CONTRACTOR’S AFFIDAVIT OF NO LIABILITIES

I, Darwin B. Ravelo,C.E, of legal age, Filipino, married with residence and postal
address at Purok C, La Fortuna, Suaybaguio District, Tagum City, having sworn to in
accordance with law, do hereby depose and state:

That I am owner of DB Ravelo Construction and Supply, under CW-18-021, 1

Lot-Construction, Renovation and upgrading for Various Barangay Health Station - Lot II
( Furnishing Labor, Equipment and materials) (a. BHS Brgy, Cadunan, Mabini, b. BHS
Brgy. Del Pilar, Mabini, c. BHS Brgy. Libudon, Mabini) under Province of Compostela
Valley.

That in a proper implementation and efficient prosecution of all my contract works

with the said agency, I hired laborers, used construction materials;

That I do hereby declare that as of this date, I have paid all the salaries and wages
of all my laborers, have paid all the construction equipment and materials, and above
all have paid all the taxes due the local and national government in connection with all
my contract work with the Province of Compostela Valley;

That I finally declare that from April 2019 to present, I have no obligation and
liability in whatever form or nature to anybody and to any government office as far as
all my contract works with the Province of Compostela Valley;

That any loss of materials in the site is the responsibilities of the contractor;

That the foregoing statement are true and correct to the best of own personal
knowledge.

IN WITNESS WHEREOF, I hereunto affix my signature this September 10, 2019 at

Tagum City, Philippines.

Darwin B. Ravelo, C.E.

 Proprietor

SUBSCRIBED AND SWORN to before me this September 10, 2019 at Tagum City, affiant
exhibiting to me his TIN ID 178-551-536-009 issued on September 2, 2019 at Tagum
City.

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