REPUBLIC OF THE PHILIPPINES)

IN THE CITY OF COLANDIA )S.s

x------------------------------------------x

CONTRACTOR’S AFFIDAVIT

KNOW ALL MEN BY THESE PRESENTS:

I, PRINCE BOROMIR, of legal age, Filipino, married, and a resident of
Colandia City, after having been sworn in accordance with law, hereby
depose and states the following:
1. That I am the proprietor/manager of Lord of the Rings Engineering
Construction,
2. That I am the contractor engaged by the Department of Public
Works through competitive public bidding for the implementation of
the project: 1230045 Road Rehabilitation of Access Road Leading to
Rivendell;
3. That as of August 7, 20___, the said project is in progress and on-
schedule;
4. That I’m executing this affidavit to attest to the truth of the foregoing
facts and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of

September 20__ at Co_____ City.

PRINCE BOROMIR
Affiant
Driver’s License No.

SUBSCRIBED and SWORN TO before me on the date and at the place

indicated below. The affiant exhibited to me his competent evidence of
identity as indicated above. Signed this on ____ of September 20__ at
Colandia City, Philippines.

WITNESS MY HAND AND SEAL.

Notary Public
Doc. No.
Page No.
Book No.
Series of 20___