REPUBLIC OF THE PHILIPPINES)

PROVINCE OF OCCIDENTAL MINDORO)S.S

MUNICIPALITY OF SABLAYAN)

OMNIBUS SWORN STATEMENT

I, the undersigned, attest to the veracity of the following:

1. There is a Sanggunian Resolution endorsing the proposed project(s),

and that the same is/are part of the duly approved Local Development
Investment Program and Annual Investment Program of the Local Government
Unit of Sablayan;

2. The Local Government Unit of Sablayan has prepared the necessary

Program of Works, Detailed Estimates and Detailed Engineering Design for the
project, in accordance with the design, plan, specifications and such other
standards and policies of the National Government;

3. The Local Government of Sablayan has the capacity to implement the

proposed project(s) either by administration or contract;

4. The proposed project(s) of the Local Government Unit of Sablayan

is/are readily implementable within the prescribed timelines and that there are
no issues related to the site/land title, including informal settlers thereon, and
right of way acquisition;

5. The Local Government Unit of Sablayan has complied with all the
standards prescribed by the appropriate government agencies and has secured
all the necessary clearances or Certification from the same agencies before the
implementation of the eligible project(s), e.g. Environmental Clearance;

6. The location area of the proposed project(s) of the Local Government

Unit of Sablayan is not: (1) privately owned land/lot; and (2) not included in
the critical geo-hazard areas or no build zones identified and/or certified by the
Mines and Geo-Sciences Bureau hazard map;

7. The Local Government Unit of Sablayan commits to fund the cost of

maintenance and repairs of the project(s);

8. The proposed project(s) of the Local Government unit of Sablayan

is/are not funded from other sources.

IN WITNESS WHEREOF, I have hereunto set my hands this _______ day

of __________________, 201____.

EDUARDO B. GADIANO
Municipal Mayor
(Affiant)
 SUBSCRIBED AND SWORN to before me this______day of_____________,
201_______ in the Municipality of Sablayan, Province of Occidental Mindoro.
Affiant is personally known to me and was identified by me through competent
evidence of identity as defined in the 2004 Rules on Notarial Practice (AM-02-8-
13-SC).Affiant exhibiting to me his/her _______________________________________
with his/her photograph and signature appearing thereon, issued
on___________ at ____________________________.

Witness my hand and seal this_______of __________________, 201_______.

Doc. No.___________;
Page No.___________;
Book No.___________;
Series of 2018.