orem tte ree Industry Authosty of the Philippines PHILIPPINE CONTRACTORS ACCREDITATION BOARD Siivrret PCAB-QMSCLR-AFF-I6 Revision No, 00, O1AUGZ022 [This Formts HOT forse Reproduction Aowad AFFIDAVIT GR. ALZHAMMER R. MANUPAC, the Authorized Managing Officer of (name of Construction Firm) AR. MANUPAC ENGINEERING DESIGN SERITOES holder of Contractor's License No. N/A, originally issued on N/Awith the principal office address BRGY. UPPER CAMPO ISLAM, LABANGAN, ZAMBOANGA DEL SUR, having been uly authorized to file for this PCAB License Application, hereby request that its application for Contractor's License be approved. After having duly sworn to in accordance with law hereby depose and state that: 1. J affirm the Integrity Pledge included in this Affidavit. 2 I certify that the business name and/or Securities and Exchange Commission (SEC) registration of the Construction firm is valid and existing, with the changes in the Owners/Stockholders/Direciors/Officers and their shareholdings as shown in the attached updated General Information Sheet (GIS). 3. I certify to the truthfulness and authenticity of all information/documents encoded in the oun documentary requirements! have accomplished and the documents thereto attached are true and correct. 4. [certify furthermore that the Social Security System (SSS), Pag-IBIG, and PhilHealth contributions were remitted in favor of the employees of this firm. 5 CAB is hereby authorized to verify and secure information and/or copies of documents submitted by or in the name of the construction firm to any of the following agencies relative to its application for PCAB License application filed with the PCAB: a. Securities and Exchange Commission (SEC) b. Bureau of Internal Revenue (BIR) for documents submitted for TIN Number 470-115-934-001 (This serves as a waiver on the confidentiality provision of Section 270 of the National Internal Revenue Code of 1997 (Memorandum Circular No. 28, s 2006 dated May 08, 2006, and your authorization to release any information that may be requested by PCAB) Social Security System (SSS) Pagtutulungan sa Kinabukasan: [kaw, Bangko, Industriya at Gobyerno (Pag-IBIG) Philippine Health Insurance Corporation (PhilHealth) Professional Regulation Commission (PRC) for the following Sustaining Technical Employees (STEs) with thei signatures ENGR, REYNOLD P.NINLERC # 0138892 -— & National Bureau of Investigation (NBI) for the AMO and following STEs. 4. AMO: ENGR. ALZHAMMER R. MANUPAC Rp ee 2, STE: REYNOLD P. NINI h. Land Registration Authority (LRA) for the following TCT with Nos, 1. 131-2023-000803 1. Land Transportation Office (LTO) for the following vehicles with OR and CR Nos. 1. MITSUBISHI MIRAGE: CR: 317200122 / OR: 0920000000161302 2. TOYOTA AVANZA: CR:474 94422-$/ OR: 2309559942 i Ustof Hey Cocsrucien Equipment: 1 N/A k Local Government Units (LGUs) 1. Other Government Agencies m, This firm's depository bank: Name of Bank: ‘SECURITY BANI Name of Manager: RAYMOND A. MONTERA Bank Account Number: 000003383316-0PCAB-QMS-CLR-AFF-F16 Revision No, 00, O1AUS2022 “This Form ls NOT for sae. Reproduction @ Nlowed (his serves as a waiver on the confidentiality provision of the Bank Secrecy Law and your ’ 0 your guuortaation 2 release ae tformeation that may ba requested Dy FCAB in relation tothe abou seid n. This firm's clients/project owners as indicated in its statement of work aceomplished/on-going. «6. Ubereby certify to the truthfulness and authenticity of all information/documents encoded in the PCAB ONLINE LICENSING PORTAL and contained in this application that information documents hereto attached and encoded are true and correct. 7. Yam fully aware that: ion documents submitted by my firm applicant or its Authorized Representative/Agent/Liaison Officer shall be subjected to investigation which may result to criminal charges and cases against me and my firm notwithstanding the disa ipproval iy firm's application, denial/suspension/revocation of license and blacHlisting of my firm and myself as its Authorized Managing Officer; be Unconfirmed information/documents submitted to support my firm's qualifications shall be excluded for categorization/classification purpose; and ¢ ‘Theevaluation of my firm's qualifications shall be solely based on the documents submitted atthe time the application was filed/accepted by PCAB. 8. I farther certify that I prepared this document, fully understood every word of it and its meaning, and have affixed my signature hereunder voluntarily and freely with the full and complete knowledge of the meaning ‘and intent of this document as well as of my rights under existing laws. ft Managing ‘thoes (AMO (Signature and date over Printed Name) AFFIANT FURTHER SAYETH NAUGHT. Republic ofthe Philippines ) Province of _2anbeaw.e dhl Sa-__) Gity/Municipality of “Pagedian _) SS AND SWORN to before me this 72S" __ day of ; affiant Identification Card bes ing —— 00 2 NOTARY PUBLIC Until December gi, 2023 Doe. No-Sd| zee ra Series of 20722. eA uae Se Until December 31,2027 PalofAttorneys No. 28316 BPOR.No.168178; 43123 *TRORNo, 3751259;1/319* Pagadion Ctyé PCAB-QMS-CLR-AFF-F16 Revislon No. 09, 01ANG2022 f ‘hia Form i HOT forsale Raproccten io ASrwm Page zara PCAB INTEGRITY PLEDGE ‘We believe that the construction industry is one of the most susceptible to all forms of corruption that hampers the noble objectives towards national progress and global competitiveness. ‘As frontrunners of nation-building, we ackn ‘our major role and responsibility in ensuring that we carry out ‘ur tasks gulded by ethical standards and equipped with the necessary capability for the successful prosecution of our contracts. In view thereof, we pledge the following: + We will present only true qualifications to PCAB so that we may be evaluated properly and be given the category and classification where we should rightfully belong; + We will uphold the dignity of the icense and not be instruments for unlicensed contractors to undertake we diuction. projects through license lending nor through false Joint ventures/consortium or pseudo combinations which is inimical to the public safety/interest; «We will not employ unlicensed sub-contractore/specialty contractors which is a clear circumvention of the requirement that all contractors must be licensed; . el emily abs away from any form of collusion that destroys the very essence and integrity of biddings; ‘© We will not engage in bribery or do any act which constitutes graft or corrupt practice which is the root cause of bloated contract amounts; «We will not use sub-standard materials which will in any way compromise the safety, reliability and performance of the built environment; «We will not abandon our contracts and we will implement our projects faithfully in accordance with the prescribed specifications thereof; + We will provide the necessary resources, financial and technical capability in carrying out our contractual obligations, and as far as possible, within the stipulated time of completion; «Weare aware that we will be imposed disciplinary action should we violate any of the commitments hereof or the PCAB Code of Ethics or be found to be a party to corruption. ‘Authorized Managing Officer (AMO) (Signature and date over Printed Name) ton ‘Name of Company acct