COMMISSION ON ELECTIONS

October 30, 2023 RCF

Barangay and Sangguniang Kabataan Elections
Report of Contractor and Business Firms
PART A: INFORMATION OF THE CONTRACTOR OR BUSINESS FIRM

NAME of CONTRACTOR/ _____CONCEPCION_______________________ __GABBY_____________________________________CRUZ_________________

BUSINESS FIRM N/A___
(SURNAME) (FIRST NAME) (MIDDLE NAME) (EXT)

NAME OF BUSINESS FIRM: _______GCC PRINTING SERVICES___________________________________________________________________________________

NAME OF PRESIDENT, OWNER: __________CONCEPCION__________________________ _GABBY__________________________________ CRUZ________________

N/A MANAGER:
OR GENERAL ____ (SURNAME) (FIRST NAME) (MIDDLE NAME) (EXT)

CONTACT DETAILS: Contact Numbers 9103740809

E-Mail Address:
OFFICE / BUSINESS
ADDRESS: B43 L20 PH1 DELA COSTA HOMES V
(STREET NO.) (STREET NAME) (BUILDING/SUBDIVISION)

BURGOS RODRIGUEZ RIZAL

(BARANGAY) (DISTRICT/AREA) (CITY/MUNICIPALITY) (PROVINCE)

PART B: LIST OF ELECTION-RELATED BUSINESS TRANSACTIONS

DESCRIPTION OF SERVICES
NAME OF DATE OF RECEIPT AMOUNT OF GOODS PURCHASED /
RENDERED/GOODS
CANDIDATE TRANSACTION NUMBER VALUE OF SERVICES RENDERED
PURCHASED
ARNOLD ROMERO OCT 19, 2023 179 TARPAULIN P2070.00

OCT 19, 2023 179 BOND PAPER P350.00

PART D: CERTIFICATION, CONSENT AND ACKNOWLEDGMENT

The undersigned, after being duly sworn, do hereby certify that : (1)the foregoing transactions for goods/services were made for the purpose of the
elections; (2)that all the information provided and stated in this report are true and correct; (3) the candidate complied with the duty to require every agent of
a candidate to present written authority to incur electoral expenditures on behalf of such candidate as mandated by Section 112 of the Omnibus Election
Code; and (6) consents on the general use and sharing of information obtained in this disclosure and its attachments for legitimate and authorized purposes.

GABBY CRUZ CONCEPCION NOVEMEBER 11, 2023

(SIGNATURE OVER PRINTED NAME) (DATE SIGNED)
(Position of the Signatory)

SUBSCRIBED AND SWORN TO BEFORE ME this , affiant exhibiting his/her

issued by , with expiry date on
[Identification (ID) Type] [Serial No. of ID] [Government Agency issuing the ID]
.
[Expiry date of ID]

AUTHORIZED PERSON TO ADMINISTER OATH