DATE: ABC

:
PROJECT:
BIDDER:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
Republic of the Philippines
Province of Quezon
Municipality of Polillo
(1st Envelope)
***Please accomplish and submit in two(2) copies properly indexed and certified true copy by the company.***
I
M
P
.


O
F
F
I
C
E
M
E
M
B
E
R
M
E
M
B
E
R
M
E
M
B
E
R
V
.
-
C
H
A
I
R
M
A
N
C
H
A
I
R
M
A
N
Initials of BAC Members if document is included.
I. ELIGIBILITY REQUIREMENTS - INFRASTRUCTURE PROJECTS
Class "A" Documents
Registration Certificate from SEC, DTI for sole proprietorship, or CDA for cooperatives
Valid PCAB license and registration for the type and and cost of the contract to be bid
Valid and Current Mayor's Permit/Municipal License.
Certificate of BIR Registration (including copy of TIN card)
G-EPS Registration Certificate
Tax Clearance (BIR)
Statement of the prospective bidder of all its ongoing government and private contract , including contract
awarded but not yet started.
Duly signed statement of all Government & Private Contracts completed which are similar in nature.
Bidder's audited financial statements, stamped "received" by the BIR or its duly accredited authorized
institutions, for the immediately preceding calendar year, showing among others the total and current assets
and liabilities.
Latest Income Tax Return (ITR including confirmation receipt)
Duly signed computation of NFCC or a commitment from a licensed bank to extend to him a credit line if
awarded the contract, or a cash deposit certificate equivalent to 10% of the ABC.
Class "B" Documents
Valid Joint Venture Agreement, if applicable.
Recent photo of office (showing business signboard) and working area. Attach in long bond paper
14. Company profile
II. BID SECURITY
Form
a. Cash, Certified Check, Cashier’s Check, Manager's Check
Bank Draft or Irrevocable Letter of Credit, 2% of ABC
b. Bank Guarantee, 2% of ABC
c. Surety Bond 5% of ABC
Validity Period: 120 calendar days from opening
Form of Bid Security
Company
Number
Official Receipt No.
Validity Period
Callable on Demand
Bid Security Amount
1.
III. PROJECT REQUIREMENTS
1.
2.
3.
4.
5.
6.
7.
8.
IV. SWORN STATEMENT BY THE PROSPECTIVE BIDDER OR ITS DULY AUTHORIZED REPRESENTATIVE
1.
2.
3.
4.
Duly Signed Construction Schedule and S-curve.
Duly Signed Manpower Schedule.
Duly Signed Construction Method in narrative form.
Duly Signed Equipment Utilization Schedule.
Duly Signed Construction Safety and Health Program
Bid Security ( ) Sufficient ( ) Insufficient
Duly signed Organizational Chart for the contract to be bid.
List of Contractor's Personnel to be assigned to the contract to be bid, with their complete qualification and
experience data.
List of contractor's equipment units, which are owned, leased and/or under purchase agreements, supported
by certification of availability of equipment lessor/vendor for the duration of the project.
Sworn statement of the prospective bidder that it is not “blacklisted” or barred from bidding by the
Government or any of its agencies, offices, corporations or LGUs, including non-inclusion in the
Consolidated Blacklisting Report issued by the GPPB or CIAP .
Sworn statement that each of the documents submitted in satisfaction of the eligibility requirements is an
authentic and original copy, or a true and faithful reproduction of the original, complete, and that all
statements and information provided therein are true and correct.
Sworn statement authorizing the Head of the Procuring Entity or his duly authorized representative/s to
verify any or all of the documents submitted.
Sworn statement that the signatory is the duly authorized representative of the prospective bidder, and
granted full power and authority to do, execute and perform any and all acts necessary and/or to represent
the prospective bidder in the bidding, with the duly notarized Secretary's Certificate attesting to such fact, if
the prospective bidder is a corporation, partnership, cooperative or joint venture.
5.
6.
7.
8.
Remarks: ( ) Passed ( ) Failed
Sworn statement of site inspection
Sworn statement that the bidder is not related to the head of procuring entity, members of the BAC, TWG
and Secretariat and members of the PMO or End-User Unit and the designers of the project, by
consanguinity or affinity up to the third civil degree and other provision under Section 47 of RA 9184 in
relation to other provisions of RA 3019
Sworn statement attesting to have complied with bidder's responsibilities
Sworn statement in compliance with existing labor laws and standards.
Note: Any missing document in the above checklist is a ground for outright rejection of the bid.
DATE: ABC:
PROJECT:
BIDDER:
1.
2.
3.
4.
Remarks: ( ) Complying ( ) Non-Complying
Initials of BAC Members if document is included.
Duly Signed Bid Prices in the Bill of Quantities
Duly Signed Detailed Estimates
I
M
P
.


O
F
F
I
C
E
M
E
M
B
E
R
M
E
M
B
E
R
M
E
M
B
E
R
V
I
C
E
-
C
H
A
I
R
M
A
N
C
H
A
I
R
M
A
N
Duly Signed Cash Flow by Quarter and Payments Schedule
Recurring and maintenance Cost, if applicable
Shall contain the following information/documents and shall be opened only if the bidder has complied with the requirements of the First
Envelope.
Province of Quezon
Municipality of Polillo
(2nd Envelope)
***Please accomplish and submit in two(2) copies properly indexed ***
Republic of the Philippines
Republic of the Philippines
Province of Quezon
Municipality of Polillo
(1st Envelope)
***Please accomplish and submit in two(2) copies properly indexed and certified true copy by the company.***
I. ELIGIBILITY REQUIREMENTS - INFRASTRUCTURE PROJECTS
Class "A" Documents
Registration Certificate from SEC, DTI for sole proprietorship, or CDA for cooperatives
Valid PCAB license and registration for the type and and cost of the contract to be bid
Valid and Current Mayor's Permit/Municipal License.
Certificate of BIR Registration (including copy of TIN card)
G-EPS Registration Certificate
Tax Clearance (BIR)
Statement of the prospective bidder of all its ongoing government and private contract , including contract
awarded but not yet started.
Duly signed statement of all Government & Private Contracts completed which are similar in nature.
Bidder's audited financial statements, stamped "received" by the BIR or its duly accredited authorized
institutions, for the immediately preceding calendar year, showing among others the total and current assets
and liabilities.
Latest Income Tax Return (ITR including confirmation receipt)
Duly signed computation of NFCC or a commitment from a licensed bank to extend to him a credit line if
awarded the contract, or a cash deposit certificate equivalent to 10% of the ABC.
Class "B" Documents
Valid Joint Venture Agreement, if applicable.
Recent photo of office (showing business signboard) and working area. Attach in long bond paper
Company profile
120 calendar days from opening
IV. SWORN STATEMENT BY THE PROSPECTIVE BIDDER OR ITS DULY AUTHORIZED REPRESENTATIVE
Duly Signed Construction Schedule and S-curve.
Duly Signed Manpower Schedule.
Duly Signed Construction Method in narrative form.
Duly Signed Equipment Utilization Schedule.
Duly Signed Construction Safety and Health Program
Bid Security ( ) Sufficient ( ) Insufficient
Duly signed Organizational Chart for the contract to be bid.
List of Contractor's Personnel to be assigned to the contract to be bid, with their complete qualification and
experience data.
List of contractor's equipment units, which are owned, leased and/or under purchase agreements, supported
by certification of availability of equipment lessor/vendor for the duration of the project.
Sworn statement of the prospective bidder that it is not “blacklisted” or barred from bidding by the
Government or any of its agencies, offices, corporations or LGUs, including non-inclusion in the
Consolidated Blacklisting Report issued by the GPPB or CIAP .
Sworn statement that each of the documents submitted in satisfaction of the eligibility requirements is an
authentic and original copy, or a true and faithful reproduction of the original, complete, and that all
statements and information provided therein are true and correct.
Sworn statement authorizing the Head of the Procuring Entity or his duly authorized representative/s to
verify any or all of the documents submitted.
Sworn statement that the signatory is the duly authorized representative of the prospective bidder, and
granted full power and authority to do, execute and perform any and all acts necessary and/or to represent
the prospective bidder in the bidding, with the duly notarized Secretary's Certificate attesting to such fact, if
the prospective bidder is a corporation, partnership, cooperative or joint venture.
Sworn statement of site inspection
Sworn statement that the bidder is not related to the head of procuring entity, members of the BAC, TWG
and Secretariat and members of the PMO or End-User Unit and the designers of the project, by
consanguinity or affinity up to the third civil degree and other provision under Section 47 of RA 9184 in
relation to other provisions of RA 3019
Sworn statement attesting to have complied with bidder's responsibilities
Sworn statement in compliance with existing labor laws and standards.
Note: Any missing document in the above checklist is a ground for outright rejection of the bid.
Duly Signed Bid Prices in the Bill of Quantities
Duly Signed Detailed Estimates
Duly Signed Cash Flow by Quarter and Payments Schedule
Recurring and maintenance Cost, if applicable
Shall contain the following information/documents and shall be opened only if the bidder has complied with the requirements of the First
Envelope.
Province of Quezon
Municipality of Polillo
(2nd Envelope)
***Please accomplish and submit in two(2) copies properly indexed ***
Republic of the Philippines
DATE: ABC:
PROJECT:
BIDDER:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Republic of the Philippines
Province of Quezon
Municipality of Polillo
(1st Envelope)
***Please accomplish and submit in two(2) copies properly indexed and certified true copy by the company.***
I. ELIGIBILITY REQUIREMENTS - GOODS
Bidder's audited financial statements, stamped "received" by the BIR or its duly accredited authorized
institutions, for the immediately preceding calendar year, showing among others the total and current assets
and liabilities.
M
E
M
B
E
R
Class "B" Documents
Statement of the prospective bidder of all its ongoing government and private contract , including contract
awarded but not yet started.
C
H
A
I
R
M
A
N
Class "A" Documents
Duly signed statement of all Government & Private Contracts completed which are similar in nature.
Valid Certification of Compliance from Bureau of Food and Drugs and Product Registration from Food and
Drugs Authority (for firm selling drugs and medicines)
G-EPS Registration Certificate
Tax Clearance (BIR)
I
M
P
.


O
F
F
I
C
E
M
E
M
B
E
R
Valid and Current Mayor's Permit/Municipal License.
Valid Joint Venture Agreement, if applicable.
Latest Income Tax Return (ITR including confirmation receipt)
Duly signed computation of NFCC or a commitment from a licensed bank to extend to him a credit line if
awarded the contract, or a cash deposit certificate equivalent to 10% of the ABC.
M
E
M
B
E
R
V
.
-
C
H
A
I
R
M
A
N
Initials of BAC Members if document is included.
Registration Certificate from SEC, DTI for sole proprietorship, or CDA for cooperatives
Certificate of BIR Registration (including copy of TIN card)
13.
14.
Recent photo of office (showing business signboard) and working area. Attach in long bond paper
Company profile
II. BID SECURITY
Form
a. Cash, Certified Check, Cashier’s Check, Manager's Check
Bank Draft or Irrevocable Letter of Credit, 2% of ABC
b. Bank Guarantee, 2% of ABC
c. Surety Bond 5% of ABC
Validity Period: 120 calendar days from opening
Form of Bid Security
Company
Number
Official Receipt No.
Validity Period
Callable on Demand
Bid Security Amount
1.
III. TECHNICAL SPECIFICATIONS
1.
2.
3.
4.
IV. SWORN STATEMENT BY THE PROSPECTIVE BIDDER OR ITS DULY AUTHORIZED REPRESENTATIVE
1.
2.
3.
4.
5.
Sworn statement authorizing the Head of the Procuring Entity or his duly authorized representative/s to
verify any or all of the documents submitted.
Sworn statement that the signatory is the duly authorized representative of the prospective bidder, and
granted full power and authority to do, execute and perform any and all acts necessary and/or to represent
the prospective bidder in the bidding, with the duly notarized Secretary's Certificate attesting to such fact, if
the prospective bidder is a corporation, partnership, cooperative or joint venture.
Sworn statement that the bidder is not related to the head of procuring entity, members of the BAC, TWG
and Secretariat and members of the PMO or End-User Unit and the designers of the project, by
consanguinity or affinity up to the third civil degree and other provision under Section 47 of RA 9184 in
relation to other provisions of RA 3019
Production/ delivery schedule
Manpower requirements
After sales service parts, if applicable
Duly signed Organizational Chart
Sworn statement of the prospective bidder that it is not “blacklisted” or barred from bidding by the
Government or any of its agencies, offices, corporations or LGUs, including non-inclusion in the
Consolidated Blacklisting Report issued by the GPPB or CIAP .
Sworn statement that each of the documents submitted in satisfaction of the eligibility requirements is an
authentic and original copy, or a true and faithful reproduction of the original, complete, and that all
statements and information provided therein are true and correct.
Bid Security ( ) Sufficient ( ) Insufficient
6.
7.
Remarks: ( ) Passed ( ) Failed
Sworn statement attesting to have complied with bidder's responsibilities
Note: Any missing document in the above checklist is a ground for outright rejection of the bid.
Sworn statement in compliance with existing labor laws and standards.
DATE: ABC:
PROJECT:
BIDDER:
1.
2.
Remarks: ( ) Complying ( ) Non-Complying
Shall contain the following information/documents and shall be opened only if the bidder has complied with the requirements of the First
Envelope.
Republic of the Philippines
Province of Quezon
Municipality of Polillo
(2nd Envelope)
***Please accomplish and submit in two(2) copies properly indexed ***
V
I
C
E
-
C
H
A
I
R
M
A
N
C
H
A
I
R
M
A
N
Initials of BAC Members if document is included.
Duly Signed Bid Prices in the Bill of Quantities
Recurring and maintenance Cost, if applicable
I
M
P
.


O
F
F
I
C
E
M
E
M
B
E
R
M
E
M
B
E
R
M
E
M
B
E
R
Republic of the Philippines
Province of Quezon
Municipality of Polillo
(1st Envelope)
***Please accomplish and submit in two(2) copies properly indexed and certified true copy by the company.***
I. ELIGIBILITY REQUIREMENTS - GOODS
Bidder's audited financial statements, stamped "received" by the BIR or its duly accredited authorized
institutions, for the immediately preceding calendar year, showing among others the total and current assets
and liabilities.
Class "B" Documents
Statement of the prospective bidder of all its ongoing government and private contract , including contract
awarded but not yet started.
Class "A" Documents
Duly signed statement of all Government & Private Contracts completed which are similar in nature.
Valid Certification of Compliance from Bureau of Food and Drugs and Product Registration from Food and
Drugs Authority (for firm selling drugs and medicines)
G-EPS Registration Certificate
Tax Clearance (BIR)
Valid and Current Mayor's Permit/Municipal License.
Valid Joint Venture Agreement, if applicable.
Latest Income Tax Return (ITR including confirmation receipt)
Duly signed computation of NFCC or a commitment from a licensed bank to extend to him a credit line if
awarded the contract, or a cash deposit certificate equivalent to 10% of the ABC.
Registration Certificate from SEC, DTI for sole proprietorship, or CDA for cooperatives
Certificate of BIR Registration (including copy of TIN card)
Recent photo of office (showing business signboard) and working area. Attach in long bond paper
Company profile
120 calendar days from opening
IV. SWORN STATEMENT BY THE PROSPECTIVE BIDDER OR ITS DULY AUTHORIZED REPRESENTATIVE
Sworn statement authorizing the Head of the Procuring Entity or his duly authorized representative/s to
verify any or all of the documents submitted.
Sworn statement that the signatory is the duly authorized representative of the prospective bidder, and
granted full power and authority to do, execute and perform any and all acts necessary and/or to represent
the prospective bidder in the bidding, with the duly notarized Secretary's Certificate attesting to such fact, if
the prospective bidder is a corporation, partnership, cooperative or joint venture.
Sworn statement that the bidder is not related to the head of procuring entity, members of the BAC, TWG
and Secretariat and members of the PMO or End-User Unit and the designers of the project, by
consanguinity or affinity up to the third civil degree and other provision under Section 47 of RA 9184 in
relation to other provisions of RA 3019
Production/ delivery schedule
Manpower requirements
After sales service parts, if applicable
Duly signed Organizational Chart
Sworn statement of the prospective bidder that it is not “blacklisted” or barred from bidding by the
Government or any of its agencies, offices, corporations or LGUs, including non-inclusion in the
Consolidated Blacklisting Report issued by the GPPB or CIAP .
Sworn statement that each of the documents submitted in satisfaction of the eligibility requirements is an
authentic and original copy, or a true and faithful reproduction of the original, complete, and that all
statements and information provided therein are true and correct.
Bid Security ( ) Sufficient ( ) Insufficient
Sworn statement attesting to have complied with bidder's responsibilities
Note: Any missing document in the above checklist is a ground for outright rejection of the bid.
Sworn statement in compliance with existing labor laws and standards.
Shall contain the following information/documents and shall be opened only if the bidder has complied with the requirements of the First
Envelope.
Republic of the Philippines
Province of Quezon
Municipality of Polillo
(2nd Envelope)
***Please accomplish and submit in two(2) copies properly indexed ***
Duly Signed Bid Prices in the Bill of Quantities
Recurring and maintenance Cost, if applicable
1.
2.
3.
4.
5.
6.
7.
8.
BIDS AND AWARDS COMMITTEE
Requirements for Accreditation
Republic of the Philippines
Province of Quezon
Municipality of Polillo
Registration/Certificate of Accreditation from SEC, DTI or CDA for cooperatives
Valid and Current Mayor's Permit/Municipal License.
Certificate of BIR Registration (copy of TIN ID)
G-EPS Registration Certificate (Certified copy by the company)
Tax Clearance (BIR) Certified True Copy by the Company
BIDS AND AWARDS COMMITTEE
Requirements for Accreditation
Recent photo of office (showing business signboard) and working area. Attach in long bond paper
Statement of the prospective bidder that it is not “blacklisted” or barred from bidding by the
Government or any of its agencies, offices, corporations or LGUs, including non-inclusion in the
Consolidated Blacklisting Report issued by the GPPB or CIAP
Republic of the Philippines
Valid Certification of Compliance form Bureau of Food and Drugs (for firm selling drugs and
medicines)
Province of Quezon
Municipality of Polillo