INTRA STRATA ASSURANCE CORPORATION

8F 88 Corporate Center Bldg., Sedeño cor. Valero Streets

Salcedo Village, Makati City
Tel. Nos. 8173031-34/FAX Nos. 8172193, 8173029

BOND APPLICATION
(For Individual)

The undersigned hereby applies for a bond in the amount of Pesos: ______85,543.6__________
in favor __Serendra condominuin corporartion________ for the purpose _____performance bond_____
(Indicate details of undertaking, or attached copy of contract and/or corresponding documents for which
bond is required.)

INDIVIDUAL INFORMATION:

1. Name: Norberto R. Golve Jr.

Age: 33
2. Nationality: Filipino
3.Civil Status: Married
If Married, Name of Spouse: Liezl B. Golve
4. Residential Address: 103 Payatas a. Quezon City
Tel. No.
5 Official Address: 103 Payatas A. Quezon city
Tel. No.
6. What is your occupation? Contractor/ technical
7. How long have you been engaged as such? 7 years
8. What is your monthly salary or income? Depend on the project
9. Are you engaged in other business? If so, describe its nature and state the income, monthly or
annually, that you derived from this source. none
10. What are your previous positions or connections? Technical head and project engineer
11. Do you have savings or checkings account? none
If so, with what bank and what is your present balance? none
12. If you own any Real Estate properties, please give the following particulars: none
13. DESCRIPTION
LOCATION
ASSESS VALUE
14. If any of the above-mentioned properties is/are presented mortgaged, please state name of
mortgagee, amount of original loan, present balance and when due.
15. Do you carry fire insurance, state how much, what company, to whom payable, how long policy has
been in force and approximate cash value thereof;
16. Do you own stocks of companies listed in the Manila/Makati Stock Exchange? If so, state name of
issuing company, kind and number of shares:
17. If you carry life insurance, state how much, what company to whom payable, how long policy has
been in force and approximate cash value thereof;
18. Are debted, besides mortgages, to anyone for sums of sums of money? If so, name of creditor, how
much on what account and when due?
19. State whether you are an endorser of surety for anyone and to what extent.
20. Have you ever had a bond cancelled, or an application denied by any Surety Company?
21. If you have ever given a bond, state particulars in the following space:
NAME OF SURETY:
TYPE OF BOND:
AMOUNT:
NAME OF OBLIGEE:
TERMINATION:
22. If you own personal properties (household furniture, shares of stock, life policy, government bonds
etc.). Please give the following particulars.
DESCRIPTON:
WITH WHAT COMPANY/LOACTION:
ASSESSED:
23. Give below name, occupation and address of responsible persona for references in no case meaning
relatives:
NAME:
OCCUPATION:
ADDRESS:

NAME:
OCCUPATION:
ADDRESS:

NAME:
OCCUPATION:
ADDRESS:

The above and foregoing statements and representations are true and correct to the best of my
knowledge and belief and are made for the purpose of including INTRA STRATA ASSURANCE
CORPORATION to execute said bond.

Date at ___________________ this ___October___ day of 18_____ 20 21_____

 Norberto R. Golve Jr.___

Signature of Applicant

SUBSCRIBED AND SWORN TO before me this ______________ day of ______________ 20 _____, Affiant
exhibited to me his/her Residence Certificate No. ______________________ issued at
_______________ on _______________________________ 20

NOTARY PUBLIC
Until Dec. 31, 20__
PTR No. ______________
Issued on ____________
Issued at ____________

Doc. No. _________

Page No. _________
Book No. _________
Series of 20 _______

Please submit the following requirements:

1. Application and co-signers statement
2. Business Name/Company Profile
3. Current Financial Statement duly received by BIR or Bank
4. Copy of Contract or Agreement/PO
5. List of completed and on-going projects
6. Photocopy of ITR
7. Photocopy of Transfer Certificate of Title & Tax Receipt Payment/Tax Declaration w/o encumbrances
8. Court Order (for Judicial Bonds Only)
9. Complaint & Answer (for Judicial Bonds Only)
10. Extra Judicial Settlement (for Heirs Bond only)
11. Affidavit of Publication (for Heirs Bond only)
12. Publication for Three Consecutive Weeks
13. Photocopy of any Gov’t I.D’s
14. List of properties with proof of ownership
15. Renewal of PCAB License