Omnibus Sworn Statement REPUBLIC OF THE PHILIPPINES ) CITY/MUNICIPALITY OF ______ ) S.S. AFFIDAVIT I, of legal age, and residing at [Name of Affiant], [Civil Status], [Nationality], [Address after having been duly sworn in accordance with law, do hereby depose and state of Affiant], that: Select one, delete the other: I am the sole proprietor or authorized representative of If a sole proprietorship: [Name with office address at of Bidder] [address of Bidder]; I am the duly authorized If a partnership, corporation, cooperative, or joint venture: and designated representative of with office address at [Name of Bidder] [address of Bidder]; Select one, delete the other: As the owner and sole proprietor, or authorized representative If a sole proprietorship: of I have full power and authority to do, execute and perform any [Name of Bidder], and all acts necessary to participate, submit the bid, and to sign and execute the ensuing contract for of the [Name of the Project] [Name of the Procuring Entity], as shown in the attached duly notarized Special Power of Attorney; I am granted full power If a partnership, corporation, cooperative, or joint venture: and authority to do, execute and perform any and all acts necessary to participate, submit the bid, and to sign and execute the ensuing contract for [Name of the Project] of the as shown in the attached [Name of the Procuring Entity], [state title of attached document showing proof of authorization (e.g., duly notarized Secretary’s Certificate, Board/Partnership Resolution, or Special Power of Attorney, whichever is applicable;)]; is not or barred from bidding by the Government of [Name of Bidder] “blacklisted” 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 recognized by the Government Procurement Policy Board;
Omnibus Sworn Statement REPUBLIC OF THE PHILIPPINES ) CITY/MUNICIPALITY OF ______ ) S.S. AFFIDAVIT I, [Name of Affiant], of legal age, [Civil Status], [Nationality], and residing at [Address of Affiant], after having been duly sworn in accordance with law, do hereby depose and state that: Select one, delete the other: If a sole proprietorship: I am the sole proprietor or authorized representative of [Name of Bidder] with office address at [address of Bidder]; If a partnership, corporation, cooperative, or joint venture: I am the duly authorized and designated representative of [Name of Bidder] with office address at [address of Bidder]; Select one, delete the other: If a sole proprietorship: As the owner and sole proprietor, or authorized representative of [Name of Bidder], I have full power and authority to do, execute and perform any and all acts necessary to participate, submit the bid, and to sign and execute the ensuing contract for [Name of the Project] of the [Name of the Procuring Entity], as shown in the attached duly notarized Special Power of Attorney; If a partnership, corporation, cooperative, or joint venture: I am granted full power and authority to do, execute and perform any and all acts necessary to participate, submit the bid, and to sign and execute the ensuing contract for [Name of the Project] of the [Name of the Procuring Entity], as shown in the attached [state title of attached document showing proof of authorization (e.g., duly notarized Secretary’s Certificate, Board/Partnership Resolution, or Special Power of Attorney, whichever is applicable;)]; [Name of Bidder] is not “blacklisted” or barred 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 recognized by the Government Procurement Policy Board;
Bidding%202017-14-%20Improvement%20of%20CVEA%20%26%20Data%20Center.docx