REPUBLIC OF THE PHILIPPINES )

Province of Zamboanga del Sur ) S.S.

City Pgadian City )
x----------------------------------------------x

AFFIDAVIT OF UNDERTAKING

I, -------------------, Filipino, of legal age, married, and a resident of

Poblacion, Lapuyan, Zamboanga del Sur, after having been duly sworn in
accordance with law, hereby depose and state:

1. That
I am the owner of the ------------------------ located at Poblacion,
Lapuyan, Zamboanga del Sur.

2. That the Local Government Unit of Lapuyan has a Water Supply

Systems that is for provision of its inhabitants, likewise, as resident
therein, I am also one of the consumer.

3. Thatthe source of water that supplied in the daily operation of my

business is from the Local Government of Lapuyan Water Supply System .

4. That I am executing this Affidavit to certify or attest to the truth of the

foregoing facts and for purpose that the source of water supply is a
potable water and safe for human consumption .

5. Further Affiant sayeth none.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ___

day of ____________ 20___ at ____________, Philippines.

MORVIN FERNANDEZ
Affiant

SUBSCRIBED AND SWORN to before me this ______ day of __________

with Issued on __________ at ____________________.

Doc. No _______
Page No _______
Book No _______
Series of 2019