CLASS D LAND BANK OF THE PHILIPPINES PROCUREMENT DEPARTMENT PRE-BID CONFERENCE REGISTRATION Project identification Number LBP-GIBAC-ITB-GS-20231130-01 Project Name ‘Supply, Delivery and Installation of 474 pes. “Emergency Evacuation Plan” Signage at LANDBANK Plaza Company Name ‘Address 7 ‘Name of Authorized Representative Contact Number eMail Address Please list down request for clarification/s, if any: Note: Please print or type all entries. Annex BProcedures in Submission and Opening of Electronic Bid Fl 1. Upon submission of a duly filled-up LBP Secure File Transfer Facility (LBP SFTF) User Registration Form together with copies of LANDBANK Official Receipt and Payment Acceptance Order for non-refundable bidding fee to the GIBAC Secretariat, the prospective bidder shall receive an email with log-in credentials to access the LBP SFTF. 2. The electronic bid shall consist of two identical copies of archived/compressed files (Copy 1 and Copy 2). The archived/compressed files shall be labelled with bidder’s assigned short name, last seven (7) digits of the bidding reference number including the parenthesis if there are any, and bid copy number, each separated with a dash sign. Thus, for a project with bidding reference number LBP-GIBAC-ITB-GS-20200819-01(2) that XYZ Company wants to bid on, the archived/compressed files shall be labelled as X¥2-081901(2)-C1 (for Copy 1) and X¥Z-081901(2)-C2 (for Copy 2). Copy 1 shall serve as the primary file while Copy 2 shall be the backup file. The archived/compressed files shall be generated using either WinZip, 7-zip or WinRAR and password-protected. The above mentioned archived/compressed files shall contain the Technical Component and Financial Component files in PDF format. These PDF files shall be labelled with bidder's assigned short name, last seven (7) digits of the bidding reference number including the parenthesis if there are any, and the word “Tech” or “Fin” in the cese of the Technical Component and Financial Component, respectively, each separated with a dash sign. Thus, using the above example, the archived/compressed files XYZ-081901(2}-C1 and XYZ- 081901(2}C2 shall both contain the PDF files labelled X¥Z-081901(2}-Tech and XYZ- 081901(2}-Fin. All the required documents for each component of the bid shall be in one (1) PDF file and Sequentially arranged as indicated in the Checklist of Bidding Documents. The documents must be signed by the authorized signatory/ies when required in the form. The archived file and the POF files shall be assigned with a different password and these passwords shall be disclosed by the bidder only upon the instruction of GIBAC during the actual bid opening. The passwords for Copy 1 and Copy 2 shall be the same. Electronic bids that are not assembled, labelled and password-protected in accordance with these procedures shall not be rejected/disqualified but the Bidder or its duly authorized representative shall acknowledge such condition of the bid as submitted. The GIBAC/LANDBANK shall assume no responsibility for the non-opening or premature opening of the contents of the improperly assembled, labelled and password-protected electronic bi In case of modification of bid, a modified version of Copy 1 and Copy 2 of the bid {archived/compressed) files shall be uploaded to the SFTF. The qualifier “Mod” and a numeric counter indicating the number of times that the bid had been modified shall be added at the end of the filenames of both the archived and PDF files. Using’again the earlier example, the sample labels and contents of the modified bid shall be as follows: a) First Modification: XYZ-081901(2)-C1-Mod1 and XYZ-081901(2)-C2-Mod1 containing XYZ- 081901(2)-Tech-Mod1 and XYZ-081901(2}-Fin-Modi, and b) Second Modification: XYZ- 081901(2)-C1-Mod2 and XYZ-081901(2)-C2-Mod2, containing XYZ-081901(2)-Tech-Mod2 Annex C-1ry 7 Ne ow and X¥Z-081901(2)-Fin-Mod2}. Only the latest modified bid shall be opened while the rést of the superseded bids will be rejected. All bids shall. be submitted electronically on or before the 10:00 A.M. deadline. All Bids must be accompanied by a bid security in any of the acceptable forms and in the amount stated in ITB Clause 14.1. Only electronic bids that are successfully uploaded to the Secure File Transfer Facility of LANDBANK on or before the deadline shall be accepted. The electronic bid shall be submitted by uploading the same in the LBP SFTF {please refer to the Guide in Accessing LBP Secure File Transfer Facility below). Electronic bids received after the set deadline basing on the date and time on the electronic folders of bidders shall not be accepted by the GIBAC, Thus, bidders are requested to upload their electronic bids at least two (2) hours before the set deadline. The prospective bidder shall receive an acknowledgement receipt via email after successful uploading of its/his/her electronic bid. If no email is received within one (1) hour after successful uploading, the bidder shall call the GIBAC Secretariat at (02) 8522- 0000 local 2924 to confirm whether the submission has been received, and if so, request for the acknowledgment of receipt of the electronic bid. On the bid opening date, the bidder shall confirm its/his/her participation in the online meeting with the GIBAC Secretariat at least one (1) hour before the scheduled meeting. The bidder shall be able to log in into MS Teams and join the Waiting Room of the GIBAC meeting. A maximum of two (2) accounts/connections per participating interested bidder shall be allowed to join the meetings. Projects with participating bidders in attendance shall be given priority in the queuing. Upon the instruction of the GIBAC Chairperson to start the bid opening activity, the GIBAC Secretariat connects the participating ‘bidder/s to the videoconferencing/eroup calling session. The GIBAC Secretariat shall record the session and act as Moderator of the meeting all throughout. In case a bidder cannot connect to the videoconferencing via MS Teams application, the GIBAC Secretariat shall contact the bidder concerned through its registered mobile phone/landline telephone up to a maximum of three (3) call attempts with five (5) minutes interval after each call attempt. A text message advising the bidder that the public bidding has already started will also be sent by the GIBAC Secretariat. If the GIBAC Secretariat still cannot contact the bidder after the said allowable call attempts or the bidder is unable to contact the GIBAC Secretariat to provide the passwords needed to open its electronic bids when required by the GIBAC, the bidder concerned shall be disqualified from further participating in the bidding process. é Once the connections are in place, the GIBAC, with the assistance of the GIBAC Secretariat, retrieves the archived file from the LBP SFTF and opens the same. The Technical Proposal shall be opened first. Upon instruction from the GIBAC, the bidder concerned shall disclose the passwords for the archived file and the POF file of the Technical Component. Annex C-2 .10. iu, 12. 13, The GIBAC then determines the eligibility and compliance with the technical requirements of the specific bidder using a nondiscretionary “pass/fail” criterion. Only bidders that have been rated “Passed” shall be allowed to participate in the succeeding stages of the bidding process. The GIBAC, with the assistance of the GIBAC Secretariat, shall then open the Financial Components of those bidders that have been rated “Passed”. Upon instruction from the GIBAC, the bidder concerned shall disclose the password for its/his/her Financial Component. In case an archived/PDF file fails to open due to a wrong password, the specific bidder shall be allowed to provide the GIBAC with passwords up to five (5) times only. The same number of attempts shall apply to Copy 2 of the bid, in case there is a need to open it. If the archived/PDF file still could not be opened after the maximum allowable attempts or due to technical issues, the bidder concerned shall be disqualified from further participating in the bidding process. Thus, the bidders are encouraged to test their electronic bids and ensure that they are free from technical errors prior to uploading of the same to the SFTF. The GIBAC, with the assistance of the GIBAC Secretariat, conducts bid evaluation and ranking of the bids. The results of bid evaluation and ranking shall be recorded in the Abstract of Bids, which shall be signed by the GIBAC Members and Observers. The result of evaluation and ranking shall also be announced to the participants. The retrieval and opening of the electronic bids, page-by-page review of documents and the results of the bid evaluation and ranking shall be shown to the participants through the screen sharing feature of MS Teams. The access of the bidders to the videoconferencing/calling session shall be terminated once the Chairperson has declared that the bid opening activity for a specific project has been finished. MS Teams Application shall be used in the conduct of online bidding through videoconferencing. In the event that it is not available, other videoconferencing/group calling applications may be used as an alternative in conducting the meeting. Annex C-3Guide in Accessing LBP Secure File Transfer Facility 4. Open browser and type the url: https://www.sftaccess.com 2. Log-in with the credentials provided via email. (Note: Log-in credentials will be received upon submission of a duly filled-up LBP SFTF User Registration Form together with copies of LANDBANK Official Receipt and Payment Acceptance Order for non- refundable bidding fee) Username: [E-mail Address] e.g. bidder1@bidder.com Password: [Landbank-provided password] 3. Upon successful login, click ‘Choose Files’ to upload file/s. Notes: 1. Files should be encrypted/password-protected. 2. Please follow the instructions in Item 2 of the above Procedures in Submission and Opening of Electronic Bids. ‘Annex C-42 ‘GhEoE6 Figs No fle chosen Upieastie} © ([SERASCH) [Change Paseword] [Seve Soa a Noe chosen (Wiimiis), (SBT) Siage aa) Annex C-5Logout SHASCE) [Thanee Password] 5, Once a successful upload is completed, the files cannot be deleted anymore. The bidder will also receive a system-generated acknowledgement receipt in its registered e-mall address. A screenshot of the uploaded Bid/s should be taken by the bidder for record purposes. Fomor rea : 1B rxway | sewing Welcome to Secure Transport: eB ‘Annex C-6 .File Repository of Bid Documents All uploaded bid documents will be stored in the dedicated SFTF directory of a particular bidder and will be accessible by the assigned GIBAC Secretariat personnel. ‘Annex C-7LBP SECURE FILE TRANSFER FACILITY REGISTRATION FORM. Name of Participating Bidder/“Company” Complete Address of the Compai Contact Number ‘AUTHORIZED LBP SECURE FILE TRANSFER USER/S: Name of Authorized Official Email Address: Contact Number/s: Representative: TERMS AND CONDITIONS: “The Company, through its Authorized User/s, shal: 1. Use LBP's Secure File Transfer Faciity to securely transmit files to LBP Goods and Infrastructure Bids and ‘Awards Committee only for the purpose of aniine submission of bidding documents. Be responsible for the confidentiality ofits assigned log-in credentials. (Le. assigned user 1D) 3. Only upload agreed upon file formats and shall not upload any flle/s containing Inappropriate content, ‘material that violates or infringes in any manner on the intelectual or proprietary rights of others, and any mabares, software virus, “Trojan Horse” program, “worm” or other harmful or damaging software or software component. 4, Agree and ensure that the computing devices to be used for LBP’s Secure File Transfer Factity have the updated anti-virus software and operating system security patches, as minimum requirements in order to establish connectivity, to maintain and ensure the security, integrty and availablity of the LAP Secure File ‘Transfer Facility. 5. Agree not to use a public wi-fyhotspot such as but not limited to those offered in coffee shops, malls, restaurant or hotels to access into the LAP Secure File Transfer Facility, 6 Agree that LANDBANK may revoke, block, or permanently disallow the use of this faciity without prior notice due to reasons that may compromise the Bank's security. (AGREEMENT: ‘As an Authorized User, Thereby agree: ‘To the above terms and condtions Not to disciose any confidential information regarding the LBP Secure File Transfer Facifty. ‘To avoid using unauthorized users/computers to input credentials; and ‘That unauthorized dissemination of information about the LBP Secure File transfer Facilty shall be considered a security breach and is ground for the immediate termination of the account. ‘Authorized User (Signature over Printed Name) Pease pane WA Da SS Annex C-8TERMS OF REFERENCE |. Project Description: One (1) lot - Supply, Delivery, and Installation of 171 pos. “Emergency Evacuation Plan* Signage at Landbank Plaza, I Material Specifications: Installation of “Emergency Evacuation Plan’ Signage with the following technical specification: Size of “Emergency Evacuation Plan" Signage: A3~ 11.7" x 16.5 High intensity laminate that glows in the dark (Photoluminescent) polyester film coated with an aggressive pressure sensitive adhesive that provides high adhesion and luminance. po 3, Duration of photoluminescent glowing should be minimum of 4 hours. 4, Non-Toxic, Non-Radioactive, Explosion Safe Self-Adhesive Vinyl Sticker. 5. luminescent Characteristics: a. Illumination: minimum of 24.0 lux for 2 hours. b. Luminance: minimum luminance after ilumination of 10 minutes >37 med/m2 60 minutes >8 medim2 90 minutes >5 medim2. 6. Adhesive Type: Pressure Sensitive Acrylic 7. Thickness (PSTC33): minimum of 0,008 in, (0.228 mm) 8. Adhesive Properties: a. Adhesion to Stainless Steel (PSTC!) Glossy (subject to FMD approval) 410. Minimum Application Temperature: 80°F (10°C) 41, Service Temperature: 40°F to 140°F (4°C to 60°C) 12. Framing is made of Polystyrene Molding, 1/8-inch Glass Face Window Mat and Durable Back Board. Printing Method: Thermal transfer 2 Tae Project Detalls: 1. Scope of Works a. Perform thorough inspection/survey to verify actual site condition for the needed details required in the implementation of the project Mobilization Removal ofthe existing emergency evacuation plan. Installation of the new emergency evacuation plan. Disposal of debris/waste certified by FMD shall be at the expense of the contractor. Inspection and punch lstinglrectification on completed works. |. Turn-over and acceptance of project. |. Demobilzation Fergaos NV. Project Duration a, The project duration will be within sixty days (60) calendar days upon receipt of Notice to Proceed (NTP) and advice from Faciities Management Department (FMD). Annet D-{v. CLASS D Submittals: ‘Submission Particulars Description ty Prior to bidding proper, Interested supplier mast | Submit Cerficate of Inspection (Cl) issued | To be submitted conduct inspection, verifeaion and overall project | by LANDBANK ~ Facies Management| one week rir 10 assessment Department (FMO). ‘Non. | bidding proper. submissovinspecton wil result fo outright sisqualfcation ofthe bid. ‘Must have minimum experience of thes (@) years i | Submit one (1) related document to FMD | May be submited supply and instalation of "Emergency Evacuation Plan’ | (e.g. previous Purchase Orders, Contacts, | before or during the signage or any similar productiproject. Oficial receipt, Sales Invoice, etc.) from | evaluation of post | various cents. qualification. “The supplier must provide te following 7. Materials sample Prior to project 2. Mock-up unit shall be submitted within | implementation, ssoven (7) calendar days upon approval of the materials sample Warranty Certfcale One (1) year against overall workmanship | Upon project turn- ic effective upon tum-over & final acceptance. | over and aoceptence Mie Manner of Payment: Ninety seven percent (97%) of the total Contract Price payable upon issuance of turn-over and acceptance cerificate/documtent by LANDBANK — Fasiliies Management Department. The remaining three percent (3%) of the total Contract Price (Retention fee) payable after the expiration of warranty period, All payments shall be subject to LANDBANK’s standard accounting and auditing rules and regulations. Notes: 1. The service provider is requited to maintain a deposit account with LANDBANK Cash Department or any of ts Branches. This dectve is pursuant to Malacafiang Executive Order No. 170 ~ Adoption of Digital Payments for Government Disbursements and Collections, directing all government agencies to uliize safe and efficient digital disbursements in the payment of goods, services and other disbursements. Payment shal be through ctect creat othe service provider's deposit account with LANDBANK. 3. The supplier shall be paid within sity (60) calendar days affer submission of biting or claim, and compiete documentary requirements. Vil. Terms and Conditions: |. All installations shall be based on the FMD-provided plan and specifications/details. Any changes in ‘the plan shall be coordinated with FMD for approval prior to any implementation. 2. The contractor shall: a. Coordinate with FMD for schedules and project briefing. Work authorization permit must be ‘secured from FMD at least one week prior to any mobilization. Work schedule is from 8:00 AM to 5:00PM from Monday to Sunday (including holiday), provided it will not cause any disruption in the operation of the Bank, otherwise, work schedules shall be adjusted accordingly.CLASS D b. Deploy only competent techniciansiworkers (with prior approval from FMD) with vast experience and expertise in the entire undertaking and implementation of the project ©. Provide its workers with the required personal protective equipment (PPE) and appropriate tools in the implementation ofthe project in compliance withthe Environmental Management ‘System (EMS) Program of the Bank in accordance withthe requirement of ISO 14000. d. Be liable and solely responsible for any harm, damage and injury that may be incurred or ‘suffered by its own crewiworkers or any person during implementation of the project and to any damage to the Bank's property arising from the acts whether partial, contributory or due entirely to the fault, negligence and/or dishonesty of its workers in the course of thelr duties, 2, Maintain cleanliness at all times. it shall be responsible forthe collection and proper disposal - ‘ouside of the Bank premises, of al waste materials resulting from any activity related to the implementation of the project, in compliance with the Bank’s Environmental Management ‘System (EMS) Program and the requirements ofthe covering policies, rules and regulations of the Department of Environment and Natural Resources (DENR) and the Environmental Management Bureau (EMB), Be bounded by and shall strictly observe the existing rules and regulations with regards to the standard security policies and prooedures while inside the Bank's premises. 3. All waste materials shall be pulled out and disposelby the service provider. FMD Property Supply Officer, with the recommendation of FMD Engineer-in-Charge, shall certify all waste material/debris to be pulled out once proper documents are approved (2. PTS, waste material report, etc.). Further, materials with value and possible usage for the Bank shall be turned over to FMD-PSO for safekeeping Vill. Contacts Persong: For further information, you may get in touch with Engr. Bryan Cauilan at Tel Nos. (02) 522-000 locals 2323 or 4047 Prepared by: Revi ROOW. CALDERON #OEMD-FSUMH.DEL PILAR STREET = = F . § . ‘ Lay = —m E = a uw I = f| 4 - 5 - ic in : “ = . ° = Be z - a E ( ° MABINI STREET TYPICAL FLOOR EVACUATION PLAN (IITH-34TH) <= Ss - > {WP HEADQUARTERS BULDING Src pany seconoany S98 MH. DEL PLAR CORNER DR. GUITOS I, MALATE. MANEA Exrsoure sxrrRouTe FIRE STATION EMERGENCY HOTLINE. LEGENDS ARROCEROS FIRE STATION EVACUATION SITE se rcevacunnonrian |) Roonenczonevocevon '528-06-41 ROXAS BLVD. EAST SERVICEROADCORNER | CIR rwctesccumer — (MB) oonorervoonoruse | INTRAMUROSFIRESTATION EL CARMEN ST. MALATE, 1336-51-36 MANILA (NEAR PALACIO DE g tention teas PACOFIRESTATION WAYRILA) 525-47-14/523-34-02 (BR swermustanon 0 Steamer cre PREPAREDEY: CHECKEDANOTEDSY: ECOMNENDEDBY: APPROVEDBY. wiietn |Anetige Mb =r 7H ROD a:QUINTOS STREET MH.DEL PILAR STREET MABINI STREET ‘TYPICAL FLOOR EVACUATION PLAN (1ITH-34TH) {UP HEADQUARTERS BUILDING 1598 WH. DEL PILAR CORNER DR, J. QUNTOS ST. MALATE, MANILA na —> ——> SPACE rune seconoaRy erreoue EXP ROUTE FIRE STATION EMERGENCY HOTLINE LEGENDS | ARROCEROS FIRE STATION EVACUATION SITE se rncevicusrionetan J oon zone oceron SoEnea ROXAS BLVD. EAST SERVICEROADCORNER | GLI resvostcaaner ® Donor NEn/D0NOTUSE INTRAMUROSFIRESTATION EL CARMENST.MALATE, | 3336-51-36 MANILA (NEAR PALACIO DE g FFREEXTINGUISHER ? vou ane ene MAYNILA) PACO FIRE STATION 525-47-14/523-34-02 PR wuarusranon race amen ron rn, PREPARED BY oCKEDA NOTED RECOMMENDEDEY: | rovener: eauphecus AUN 7 ne I 7H UO.IR. TRESSQUINTOS STREET MH.DEL PILAR STREET MABINI STREET TYPICAL FLOOR EVACUATION PLAN (I1TH-34TH) {BP HEADQUARTERS BUILDING 1598. H. DEL PLAR CORNER DR. J. GUINTOS ST, MALATE, MANILA corre ME FIRE STATION EROS FIRE STATION SRGENCY HOTLINE LEG Se a rmeevicuvonrin ff nocemnezn can ROXAS BLVD. EAST eae SERVICEROADCORNER | CIID ratvsecaner — () rororerer sonore MUROSFIRESTATION DEL CARMENST.MALATE, 36-51-36 MANILA (NEARPALACIODE/ — peerarsen -yousneyene: ACO FIRE STATION MAYNILA) 525-47-146/523-34-02 BB) enteustanon CO Sinan PREPARED: CHECKED ANOTEDEY fecomuenceDav. BRYSMH.DEL PILAR STREET = QUINTOS STREET MABINI STREET TYPICAL FLOOR EVACUATION PLAN (IITH-34TH) LBP HEADQUARTERS BUILOING 1598 MH. DEL PAR CORNER DR. J. QUINTOS ST. MALATE, MANKA FIRE STATION EMERGENCY HOTLINE ARROCEROS FIRE STATION mmm rreevacurmonrtan [BB Roonrne zone ocaron 5828-06-41 va SERVICEROADCORNER | CITI recvosecame — (B) oonorern/ovor se INTRAMUROSFIRE STATION DEL CARMENST. MALATE, 36-51-36 MANILA (NEAR PALACIO DE q (FRE EXTINGUISHER “You ARE MERE ee MAYNILA) 525-47-14/523-34-02 BR) wmuruistanon pms ere PREPARED BY CAE A NOTED. RECOMMENDED EY: ‘sPPROVEDEN, wien cye 4 BILL OF QUANTITIES Project LANDBANK Plaza Location: 1598 M.H. det Pliar corner Quintos Streets, Malate, Manita Trem Description Uncen | Toulcont [Supply, Delivery and Installation of "Emergency Evacuation Plan™ Signage at LANDBANK Plaza Emergency Evacuation Plan” Signage a. Sie: AB-117"x165" b. High intensity laminate thet glows in the dark (photoluminescent) polyester film coated with an aggressive pressure sensitive ‘adhesive that provides high adhesion and luminance” ©. Duration of photoluminescent glowing should be minimum of ‘hours 4. Non-toxic, non-radioactive, explosion safe self-adhesive vinyl sticker § ¢. luminescent characteristies: ‘lamination: minimum of 23.0 ux for 2 hours Luminance: minimum luminance after illumination of 10 minutes 37 mad/m2 60 minutes >8 med/m2 90 minutes >§ med/m2 {adhesive type: Pressure sensitive acryic {Thickness (PSTC33}: Minimum of 0.009 in, {0.228 mm) , h. Adhesive properties: + Adhesion to stainless steel (PSTC3) i. Glossy (subject to FMD approval) |. Minirrur application temperature: 50°F (10°C) ~ Service temperature: 40°F to 140°F (4°C to 60°C) = |. Framing is made of polystyrene molding, 1/8-inch glass face window mat and durable back board ~ ‘Printing method: Thermal transfer. Cc Total con irene ctv | |} Note: Th der shal ln cates nd pices oral Rem of the Blof Quant, ls no adres ot roving al ofthe required items inthe Bl of Quanties shal be considered noveaponsive ad, than, tomatic quad ois ear, where a requed ae provided, but no price Is indicated, the same shall be considered as nonresponsve, bt speciying "0" zero) forthe sald Kem would ‘mean that itis being offered fr fre, Name of the Bidder Signature Over Printed Name of Authorizad Representative ANNEXEy ) Omnibus Sworn Statement ~~ REPUBLIC OF THE PHILIPPINES ) CITYIMUNICIPALITY OF )ss. AFFIDAVIT 1 of legal age, and residing at ‘ae ot Aan {Chi st) (aon) after having been duly swom in accordance with law, (fers of Aan do hereby depose and state that: 1. Select one, delete the other: 1 a sole proprietorship: | am the sole proprietor or authorized representative of. (ame et i8den with office address at 5 (fasess o Bio) Ifa partnership, corporation, cooperative, or joint venture: | am the duly authorized and designated representative of with office address at (Nome of Bide) (dere o Biter) 2. Select one, delete the other: Wf a sole proprietorship: As the owner and sole proprietor, or authorized representative of, {have full power and authority o do, execute and perform any and all acts (are of Bidder) necessary to paticipate, submit the bid, and to sign and execute the ensuing contract forthe Land Bank of the Philippines, ‘88 shown in the attached duly notarized Special Power of Attomey, Wapartnership, corporation, Cooperative, orjoint venture: | am granted ful power and authority to do, execute and perforin ‘any and all acts necessary to participate, submit the bid, and to sign and execute the ensuing contract for Land Bank of the Philippines, as shown in the attached [state tile of attached document showing proof of authorization (o.g., duly notarized Secretary's Certificate, Board/Partnership Resolulion, or Special Power of Attomey, whichever is applicable), 3 |g not “blacklisted” or barred from bidding by the Government of the Philippines ‘Warne of Bae) ‘oF any of its agencies, offices, corporations, or Local Government Units, foreign government/foreign or intemational financing institution whose blacklisting rules have been recognized by the Government Procurement Policy Board, by itself or by relation, membership, association, affiliation, or controlling interest with another blacklisted person or entity 8 defined and provided for in the Uniform Guidelines on Blacklisting; 4, Each of the documents submited in satisfaction of the bidding requirements is an authentic copy of the original, complete, and all statements and information provided therein are true and correct; 5 Is authorizing the President and CEO of Land Bank of the Philippines orits duly ‘ams of Bee authorized representative(s) to verify all the documents submitted; 6. Select one, delete the rest: Ifa sole proprietorship: The owner or sole proprietor isnot related by consanguinity or affinity up to the third level degree to the folowing LANOBANK officers, employees and consultants: ) members of the Board of Directors; 2) President and CEO; 3) members of the Bids and Awards Committee for Goods and Infrastructure (GI-BAC) and Bids and Awards Committee for information and Communications Technology (ICT-BAC); 4) HOBAG (GI-BAC) and ICT-BAC Secretariat, 5) members ofthe Technical Working Group. if applicable; 6) personnel of Procurement Department; 7) personnel ofthe implementing unit or the end-user unt; and 8) project consultants, if epplicable;! Annex F-1 asersss029\ Ifa partnership or cooperative: None of the officers, members, of___ = _isrelated (Wem of Bien by consanguinity or affinity up to the third civil degree, to the foliowing LANDBANK officers, employees and consuitants: 1) members of the Board of Directors; 2) President and CEO; 3) members of the Bids and Awards Committee for Goods tnd Infrastructure (GHBAC) and Bids and Awards Committee for Information and Communications Technology (ICT- BAC); 4) HOBAG (GI-BAC) and ICT-BAC Secretariat; 5) members of the Technical Working Group, if applicable: 6) personnel of Procurement Department; 7) personnel of the implementing unit or the end-user unit; and 8) project consultants, if applicable; a comoration or joint venture: None of the officers, directors, controling stockholders of is related, by consanguinity or afiity up to the third civil degree, (ame of Bidder to the following LANDBANK officers, employees and consultants: 1) members of the Board of Directors; 2) President and CEO; 3) members of the Bids and Awards Committee for Goods and Infrastructure (GI-BAC) and Bids and Awards ‘Committee for Information and Communications Technology (|CT-BAC); 4) HOBAC (GIBAC) and ICT-BAC Secretariat; '5) members of the Technical Working Group, if applicable; 6) personnel of Procurement Department; 7) personnel of the implementing unit or the end-user unit; and 8) project consultants, if applicable;* 7, has no unsatisfactory performance with its ongoing projects. Wane TIE 8, complies with existing labor laws and standards; and Wane ofS 9, is aware of and has undertaken the responsibilities as a Bidder in (Ware of Boe ‘compliance with the Philippine Bidding Documents, which includes: 8) Carefully examine al ofthe Bidding Documents; b) Acknowledging all conditions, local or otherwise, affecting the implementation ofthe Contract; ©) Making an estimate ofthe facities avallable & needed forthe contract o be bi, any, and 44) Inquiring or securing Supplemental Bulletin(e) issued forthe [Name of the Projec. 10. did not give or pay directly or indirectly, any commission, amount, fee, of Tare ose ‘any form of consideration, pecuniary or otherwise, to any person or official, personnel or representative of the government in relation to any procurement project or activity. ‘14. In case advance payment was made or given, failure to perform or deliver any of the obligations and undertakings in the ‘contract shall be sufficient grounds to constitute criminal liability for Swindling (Estafa) or the commission of fraud with unfaithfuiness or abuse of confidence through misappropriating or converting eny payment received by a person or entity ‘under an obligation involving the duly to deliver certain goods or services, tothe prejudice of the public and the government of the Philippines pursuant to Article 315 of Act No. 3816 s. 1930, as amended, or the Revised Penal Code. IN WITNESS WHEREOF, | have hereunto set my hand this __ day of . 20__at Philippines. insert NAME OF BIDDER OR ITS AUTHORIZED REPRESENTATIVE] Ainsert signatory's legal capacity) Affiant SUBSCRIBED AND SWORN to before me this __day of in Affant's isfare personally known to me and was/were identified by me through competent evidence of identity as defined in the 2004 Rules on Notarial Practice (A.M. No. 02-8-13-SC). Affiants exhibited to me hisiher [insert type of goverment identification catd used], with his/her photograph and signature appearing thereon, with no. ‘and his/her Community Tax Cerificate No. ‘issued on__at ‘Witness my hand and seal this_ day of fmonth] [year Notary Public. Doc. No. Page No. Book No. 8. of ‘The names of specific LANDBANK office, employees and consutants being refered fo are shown in Annexes F-1.1 to F-1.2 of the Omibus Som ‘Statement Annex F-2 asers1970List of LANDBANK Office CN , Employees and Consultant(s) a a ANNEX F-4.1 ‘A. Board of Directors: ExOfficio Chairman: Sec. Benjamin E. Diokno, Department of Finance (DOF) Ms. Sharon P. Almanza, Deputy Treasurer, Primary Alternate ~ DOF Mr. Erwin D. Sta, Ana, Deputy Treasurer, Secondary Alternate DOF. Vice Chairperson: Ms. Ma, Lynette V. Ortiz, President and CEO Members: ‘See. Francisco Tiu Laurel Jr, Department of Agrctiture (DA) See. Bienvenido E. Laguesma, Department of Labor and Employment (OOLE) Mr. Benedicto Emesto R. Bitonio, r., Undersecretary, Alternate Member ~ DOLE Atty. Lennard Constantine C. Serrano, Assistant Secretary, Secondary ‘Alternate ~ DOLE ‘Sec. Conrado M. Estrella Ill, Department of Agrarian Reform (DAR) Mr. Napoleon U. Galt, Undersecretary, Alternate Member ~ DAR Atty. David D. Ero, Representative - Agrarian Reform Beneficiaries Sector Ms, Viginia N. Orogo, Representative - Agrarian Reform Beneficiaries Sector Ms. Nancy D. Irland, Representative - Private Sector B. President and CEO: Ms. Ma, Lynette V. Ortiz c. D. FB Bids and Awards Committee for Goods and Infrastructure (GI-BAC) Chairman: Mr. Emmanuel G. Hio, Jr, First Vice President — Facilities Engineering Services Group Vice Chairman: Mr. Reo S. Andarino, Vice-President ~ Digital Banking Support Department Regular Members: Ms, Ma. Francia O, Titar, First Vice President - Financial Markets Group Mr Aiwin |. Reyes, Vice President ~ Procurement Department Ms. Mira Leah B. Patio, Vice President - Employee Relations Department Provisional Member: Atty. Joseph Dennis C. Castro, Legal Manager - Legal Services Group GI-BAC Secretariat Head: Atty. Honorio T. Diaz Jr. Officers and Staft ‘Ms, Remedios S. Lacaden, Senior Management Associate Ms. Ruby S. Cortez, Procurement Specialist Ill Ms, Farah Eva B, Esguerra, Administrative Specialist It Ms, Maribel J. Paredes, Procurement Specialist ‘Mr. Mark Anthony C. Pantalla, Procurement Analyst Ms. Jenica V. De Vicente, Procurement Analyst Mr. Jerome C. Relucio, ASO Mr. Roman &, Eala, ASO Bids and Awards Committee for Information and Communications Technology (ICT-BAC) Chairman: ‘Ms. Leila C. Martin, Senior Vico President - Digital Banking Sector Vice Chairman: Ms. Marilou L. Vilafranca, Senior Vice President — North National Capital Region Branches Group Reguler Members; Ms. Marjorie R. Cortez, Vice President - Enterprise Data Management Department Mr. Ramilito R. Basbacio, Vice President — Property Valuation Services Department Mr. Archieval B. Tolentino, Assistant Vice President — Network Operations Department Provisional Member: Atty. Chrisa Sheila |, Pimentel, Legal Officer - Legal Services Group ICT-BAC Secretariat Head: Atty. Auxillador Avitus D. Dofeliz Officers and Staft: Atty, Karla May M. Temporosa, Administrative Officer Mr. Leonico Henry T. Sison lit, Assistant Division Chief Mr. John Philip G. Hilario, Administrative Analyst Ms. Katherine B. Mantilla, Administrative Assistant Mr. Comnelio B. Umipig Jt., Administrative Assistant aeers13020QO O ANNEX F-4.2 G._ Technical Working Group Chairman: Vice Chairman: Members: (Ay H. Procurement Department Head: Officers and Staff: Mr. Alwin |. Reyes, Vice President Ms. Ma, Victoria C. Viray, Senior Procurement Officer Team Leader Ms. Rosemarie SJ. Mirando, Senior Procurement Officer/Team Leader Ms. Leonor F. Santos, Acting Senior Procurement SpecialisTeam Leader Mr. doe! R. Perez, Senior Procurement SpecialistTeam Leader Ms. Helen 8, Puriicacion, Senior Procurement Specialist Team Leader Mr. Donato DR. Cariaga, Senior Procurement SpecilisvTeam Leader MMs, Kristi Ann P. Rutab, Procurement Offcer/Team Leader Mr, Rommel C. Pascua, Procurement Speciaist Il Ms. Cathrina Marie A. Garcia, Procurement Specialist I Mr. Rosalino V. Cruz, Procurement Specialist I Ms. Lubelle B, Lumabas, Procurement Specialist I Mr, Jetome V. Bueno, Procurement Specials I Ms. Nadia G. lleto, Procurement Specialist Ms. Ma, Angela Q. Emeterio, Procurement Analyst Ms. Jeramae F. Cancepcion, Procurement Analyst Ms. Kimberly Joy A. Sto, Tomas, Procurement Analyst Mr Jolfanz Jenkin G. Dy, Procurement Analyst Ms. Charmaine F. Manglit, Procurement Analyst Ms. Jean Crysel Escalona, Procurement Analyst Mr. Marlon R. Faraon, Procurement Analyst Mr. Aaron V. Sedanto, Procurement Analyst Mr. Rudytick B. Siva, Procurement Analyst Mr. Jake L. Rosita, Acting Procurement Analyst Ms. Fretch Camilo J. Japole, Procurement Assistant Mr. Merk Anthony M, Abad, Procurement Assistant ‘Ms. Almay Joyce B, Ruz, Procurement Assistant Ms. Vinna Mariella T. Custodio, Procurement Assistant Ms. Diana R. Fronda, Acting Procurement Assistant Ms, Jade Rodezza M. Cupino, Executive Assistant Ms. Joy L, Gabay, Administrative Assistant ‘Mr. Jesus David, SCW Mr. Emil Dela Cruz, SCW Mr. Erikson Guani, SCW Mr. Vicente Gutierez, Jr, SOW Me. Andrew Palma, SOW Mr. Dexter Naguit, SOW Mr. Rami Pendila, SCW Mr. Frederick Reyes, SCW Mr. Pablo Tenoria, SOW sso s430201. Implementing & End-User Unit Head: Officers and Staff J. Project Consultants Team Lead: Members: CO ANNEX 4.3 Mr. Alexander 8, Lazaro, AVP/Hiead, Facilities Management Department (way sor s13029FACILITIES MANAGEMENT DEPARTMENT List of Personnel 1 Abuzo, Eimer M. [Assistant Department Manager 2|Aguila, Alexis C. [Administrative Aide | 3{Alfonzo, Ashley Shayri D. Records Analyst alAlmaiz, Alfrance M1. lOffice Aide 5|Antipala, Rachel Records Assistant 6|Apurado, Edgar ¥ [Office Aide 7 Austria, Rovelyn D Office Aide 8|Balido, Rene Records Assistant 9|Bantug, Jocelito L. Project Development Specialist 10[Barrocan, Aileen R. Procurement Specialist It 11[Batis, Michael Robin B. [Administrative Services Officer | 12|Bayani, Abner M. vision Chief 13|Bonite, Peter Jayson D Office Aide 14|Cabangin, Jayby A. Property Analyst 15|Cajigal, Elvie F. Division Chief 116|Calderon, Edgardo V. Division Chief 17]Calilong, John C. Engineer 18|Caullan, Bryan Nathaniel ¥. Project Development Specialist | 19|Cerilla, Flordelyn A. [Assistant Department Manager 20|Cruz, Emerose A. [Customer Relations Assistant 21\Cruz, Helen R. Buyer 22|Dana, Rey Vincent B. Project Development Assistant 23|Del Rosario, Enrico BenignoV. [Engineer 24|Delmonte, Jerry E. [Assistant Division Chief 25|Desingafio, Anthony P. [Motorized Messenger 26|Feliciano, Mylene Records Assistant 27|Gange, Aries [Administrative Aide | 28[Gayo, Fernando F Reproduction Machine Operator 29|Gumaru, Charlotte D. Engineer 30[llag, Julius C [Senior Project Development Specialist 31Inguito, Wilmer M. Engineer 32[Jagonob, Olivia E. [Records Specialist I 33[Laroza, Christine Joy t. Architect 34[Lazaro, Alexander S. [Assistant Vice President 35|Lomanta, Mark Anthony A. Motorized Messenger 36|Lopez, Evelyn S loffice Aide 37|Macawili, Manelyn L. Records Specialist I 38|Magbojos, Alan M lOffice Aide 39|Mallari, Ricardo Y. [Senior Mechani¢/Technician 40| Mangubat, Ermie |. [Administrative Aide | page 1 of 2 pages Annex F-2.1ay 42 43 44 45| 46| 47 48| 49| 50| 51] 52| 53 5a 55| 56| 57] 58| co) 60| 61| 62 63 64 6 66| 67 63| 69| 70| n 7 FACILITIES MANAGEMENT DEPARTMENT Ust of Personnel Marzan, Laurence M. [Utility Worker Maturan, Junrey C. [Administrative Aide | Medalla, Analiza A Office Aide Medrano, Hannah Pauline J. Executive Assistant Memorando, Brian PatrickG. [Engineer Mercado Jr., Spyros Delfin V. [Assistant Division Chief Merida, Julie Ann D. [Customer Relations Assistant Morales, Sandy, Jr. M. [Clerk Naguit, Christian Records Assistant Nuque, Dennis DL. Property Specialist I lOlbes Jr., Rodrigo P. [Account Officer Pablo, Jehomar S. [Engineer Palafox, Roderick B. [Administrative Aide | Pamintuan, Marilou V. [Assistant Department Manager Pandongon, Umer R Project Development Specialist II Perez, JerickS Project Development Specialist Il Ramos, Marie Grace G. [Architect Real, Edilyn L [Assistant Division Chief Rubio, Lexter [Property Assistanct [Saet, Errold C Office Aide [Salvador, John Michael B. Property Analyst [Salvador, Kristine . Project Development Assistant [Santos, Imelda U. [Assistant Division Chief [Sombillo, Mary Ann G. [Records Specialist Il [Sumaylo, Erwin Neil S [Engineer [Testa, Ricardo S. [Carpenter General Foreman [Tomas, Melanio Jr. M1 Office Aide lTorres, Concepcion L. Project Development Specialist Il [Tulio, taira B. [Customer Relations Assistant lValdepefia, Jerome $ Engineer lVelasco, Romeo T. [Administrative Aide | lVicencio, Michael Anthony L._ [Records Officer page 2 of 2 poges F22