OMNIBUS SWORN STATEMENT ( Sole Proprietorship)

OMNIBUS SWORN STATEMENT

REPUBLIC OF THE PHILIPPINES )

CITY/MUNICIPALITY OF __________ ) S.S.

AFFIDAVIT

 I, (Name of Affiant), of legal age, (Civil Status), (Nationality) and (Address of Affiant), after having been duly sworn in accordance with law, do hereby depose and state that:

 1. I am the sole proprietor of (Name of Bidder) with office address at (Address of Bidder);

 2. As the owner and sole proprietor of (Name of Bidder), I have full power and authority to do, execute and perform any and all acts necessary to represent it in the bidding for (Name of Project) of the Local Government Unit of Magpet;

 

 3. (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;

 4. Each of the documents submitted 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. (Name of Bidder) is authorizing the Head of 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, members of the Bids and Awards Committee (BAC), the Technical Working Group, and the BAC Secretariat, the head of the Project Management Office or the end-user unit, and the project consultants by consanguinity or affinity up to the third civil degree;

 7. (Name of Bidder) complies with existing labor laws and standards; and

8. (Name of Bidder) is aware of and has undertaken the following responsibilities as a Bidder:

a) Carefully examine all of 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 (Name of Project).

IN WITNESS WHEREOF, I have hereunto set my hand this __ day of ___, 2011 at ______________________, Philippines.

 _____________________________________

 Bidder’s Representative/Authorized Signatory

SUBSCRIBED AND SWORN to before me this _____________, affiant exhibiting to me his Residence Certificate No. ___________, issued on _________________, at ______________________________.

                                                                      

                                                                                                _______________________

                                                                                                          Notary Public

                                                                                               

Doc No. ___________

Page No ___________
Book No ___________
Series of ___________