DEPARTMENT OF HEALTH – CAGAYAN VALLEY FOR HEALTH DEVELOPMENT

Health Facilities Enhancement Program

Contract ID : _____________
Contract Name : _____________

Location of the Contract : ______________

________________________________________________

AFFIDAVIT OF SITE INSPECTION

I, DANILLO GREGORIO II, and LOENARD BATARA, Filipino Citizens, both of legal age and
presently residing at CAMASI PEÑABLANCA CAGAYAN PHILIPPINES, and BAGGAO
CAGAYAN PHILIPPINES, respectively, after being duly sworn to, under oath and in accordance
with the law, depose and say that:

1. That we personally know each other as coworkers as Civil Engineers at the Health Facilities
Enhancement Program (HFEP) Department of the Department of Health – Cagayan Valley for
Health and Development;

2. That we personally inspected validated assessed the subject project at the above stated
location; and

3. That we are having reviewed the same it was found out that it is in accordance with the
stipulation of the contract document; compliant to the program of works and detailed
estimates and is within the bound of the contract duration;

4. That we are willingly and voluntarily executing this affidavit to attest the truth and veracity of
facts and for whatever legal purpose that it may serve.

IN WITNESS WHEREOF, we have hereunto set our hands and affixed our signatures this
____________ 2023, in the city of Tuguegarao, Cagayan Philippines.

AFFIANTS

__________________________ _______________________
ID TYPE/NUMBER: ______________ ID TYPE/NUMBER: ______________
Date/Place Issued: ________________ Date/Place Issued: _________________

SUBSCRIBED AND SWORN TO before me this _______________ 2023 at Tuguegarao

City, Cagayan Valley, Philippines.

Doc. No. ________________

Page No. ________________
Book No.________________
Series of 2023