IO’s LETTERHEAD

Certificate of Clearance for Equipment Rental

This is to certify that (Contractor), contractor for the Contract ID No. ______–
(Contract Name Location) has no outstanding obligation with regard to equipment
rentals and/or lease in connection with the aforementioned project based on the submitted
Contractor’s Affidavit.

Issued this (Date) to comply with Item ___ of the checklist of supporting documents and
attachments for ___ Progress Billing as required under Department Order No. 11, Series of
2021 (or latest issuance for DoTS).

NAME & SIGNATURE

Project Engineer
DPWH & Consultant, if any

Noted:

NAME & SIGNATURE

Chief of Implementing Section/Division/
Project Manager
DPWH & Consultant, if any

PIF-06-BIL-06 Rev 00