PhilGEPS Sworn Statement

REPUBLIC OF THE PHILIPPINES )

CITY/MUNICIPALITY OF ______ ) S.S.

AFFIDAVIT

I, ____________________________, of legal age, single, Filipino, and residing at

________________________________________, after having been duly sworn in accordance
with law, do hereby depose and state that:

1. Select one, delete the other:

I am the duly authorized and designated representative of

____________________________________________. with office address at
__________________________________________;

2. As the authorized representative of __________________________________., as

shown in the attached ______________________________, I have full power and
authority to upload and maintain in the Philippine Government Electronic Procurement
System (PhilGEPS) a current and updated file of the following Class “A” eligibility
documents under Sections 23.1(a) and 24.1(a):

a) Registration Certificate;
b) Mayor’s/Business Permit or its Equivalent Document;
c) Tax Clearance;
d) Philippine Contractors Accreditation Board (PCAB) license and registration (if
applicable); and
e) Audited Financial Statements;

3. Each of the documents submitted is in satisfaction and compliance with the

requirements for PhilGEPS Platinum Membership and for participation in any
Philippine government bidding;

4. Each document is an authentic copy of the original, complete, and all statements and
information provided therein are true and correct;

5. I assume responsibility and full accountability on the validity and authenticity of the
documents submitted;

6. I am authorizing the PS-PhilGEPS and the authorized representative(s) of the Procuring

Entities to verify all the document submitted, if necessary; and

7. I am aware of and understood the following guidelines for the use of the Government
of the Philippines- Official Merchant Registry (GoP-OMR):

a. The PhilGEPS office shall not determine the eligibility of merchants. The
PhilGEPS office’s evaluation of the eligibility requirements shall be for the sole
 purpose of determining the approval or disapproval of the merchant’s
application for registration.

b. A merchant’s registration and membership in the GOP-OMR is neither

contract-specific nor understood to be tantamount to a finding of eligibility.
Neither shall the merchant’s successful registration in the GOP-OMR be relied
upon to claim eligibility for the purpose of participation in any public bidding.

c. The determination of the eligibility of merchants, whether registered with

the GOP-OMR or not, shall remain with the Bids and Awards Committee
(BAC). The BAC’s determination of validity of the eligibility requirements
shall be conclusive to enable the merchant to participate in the public
bidding process.

IN WITNESS WHEREOF, I have hereunto set my hand this __ day of ___, 20__ at
____________, Philippines.

_____________________________________
Bidder’s Representative/Authorized Signatory

SUBSCRIBED AND SWORN to before me this __ day of ________________ 2019 at

the ____________________, affiant exhibiting to me his
____________________________________________issued on ____________________ at
____________________________.

NOTARY PUBLIC

Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 2019.