ENGINEERING OFFICE

CHECKLIST FOR PRE-QUALIFICATION

Name of Contractor : RUCS KONSULT & CONSTRUCTION SERVICES

Date : _________________________

Submitted Remarks

1 Contractor's Prequalification Statement

2 Contractor's General Information Sheet

3 Contractor's Legal Aspects Information Sheet

4 Contractor's Technical Aspects Information Sheet

5 Contractor's Present Organizational Chart

6 Contractor's Financial Aspects Information Sheet

7 Auditor’s or Accounts Certificate on Financial Statement

Checked by: _________________________

Noted by: _________________________

Conforme: _________________________
Contractor

CONTRACTOR’S CONFIDENTIAL PREQUALIFICATION STATEMENT

 I, RICO I. UY of legal age, with address of
____________________________________ after having been sworn in accordance
with law hereby dispose and say:

1. That I am the Authorized Managing Officer of the RUCS Konsult &

Construction Services, duly authorized to make this statement, evidenced
by the attached written authority from the owner(s) / Governing Board of
Contractor (Annex 1).

2. That I hereby present the following information in response to the invitation for
application for Phase 1 Prequalification of Contractors for Hotel Sogo, Eurotel,
Icon Hotels ____________________.

a. SSS Certificate
b. SEC Certificate
c. DOLE Certificate
d. Updated Business Permit
e. DTI Certificate
f. BIR Registration
g. PCAB Certificate

AFFIDAVIT

I hereby certify that all information in this Phase 1 Prequalification Statement,

including the annexes and enclosures thereto, are true and correct, and I hold myself
liable, criminally or civilly, for any misrepresentation or false statement made therein,
and grounds for disqualifications and termination of accreditation.

In faith whereof, I have hereto affixed my signature this ___ day of ________, 20__ at
________________, affiant issued on _______________.

RICO I. UY
Affiant _______________________
Notary Public
Until________________, 20___
PTR No.___________________
Date______________________
Place _____________________
TAN ______________________

Doc No.__________________
Pages No.________________
Book No._________________
Series of _________________

AUDITOR’S OR ACCOUNTANT’S CERTIFICATE

To Whom It May Concern:

I / We certify that I / we have examined the books and accounts of:

RUCS KONSULT & CONSTRUCTION SERVICES, at Valencia Drive Corner Casas
Drive, Colinas Verdes, Lagao, General Santos City, an individual proprietorship /
partnership / association / corporation have prepared the foregoing Financial Statement;
and have verified the items appearing therein in accordance with the approved
accounting and auditing standards; and, in my / our opinion, the foregoing Financial
Statement fairly reflects the true condition of the aforesaid contractor as of the date
stated above.

Date ______________________ RAYMOND O. SABADO

(Date of Certificate) (Name and Signature)

Certified Public Accountant

Registration No. ______________
License No.__________________
Dates Effective _______________
From _______________________
To __________________________
Place ______________________________
(Accountant’s Office Address)

GENERAL INFORMATION

1. Name of Contractor RUCS KONSULT & CONSTRUCTION SERVICES

2. a. Home/ Office Address ________________________________________

________________________________________ b. Telephone No.

________________________________________
c. Cable Address ________________________________________
d. Telex No. ________________________________________

3. a. In the case of a foreign contractor, Philippine address, if any:

_____________________________________________________________
b. Telephone No. ________________________________________

4. Type of Contractor’s Organization (Please Check):

( X) Sole Proprietorship ( ) Corporation
( ) Partnership ( ) Joint Venture

5. a. Person Managing the affairs of Contractor’s Organization RICO I. UY

b. Designation PROPRIETOR/AUTHORIZED MANAGING OFFICER
c. Certified Copy of his appointment / designation and authority (Annex 2).

6. Type of trade for which the contractor wishes to pre-qualify (Please Check)
( ) Structural ( ) Auxiliary
( ) Civil Works ( ) Fire Protection
( ) Electrical ( ) Architectural
( ) Sanitary ( ) Interior Design
( ) Mechanical ( ) Others (Pls. specify)

LEGAL ASPECTS
1. Date Contractor’s organization had been organized Sept. 24,2010
2. Place of registration: GENERAL SANTOS CITY
3. Certified Copy of Contractor’s License for the current year (Annex 3)
4. Certified Copy of Contractor’s latest privilege tax receipt PTR (Annex 4)
5. If Contractor is a Sole Proprietorship
a. Certified Copy of Certificate of Registration (Annex 5)
b. Name of Owner RICO I. UY
6. If Contractor is a Partnership
a. Certified copy of Deed or Articles of Partnership (Annex6)
b. Partners:

Name Value of Contribution

_________________________
_________________________
___________N/A____________
_________________________
_________________________
_____________________________
_____________________________
___________N/A_______________
_____________________________
_____________________________

7. If the Contractor is a Corporation

a. Certified Copy of Articles of Incorporation (Annex 7)
b. Stockholders and others financially interested in the corporation owning 5% or
more of the stocks and other interest, as certified by the Securities and
Exchange Commission.

Types of Stocks

Name and/or Interest Value Extent of Financial Control

_______________ _____________ ____________ _____________________
_______________ _____________ ____________ _____________________
_______________ _____________ ____________ _____________________
_______________ _____________ ____________ _____________________
_______________ _____________ ____________ _____________________

c. Members of the Governing Board of the Corporation, as Certified by Corporate

Secretary.
 Name
_________________________
_________________________
_________________________
_________________________
_________________________
Designation
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

8. If Contractor is a Joint Venture:

a. Certified Copy of Agreement and Articles of Joint Venture (Annex 8)
b. Certified Copy of a Joint Venture License per Republic Act No. 4566 (Annex 9)
c. Contractor – members of Joint Venture

Name
_________________________
_________________________
_________________________
_________________________
_________________________
Designation
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

9. In the case of a foreign Contractor, Certificate as bonafide contractor from its

embassy or consulate (Annex 10).

10. Extent of Filipino ownership of the assets of Contractor’s Organization.

LIABILITIES AND NETWORTH

LIABILITIES
(1) Notes Payable:
(a) To Banks “for regular conduct of business” P 1,996,920.00
 (b) To Banks “for Certified Checks” ___________
(c) To others “for regular conduct of Business” ___________
(d) To others “for Equipment” P 1,351,044.00
(e) To others “for Sundry Purposes” ___________

(2) Accounts Payable

Net Due Past Due

(a) Business P 3,433,368.00 __________________

(b) Other P 18,795.00 __________________

(3) Accrued Liabilities (Itemize below)

(a) _____________________________________________________
(b) ________________________________________________

(4) Long-Term Obligation (Itemize below and indicate assets pledged as Security)
(a) EQUIMENT ( HINO MIXER) P 1,340,622.00
(b) _____________________ _____________________ _________________
(c) _____________________ _____________________ _________________

(5) Other Liabilities (Itemize below)

(a) ADDITIONAL CAPITAL ( CASH BORROWING) P 86,591,263.00
(b) _____________________ _____________________ _________________

(6) Reserves – Other than Depreciation

(a) _____________________ _____________________ _________________
(b) _____________________ _____________________ _________________

TOTAL LIABILITIES P 94,732,012.00

NET WORTH

If Proprietor or Partnership Proprietor or Partners

CAPITAL BEG: ____________________ P 99,979,683.00
______________________________ _____________________________
______________________________ _____________________________
______________________________ _____________________________

Less: Personal Drawings P 801,800.00

Total P 98,177,883.00
Add: Net Income for the Period P 3,224,177.00

TOTAL NET WORTH P 102,402,060.00

If Corporation or Joint Venture
(a) Capital Stock:
Preferred (describe fully)

__________________________________ P_________________
__________________________________ _________________
__________________________________ _________________
Total
Add: Paid-in Surplus (if any)
Total Capital Stock Paid-up P_________________
(b) Surplus
Appropriated (Itemize below)

1. ________________________________ _________________
2. ________________________________ _________________
3. ________________________________ _________________
4. ________________________________ _________________
Appraisal Surplus if any________________

TOTAL NET WORTH P 102,402,060.00

TOTAL LIABILITIES AND NET WORTH P 197,134,072.00

PROJECT NAME:
OWNER:
CONTACT PERSON/NUMBER:
LOCATION:
DATE STARTED: DATE
FINISHED:
PROJECT COST:
SCOPE OF WORK:

SSS CERTIFICATE
SEC(if any) DTI
CERT.
DOLE CERT.(if any)
BUSINESS PERMIT 2023
PCAB CERT.(if any) BIR
CERT.

Please include
UPDATED RESUMES (President, Gen.Manager, etc)
TOOLS & EQUIPMENTS CHECKLIST (QTYS)
SEPARATE ON GOING TO COMPLETED PROJECTS