REPUBLIC OF THE. CITY OF AFFIDAVIT I, SNAME OF AFFIANT>, of legal age, , after having been duly sworn in accordance with law, do hereby depose and state that ‘That I am the duly elected and qualified Corporate Secretary of ,a corporation duly organized and existing under and by virtue of the law of the Philippines with office address at INSERT COMPANY ADDRESS> “That the lists of stockholders are: NAME 01 [OCKHOLDER NO. OF SHAI PERCENTAGE OF SHAREHOLDING ‘That Lam executing this affidavit as part of the bidding requirement of . Afian ACKNOWLEDGMENT SUBSCRIBED AND SWORN to before me this _ day of [month] [year] at [place of execution], Philippines. Affiant/s is/are personally known to me and was/were identified by me through competent evidence of identity as defined in the 2004 Rules on Notarial Practice (A.M. No. 02-8-13-SC). Affiant/s exhibited to me his/her [insert type of government identification card used]. with bis/ber photograph and signature appearing thereon, with no and his/her Community Tax Certificate No._____ issued on. at ‘Witness my hand and seal this __ day of [month] [year]. NAME OF NOTARY PUBLIC oo A any Serial No. of Commission. Notary Public for ‘unt sve Roll of Attorneys No. PIRN [date issued), [place issued] IBP No. [date issued], [place issued] Doe. No. Page No. Book No. Series of The above information are among the financial documents required for Eligibility Check. Together with the legal and technical documents required, the financial documents shall be placed inside the Eligibilty Envelope ‘and submitted to the BAC on or before the deadline for the submission and receipt of Elgibilty Envelopes.