

13

/ / Midea, Floor mounted. Split Type, 3TR1 / / Midea, Wall Mounted, Split Type, 1.5HP

1 / / Condura, Window Type, 2.5HP

Directorate for logistics

1

4

Wall Mounted, Split Type, 3 HP1 Midea, Floor Mounted, Split Type, 5TR

1 Wall Mounted, Split Type, 1.5 HP1 Kolin, Window Type, 2.5hp

Legal Service Office

13

/ / Haier, Floor Mounted, Split type, 3TR1 / / LG,Wall Mounted Split type, 2.5hp

1 / / Kolin, Window type, 2.5hpSupply

AccountableOffice

12

/ / LG, Wall Mounted, 2.5hp

1 / / Kolin, Window type, 2.5hp

rwmDirectorate 1 / / Arne home. Wall Mounted, 2.5hpfor Program 1 3 / / Carrier, Ceiling Mounted.2.5hpDevelopment 1 / / LG, Window type,2.5hp

Accounting Service Office

1 / / Arne home. Wall Mounted, 2.5hp1 3 / / LG,Wall Mounted Split type, 2.5hp1 / / Carrier, Wall Mounted split type, 2.5 hp

Directorate 1 / / Koppel,Wall Mounted Split type, 2.5hpfor Inmate 1 4 / / Ame.Home,Wall Mounted,Split type,2.5hp

Welfare and 1 / / Ame.Home,Wall Mounted,Split type,2.5hpDevelopment 1 / / LG, Window type,2.5hp

COA 1 4 / / Koppel, Floor Mounted, Split type,3TR1 / / Koppel, Wall Mounted, Split type,2hp

Page 8 of 10

Page 9: DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT Preventive... · a. General cleaning of Air Conditioning Units (ACU’s) (Indoor and Outdoor Units) b. Use detergent or mild chemical

1 / / Wall Mounted, Split Type, 1 HP1 / / Wall Mounted, Split Type, 2.5hp

Directorate for Human Resource

andDevelopment

1

3

/ / Haier, Floor Mounted Split type, 3TR1 / / Haier,Floor Mounted Split type, 3TR

1 / / LG, Window type, 2.5hp

HealthService Office

1

5

/ / Carrier, Wall Mounted Split type, 1.5hp1 / / Carrier, Wall Mounted Split type, 1.5hp

1 / / Arne home. Wall Mounted Split type, 2.5hp

1 / /Arne home, Wall Mounted Split type,

1.5hp

1 / /Arne home. Wall Mounted Split type,

1.5hp

HSSU 1 2 / / LG, Window type, 2.5hp1 / / Carrier, Window type, 2.5hp

Directorate for Personnel

Records Management

1

12

/ / LG, Window type, 2.5hp1 / / LG, Window type, 2.5hp1 / / LG, Window type, 2.5hp1 / / LG, Window type, 2.5hp1 / / Kolin, Window type, 2.5hp

1 / / Koppel, Floor Mounted, Split type,3TR1 / / Koppel, Floor Mounted, Split type,3TR

1 / / Koppel, Wall Mounted Split type, 2.5hp1 / / Koppel, Wall Mounted Split type, 2.5hp1 / / Koppel, Wall Mounted Split type, 2.5hp

1 / / Condura, Window type, 2.5hp1 / / Midea, Floor Mounted, 3TR

ICTS Power Room

1 2 / / Koppel, Wall Mounted, Split type, 3hp1 / / Koppel, Wall Mounted, 3hp

Star Team Barracks 1 1 / / Carrier, Window type, 2.5 hp

Total 35 43 20 5 103 Toltal number of ACU’s with different types of cooling capacity from window type to split type units

Page 9 of 10

Page 10: DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT Preventive... · a. General cleaning of Air Conditioning Units (ACU’s) (Indoor and Outdoor Units) b. Use detergent or mild chemical

Annex C. (Summary of ACU’s for Preventive Maintenance per Month per Quarter)Monthly Schedule for

Preventive Maintenance Quantity of ACU’s Implemented Type/s of ACU’s Implemented

QUARTER 1

43 Wall mounted Split Type20 Floor Mounted Split Type5 Ceiling Mounted Split Type35 Window Type

QUARTER 2

43 Wall mounted Split Type20 Floor Mounted Split Type5 Ceiling Mounted Split Type35 Window Type

Page 10 of 10

Page 11: DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT Preventive... · a. General cleaning of Air Conditioning Units (ACU’s) (Indoor and Outdoor Units) b. Use detergent or mild chemical

OMNIBUS SWORN STATEMENT

REPUBLIC OF THE PHILIPPINES) CITY/MUNICIPALITY OF _____ ) S.S.

AFFIDAVIT

I, [Name of Affiant], of legal age, [Civil Status], [Nationality], and residing at [Address of Affiant], after having been duly sworn in accordance with law, do hereby depose and state that:

1. Select one, delete the other:

If a sole proprietorship: I am the sole proprietor or authorized representative of [Name of Bidder] with office address at [address of Bidder],

If a partnership, corporation, cooperative, or joint venture: I am the duly authorized and designated representative of [Name of Bidder] with office address at [address of Bidder];

2. Select one, delete the other:

If a sole proprietorship: As the owner and sole proprietor or authorized representative of [Name of Bidder], I have 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 ensuing contract for [Name of the Project] of the [Name of the Procuring Entity] [insert "as shown in the attached duly notarized Special Power of Attorney" for authorized representative];

If a partnership, corporation, cooperative, or joint venture: I am 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 ensuing contract for [Name of the Project] of the [Name of the Procuring Entity], accompanied by the duly notarized Special Power of Attorney, Board/Partnership Resolution, or Secretary's Certificate, whichever is applicable:

3. [Name of Bidder] is not "blacklisted" or barred from bidding by the Government of the Philippines or any of its agencies, offices, corporations, or Local Government Units, foreign government/foreign or international financing institution whose blacklisting rules have been recognized by the Government Procurement Policy Board;

4. Each of the documents submitted in satisfaction of the bidding requirements is an authentic copy of the original, complete, and all statements and information provided therein are true and correct:

5. [Name of Bidder] is authorizing the Head of the Procuring Entity or its duly authorized representative(s) to verify all the documents submitted;

6. Select one, delete the rest:If a sole proprietorship: The owner or sole proprietor is not related to the Head of the Procuring Entity, members of the Bids and Awards Committee (BAC), the Technical Working Group, and the BAC Secretariat, the head of the Project Management Office or the end-user unit, and the project consultants by consanguinity or affinity up to the third civil degree;

If a partnership or cooperative: None of the officers and members of [Name of Bidder] is related to the Head of the Procuring Entity, members of the Bids and Awards Committee

Page 12: DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT Preventive... · a. General cleaning of Air Conditioning Units (ACU’s) (Indoor and Outdoor Units) b. Use detergent or mild chemical

(BAG), the Technical Working Group, and the BAG Secretariat, the head of the Project Management Office or the end-user unit, and the project consultants by consanguinity or affinity up to the third civil degree;

If a corporation or joint venture: None of the officers, directors, and controlling stockholders of [Name of Bidder] is related to the Head of the Procuring Entity, members of the Bids and Awards Gommittee (BAG), the Technical Working Group, and the BAG Secretariat, the head of the Project Management Office or the end-user unit, and the project consultants by consanguinity or affinity up to the third civil degree;

7. [Name of Bidder] complies with existing labor laws and standards; and

8. [Name of Bidder] is aware of and has undertaken the following responsibilities as a Bidder:

a) Garefully examine all of the Bidding Documents;

b) Acknowledge all conditions, local or otherwise, affecting the implementation of the Gontract;

c) Made an estimate of the facilities available and needed for the contract to be bid, if any; and

d) Inquire or secure Supplemental/Bid Bulletin(s) issued for the [Name of the Project].

9. [Name of Bidder] did not give or pay directly or indirectly, any commission, amount, fee, or any form of consideration, pecuniary or otherwise, to any person or official, personnel or representative of the government in relation to any procurement project or activity.

IN WITNESS WHEREOF, 1 have hereunto set my hand this___day of_____________ Philippines.

20 at

[Bidder's Representative/Authorized Signatory]

SUBSCRIBED AND SWORN to before me this___day of [month] [year] at [place of execution],Philippines. Affiant/s is/are personally known to me and was/were identified by me through competent evidence of identity as defined in the 2004 Rules on Notarial Practice (A.M. No. 02- SI 3-SG). Affiant/s 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]

Doc. No_ Page No.- Book No_ Series of.

until

NAME OF NOTARY PUBLICSerial No. of Commission___Notary Public for_____Roll of Attorneys No--------------------------------PTR No._____[date issued], [place issued]IBP No._____[date issued], [place issued]