Accreditation of Port Service Providers Annex C Omnibus Sworn Statement REPUBLIC OF THE PHILIPPINES ) CITY/MUNICIPALITY OFPoblacion, San lidefon9$,$ulaca: AFFIDAVIT |, Jetro Joseph David Castro_of legal age, Married , Filipino, and residing at Sapang Putol, ‘San Ildefonso, Bulacan after having been duly swom in accordance with law, do hereby depose and state that: 1. 1am the sole proprietor of PRISMO ENTERPRISE with office address at _San Ildefonso, Bulacan. 2. As the owner of sole proprietor of PRISMO ENTERPRISE. , | have full power and authority 10 do, execute and perform any and all acts necessary to represent nthe application for accreditation of port service providers pursuant to PPA Administrative Order No. 01-2022. 3. That the _PRISMO ENTERPRISE. intends to apply for accreditation of port service providers at the Philippine Ports Authority pursuant to PPA Administrative Order No. 01-2022, and is not blacklisted and has no terminated/cancelled contracts with PPA; 4, That the PRISMO ENTERPRISE does not have any owner, incorporator, organizer, stockholder, member of the board of directors, trustee, officer, consultant, counsel, broker, agent, trustee, nominee or personnel with a pending case filed by or against PPA 5. That the PRISMO ENTERPRISE does not have any owner, incorporator, organizer, stockholder, member of the board of directors, trustee, officer, consultant, counsel, broker, agent, nominee or personnel who is an official or employee of PPA, including those separated from PPA within one (1) year from separation6. That each of the documents submitted in satisfaction of the documentary requirements is an authentic copy of the original, complete, and alll statements and information provided therein are true and correct; 7. That the _PRISMO ENTERPRISE shall abide with the existing laws, rules and regulations, such as those issued by the Authority and the Department of Labor and Employment (DOLE), in connection with the implementation of PPA Administrative Order No. 01-2022 _ 8. That the _PRISMO ENTERPRISE has no outstanding accounts with the Philippine Ports Authority; 9, That the _PRISMO ENTERPRISE is authorizing the ity or its duly authorized representative(s) to verify the statements, documents and lation submitted herewith to substantiate our application: The following persons, including telephone numbers and email addresses, may be contacted to provide further information with regard to this application: NAME TEL NUMBER E-MAIL ADDRESS a. _Adriel Manuel Pedralvez 09365892060 __raulzenkie@gmail.com Jetro Joseph D Castro (Name of Applicant / Authorized Signatory) htps:tappps.ppa.com ph eubserib ‘Swom to before me this _SEP_1.4 2929 in Bulacan, Philippines Dos. No. __ 448, Page No.1. Book No, __0%3 —_ Series of __ 2028 wt i Notary Public until Gect Roll of Attoneys No.: 63815 IBP Bulacan Lifetime Member No. 012703 PTR No. 8037009/ Jan. 03,2022 = _ {9 Wational Highway Poblacion, San ligand Rilaran