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Department of Trade & Industry Philippines

Construction Industry Authority of the Philippines


PHILIPPINE CONTRACTORS ACCREDITATION BOARD
NEW REGULAR CONTRACTOR’S LICENSE APPLICATION
PCAB-PAD-NEW-F01. Revision No. 07, 10/19/2017 | This Form is NOT for sale. Reproduction is Allowed

Instruction: Read Important Reminders (page 21 and 22). The following pertinent documents and information shall be submitted in
support to PCAB License New Application.
Checklist of Requirements Remarks
A. LEGAL
A.1. Affidavit of Attestation and General Information (page 3 and page 5);
A.1.1. For Sole Proprietorship - Certified true copy of Business Name Registration Certificate
(scope of business: national; nature of business: construction);
A.1.2. For Corporation or Partnership - Certified true copy of SEC Certificate of Registration and
Articles of Partnership/Incorporation and By-Laws with construction contracting as one of the
purposes and subsequent amendments thereto, if any;
A.2. PCAB Integrity Pledge (page 4);
A.3. Authorized Managing Officer (AMO) Nomination (with at least two (2) years experience in the
construction industry):
A.3.1. AMO Affidavit (page 6) with recent passport size picture;
A.3.1.1. For Corporation - Original Corporate Secretary's certificate as to the nomination of the
AMO (page 7);
A.3.1.2. For Corporation - If AMO is not the President, submit Board Resolution on AMO’s
duties and responsibilities: (1) sign checks and other financial documents, (2) hire and
fire employees, (3) approve, negotiate and sign contracts, (4) commit and answer for the
corporation, (5) oversee all contracts of the company;
A.3.1.3. For Corporation - Organizational Chart
A.3.2. Original NBI clearance of Filipino AMO (valid as of the date of filing);
A.3.3. If AMO is Non-Filipino (in addition to A.3.1):
A.3.3.1. Working Visa;
A.3.3.2. Alien Certificate of Registration;
A.3.3.3. NBI clearance if AMO has resided in the Philippines for six (6) months or longer if not,
equivalent clearance from AMO's home country duly authenticated by the Philippine
Embassy;
A.4. For Corporations or Associations with foreign shareholders, the following documents shall be
submitted:
A.4.1. Corporate Secretary’s Certification: (1) List of stockholders showing their nationalities and
shareholdings, (2) List of Board of Directors showing their names and nationality;
A.4.2. 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%;
B. FINANCIAL
B.1. Complete Financial Statements with accompanying Auditor’s notes dated within the last six (6) months
immediately preceding the filing of application (duly audited and signed on every page by an
Independent CPA with valid PRC-BOA accreditation) and a CD-R (compact disc recordable)
containing the firm’s Audited Balance Sheet & Income Statement in the prescribed template to be
uploaded in the CIAP database. The PCAB Financial Statement Forms A & B (A. Balance Sheet / B.
Income Statement) can be downloaded at CIAP website, www.ciap.dti.gov.ph;
B.1.1. For old companies, audited financial statements for the immediately preceding taxable year
and copy of the Quarterly or Annual Income Tax Return certified by the BIR;
B.1.2. Cash - Original copy of Bank Certification/Bank statement of account certified by Bank
Manager of cash deposits as of the Balance Sheet date; (Note: Amount in excess of 1% of
the Networth per Audited Balance Sheet or P 500,000.00 whichever is higher, reflected
as “Cash” or “Cash on Hand” will be deducted from the Networth);
B.1.2.1. Authorization to Depository Bank (page 8);
B.1.3. Land and Building - List of Land and Building/Industrial Plants owned by the applicant and
registered in its name (page 11);
B.1.3.1. Certified Copy of Transfer of Certificate of Title (TCT) including back page;
B.1.3.2. Certified Copy of Deed of Sale or Tax Declaration of Land / Building owned by the
applicant;
B.1.4. Transportation & Construction Equipment - List of Construction and/or Transportation /
Delivery Vehicles / Equipment/ Machineries / Plants owned by the applicant and registered in
its name (page 12);
B.1.4.1. Certified Copy by Land Transportation Office (LTO) of Certificate of Registration and
Current Official Receipt of Registration of Construction and/or Transportation/Delivery
Vehicles/Equipment reported;
B.1.4.2. Certified Copy of Deed of Sale or sales invoices/official receipts of other construction
equipment/machineries;
B.1.5. Other Assets - (i.e. investment in Banks and / or Shares of stocks and other accounts);
B.1.5.1. Certified true copies of certificates of Stock, time deposits, & other pertinent proofs of
ownership of other assets;
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 2 of 30

Checklist of Requirements Remarks


B. FINANCIAL
B.1.6. Schedule of Receivables - if the value of the applicant's receivables exceed more than 50% of
the contractor’s networth duly signed by AMO and certified by the firm’s PRC BOA accredited
CPA, otherwise, the amount in excess of said account shall be deducted for categorization
purposes (page 13);
B.2. Authorization to verify documents from BIR & other agencies and/or quarterly income tax return to
cover income reported on interim financial statements (page 9 and page 10);
C. TECHNICAL
C.1. List of Sustaining Technical Employee/s - STE (page 14) supported by the following documents for
each STE:
C.1.1. Completion of 40-hour Safety Seminar (COSH) of at least one of the listed qualified Sustaining
Technical Employees;
C.1.2. STE Affidavit/s with recent passport size picture/s (page 15);
C.1.3. Certified true copy of valid PRC ID of STE as licensed professional;
C.1.4. Original NBI Clearance/s of nominated STE/s;
C.1.5. STE Affidavit/s of Construction Experience (page 17);
C.1.6. Personal Appearance Form duly accomplished and signed by the STE/s appearing before the
designated officer of the PCAB or the nearest DTI Regional/Provincial Office/CIAP Window
(page 18);
C.2. Affidavit of No Construction Activity (page 19);
C.3. Certificate of DOLE-accredited Safety Practitioner for Category “AAA” applicants (for additional credit
points);
D. GENERAL INFORMATION (page 5)
D.1. Membership with SSS, PHILHEALTH & PAG-IBIG;
D.2. Completion of 2-day AMO Seminar - to be completed by the AMO himself whether the firm be sole
proprietorship or corporate/partnership and the like;
D.3. Completion of 40-hour Safety Seminar (COSH, BOSH with Construction Safety Components) - to
be completed by the AMO himself in case of sole proprietorships or by any responsible/senior officer of
the corporation/partnership and the like;
D.4. E-mail Address;
D.5. Certificate of ISO accreditation (for additional credit points);
E. OTHERS
E.1. Firm’s Authorized Representatives (note: must be an employee of the firm) Affidavit with recent
passport size picture (page 20);
E.1.1. Copy of company ID of the Authorized Representatives;
E.1.2. Latest CCL - formerly SSS Form R-3 (for below 60 years old) or Certificate of Income Tax
Withheld - BIR Form 2316, formerly BIR W-2 (for 60 years old and above) of the representatives;
E.2. Original signature of AMO on each and every page of the application forms including supporting
documents;
E.3. Certified documents. In lieu of certified copies, photocopies may be accepted provided original copies
are presented for authentication;
E.4. AMO Examination;
E.5. 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;
E.6. Self-stamped envelopes for verification of supporting documents (one self-stamped envelope per
supporting document);
E.7. Mode of Release of License (please check only one): [ ] Mail using the attached prepaid courier pouch;
[ ] Claim at PCAB Makati; [ ] Claim at CIAP Window / DTI ROG Office ________________________.
F. ARC APPLICATION
F.1. Application for registration in government projects should be accomplished in PCAB-PAD-ARC-F01 (Application for
Registration and Classification of Contractor for Government Infrastructure Projects) which may be filed simultaneously in a
separate folder with the PCAB License Application.
FOR PCAB / DTI-ROG USE ONLY
1st Prescreening 2nd Prescreening 3rd Prescreening 4th Prescreening
Item [ ] PCAB Makati [ ] DTI-ROG ______
[ ] PCAB Makati [ ] PCAB Makati [ ] PCAB Makati
No. Prescreener: Date:
[ ] DTI-ROG ______ [ ] DTI-ROG ______ [ ] DTI-ROG _____
[ ] Accepted [ ] Comply lacking items
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 3 of 30

AFFIDAVIT OF ATTESTATION
In behalf
of K2RJL Industrial Sales and Services Corp.
(Name of Firm)

I hereby request that its application for Contractor's License be approved.

I certify to the completeness of the information/documents contained in this application appertaining to


the category/classification the company is applying for and that the information/documents are true and
correct.

I further certify that the business name and/or SEC registration of this firm is valid and existing.

I certify furthermore that the SSS, Pag-IBIG, and PhilHealth contributions were remitted in favor of the
employees of this firm.

I am fully aware that:

1. All documents submitted in support to 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 shall be


excluded for categorization/classification purposes.

4. The evaluation of my qualification shall be solely based on the documents submitted at the time
the application was filed/accepted by PCAB.

JOSE MIGUEL P. SANDICHO


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/her Community Tax
Certificate No. _______________ issued at ______________________ on _________________ 20 ___.

NOTARY PUBLIC
Until December 31, 20 ____

Doc. No.
Page No.
Book No.
Series of 20 __.
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 4 of 30

PCAB INTEGRITY PLEDGE


We believe that the construction industry is one of the most susceptible to all forms of corruption that hampers the
noble objectives towards national progress and global competitiveness.

As frontrunners of nation-building, we acknowledge our major role and responsibility in ensuring that we carry out
our tasks guided by ethical standards and equipped with the necessary capability for the successful prosecution of
our contracts.

In view thereof, we pledge the following:

 We will present only true qualifications to PCAB so that we may be evaluated properly and be given the
category and classification where we should rightfully belong;

 We will uphold the dignity of the license and not be instruments for unlicensed contractors to undertake
construction projects through license lending nor through false joint ventures/consortium or pseudo
combinations which is inimical to the public safety/interest;

 We will not employ unlicensed sub-contractors/specialty contractors which is a clear circumvention of the
requirement that all contractors must be licensed;

 We will absolutely shun away from any form of collusion that destroys the very essence and integrity of
biddings;

 We will not engage in bribery or do any act which constitutes graft or corrupt practice which is the root
cause of bloated contract amounts;

 We will not use sub-standard materials which will in any way compromise the safety, reliability and
performance of the built environment;

 We will not abandon our contracts and we will implement our projects faithfully in accordance with the
prescribed specifications thereof;

 We will provide the necessary resources, financial and technical capability in carrying out our contractual
obligations, and as far as possible, within the stipulated time of completion;

 We are aware that we will be imposed disciplinary action should we violate any of the commitments hereof
or the PCAB Code of Ethics or be found to be a party to corruption.

____JOSE MIGUEL P. SANDICHO__


Authorized Managing Officer
(Signature over Printed Name)

K2RJL INDUSTRIAL SALES AND SERVICES CORP.


Name of Company

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/her
Community Tax Certificate No. _______________ issued at __________________ on _________________ 20 ___.

NOTARY PUBLIC
Until December 31, 20 ____

Doc. No.
Page No.
Book No.
Series of 20 __.
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 5 of 30

CONTRACTOR’S GENERAL INFORMATION


Note: Please use additional sheets if necessary.
Name of Firm: (as per SEC or DTI)
K2RJL Industrial Sales and Services Corp.
Office Address Telephone/Fax No. (include area code)
632 8282-0568
70 E Rodriguez Highway Brgy. San Jose Rodriguez Rizal 632 8655-6697
If Provincial based, contact address in Manila, if any

N/A
Website E-mail Address Mobile No.
www.k2rjl.com sales@k2rjl.com 09988444407
Type of Firm (please check only one) Equity
[ ] Sole Proprietorship [ ] Partnership [ / ] Corporation Filipino: 100 % Foreign: % Nationality: Filipino
International Organization for Standardization (ISO) Certification (please check, if any)
[ ] ISO 14001:2004 [ ] OSHAS 18001:2007 [ ] ISO 9001:2008 [ ] ISO 9001:2015
SEC / Business Name Registration No. Registration Date (mm/dd/yyyy) Expiry Date (mm/dd/yyyy)
CS201503974 March 04, 2015 N/A
Firm’s SSS No. Tax Identification No. PhilHealth No. PAG-IBIG No.
03-9261112-3 008-971-077-000 003010000289 20280634005
Category Applied for Principal Classification Applied for Other Classification/s Applied for
(please check only one) (please check only one) (please check, if any)
[ ] AAAA [ ]B [ ] General Engineering [/] General Building [ ] General Engineering [/] General Building
[ ] AAA [ ]C [ ] Trade [ ] Specialty (please specify below): [/ ] Specialty (please specify below):
[ ] AA []D
[ ]A [ /] E/Trade
2-day AMO Seminar
Participant Host/Organizer Inclusive Dates Venue
Jose Miguel P. Quezon City Sports Club
SPECS May 31, 2018 – June 1, 2108
Sandicho Inc.
40-hour Safety Seminar ( [ ] COSH or [ ] BOSH with Construction Safety Components )
Participant Company Position Course Provider Inclusive Dates Venue
Jose Miguel P. Salus Consultancy
CEO May 15-18, 2018 UP Diliman, QC
Sandicho Sevices
Owners / Stockholders / Officers (for corporation / partnership)
Percentage
Paid-up
Name Position Nationality Capital Subscription Capital Peso
Shares value
Jose Miguel P. Sandicho President Filipino 6,250 156,250 25% 625,000
Joana Christina L. Lagrosa Treasurer Filipino 334 8,350 1.336% 33,400
Corporate
Ramon P. Sandicho Filipino 333 8,325 1.332% 33,300
Secretary
Rado P. Sandicho Board Member Filipino 333 8,325 1.332% 33,300
Directors / Officers (for corporation only)
Name Position Nationality Address
Jose Miguel P. Sandicho President Filipino Cortijos De San Rafael, Brgy. San Rafael, Rodriguez Rizal
Joana Christina L. Lagrosa Treasurer Filipino Lot 51 Virginia St., BF Homes, Sucat Parañaque
Corporate
Ramon P. Sandicho Filipino B15 L13 Armall Village, Sta Ana, Taytay Rizal
Secretary
Rado P. Sandicho Board Member Filipino 7 Magdalena Subd. F. Antonio St. Pasig City

Certified correct by:

JOSE MIGUEL P. SANDICHO


Authorized Managing Officer
(Signature over printed name)
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 6 of 30

AUTHORIZED MANAGING OFFICER (AMO) AFFIDAVIT Picture of


Note: Please accomplish this affidavit properly. Please use additional sheets if necessary. AMO
see Important
Republic of the Philippines ) Reminders
Province of ______________) (page 21, item
City/Municipality of ________) S.S no. 4) for
specification
Last Name First Name Ext. Name (Jr/Sr, if any) Middle Name
I,
Sandicho Jose Miguel Ponsaran

Citizenship dd mm yyyy Single / Last Name First Name Middle Name


Born on 03 03 1978 Sandicho Norafe Munat
Filipino Married to
Room/Floor/Unit/Bldg. Name, Lot/Block/Phase No., Street, Subdivision, Barangay, City/Municipality, Province, Zip Code
and .
residing at:
Lot 41 Blk 8 Gloria Vista Subdivision, Brgy. San Rafael Rodriguez Rizal
having duly sworn to in accordance with law depose and say:
1. That I am the Authorized Managing Officer of:
_______________________________ K2RJL INDUSTRIAL SALES AND SERVICES CORP._____________________
(Name of Firm)
with position of:
_____________________________________ CEO/ President ____________________________________________________
(Position in the Firm)
2. That I possess the following educational attainments (attach additional sheet if necessary)
Name of School Address Course Inclusive Dates

V.V Soliven Ave II, Cainta, 1800


ICCT Colleges Computer Science March 20, 2001
Rizal

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)
Dates of
Designation / Position Company / Nature of Business Address Job Description
Employment
K2RJL Industrial Sales and Lot1 Block 8 Gloria Vista Subd.
Sales Manager / Safety August 01.
Sales Manager/Safety Officer Services Co. General Brgy. San Rafael Rodriguez
Officer 2012
Construction and Trading Rizal

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 (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
9. That I certify under pain of perjury that all information on this affidavit are true and correct.
FURTHER AFFIANT SAYETH NAUGHT.
JOSE MIGUEL P. SANDICHO
Affiant

SUBSCRIBED AND SWORN to before me this _____ day of __________________________________________________ 20___


at ___________________________________________________________________________; affiant exhibited his/her Community
Tax Certificate No. _____________ issued at _________________________________________ on ______________ 20________.

NOTARY PUBLIC
Until December 31, 20 ___
Doc. No.
Page No.
Book No.
Series of 20 ___
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 7 of 30

SECRETARY’S CERTIFICATION
Note: For Corporations only

Republic of the Philippines )


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

Last Name First Name Ext. Name (Jr/Sr, if any) Middle Name
I,
Sandicho Ramon III Ponsaran
Room/Floor/Unit/Bldg. Name, Lot/Block/Phase No., Street, Subdivision, Barangay, City/Municipality, Province, Zip Code
and residing
at:
Blk. 15 L13 Armall Village, Sta Ana, Taytay Rizal.
do hereby certify, in my capacity as the duly elected and incumbent Corporate Secretary of

___K2RJL Industrial Sales and Services Corp.____


(Name of Firm)
dd mm yyyy City / Municipality of Meeting
That during its regular meeting held on held at
30 09 2019 San Jose Rodriguez Rizal

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

Jose Miguel___________________Ponsaran____________________Sandicho_,
(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 ___________________ 20___, in
______________________________, Philippines.

____RAMON P. SANDICHO_III__
Corporate Secretary
(Signature over Printed Name)

SUBSCRIBED AND SWORN to before me this ______ day of ______________________________________ 20___


at _____________________________________________________; affiant exhibited his/her Community Tax
Certificate No. ________________ issued at _________________________________ on ______________ 20______.

NOTARY PUBLIC
Until December 31, 20 ___

Doc. No.
Page No.
Book No.
Series of 20 ___
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 8 of 30

AUTHORITY TO VERIFY BANK ACCOUNT

THE MANAGER
___Ms. Marivic M. Dionisio________
___Eastwest Bank_______________
___Rodriguez Rizal_______________

Subject: Bank Account # ___ 200018532556__

Madame:

Please provide the Philippine Contractors Accreditation Board (PCAB), a government agency
under the Department of Trade and Industry, any information they need regarding the subject
account with your bank.

I am applying for a contractor's license from PCAB and part of their evaluation process is the
verification of bank deposits and other assets of an applicant.

This will serve as your authorization to release any information that may be requested by PCAB
regarding the above subject account.

Thank you.

Very truly yours,

Name of Firm:
K2RJL INDUSTRIAL SALES AND SERVICES CORP.

By: JOSE MIGUEL P. SANDICHO


Signature over Printed Name of
Authorized Managing Officer or
Authorized Signatory with the Bank

Date:_______________________
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 9 of 30

AUTHORITY TO VERIFY ITR / AFS FROM B.I.R.

THE REVENUE DISTRICT OFFICER


_Ms. Mariza Rabago- Uy_____________
_Revenue District officer_____________
_Revenue Region 045______________

Subject: Income Tax Return and Audited Financial Statement as of _2019__

Madame:

Please provide the Philippine Contractors Accreditation Board (PCAB), a government agency
under the Department of Trade and Industry, any information they need regarding the subject ITR
and AFS filed with your office.

I am applying for a contractor's license from PCAB and part of their evaluation process is the
verification of ITR and AFS, of an applicant.

This will serve as a waiver on the confidentiality provision of Section 270 of the National Internal
Revenue Code of 1997 (memorandum circular No.28, 2006 dated May 08, 2006) and your
authorization to release any information that may be requested by PCAB regarding the above
subject document/s.

Thank you.

Very truly yours,

__JOSE MIGUEL P. SANDICHO___


Signature over Printed Name of
Authorized Managing Officer

Date:____________________
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 10 of 30

AUTHORITY TO VERIFY FROM GOVERNMENT AGENCY/IES

AUTHORIZATION

The Philippine Contractors Accreditation Board (PCAB) is hereby authorized to verify and
secure information and/or copies of documents submitted by or in the name of the firm to any or all of
the following agencies relative to its application filed with the PCAB:

1. Securities and Exchange Commission (SEC)

2. Land Registration Authority (LRA)

3. Land Transportation Office (LTO)

4. Social Security System (SSS)

5. Professional Regulation Commission (PRC)

6. Philippine Health Insurance Corporation (PhilHealth)

7. Home Development Mutual Fund (Pag-IBIG)

__JOSE MIGUEL P. SANDICHO__


Signature over Printed Name of
Authorized Managing Officer

Date:______________________
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 11 of 30

LIST OF CONSTRUCTOR’S REAL PROPERTIES


Note: Please use additional sheets if necessary.

REAL PROPERTIES OF THE FIRM AS OF THE BALANCE SHEET DATE


COMPLETE *TCT-CLT/ LOCATION
ACQUISITION ACQUISITION
DESCRIPTION CCT/TD (Street No., Barangay,
COST DATE
(Type of land/building) NUMBER Municipality/City, Province)

N/A N/A N/A N/A N/A

*LEGEND:
TCT – Transfer Certificate of Title
CCT – Condominium Certificate of Title
TD – Tax Declaration
CLT – Certificate of Land Title

_JOSE MIGUEL P. SANDICHO_


Signature over Printed Name of
Authorized Managing Officer

Date:________________________
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 12 of 30

LIST OF CONSTRUCTOR’S PLANTS, VEHICLES AND EQUIPMENT


Note: Please use additional sheets if necessary.

A. DELIVERY AND TRANSPORTATION EQUIPMENT OF THE FIRM AS OF BALANCE SHEET DATE

COMPLETE DESCRIPTION ACQUISITION BOOK


VALUE
Year Cost (in Php)
Vehicle Brand / Type Plate No. OR No. / Date Date
Model (in Php)
N/A N/A N/A N/A N/A N/A N/A

OVERALL TOTAL VALUE Php N/A Php N/A

B. MACHINERIES/PLANTS AND OTHER CONSTRUCTION EQUIPMENT OF THE FIRM AS OF BALANCE


SHEET DATE
ACQUISITION BOOK
COMPLETE
SERIAL NO. VALUE
DESCRIPTION Cost
Date (in Php)
(in Php)
N/A N/A N/A N/A N/A

OVERALL TOTAL VALUE Php N/A Php N/A

_JOSE MIGUEL P. SANDICHO__


Signature over Printed Name of
Authorized Managing Officer

Date:_________________________
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 13 of 30

SCHEDULE OF RECEIVABLES
Note: To be accomplished if the applicant's receivable accounts (accounts/contracts & other receivable) exceed 50% of the total
networth/equity as of the latest audited balance sheet submitted in support of its application. Please use additional sheets if
necessary.

Amount Due for


Name of Projects Age Client Name / Complete Address
Collection

N/A N/A N/A N/A

Certified Correct by:

________CONRADO M. BRIONES___________ JOSE MIGUEL P. SANDICHO_____


Printed Name and Signature of External Auditor Printed Name and Signature of AMO
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 14 of 30

LIST OF NOMINATED SUSTAINING TECHNICAL EMPLOYEES

PRC Registration
Date Position
Name of STE License Date of
Employed in the Firm
Prof.
Number Registration Validity
Previously Nominated
1.N/A N/A N/A N/A N/A N/A N/A
2.
3
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
Newly Nominated
Civil Project
1.Engr. ORLANDO M. CASAS Engineering 0116535 4/6/2010 7/29/2020 11/15/2012
Engineer
Mechanical Technical
2.Engr.NOMAR LOPEZ Engineer Supervisor
3.
4.
5.
6.
7.
8
9.
10.

__JOSE MIGUEL P. SANDICHO__


Signature over Printed Name of
Authorized Managing Officer

Date:________________________
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 15 of 30

SUSTAINING TECHNICAL EMPLOYEE AFFIDAVIT


Note: Please accomplish this affidavit properly. Refer to the next page for STE qualification requirements.

Republic of the Philippines )


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

Last Name First Name Ext. Name (Jr/Sr, if any) Middle Name
I,
CASAS ORLANDO MANUEL
mm dd yyyy Single / Last Name First Name Middle Name
Born on 12 6 1979 NAGBUYA ARLENE CAHATOL
Married to
Room/Floor/Unit/Bldg. Name, Lot/Block/Phase No., Street, Subdivision, Barangay, City/Municipality, Province, Zip Code
and 475 GEN. LUNA ST. DULONG BAYAN, SAN MATEO, RIZAL
residing at
Telephone / Mobile No. (required) Email Address (required)
with
having been duly sworn in accordance with law depose and say:
1. That I am a duly licensed ______CIVIL ENGINEER_________ and holder of PRC License No. 0116535
(Profession)
valid up to __12/6/2020__, as evidenced by a copy of my PRC ID posted below;
Course / Profession
That I hold a Bachelor's Degree in
CIVIL ENGINEER
2. Name of School Inclusive Dates
Given at: Given 1on:
CENTRAL COLLEGES OF THE PHILIPPINES MARCH 2005
That my Tax Identification Number is : 234-719-913-000
3.
and my Social Security System Number: 33-8124751-8
That I am employed on a regular and full-time Name of Firm
basis by: K2RJL INDUSTRIAL SALES AND SERVICES CORP.
4.
Position in the Firm CFY
With the position of as STE for
PROJECT ENGINEER 2012-PRESENT
5. That I am not presently employed by either a private company or any government office or government owned/controlled
corporation, nor a full time instructor, nor working abroad;
6. That I am not a holder of a valid contractor's license;
7. That I am not involved in any construction malperformance suggestive of negligence, incompetence or malpractice or any
act or omission liable for disciplinary action by myself or in collaboration with any other person;
8. That I have not been convicted by a court of competent jurisdiction of any offense involving moral turpitude;
9. That I am fully aware that my failure to notify the PCAB of my disassociation from my present employer within 30 days from
such disassociation shall cause my disqualification from being a Sustaining Technical Employee, an Authorized Managing
Officer and an applicant for a contractor’s license with PCAB;
10. That I authorize the PCAB to verify and investigate any or all information in this affidavit from whatever sources PCAB may
consider appropriate;
11. That I am executing this affidavit to attest to the truth of the foregoing.
FURTHER AFFIANT SAYETH NAUGHT.
__ORLANDO M. CASAS___
Affiant

SUBSCRIBED AND SWORN to before me this _____ day of ___________________, 20___ at ___________________________;
affiant exhibited his/her Community Tax Certificate No. _____________ issued at __________________ on ______________ 20___.

Doc. No. NOTARY PUBLIC


Page No. Until December 31, 20 ___
Book No.
Series of 20 ___
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 16 of 30

QUALIFICATION REQUIREMENTS FOR STE

1. A technology professional, such as engineer or architect, duly licensed by the Professional


Regulation Commission (PRC).

2. Holder of a valid PRC I.D.

3. With three (3) years minimum actual construction experience.

4. A full-time employee of the nominating contractor not associated professionally or by


employment with any other party, particularly a party engaged in construction or construction-
related activities.

5. Have none of the following disqualifications:


a) Involvement, in any capacity, in any construction malperformance of grave consequence,
suggestive of his negligence, incompetence and/or malpractice;
b) Involvement, by himself or in collaboration with any other person or firm, in any act or
omission liable for disciplinary action of which he/she is or the other person or firm was
found guilty by the PCAB Board ;

c) Conviction by a court of competent jurisdiction of any offense involving moral turpitude; and

d) If formerly a Sustaining Technical Employee or an Authorized Managing Officer of any


construction firm but disassociated there from, failure to notify the Board of his
disassociation in accordance with paragraph 5 and 6 of the Affidavit of Undertaking.

This is to certify that I have verified with PRC the above stated professional eligibility/registration of
the Sustaining Technical Employee. Affiant herein and found the same to be true and correct.

__JOSE MIGUEL P. SANDICHO___


Authorized Managing Officer
(Signature over printed name)

__________________________________________
Date
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 17 of 30

AFFIDAVIT OF STE CONSTRUCTION WORK EXPERIENCE


Note: Please use additional sheets if necessary.

Republic of the Philippines )


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

I, ORLANDO M. CASAS__, single/married, Filipino, of legal age, with postal address at 475 GEN. LUNA ST. DULONG
BAYAN, SAN MATEO, RIZAL, having been duly sworn in accordance with law depose and say that the projects
enumerated below constitute my full & complete construction experience.

Name and Work Nature/Scope of Work Project Duration


Complete Address of Employer/ Classification Assignment (mm/dd/yyyy)
Name & Location of Projects Undertaken (GE, GB, SP) (Proj. Engr.) From To
1. K2RJL Industrial Sales and Services Corp. SP-FW Site/Project Engineer July 25, 2017 August 21,
Re-grouting of FM2 Pinion Bearing Foundation ND 2017
and NDE Sides
Brgy. Minuyan, Norzagaray Bulacan
GB-1, SP-CC Project Engineer August 25, October 15,
Supply of Manpower, Labor, tools, equipment. 2017 2017
Mobilization, delivery, consumables and technical
expertise on the application of castable wearing
compound using Valor 400 GB-1, SP-WP Project Engineer January 2019
November 2018
Waterproofing of Cement Silo 1,2 and 3
Brgy. Akle, San Ildefonso Bulacan

Repair of Worn Cyclone Feed Hopper GB-1, SP-ME Project Engineer May 11, 2019
Runruno, Nueva Vizcaya May 7, 2019

Sandblasting of BIOX Tank and Painting of PPO GB-1, SP-ME Project Engineer Nov. 18, 2019
Sept.14, 2019
2. K2RJL Industrial Sales and Services Co. GB-1 Head Engineer November 2012 March, 2013
“Construction of Two storey building of K2RJL (Civil & Structural works)
Industrial Sales and Services Co.”
Blk8 Lot1 Gloria Vista Subd., San Rafael Rodriguez
Rizal

3. Wai Fong (Qatar) L.L.C. GB-2 Section Engineer July, 2010 November
2010
Doha Qatar

4.Gamuda Berhad GE-3 Civil / Site Engineer January, 2007 March, 2010
(Sinohydro-Gamuda-WCT J V) (Tunnel)

5. RJ Gravel & Sand GE-1 Supervisor April, 2004 January, 2007


“Various Excavation and Land
Development Project”

That I authorize the PCAB to verify and investigate any or all information in this affidavit from whatever sources PCAB may consider
appropriate;

That I am executing this affidavit to attest to the truth of the foregoing.

FURTHER AFFIANT SAYETH NAUGHT.

_______ORLANDO M. CASAS_______
Affiant

SUBSCRIBED AND SWORN to before me this ________ day of ___________________________________ 20_____ at


______________________________________________________________; affiant exhibited his/her Community Tax Certificate No.
______________ issued at ___________________________ on ____________________ 20___.

NOTARY PUBLIC
Until December 31, 20 ___

Doc. No
Page No.
Book No.
Series of 20 _____.
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
STE PERSONAL APPEARANCE Page 18 of 30
Note: To be accomplished by the STE. The STE Personal Appearance is valid only for three (3) months from the date signed
by the PCAB/DTI Personnel.
SUSTAINING TECHNICAL EMPLOYEE AFFIDAVIT
Name of STEaccomplish this affidavit properly. Refer to the next page for STE qualification requirements.
Note: Please
Last Name First Name Ext. Name (Jr/Sr, if any) Middle Name
CASAS ORLANDO MANUEL
Profession PRC ID No. Expiration Date
CIVIL ENGINEER 0116535 12/6/2020
Present Employer
K2RJL INDUSTRIAL SALES & SERVICES CORP.

I hereby confirm the following:

1. The veracity of the information reflected on the STE Affidavit and Affidavit of Construction Experience
that I executed in favor of the above present employer;

2. That I am fully aware that my failure to notify the PCAB of my disassociation from the above-stated
nominating firm and any misrepresentation in the attached forms shall cause my disqualification as
sustaining technical employee, or authorized managing officer, or a licensee applicant with PCAB per
Board Resolution No. 401, Series of 2001.

3. That I have been previously connected with the following companies and disassociated therefore:

Date of Date of
Previous Employers Position
Employment Resignation

WAI FONG (QATAR) L.L.C. July 2010 July 2011 Section Engineer

GAMUDA BERHAD (SINOHYDRO-GAMUDA-WCT JV) January 2007 March 2010 Site Engineer

4. Other Remarks:
_____________________________________________________________________________________

_____________________________________________________________________________________

Valid I.D.(s) Presented:

1. _ PRC LICENSE No: 0116535________ ________________________


STE’s Signature
2. ________________ No: ______________
________________________
Date Signed

-----------------------------------------------------------------------
To be filled out by PCAB/DTI ROG Personnel
STE’s Specimen Signature (during interview):

Signature over Printed Name


Date: Date:
PCAB/DTI Office:
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 19 of 30
SUSTAINING TECHNICAL EMPLOYEE AFFIDAVIT
Note: Please accomplish this affidavit properly. Refer to the next page for STE qualification requirements.

Republic of the Philippines )


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

Last Name First Name Ext. Name (Jr/Sr, if any) Middle Name
I,
BOLEN JUNE AGUILAR
mm dd yyyy Single / Last Name First Name Middle Name
Born on 07 06 1977 BOLEN ALMA ROMASANTA
Married to
Room/Floor/Unit/Bldg. Name, Lot/Block/Phase No., Street, Subdivision, Barangay, City/Municipality, Province, Zip Code
and 146-B E. SANTOS ST., SAN JOAQUIN, PASIG CITY
residing at
Telephone / Mobile No. (required) Email Address (required)
with
having been duly sworn in accordance with law depose and say:
1. That I am a duly licensed ______MECHANICAL ENGINEER_________ and holder of PRC License No. 0060013
(Profession)
valid up to __06/07/2020__, as evidenced by a copy of my PRC ID posted below;
Course / Profession
That I hold a Bachelor's Degree in
MECHANICAL ENGINEER
2. Name of School Inclusive Dates
Given at: TECHNOLOGICAL UNIVERSITY OF THE PHIL. Given 1on:
VISAYAS
MARCH 2001
That my Tax Identification Number is : 226-074-663-000
3.
and my Social Security System Number: 07-1708509-1
That I am employed on a regular and full-time Name of Firm
basis by: K2RJL INDUSTRIAL SALES AND SERVICES CORP.
4.
Position in the Firm CFY
With the position of as STE for
TECHNICAL SUPERVISOR 2017-PRESENT
5. That I am not presently employed by either a private company or any government office or government owned/controlled
corporation, nor a full time instructor, nor working abroad;
6. That I am not a holder of a valid contractor's license;
7. That I am not involved in any construction malperformance suggestive of negligence, incompetence or malpractice or any
act or omission liable for disciplinary action by myself or in collaboration with any other person;
8. That I have not been convicted by a court of competent jurisdiction of any offense involving moral turpitude;
9. That I am fully aware that my failure to notify the PCAB of my disassociation from my present employer within 30 days from
such disassociation shall cause my disqualification from being a Sustaining Technical Employee, an Authorized Managing
Officer and an applicant for a contractor’s license with PCAB;
10. That I authorize the PCAB to verify and investigate any or all information in this affidavit from whatever sources PCAB may
consider appropriate;
11. That I am executing this affidavit to attest to the truth of the foregoing.
FURTHER AFFIANT SAYETH NAUGHT.
_JUNE BOLEN
Affiant

SUBSCRIBED AND SWORN to before me this _____ day of ___________________, 20___ at ___________________________;
affiant exhibited his/her Community Tax Certificate No. _____________ issued at __________________ on ______________ 20___.

Doc. No. NOTARY PUBLIC


Page No. Until December 31, 20 ___
Book No.
Series of 20 ___

PROF. I.D. CARD

VALID FOR

CURRENT YEAR

(Front)
(photocopy)
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 20 of 30

QUALIFICATION REQUIREMENTS FOR STE

1. A technology professional, such as engineer or architect, duly licensed by the Professional


Regulation Commission (PRC).

2. Holder of a valid PRC I.D.

3. With three (3) years minimum actual construction experience.

4. A full-time employee of the nominating contractor, not associated professionally or by


employment with any other party, particularly a party engaged in construction or construction-
related activities.

5. Have none of the following disqualifications:

a) Involvement, in any capacity, in any construction malperformance of grave consequence,


suggestive of his negligence, incompetence and/or malpractice;
b) Involvement, by himself or in collaboration with any other person or firm, in any act or
omission liable for disciplinary action of which he/she is or the other person or firm was
found guilty by the PCAB Board ;

c) Conviction by a court of competent jurisdiction of any offense involving moral turpitude; and

d) If formerly a Sustaining Technical Employee or an Authorized Managing Officer of any


construction firm but disassociated there from, failure to notify the Board of his
disassociation in accordance with paragraph 5 and 6 of the Affidavit of Undertaking.

This is to certify that I have verified with PRC the abovestated professional eligibility/registration of
the Sustaining Technical Employee. Affiant herein and found the same to be true and correct.

__JOSE MIGUEL P. SANDICHO___


Authorized Managing Officer
(Signature over printed name)

__________________________________________
Date
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 21 of 30
AFFIDAVIT OF STE CONSTRUCTION WORK EXPERIENCE
Note: Please use additional sheets if necessary.

Republic of the Philippines )


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

I, JUNE A. BOLEN__, married, Filipino, of legal age, with postal address at 146-B E. SANTOS ST., SAN JOAQUIN,
PASIG CITY, having been duly sworn in accordance with law depose and say that the projects enumerated below
constitute my full & complete construction experience.

Name and Work Nature/Scope of Work Project Duration


Complete Address of Employer/ Classification Assignment (mm/dd/yyyy)
Name & Location of Projects Undertaken (GE, GB, SP) (Proj. Engr.) From To
1. K2RJL Industrial Sales and Services Corp.
No. 70 E. Rodriguez Highway, Brgy. San GB-1, SP-CC Project Engineer/Technical April 2017 Present
Jose, Rodriguez Rizal Supervisor

2. Saudi German Company for Non-Wovens GB-1 Production Shift Supervisor February 2013 February 2017
Dammam, Saudi Arabia

3. Rapu-rapu Processing Incorporated, Brgy. GB-1, SP-ME Supervisor September January 2013
Pagcolbon, Rapu-rapu, Albay 2012

4. Unilox Industrial Corporation GB-1 Project Engineer/ Internal June 2003 August 2012
Pasig City Philippines Quality Auditor/Document
Controller

5. ROHM Electronics Philippines Inc. GB-1 Facilities Manager March 2002 September
Cavite Philippines 2002

That I authorize the PCAB to verify and investigate any or all information in this affidavit from whatever sources PCAB
may consider appropriate;

That I am executing this affidavit to attest to the truth of the foregoing.

FURTHER AFFIANT SAYETH NAUGHT.

_______JUNE A. BOLEN_______
Affiant

SUBSCRIBED AND SWORN to before me this ________ day of ___________________________________ 20_____


at ______________________________________________________________; affiant exhibited his/her Community
Tax Certificate No. ______________ issued at ___________________________ on ____________________ 20___.

NOTARY PUBLIC
Until December 31, 20 ___

Doc. No
Page No.
Book No.
Series of 20 _____.
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 22 of 30

STE PERSONAL APPEARANCE


Note: To be accomplished by the STE. The STE Personal Appearance is valid only for three (3) months from the date
signed by the PCAB/DTI Personnel.

Name of STE
Last Name First Name Ext. Name (Jr/Sr, if any) Middle Name
BOLEN JUNE AGUILAR
Profession PRC ID No. Expiration Date
MECHANICAL ENGINEER 0060013 06/07/2020
Present Employer
K2RJL INDUSTRIAL SALES & SERVICES CORP.

I hereby confirm the following:

3. The veracity of the information reflected on the STE Affidavit and Affidavit of Construction Experience
that I executed in favor of the above present employer;

4. That I am fully aware that my failure to notify the PCAB of my disassociation from the above-stated
nominating firm and any misrepresentation in the attached forms shall cause my disqualification as
sustaining technical employee, or authorized managing officer, or a licensee applicant with PCAB per
Board Resolution No. 401, Series of 2001.

3. That I have been previously connected with the following companies and disassociated therefore:

Date of Date of
Previous Employers Position
Employment Resignation
Production Shift
Saudi German Company for Non-Wovens February 2013 February 2017
Supervisor
Rapu-rapu Processing Inc. September 2012 January 2013 Supervisor
Project Engineer/Internal
Unilox Industrial Corporation June 2003 August 2012 Quality Auditor/Document
Controller
September
ROHM Electronics Philippines Inc. March 2002 Facilities Manager
2002

4. Other Remarks:
_____________________________________________________________________________________

_____________________________________________________________________________________

Valid I.D.(s) Presented:

3. _ PRC LICENSE No: 0060013________ ________________________


STE’s Signature
4. ________________ No: ______________
________________________
Date Signed

-----------------------------------------------------------------------
To be filled out by PCAB/DTI ROG Personnel
STE’s Specimen Signature (during interview):

Signature over Printed Name


Date: Date:
PCAB/DTI Office:
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 23 of 30

AFFIDAVIT OF NO CONSTRUCTION ACTIVITY FOR NEW LICENSE APPLICANTS

Republic of the Philippines )


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

I, _JOSE MIGUEL P. SANDICHO__ of legal age, Filipino, single/married, and residing at Lot 41 Blk 8
Gloria Vista Subd. Brgy. San Rafael Rodriguez Rizal.., after having been sworn to in accordance with law,
depose and say that:

1. I am the Proprietor / AMO of K2RJL Industrial Sales and Services Corp.


2. I am aware of the provisions of Section 35 of R.A 4566 (the Contractor’s License Law) that requires
a contractor to secure a license before engaging in the business of construction contracting in the
Philippines;
3. I have not undertaken any construction activity that requires a contractor’s license prior to the filing
of this application;
4. I will not engage or have not engaged in any construction activity that requires a contractor’s
license during the pendency of this application;
5. I am executing this affidavit to support my application for license and to attest to the truth of the
foregoing.

_ JOSE MIGUEL P. SANDICHO_


Affiant

SUBSCRIBED AND SWORN to before me this _________ day of ________________________ 20___ at


________________________________________________; affiant exhibiting to me his/her Community
Tax Certificate No. _______________ issued at _________________ on _______________ 20______.

NOTARY PUBLIC
Until December 31, 20 ____

Doc. No.
Page No.
Book No.
Series of 20 __.

IMPORTANT:

1. Submit this affidavit only if you have not undertaken any construction activity.
2. If construction has been undertaken prior to application or during the pendency of the application, inform the Public Assistance
Desk for assessment of Additional License Fee.
3. Misrepresentation in the application for a license may result in the disapproval thereof without prejudice to administrative, civil,
and criminal prosecution
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 24 of 30

AUTHORIZED REPRESENTATIVES AFFIDAVIT


Note: To be accomplished by the AMO.

Republic of the Philippines )


Province of ______________)
City/Municipality of ________) S.S
Last Name First Name Ext. Name (Jr/Sr, if any) Middle Name
I, Sandicho Jose Miguel Ponsaran
mm dd yyyy Single / Last Name First Name Middle Name
born on 03 03 1978 Married to Sandicho Norafe Munat
and Room/Floor/Unit/Bldg. Name, Lot/Block/Phase No., Street, Subdivision, Barangay, City/Municipality, Province, Zip Code
residing
Lot 41 Blk 8 Gloria Vista Subd. Brgy. San Rafael Rodriguez Rizal
at:
having duly sworn to in accordance with law depose and say:
That I am the Name of Firm
Authorized K2RJL Industrial Sales and Services Corp.
Managing
1. Officer of :
Room/Floor/Unit/Bldg. Name, Lot/Block/Ph. No., Street, Subdivision, Barangay, City/Municipality, Province, Zip Code
with office
70 E Rodriguez Hiway, Brgy. San Jose ,Rodriguez, Rizal
address at:
That I appoint two (2) representatives, whose pictures and signatures appear below:
Name of Representative and Picture Signature of Representative over
See Important Reminders (page 21,
Position in the Firm item no. 4) for specification
Printed Name
A.Daren Anne D. Jatulan
Sales Supervisor

2.

B. Nico B. Aldueso
Messenger

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.
That I am aware that I am responsible/liable for any or all acts/representation made by my representatives in
3.
connection with the functions stated herein.
4. That I undertake to notify PCAB in the event that this appointment is modified, amended or revoked.
That I have read and fully understood and complied with the requirements of PCAB Board Resolution No. 515 s.
5.
2011 (copies of required documents are attached).

JOSE MIGUEL P. SANDICHO


Affiant
(Authorized Managing Officer of Firm)

SUBSCRIBED AND SWORN to before me this _________ day of ____________________________, 20_____ at


_____________________________________________________; affiant exhibited his/her Community Tax Certificate
No. _____________________ issued at _____________________________ on ________________ 20_________.

NOTARY PUBLIC
Until December 31, 20 ___
Doc. No.
Page No.
Book No.
Series of 20 ___
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 25 of 30

IMPORTANT REMINDERS (A)


1. All required information in the application forms should be properly filled out. Do not leave an item blank. If an item is not
applicable, indicate “N/A”.
2. The recommended paper size in printing the application forms is 8.27” x 11.69” (A4 size).
3. Application forms and its corresponding supporting documents/attachments should be:
a. arranged according to page number with index tabs;
b. fasten in a long size folder.
4. The required picture specification for the AMO / STE / Authorized Representatives Affidavit as follows:
a. taken within the last three (3) months prior to filing of application;
b. Philippine passport size (4.5 cm x 3.5 cm or 1.78” x 1.38”);
c. colored, with white background and printed on good quality photo paper;
d. in standard close-up shot, taken in full-face view directly facing the camera;
e. in bare face (with no eyeglasses or any accessories that may cover the facial features), showing left and right ears;
f. with handwritten (not computer-generated) name tag legibly showing signature over printed full name in the format:
First Name, Middle Initial, Last Name and Extension Name, if any;
5. Only the Authorized Managing Officer or one of the two (2) Authorized Representatives of the Firm is allowed to transact
with PCAB (Board Resolution No. 515, s. 2011).
6. All applicants are required to pay non-refundable upfront fees for all types of license applications upon acceptance (Board
Resolution No. 313, s. 2011).
7. Avoid the rush and delay in the filing/processing of renewal application. Observe and follow the revised filing schedule
(Board Resolution No. 376, s. 2014) as stated below:
Last Digit of License No. Filing Month
0 February 1-14
1 February 15-28
2 March 1-15
3 March 16-31
4 April 1-15
5 April 16-30
6 May 1-15
7 May 16-31
8 and new license approved from
June 1-15
January to March
9 and approved from April to June June 16-30
 Contractors with license number ending 0-3 filing on their time schedule and whose accounting period is on
calendar year i.e., from January 1-December 31 may submit the previous year’s Audited Financial Statements
(AFS). For contractors whose accounting periods are other than calendar year may submit the latest AFS submitted
to the Bureau of Internal Revenue;
 Release of the license certificate for these contractors is subject to the submission of the current AFS filed with the
BIR and that no significant erosion of net worth or equity is suffered by the contractor as not to qualify it for its
present category;
 Should the contractor become unqualified for its present category due to financial erosion, the application shall be
reviewed by the Board for issuance of the highest category sustainable by the contractor’s qualification;
 Contractors filing their renewal applications beyond the schedule for their license number ending shall be assessed
an Additional Processing Fee (APF) of Php 5,000.00; and
 If the renewal application is filed after the end of the CFY which is 30 June, an Additional License Fee (ALF) which
existed before the APF will still be imposed or a total of Php 10,000 will be collected on top of the regular renewal
fees for each category.
8. Filing/submission of application/s can be done at PCAB Makati / CIAP Windows / DTI Regional or Provincial Offices /
PCAB Accredited Contractors’ Associations & Professional Organizations.
9. Application Forms (i.e. ARC, Amendments, Special License, etc.), Citizen’s Charter, Board Resolutions, Advisories and
other relevant information about PCAB application can be downloaded at www.ciap.dti.gov.ph
10. For further inquiries or clarifications, please communicate with us thru email or thru contact numbers below:

Department of Trade & Industry Philippines


Construction Industry Authority of the Philippines
PHILIPPINE CONTRACTORS ACCREDITATION BOARD
5F Executive Building Center, 369 Sen. Gil J. Puyat Ave.,
Makati City 1209
Tel/TeleFax: 895-4258 / 895-4220 / 09178482427
E-mail Address: ciappcab.main@gmail.com, pcab@dti.gov.ph

Note: Do not include this page in your application folder. For reference use only.
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 26 of 30

IMPORTANT REMINDERS (B)

Common causes of documentary deficiency resulting to non-acceptance/undue delay in the filing/


processing of application for New Regular Contractor’s License:

A. Legal Requirement:

1. No signature of Authorized Managing Officer (AMO)/Proprietor on all documents and


application forms;
2. Original copies of the following documents were not presented in lieu of the certified
copies:
a. Audited Financial Statement (AFS)/Income Tax Return (ITR);
b. SEC Registration, By-Laws and General Information Sheet;
c. Business Name Registration;
d. SSS, PHILHEALTH and PAG-IBIG Membership of the firm;
e. Construction Occupational Safety and Health Seminar Certificate;
f. Official Receipt Certificate of Registration (ORCR);
g. Transfer Certificate of Title (TCT);
h. Deed of Sale;
3. AMO failed the written examination;

B. Financial Requirement:

1. No Notes to Financial Statement (Audited Financial Statements (AFS));


2. No Signature of the Auditor on the Audited Financial Statement;
3. Expired Professional Regulation Commission (PRC) ID / Board of Accountancy (BOA) /
Accreditation;
4. No Accounts Receivables/Schedule of Inventories;

C. Technical Requirement:

1. Sustaining Technical Employee (STE) Affidavit of Undertaking not duly accomplished;


2. No Personal Appearance of STE;
3. Expired PRC ID;
4. STE’s Affidavit of Work Experience not duly accomplished;
5. No SSS R-3/CCL for the quarter preceding the application

Please make sure to check the completeness of your application to avoid non-acceptance.

Note: Do not include this page in your application folder. For reference use only.
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 27 of 30

GUIDELINES FOR CLASSIFICATION AND CATEGORIZATION OF CONTRACTORS


1. Classification means the area of operation that a contractor can engage is based on
the technical experience of his sustaining technical employee (STE). A contractor may apply for and be issued more than one
classification, one of which shall be designated as his principal classification.

2. Category indicates the graded level of aggregate capability of a contractor with respect
to his principal classification and is based on predetermined qualification criteria which include financial capacity, experience
of STE, track record and equipment. Evaluation of category shall be based on the following criteria quantified by credit points
in scales as determined by the Board.
2.1 Financial capacity
Financial capacity shall be in term of Networth based on the latest audited financial statements submitted to the
Bureau of Internal Revenue (BIR), or paid-up capital based on the latest audited financial statements submitted to the
Securities and Exchange Commission (SEC), if a newly-organized partnership or corporation. PCAB has the right to
reject or reduce portion thereof if, upon verification, the reported assets of the contractor were found to be erroneous
or not adequately supported with appropriate documents. Corresponding credit points is 1 for every P100,000.00 of
the value of Networth/Stockholder’s Equity.
2.2 Equipment Capacity
Equipment capacity shall be in term of book value as reflected in the constructor’s latest audited financial statement
submitted to the BIR or the SEC, whichever is applicable, or equipment owned which are in operational condition and
applicable to construction of the classification in which the constructor is to be categorized. Said owned equipment
shall include units under installment and/or under lease purchase. Corresponding credit points is 1 for every
P100,000.00 of the NBV of the contractor owned equipment.
2.3 Experience of firm
Experience of firm shall be in terms of:

2.3.1 Aggregate number of years in which the constructor firm, under the same business identify, has been actively
engaged in construction contracting operation. Corresponding credit points is 10 for every year of actual
construction operation as a licensed contractor; and
2.3.2 Average annual value of work completed by the firm during the past three (3) years or, if constructor’s license
is less than three (3) years, since being licensed, based on the audited financial statements submitted to the
BIR. Corresponding credit points is one (1) for every P100,000.00 of the annual value of work
accomplishment.
2.4 Experience of technical personnel
Experience of technical personnel shall be the sum total of individual experience of each STE nominated to the
classification and shall be subject to the qualification requirement of each category as indicated in the PCAB
Classification and Categorization Table. Said individual experience of the STE shall be as defined and qualified
below:

2.4.1. The experience shall be in term of aggregate number of years in which the STE, in his present employment as
well as previous, has been involved in construction is to be categorized.

2.4.2. It shall include only the years in which he was performing in managerial/supervisory capacity bearing on
construction operation and/or contract implementation.

2.4.3. It shall be subject to a creditable ceiling of thirty (30) years, over which no excess shall be recognized.

Corresponding credit point is five (5) for every year of experience in construction.

The category of a contractor shall be determined on the basis of the number of points credited on the
aggregate/combined experience of all its qualified STE. Only STEs who meet the minimum individual experience
required shall be considered in determining aggregate experience and credit points. Thus, in order to qualify to the
technical capacity requirement for category “AAA”, the contractor must have qualified STEs whose individual
experience is not less than ten (10) years with a creditable ceiling of thirty (30) years and have an
aggregate/combined experience of at least sixty (60) years.

3. In determining a contractor’s category, his qualification must satisfy all the minimum
requirements, corresponding to the classification and category applied for, qualified and rated according to equivalent credit
points and shall be the lowest sustainable by all three determinants as follows:

3.1 Financial Capacity


3.2 Experience of STE
3.3 Overall credit points based on the four qualification criteria referred to in item 2 of these guidelines.
Note: Do not include this page in your application folder. For reference use only.
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 28 of 30

CATEGORIZATION – CLASSIFICATION TABLE


C MINIMUM QUALIFICATION REQUIREMENTS
A (1)
(2)
T STE Min. Const.
Financial Capacity (3)
Exp. Requirement
E Overall
CLASSIFICATION
G Credit Credit
Min. Points
O Stockholder’s Points Indivi- Aggre-
C.P.
Equity (C.P.) dual gate Required
R Req’d.
Req’d.
Y
A. GENERAL ENGINEERING AAA P90,000,000.00 900.00 10 60 300 1,950.00
GE-1 (Road, Highways, Pavement, AA 45,000,000.00 450.00 10 50 250 915.15
Railways, Airport Horizontal
Structure, and Bridges) A 9,000,000.00 90.00 7 21 105 265.00
GE-2 (Irrigation or Flood Control)
B 4,500,000.00 45.00 5 10 50 122.50
GE-3 (Dam, Reservoir or Tunneling)
GE-4 (Water Supply) C 3,000,000.00 30.00 3 3 15 75.50
GE-5 (Port, Harbor or Offshore
Engineering)
D 900,000.00 9.00 3 3 15 24.00

B. GENERAL BUILDING AAA P90,000,000.00 900.00 10 60 300 1,910.00

GB-1 (Building or Industrial Plant) AA 45,000,000.00 450.00 10 50 250 895.00


GB-2 (Sewerage or Sewage System)
A 9,000,000.00 90.00 7 21 105 261.00
GB-3 (Water Treatment Plant & System)
B 4,500,000.00 45.00 5 10 50 120.50
GB-4 (Park, Playground or Recreational
Work) C 3,000,000.00 30.00 3 3 15 66.50

D 900,000.00 9.00 3 3 15 24.00

C. SPECIALTY
AAA P90,000,000.00 900.00 10 60 300 1,510.00
SP-FW (Foundation Work)
SP-SS (Structural Steel Work)
SP-CC (Concrete Pre-casting, Pre-
Stressing or Post-tensioning) AA 45,000,000.00 450.00 10 50 250 695.00
SP-PS (Plumbing & Sanitary Work)
SP-EE (Electrical Work)
SP-ME (Mechanical Work)
A 9,000,000.00 90.00 7 21 105 211.00
SP-AC (Air-conditioning or Refrigeration)
SP-ES (Elevator or Escalator)
SP-FP (Fire Protection Work)
B 4,500,000.00 45.00 5 10 50 110.50
SP-WP (Waterproofing Work)
SP-PN (Painting Work)
SP-WD (Well-Drilling Work)
C 3,000,000.00 30.00 3 3 15 60.50
SP-CF (Communication Facilities)
SP-MS (Metal Roofing & Siding Installation)
SP-SD (Structural Demolition)
SP-LS (Landscaping)
D 900,000.00 9.00 3 3 15 24.00
SP-EM (Electro Mechanical Work)
SP-NF (Navigational Facilities)
D. SP-TRADE TRADE 45,000.00 0.40 none none none 0.45
* Minimum Qualification Requirements for Principal Classification
** For Other Classification/s, Minimum of 3 Years Actual Construction Experience
*** Overall credit points inclusive of Equipment Capacity (1 point/P100Th); Experience of Firm (10 points/year of active existence); &
1 point/P100Th of 3 year Average Annual Volume of Work Accomplished; and COMTCP points if STEs are COMTCP certified
Note: Do not include this page in your application folder. For reference use only.
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 29 of 30

GUIDELINES FOR THE LICENSING OF CATEGORY QUADRUPLE A CONTRACTORS


Board Resolution No. 079, series of 2017

Introduction

The Quadruple A category license is a new category that will allow for the issuance of a regular license (with
annotation) to contractors with more than 40% foreign equity participation.

Scope of Registration

A newly organized domestic corporation (up to 100% foreign-owned) whose purpose is construction is eligible to
apply for the category. Likewise, a licensed contractor who has an equity/net worth at least PHP 1 Billion may apply
for upgrading to Quadruple A.

There will be two types of Quadruple A Licenses:

1. Quadruple A Platinum - locally owned licensed contractors with at least PHP 1 Billion equity

2. Quadruple A Gold - foreign-owned domestic corporation with at least PHP 1 Billion equity

Authorized Managing Officer (AMO)

The AMO may be a foreigner provided that the foreign AMO complies with the PCAB qualification standards of a
Filipino AMO. The AMO should be at least 35 years old.

The AMO should complete the AMO seminar, COSH and pass the AMO examination and interview by the Board.

Financial Qualification

The Financial Qualification shall be evidenced by Audited Financial Statements with at least PHP 1 Billion equity. For
newly organized foreign owned subsidiaries, the equity of PHP 1 Billion in cash shall be evidenced by inward
remittance through the Banko Sentral ng Pilipinas.

Technical Qualification

The Technical Qualification shall be that of the AAA category.

Limitation of the License

Quadruple A Gold contractors may undertake private projects under the following contract cost:

• For vertical projects - minimum contract cost of PHP 5 Billion


• For horizontal projects - minimum contract cost of PHP 3 Billion

Quadruple A Platinum contractors may undertake government and private projects of any contract cost.

The Quadruple A category shall be limited to general contractors. However, Quadruple A contractors may engage
licensed subcontractor/specialty contractors to work on portions of its projects.

Renewal

Quadruple A Gold contractors should maintain the Financial and Technical Qualifications for Quadruple A category. If
a Quadruple A contractor does not maintain its P 1 Billion equity, its license will be invalidated.

Quadruple A Platinum contractors who fail to meet the Financial and Technical Qualifications shall be downgraded to
the highest category they will qualify for.

Note: Do not include this page in your application folder. For reference use only.
PCAB-PAD-NEW-F01
Revision No. 07, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 30 of 30

FEE STRUCTURE

New Regular License Application


Category
Fee Particulars AAA AA A B C D E/Trade
Filing Fee 1,200 1,200 1,200 1,200 1,200 1,200 1,200
Classification Fee
Principal 4,800 2,400 480 240 144 48 nil
Other/s (chargeable for
2,400 1,200 240 120 72 24 nil
each classification)
Categorization Fee 43,200 21,600 7,200 4,800 2,400 1,200 nil
License Fee 100 100 100 100 100 100 100
Documentary Stamp Tax 15 15 15 15 15 15 15
Legal Research Fund 12 12 12 12 12 12 12
Grand Total (P) 51,727 26,527 9,247 6,487 3,943 2,599 1,327
New Regular License Application with Annotation (Quadruple A Category)
P 100,000
Form of Payment - Cash / Manager’s Check or Cashier’s Check payable to “CIAP”

Note: Do not include this page in your application folder. For reference use only.

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