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FORM NO.

1 LETTER OF INTENT (LOI) AND APPLICATION FOR ELIGIBILITY (Date of Issuance) Commissioner Bureau of Customs Port Area, Manila Attention : Deputy Commissioner Gregorio B. Chavez Chairman Committee on the Accreditation of Service Provider (CASP)

Dear Sir / Madame: I hereby express my intention to apply for eligibility pursuant to CAO No. 42010 as implemented by CMO 24-2010 to become a Customs Electronic GPSEquipped Barrier Seal Service Provider (CEGBSSP). The company which I represent is committed to undertake the following: To supply the required number of Customs Electronic GPS-Equipped Barrier Seals (CEGBS) to be installed on containers carrying transit cargo; 2. To provide the appropriate hardware, software and application system for the tracking and monitoring of transit cargo installed with CEGBS; 3. To establish a network of competent personnel deployed in designated customs ports to handle the attachment and removal, maintenance, transport, and security and ensuring availability of CEGBS units 4. To provide training to BOC personnel and its partner agencies in the monitoring and tracking of CEGBS installed transit cargo as well as in the audit of historical transit data; 5. To deliver all the services detailed in the Invitation to Apply for Eligibility.
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I hereby certify that all information provided herein, is true and correct, and I hold myself liable, criminally or civilly, for any misrepresentation or false statement made herein. Very truly yours, Name, Position and Signature of Authorized Signatory

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after having sworn in accordance with law hereby deposes and states that: 1. in Manila. (name of the company) is an applicant as Customs Electronic GPS-Equipped Barrier Seal Service Provider (CEGBSSP) with the Bureau of Customs pursuant to Customs Administrative Order No. No. 04-2010 and Customs Memorandum Order No. 24-2010. Filipino. I am executing this Affidavit to attest to the truth of the foregoing facts and in compliance with the eligibility requirement as Customs Electronic GPSEquipped Barrier Seal Service Provider (CEGBSSP).s. and 4. X Affiant SUBSCRIBED AND SWORN to before me this __ day of January 2011. (name of the company) is not included in the blacklist of contractors for any government projects including its subdivisions or was included in the Consolidated Blacklisting Report issued by the Government Procurement Policy Board (GPPB). AFFIANT FURTHER SAYETH NAUGHT. Attached herewith is the certification from the GPPB.Form No. 3. AFFIDAVIT OF NON-INCLUSION IN THE BLACKLIST I. I am the (designation) of (name of applicant corporation). 2 REPUBLIC OF THE PHILIPPINES) MANILA ) S. Mr. Page No. Series of 2011 2 . of legal age and (address). Book No. NOTARY PUBLIC Doc. (name and designation of authorized signatory). 2. as shown by a Secretary’s Certificate which is hereto attached.

Form No. attached copy of Certificate of Satisfactory Completion issued by the client Submitted by: Printed Name. attached copy of contract B. On-going Undertakings Name of Inclusive Project Dates Description Service/s Provided of Amount of Project Being * For the above list. Position & Signature of Authorized Signatory 3 . Completed Undertakings Name Project of Inclusive Dates Description of Amount of Project Service/s Provided * For the above list. 3 LIST OF ONGOING & COMPLETED UNDERTAKINGS (2007-2010) Name of Company: _____________________________________ Business Address: _____________________________________ A.

FORM NO. Committee on the Accreditation of Service Provider (CASP) Dear Sir/Madame: In compliance with the requirements of the Bureau of Customs CASP for eligibility to be accredited as Customs Electronic GPS-Equipped Barrier Seal Service Provider (CEGBSSP). 5. we certify to the technical competence. n. 4. Position and Signature of Authorized Signatory 4 . 3. Very truly yours. hereunder enumerated: Name 1. Name. Chavez Chairman. experience and expertise of the following officers/personnel. Manila Attention : Deputy Commissioner Gregorio B. Educational Attainment Years with Firm Age Attached are their respective bio-data. 2. 4 STATEMENT ON TECHNICAL COMPETENCE AND EXPERTISE OF OFFICERS / PERSONNEL Date of Issuance Commissioner Bureau of Customs Port Area.

5 LETTER OF AUTHORITY TO VALIDATE SUBMITTED DOCUMENTS Commissioner Bureau of Customs Port Area. ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ Very truly yours. we hereby authorize the CASP or its authorized representative/s to verify the statements. Fax No. Committee on the Accreditation of Service Provider (CASP) Dear Sir/Madame: In compliance with the eligibility requirements of the Bureau of Customs CASP for accreditation as Customs Electronic GPS-Equipped Barrier Seal Service Provider (CEGBSSP). 3. documents and information submitted herewith to substantiate our eligibility. Telephone No. 2.FORM NO. Manila Attention : Deputy Commissioner Gregorio B. The following persons. including telephone/fax numbers may be contacted to provide further information with regard to this application: Name 1. Position and Signature of Authorized Signatory 5 . Chavez Chairman. Name.

Philippines. ___________________________________ Name. affiant exhibiting to me his/her (Passport or any valid ID) No. 6 AFFIDAVIT OF AUTHENTICITY I. That each of the documents submitted is original copy or certified true copy and that all statements and information contained therein are true and correct. That I am the __(Position in the Signatory)__ of the ___(Name of the Company)___. That this affidavit is being executed to attest to the truth of the foregoing and in compliance with the eligibility requirement of __(Name of the Company)__ for qualification as Customs Electronic GSP-Equipped Barrier Seal Service Provider (CEGBSSP). under oath. 3. No. of legal age. 20___ at _____________. IN TRUTH WHEREOF. Filipino and residing at ___(Address of the Representative)_. ___(Representative of the Company)___. Book No. 2. hereby depose and say: 1. day of ______ 2003. Series of 2011 6 . I hereby affix my signature this _____ day of _____. Page No. Philippines. ________________ issued on _________ at _____________________. Position & Signature of Authorized Signatory SUBSCRIBED AND SWORN TO before me this _________. __(civil status)__.FORM NO. with principal office address at ___(Address of the Company)___. (Notary Public) Doc.