Annex “B”
CERTIFICATION
1, AZUCENA P. MIRAMBEL, MD., FPOGS, of legal age, Filipino, and with office address
located at Sto. Niffo Street, Brgy. Poblacion, Inopacan, Leyte after having been duly sworn to in
accordance with law, do hereby undertake that:
1. 1am presently the Municipal Mayor of the Local Government Unit of Inopacan, Leyte;
2, That the Local Government Unit of Inopacan, Leyte is requesting for Certificate of
Exception under COMELEC Resolution No. 10747, for its public works project/s (Please
use Annex B-1 for details);
3. Inaddition, the requirements for the issuance of the Certificate of Exception for the above-
mentioned public works project/s, as set forth by COMELEC Resolution No. 10747,
cannot be submitted and/or complied with (Please see Annex B-2 for reason/s for non-
submission);
4, The statements stated herein are all willingly, freely and voluntarily executed, according
to the best of my knowledge and /or based on existing records, to attest to the truth of the
foregoing facts for whatever purpose it may serve.
IN WITNESS WHIEREOF, Ihave hereunto alfxed my signature aul seal of my office on this_
day of FEB 0 8 W299 in the City/Municipality of 1NOPACAM LEYTE _ Philippines.
AZUCEN. IRAMBEL, MD., FPOGS.
Republic of the Philippines)
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at wa
SUBCRIBED AND SWORN TO BEFORE me this _ eR ot 2022, in the
City/Municipality of _~°""""_,_ Republic of the Philippines, affiant personally
appeared before me Azucena P. Mirambel, MD. FPOGS with PRC Physician’s Identification No.
(0058417 valid until April 11, 2022.
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TSN MEY
tr al fame 9, 2022
ened Gat ue 30 202 yy