Name of Project: Construction/Repair/Rehabilitation of Various Projects namely:

1. Lantangan P/S, Pinoy Espinosa E/S, 3. Panta Buri E/S, $.

Tagubanhan E/S, 5.
Camambugan E/S, 6. Pedro Bedez E/S, 7. Quiasan E/S, 8. Salong
E/S, 9. Ajuy Rural
Health Unit, 10. Bay ang Brgy. Health Center. 11. Lantagan
Brgy.Health Center,
12. Balasan Rural Health Unit, 13. Cabalic Brgy. Health Center.

OMNIBUS SWORN STATEMENT

REPUBLIC OF THE PHILIPPINES
Roxas City, Capiz
AFFIDAVIT
I, RAMIL S. ARTATES, of legal age, married, Filipino, and a resident Brgy. Dumulog,.
Roxas City Capiz, after having been duly sworn in accordance with law, do hereby
depose and state that:
1. I am the AMO/Proprietor of CSC BUILDERS. , with office address at Rendon
Bldg., Legaspi St., Roxas City
2. As the AMO/Proprietor of CSC BUILDERS., I have full power and authority to
Do, execute and perform any and all acts necessary to represent it in
the Construction/
Repair/ Rehabilitation of Various Projects Namely: 1. Lantangan P/S, 2. Pinoy
Espinosa E/S, 3. Panta
Buri E/S, 4. Tagubanhan E/S, 5. Camambugan E/S, 6. Pedro Bedez E/S, 7.
Quiasan E/S, 8. Salong E/S,
9. Ajuy Rural Health Unit, 10. Bay ang Brgy. Health Center, 11. Lantagan Brgy.
Health Center,
12. Balasan Rural Health Unit, 13. Cabalic Brgy. Health Center.
3CSC BUILDERS, is not blacklisted or Banned from bidding by the
Government of the Philippines or any of its agencies, offices,
corporations, or local
Government Units, foreign government / foreign or international financing
institution whose
Blacklisting rules have been recognize by the Government Procurement Policy
Board;
4. Each of the documents sudmitted in satisfaction of the bidding requirement is
an authentic
copy of the original, complete, and all statement and information provided
therein sre true
and correct;
5. CSC BUILDERS., is authorizing the Procuring Entity or its duly authorized

Representative (s) to verify all the documents submitted;

6. I am not related to the Head of the Procuring Entity, memmbers of the
Bids and Awards
Committee (BAC), the Technical Working Group, and the BAC Secretariat, the
Head of the
Project Management Office of the end user unit, and the Project Consultants by
consanguinity
Or affinity up to the third civil degree;
7. CSC BUILDERS complies with the existing labor laws and standards; and
8. CSC BUILDERS is aware of and has undertaken the following responsibilities
As a bidder:
a. Carefully examine all the Bidding Documents;
b. Acknowledge all conditions, local or otherwise, affecting the
implementation of the
contract;
c. Made an estimate of the facilities available and needed for the contract to be
bid, if any;
and
d. Inquire or secure Supplemental/Bid Bulletin(s) issued for the:
Construction/Repair/Rehabilitation of Various Projects namely: 1. Lantagan
P/S, Pinoy Espinosa
E/S, 3. Panta Buri E/S, 4. Tagubanhan E/S, 5. Camambugan E/S, 6. Pedro
Bedez E/S, 7. Quiasan E/S.
8. Salong E/S, 9. Ajuy Rural Health Unit, 10. Bay ang Brgy. Health Center, 11.
Lantagan Brgy.
Health Center, 12. Balasan Rural Health Unit, 13. Cabalic Brgy. Health Center.
9. SDB STEELSTRUCT BUILDERS ENT., did not or pay directly, any commission,
amount, fee, or 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.
IN WITNESS WHEREOF, I have hereunto set may hand this _____ day of _________at
Roxas City Capiz
Philippines.

RAMIL
S. ARTATES
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME This _____day of __________, affiant

exhibiting to me his
Community Tax Certificate No.______________ issued on _______________at Roxas city
Capiz, Philippines.

DOC. No. _____

Page No. _____
Book No. _____
Series of 2016