REPUBLIC OF THE PHILIPINES ]

BUTUAN CITY ] SS.

AFFIDAVIT OF UNDERTAKING

I, ___________________________, of legal age, Filipino and a resident of

___________________________, Philippines, after having been duly sworn to
in accordance with law, hereby depose and state that:

1. I am the authorized representative of _______________________,

per Board Resolution No. ___ as certified by Secretary’s
Certificate dated _____________________, attached herein;

2. I acknowledge, affirm, and/or confirm that the Cooperative

failed to comply with the requirement of securing a Certificate
of Occupancy / Occupancy Permit from the City Architect’s
Office and/or Office of the Building Official, subject to imposition
of administrative fines, penalties, and/or surcharges under the
Implementing Rules and Regulations of Presidential Decree No.
1096;

3. In behalf of the Cooperative, I shall process, submit the

requirements of, and secure the Certificate of Occupancy /
Occupancy Permit from appropriate city government office(s),
agency(ies), and/or department(s) before December 31, 2020;

4. The Cooperative shall fully cooperate with the city government

in the inspection and evaluation of its building/structure where
its business is being conducted;

5. The Cooperative hereby waives all rights and privileges in its

business permit if it fails to comply with the requirements of
Certificate of Occupancy / Occupancy Permit before
December 31, 2020, subject to imposition of administrative fines,
penalties, and/or surcharges under the Implementing Rules and
Regulations of Presidential Decree No. 1096;

6. The Cooperative shall comply with all existing laws, ordinances,

and regulatory requirements mandated by law for the operation
of its business and understands that it may be held criminally,
civilly, and/or administratively liable for violation of any law or
ordinance;

7. Any violation of this undertaking shall result in the imposition of

fines and/or penalties as provided by law, or warrant the
 suspension, cancellation, or revocation of the Cooperative’s
Mayor’s/Business Permit, and it shall not oppose the closure of its
business as a result thereof ;

8. If the Cooperative fails to comply with this undertaking after the

December 31, 2020 deadline imposed by the City Government
of Butuan, it shall voluntarily cease and desist from its business
operations.

9. I am executing this Affidavit to attest to the truth of the foregoing

and for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this

________________________ at __________________________, Philippines.

__________________________

Affiant

SUBSCRIBED AND SWORN TO before me, this _____________ at

________________, Philippines. Affiant exhibited to me his/her ___________ ID
No. ___________________ as competent proof of his/her identity.

Doc. No. _____;

Page No. ______;
Book No. ______;
Series of 2020.