REPUBLIC OF THE PHILIPPINES

Province of Negros Occidental)S.S.

City of Bacolod )

AFFIDAVIT

I, ENRICO Z. DE LA CRUZ, of legal age, single, Filipino, with residence at Brgy. Alijis,
Bacolod City, Negros Occidental, after having been duly sworn to in accordance with law, do
hereby depose and state the following:

1. That I am a Supplier of the Province of Negros Occidental for the item FEEDMILL
under SUPPLY AND DELIVERY OF EQUIPMENT FOR THE USE OF TLDC;

2. That I suppose to deliver the said item until August 29, 2017;

3. That for some reasons, I requested for the period of extensions to comply on the
delivery of FEEDMILL to the Province of Negros Occidental;

4. That due to shipment delays, the said item will more or less reach the Province of
Negros Occidental Office by October 10, 2017 for reasons beyond my end;

5. That I am making best efforts to put this transaction in order and to meet all
compliance obligations;

6. That I am willing to deliver the said item under PO No. 17-04-000411 dated April 26,
2017 before the awarding of the new contract and to waive my bid if the condition
is not complied with;

7. That I am requesting the Province of Negros Occidental to consider my request in

this regard;

8. That I am executing this affidavit in order to attest to the truth of the foregoing.

IN WITNESS WHEREOF, I have hereunto set my hands this October 2, 2017, in the City of
Bacolod, Philippines.

ENRICO Z. DE LA CRUZ
AFFIANT

SUBSCRIBED AND SWORN to before me, this October 2, 2017, by Enrico Z. De La Cruz,
who exhibited to me his Driver’s License (FO1-76-012143) issued at Bacolod City, Philippines.

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Series of 2017