Doc. No. - Page No. - Book No. - Series of 2014

Omnibus Sworn Statement
--------------------------------------------------REPUBLIC OF THE PHILIPPINES)

MUNICIPALITY OF INFANTA....)S.S.
AFFIDAVIT
I, LEO D. LLACUNA, of legal age, married, Filipino and residing at San Jose St., Polillo, Quezon after having
been duly sworn in accordance with law, do hereby depose and state that;
1
I am the General Manager of L.D. LLACUNA CONSTRUCTION AND SUPPLY, with office address 16 San Jose
St., Polillo, Quezon.
I am granted full power and authority to do execute and perform any and all acts necessary and/or to
represent L.D. LLACUNA CONSTRUCTION AND SUPPLY, in the bidding for LABOR FOR THE
CONSTRUCTION/PREPARATION OF HORIZONTAL INFRASTRUCTURE.
L.D. LLACUNA CONSTRUCTION AND SUPPLY, is not blacklisted or barred from bidding by the
government of the Philippines or any of its agencies, office, corporations or Local Government Units
foreign government/foreign or international financing institution whose blacklisting rules have been
recognized by the Government Procurement Policy Board;
Each of the documents submitted in satisfaction of the bidding requirements is an authentic copy of the
original, completed, all statements and information provided therein are true and correct;
L.D. LLACUNA CONSTRUCTION AND SUPPLY, is authorizing the Head of the Procuring Entity or its duly
authorized representatives(s) to verify all the documents submitted;
I am 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 degree,
L.D. LLACUNA CONSTRUCTION AND SUPPLY complies with existing labor laws and standards, and
L.D. LLACUNA CONSTRUCTION AND SUPPLY is aware and has undertaken the following responsibilities as
a Bidders;
a.) Carefully examines all of the Bidding Documents;
b.) Acknowledge all conditions, local or otherwise, affecting the implementation of the contract;
c.) Made an estimate of the facilities available and needed for the contract to be bid, if any; and
Inquire or secure Supplemental/Bid Bulletin(s) issued for

CONSTRUCTION/PREPARATION OF HORIZONTAL INFRASTRUCTURE.
the
LABOR
FOR
THE
IN WITNESS WHEREOF, I have hereunto set my hand this _______ day of February 2014, at
Infanta, Quezon, Philippines.
LEO D. LLACUNA
General Manager
SUBSCRIBED AND SWORN to before me this ______ day of February, 2014 affiant exhibited to me his
Residence Certificate No.30488792 issued on January 6, 2014 at Polillo, Quezon.
Doc. No._____
Page No. ____
Book No._____
Series of 2014
Omnibus Sworn Statement

--------------------------------------------------REPUBLIC OF THE PHILIPPINES)
MUNICIPALITY OF LUCENA
)S.S.
AFFIDAVIT
I, LEO D. LLACUNA, of legal age, married, Filipino and residing at San Jose St., Polillo, Quezon after having
been duly sworn in accordance with law, do hereby depose and state that;
10 I am the General Manager of LD LLACUNA CONSTRUCTION & SUPPLY, with office address San Jose St.,
Polillo, Quezon.
11 I am granted full power and authority to do execute and perform any and all acts necessary and/or to
represent LD LLACUNA CONSTRUCTION & SUPPLY, in the bidding for construction of PBLARC MPC PHF
(post harvest facility) Brgy. Libjo, Polillo, Quezon.
12 LD LLACUNA CONSTRUCTION & SUPPLY, is not blacklisted or barred from bidding by the government of
the Philippines or any of its agencies, office, corporations or Local Government Units foreign
government/foreign or international financing institution whose blacklisting rules have been recognized
by the Government Procurement Policy Board;
13 Each of the documents submitted in satisfaction of the bidding requirements is an authentic copy of the
original, completed, all statements and information provided therein are true and correct;
14 LD LLACUNA CONSTRUCTION & SUPPLY, is authorizing the Head of the Procuring Entity or its duly
authorized representatives(s) to verify all the documents submitted;
15 I am 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 degree,
16 LD LLACUNA CONSTRUCTION & SUPPLY complies with existing labor laws and standards, and
17 LD LLACUNA CONSTRUCTION & SUPPLY is aware and has undertaken the following responsibilities as a
Bidders;
d.) Carefully examines all of the Bidding Documents;
e.) Acknowledge all conditions, local or otherwise, affecting the implementation of the contract;
f.) Made an estimate of the facilities available and needed for the contract to be bid, if any; and
g.) Inquire or secure Supplemental/Bid Bulletin(s) issued for the construction of PBLARC MPC PHF
(post harvest facility) Brgy. Libjo, Polillo, Quezon.
IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of August 2013, at Lucena City,
Philippines.
LEO D. LLACUNA
General Manager
SUBSCRIBED AND SWORN to before me this ___ day of August, 2013 affiant exhibited to me his
Residence Certificate No.22866692 issued on January 2, 2013 at Polillo, Quezon.
NOTARY PUBLIC
Doc. No._____
Page No. ____
Book No._____
Series of 2013

Doc. No. - Page No. - Book No. - Series of 2014

Uploaded by

Copyright:

Available Formats

Doc. No. - Page No. - Book No. - Series of 2014

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Doc. No. - Page No. - Book No. - Series of 2014

Uploaded by

Copyright:

Available Formats

Omnibus Sworn Statement

--------------------------------------------------REPUBLIC OF THE PHILIPPINES)

Inquire or secure Supplemental/Bid Bulletin(s) issued for

Omnibus Sworn Statement

You might also like