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SUBCONTRACTOR REGISTR

; DOC. NO.: FO-R23-001; REV. NO.: 2 I


EFFECTIVITY DAT

Keppel Subic Shipyard, Inc.


Manila Office : Unit 3-B Country Space Building., Sen Gil Puyat Ave., Salcedo Village, Makati City 1200, Philippines; Tel. No. (63) 02 892 1816; Fax No. (63) 02 815 2581
Shipyard: Subic Special Economic Zone, Cabangaan Pt., Cawag, Subic 2209, Zambales, Philippines; Tel. No.: (63) 47 232 9210/ 232 2380/ 232 5670/ 232 2710/ 232 3410 Fax No.: (63) 47 232 3883-84
Email: all@subicship.com

1. Name of Company:

JOURNEYMAN WELDING & PIPING SERVICES INTL. CORPORATION

2. Business Address:

Sulpi Bldg. 2nd flr. Unit 11 - Finlandia st. Corner Galvani st. Brgy Sn Isdro ma

3. Contact Numbers - Tel. No.:

02-5123279

Fax No.

4. Type of Company:
Corporation

Partnership

Single Proprietorship

5. Proprietor/Partners/Managers/Officers:
NAME
Vivencio D. Menchavez Jr
Domingo S. Serundo
Dyna H. Endaya
6. Date Organized:

POSITION
President / CEO
Vice President
Director

ADDRESS
Calbayog City Samar
Pondol Balamban Cebu
Sariaya Quezon

1-Apr-09

How long has your organization been in this business?

4 years

7. Bankers:
Bank
BDO

8. Authorized Capital Stock:

Address
Makati City

Acct. Manager/Officer

3 Milyun Peso

9. SSS Membership No.:0986396-7


( Note: All workers should be members of Social Security System)
10. Philhealth Membership No. :

7030002160

11. Pag-Ibig Fund Membership No.: 800170123093


12. Taxpayer Identification No.:

008-279-038

13. Insurance and Bond ( To be procured upon award of first job )


Amount of
Policy
A. Public Liability Insurance
Company :
Address:
B. Labor Surety Bond
Company :
Address:

11. No. of Permanent Workers :

No. of Casual Workers :

11

12. Do you have the full range of tools and equipment for Contract jobs you engaged in?
Yes
No
X
If so, please specify
13. Does you Company have safety equipment? ( Yes / No )
Safety Helmets
X
X

14. Services you are engaged in ( Rank according to no. of men )


1. fabrication / Erection
2. Oil & Gas Services Provider
3. Welding and piping Services

4. Welding and Piping Inspection


5.
6.

15. Declaration:
We the undersigned contractor hereby declare with the company the following:
a.) We acknowledge that the information given in the registration is true and correct.
b.) We acknowledge reciept of the General Terms and Conditions for Contractors,
the contents of which have been read, fully understood and accepted.
16. Please submit the following supporting documents:
For Partnership and Corporation
a.) Registration Certificate with Security & Exchange Commission
b.) Articles of Incorporation and by-laws, if Corporation
c.) Articles of Co-Partnership, if Partnership
d.) Registration Certificate with the Department of Trade and Industry
e.) SSS Registration
f.) Philippine Health Insurance Registration
g.) Pag-ibig Fund Registration
h.) BIR Registration
i.) Mayor's Permit, from Subic Municipality
j.) DOLE Certificate
k.) Consort Land Certificate
l.) Accident Insurance
m.) Organizational Chart
For Single Proprietorship
From Item d to f, g, h and i.
k.) Sample copy of BIR Registered Invoice and Official Receipt

Vivencio D. Menchavez Jr
Name of Authorized Representative
29-Jul-13
Signature and Date
For Contracts and Finance use only

*Above is an Interested Party Transaction (IPT)


-If yes, approval obtained on___________________
-To attach approval document.

Yes

No

TOR REGISTRATION

. NO.: FO-R23-001; REV. NO.: 2 ISSUANCE NO.: 1


EFFECTIVITY DATE: JULY 16, 2013

(63) 47 232 3883-84

. Brgy Sn Isdro makati City

ngle Proprietorship

yog City Samar


ol Balamban Cebu
iaya Quezon

anager/Officer

Date of
Expiry

nd correct.

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