BOND APPLICATION

(For Corporation/Partnership)

To : STRONGHOLD INSURANCE CO., INC.

17th Floor Security Bank Centre
6776 Ayala Avenue, Makati City

The undersigned hereby applies for a Surety Bond described as follows:

Kind of Bond: PERFORMANCE SECURITY BOND Amount: PhP805,804.50 (30% of PhP2,686,015.00)

Obligee: PNOC EXPLORATION CORPORATION

Conditions of the Bond: For the Supply and Delivery of Explosion Proof-Lightings for Mine 3 Coal
Project of the PNOC Exploration Corporation

We are submitting to you the following information about ourselves which you may consider in the processing of
this application.

You are hereby authorized to obtain such other information you may wish to secure about ourselves pertaining to
the data hereunder furnished you. We hereby affirm that the following answers are the truth without reservation
and agree that the documents shall remain your property whether or not the bond shall be granted.

PLEASE FILL-UP BLANKS. ALL ANSWERS MUST BE MADE IN FULL TO RECEIVE PROMPT ACTION AND
IF THE ANSWER BE “NONE,” WRITE SO. KINDLY PRINT OR TYPE THE ANSWERS.

1. Name of Company: SUN IMPACT ENTERPRISE TIN: 270-477-996-000

2. Business Address: Block 40 Lot 2 PH4 Deca Clark Residence Margot, Angeles City, Pampanga,
Philippines Tel. No.: 09196176242
3. If a CORPORATION:
3.1 When Incorporated:
3.2 Total Paid-up Capital:
Please Attach Copy:
________Articles of Incorporation
________SEC Certificate of Registration
________List of Key Personnel
________Latest Financial Statement (Audited)
3.3 Name of Authorized Signatory for Bond:___________________________________________
Designation:_________________________________
Community Tax Cert. No.: ________________________Date:_____________________________
Place Issued:___________________________________TIN:______________________________
(Please Attach Corporate Authority to Sign Bond)

4. If a PARTNERSHIP:
4.1 When Organized: _____________________________________________________________
4.2 Total Paid-up Capital: Ps._______________________________________________________
4.3 Is the Partnership General or Limited? _____________________________________
If limited, explain fully:__________________________________________
4.4 Name of Partners and Addresses:
______________________________________ ____________________________________
______________________________________ ____________________________________
______________________________________ ____________________________________
4.5 Please Attach Copy:
_________Partnership Agreement
_________SEC Certificate of Registration
_________Latest Financial Statement (Audited)
4.6 Name of Authorized Signatory for Bond:___________________________
Designation:_________________________________
Community Tax Cert. No.: _______________________ Date: _____________________________
Place: ________________________________________TIN: ______________________________
(Please Attach Partnership Authority to Sign Bond)
5. How many years has your organization been in business under its present business name: 14
years
6. In what other lines of business do you have a financial interest?
Please state: Wholesale, Retail, Trading
7. Personal Property Owned:
Date Fair Market
Acquired Location Description Value Encumbrances
________ _____________________ ___________ ___________ _____________
________ _____________________ ___________ ___________ _____________
________ _____________________ ___________ ___________ _____________
8. Trade Reference:
Name of Company Address & Telephone Number
___________________________________ _______________________________________
___________________________________ _______________________________________
___________________________________ _______________________________________
9. Bank Accounts:
Savings Accounts #:___________________ Name of Bank & Branch: ______________________
Current Account #:___________________ Name of Bank & Branch: ______________________ 10.
Please state on what banks you have established line of credit.
What is the extent and on what basis have they been granted?___________________________
______________________________________________________________________________
______________________________________________________________________________
11. Are there any judgment, suits, or claims pending against you, or against any member of your
firm, or any of your officers?_______________________________________________________
12. Are you acting as surety or bondsman for others, or as indorse on their notes of accounts?
_________________________________________________________________
13. Have you or any member of your firm, or any of your officers ever failed in business or
compromised with creditors?__________________________________________________
14. Are you or any member of your firm, or any of your officers engaged any other lines of business?
_________________________________________________________________
15. Has any surety company ever paid loss on you, or any member of your firm or any of your
officers?___________If so, state the name of Surety Company and give full
particulars:________________________________________________________________
________________________________________________________________________
________________________________________________________________________
16. Please list insurance carried by your organization, including life insurance of the officers and
payable to the company, partnership or business:___________________________________
________________________________________________________________________
17. Have you secured a bond before? ________________ If so, please fill up the following details:
Bonding Period of
Company Amount Obligee Bond Terminate
_________ ______________ ______________ __________ _________
_________ ______________ ______________ __________ _________
_________ ______________ ______________ __________ _________
The above forgoing statements and representations are true and correct to the best of my knowledge and
belief and are made for the purpose of inducing your goodselves to approve and execute the bond we are
applying for.

____________________________________
(Name of Company)
By:

_____________________ _______________________________________
(Date) (Signature & Designation)