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PCAB

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R Eff. Date 11/8/2010
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PHILIPPINE CONTRACTORS ACCREDITATION BOARD


CHANGE OF AUTHORIZED MANAGING OFFICER
APPLICATION
REQUIRED ITEMS
The following pertinent documents and information shall be submitted in support of Change AMO of PCAB license application.(Applicant may Initially fill
out the check boxes subject for final validation by PCAB/DTI-ROG pre-screener)
A. LEGAL

In behalf of ____________________________________________________________________________
(Name of Firm)
holder of Contractor’s License No. ________, originally issued on ______________ and last renewed during
the CFY 20__ - 20__ , I hereby request for change of Authorized Managing Officer (AMO) as follows:
Name Nationality
From : ____________________________________ ________________________________
To : ____________________________________ ________________________________
I hereby certify to the completeness of the information/documents contained in this application appertaining
to the category/classification the company is applying for and that they are true and correct.
I am fully aware that:
1. all documents submitted in support of this application are subject to verification before PCAB action;

2. any discovered misrepresentation of information and/or manifestations of fraud on the application


documents submitted by my firm applicant or its Authorized Representative/Agent/Liaison Officer shall
be subjected to investigation which may result to the disapproval of my application,
denial/suspension/revocation of license and blacklisting of my firm and myself as its Authorized
Managing Officer; and

3. unconfirmed information/documents submitted to support my firm's qualifications will be excluded


for categorization/classification purposes.

_______________________________
Authorized Managing Officer
(Signature over Printed Name)
Republic of the Philippines )
Province of ______________)
City/Municipality of ___________) S.S

SUBSCRIBED AND SWORN TO before me this ________ day of ___________________ 20____ at


______________________; affiant exhibited to me his Community Tax Certificate No. _______________
issued at __________________ on _________________ 20 ___.

Doc. No.
Page No.
Book No.
Series of 20 __. NOTARY PUBLIC
(Until December 31, _______)
CHANGE OF AMO LICENSE APPLICATION
PCAB
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For Corporations or Associations with foreign shareholders, the following documents shall be submitted:
1. Corporate Secretary’s Certification as follows:
a. List of stockholders showing their nationalities and shareholdings; and
b. List of Board of Directors showing their names and nationality.
2. Copy of latest General Information Sheet duly filed with SEC showing the names of stockholders and directors, nationality and
shareholdings.
 The percentage control of the number of seats occupied by foreigners in the Board of Directors shall not exceed 40%.

Complied
CHECLIST OF REQUIREMENTS: Yes No N/A

1. AMO Nomination / Original Corp. Secretary's certificate as to the [ ] [ ] [ ]


nomination of the AMO(Page 4 of 5);
2. AMO Affidavit (Page 3 of 5) with a passport size picture of AMO; [ ] [ ] [ ]

3. Original NBI Clearance of Filipino Authorized Managing Officer (AMO) and [ ] [ ] [ ]


non-Filipino AMO who has resided in the Philippines for six (6) months or longer;
[ ] [ ] [ ]
4. Certified true copy of NBI Clearance Equivalent for non-Filipino AMO/RAR
duly authenticated by the Phil. Embassy in the home country of the AMO/RAR;

5. Original copy/certified true copy by the BID of the Alien Certificate of Registration (ACR) [ ] [ ] [ ]
& valid working visa.

6. Certified copy latest General Information Sheet submitted to SEC. (for corporations [ ] [ ] [ ]
only)
Note: Photo/xerox copies of documents may be submitted provided that original
documents are Presented for comparison to PCAB.
B. OTHERS
B.1. Original Signature of AMO on each and every page of the application forms including
Supporting documents. [ ] [ ] [ ]
B.2. The Board may require the AMO interview and submission of pertinent documents/information
other than the above in order to fully determine the qualifications of the applicants; [ ] [ ] [ ]
B.3. New AMOs/Applicants shall be required to take the AMO Examinations except category
[ ] [ ] [ ]
TRADE applicants.
B.4. Self-stamped envelopes (One self stamped mailing envelope is required for each supporting
[ ] [ ] [ ]
document submitted), or a prepaid courier pouch.
B.5. Applicants interested to participate in government projects should accomplish Application for
Registration and Classification of Contractor for Government Infrastructure Projects(PCAB- [ ] [ ] [ ]
PAD-ARC-F01) and file the same together with the PCAB Application Form.
B.6. Accomplished Affidavit for Firm’s Authorized Representatives [ ] [ ] [ ]

FOR PCAB/ DTI-ROG USE ONLY


PCAB
F PCAB-PAD-CMO-F01
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R Eff. Date 11/8/2010
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No. of Pre-
screening Prescreening Results Filed Pre-screener / Date
[ ] Comply lacking items as listed in the Remarks [ ]
1st Accepted [ ] PCAB Makati [ ] DTI-ROG
[ ] Comply lacking items as listed in the Remarks [ ]
2nd [ ] PCAB Makati [ ] DTI-ROG
Accepted
[ ] Comply lacking items as listed in the Remarks [ ]
3rd [ ] PCAB Makati [ ] DTI-ROG
Republic of the Accepted
Philippines )
Province of ______________ )
City/Municipality of ___________ ) S.S.

SURNAME FIRSTNAME MIDDLE NAME


I,
DD MM YYYY Single / Married SURNAME FIRSTNAME MIDDLE NAME
Born on
REMARKS: to
ST. # & NAME BARANGAY DISTRICT CITY/MUNICIPAL PROVINCE ZIPCODE
and residing
LETTER / at:
ITEM NO. COMMENTS:

Having duly sworn in accordance with law depose and say:


1. That I am the Authorized Managing Officer of :
________________________________________________________________________________
(Name of firm)
2. That I possess the following educational attainments (attach additional sheet if necessary)
AMO AFFIDAVIT
NAME OF SCHOOL ADDRESS COURSE INCLUSIVE DATES

Recent Photo

Passport Size
3. That I possess at least two (2) years experience in the construction industry as follows (Ref. Sec. 20 of
IRR of R.A. 4566) (attach additional sheet if necessary)
DESIGNATION / COMPANY / NATURE DATES OF
ADDRESS JOB DESCRIPTION
POSITION OF BUSINESS EMPLOYMENT

4. That I possess knowledge of the building, safety, health , & lien laws of the Republic of the Philippines
& the rudimentary administrative principles of construction contracting from my work experiences in item 3
above and from the following training/seminars (Ref. Sec. 20 of IRR of R.A. 4566):
5. That I am not involved in any construction malperformance suggestive of negligence, incompetence or
malpractice or any act of omission liable for disciplinary action by myself or in collaboration with any other
person (Section 4.2 of IRR of R.A. 4566)
6. That I have not been convicted by a court of competent jurisdiction of any offense involving moral turpitude
(Rule (Section 4.2 of IRR of R.A. 4566)
7. That I am fully aware that my failure to notify PCAB of my disassociation with my present employer shall
cause my disqualification to be an Authorized Managing Officer, a Sustaining Technical Employee or a
license applicant with PCAB .
8. That I authorize the PCAB to verify and investigate any or all information in this instrument from whatever
sources PCAB may consider appropriate
That I certify under pain of perjury that all information on this affidavit are true and correct.
FURTHER AFFIANT SAYETH NAUGHT.
_________________________________
Affiant
SUBSCRIBED and sworn to before me this _____ day of _________________, 20___ affiant exhibited his/her
Community Tax Certificate No. __________ issued at _____________________ on ________________.

Doc. No.
Page No.
Book No. NOTARY PUBLIC
Series of 20__ Until December 20__
PCAB
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R Eff. Date 11/8/2010
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SECRETARY’S CERTIFICATION (for Corporation/Cooperatives only)

Republic of the Philippines )


Province of _____________ )
City/Municipality of ________) S.S

SURNAME FIRSTNAME MIDDLE NAME


I,
ST. # & NAME BARANGAY DISTRICT CITY/MUNICIPAL PROVINCE ZIPCODE
and residing at:

do hereby certify, in my capacity as the duly elected and incumbent Corporate Secretary of
______________________________________________________________________________
(Name of firm)
DD MM YYYY Held CITY / MUNICIPALITY OF MEETING
That during its regular meeting held on
at

Wherein a quorum was present , the following resolution was unanimously approved, to wit:

AMO NOMINATION

"R E S O L V E as it is hereby resolved that

_______________________________________________________________________,
(FIRSTNAME MIDDLENAME SURNAME)

a senior executive who has been granted the power to render general management and
administrative decision, be appointed as the firm's Authorized Managing Officer to act on
all matters concerning the requirements of the PCAB and implementation of R.A. 4566 as
amended by P.D. 1746."

In WITNESS WHEREOF, I have hereunto affixed my hand this ___________ day of ______ 200___, in

______________________________, Philippines.

_________________________________
Corporate Secretary
(Signature Over Printed Name)

SUBSCRIBED and sworn to before me this ________ day of _______ 20___ affiant exhibited to me his/her

Community Tax Certificate. No. ____________ issued on _____________ at ________________________.

Doc. No.
Page No.
Book No.
Series of 20 __. NOTARY PUBLIC
Until December 20 ____
PCAB
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AFFIDAVIT OF REPRESENTATIVE R
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Eff. Date
Page
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Republic of the Philippines)


Province of _____________ )
City/Municipality of ________) S.S

I, _______________________________, of legal age, Filipino, married/single with postal


address at ____________________________________, after having been sworn to in accordance
with law, hereby depose and say:

1. That I am the Proprietor/Authorized Managing Officer (AMO) of


______________________________________________________________________;
(Name of Firm)

2. That I appoint ____________________________, whose picture and signature appear


below, to transact business with PCAB; i.e., present for pre-screening my application for
contractor’s license or any application related thereto, file/follow-up, submit documents,
receive notices/license in connection with the said application and the like.

Passport Size Photo Representative Signature over printed


Most Recent
Taken within the last six Address: _______________________
months prior to application
of PCAB license
_______________________________

Type of3.Application:
That I am aware
(Pls. that I am responsible/liable for any or all acts/representation made by my
check)
 New representative in connection with the functions stated herein.
 Upgrading
4. That I undertake to notify PCAB in the event that this appointment is modified, amended or
 Renewal
 Others, revoked.
pls. specify
_______________________

______________________________________
AFFIANT
(Authorized Managing Officer of Firm)

SUBSCRIBED and sworn to before me this ______ day of ____________, 20___, affiant exhibited
his/her Community Tax Certificate No. _______________ issued at ___________ on
___________________.
Type of Application: (Pls. check)
 New
 Upgrading
Type of Application: (Pls. check)
Renewal NOTARY PUBLIC
Type of Application: (Pls. check)

 New
Others, pls.(Pls.
specify Until December 20 ____
 New
Type of Application:
Upgrading check)
_______________________
 New
Upgrading
Renewal
 Upgrading
Renewal
Others, pls. specify
Renewal
 _______________________
Others,
Doc.
 No.pls. pls.
Others, specify
specify
Page No.
_______________________
Book No.
Series of 20 __.

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