Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
(Date of Issuance)
Commissioner
Bureau of Customs
Port Area, Manila
I hereby certify that all information provided herein, is true and correct, and I
hold myself liable, criminally or civilly, for any misrepresentation or false statement
made herein.
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Form No. 2
3. (name of the company) is not included in the blacklist of contractors for any
government projects including its subdivisions or was included in the
Consolidated Blacklisting Report issued by the Government Procurement
Policy Board (GPPB). Attached herewith is the certification from the GPPB;
and
4. I am executing this Affidavit to attest to the truth of the foregoing facts and in
compliance with the eligibility requirement as Customs Electronic GPS-
Equipped Barrier Seal Service Provider (CEGBSSP).
Mr. X
Affiant
NOTARY PUBLIC
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Page No.
Book No.
Series of 2011
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Form No. 3
A. On-going Undertakings
Name of Inclusive Description of Amount of Project
Project Dates Service/s Being
Provided
B. Completed Undertakings
* For the above list, attached copy of Certificate of Satisfactory Completion issued by
the client
Submitted by:
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FORM NO. 4
Date of Issuance
Commissioner
Bureau of Customs
Port Area, Manila
Dear Sir/Madame:
In compliance with the requirements of the Bureau of Customs CASP for eligibility to
be accredited as Customs Electronic GPS-Equipped Barrier Seal Service Provider
(CEGBSSP), we certify to the technical competence, experience and expertise of the
following officers/personnel, hereunder enumerated:
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FORM NO. 5
Commissioner
Bureau of Customs
Port Area, Manila
Dear Sir/Madame:
In compliance with the eligibility requirements of the Bureau of Customs CASP for
accreditation as Customs Electronic GPS-Equipped Barrier Seal Service Provider
(CEGBSSP), we hereby authorize the CASP or its authorized representative/s to
verify the statements, documents and information submitted herewith to substantiate
our eligibility.
1. ___________________________________________________________
2. ___________________________________________________________
3. ___________________________________________________________
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FORM NO. 6
AFFIDAVIT OF AUTHENTICITY
2. That each of the documents submitted is original copy or certified true copy
and that all statements and information contained therein are true and correct;
3. That this affidavit is being executed to attest to the truth of the foregoing and
in compliance with the eligibility requirement of __(Name of the Company)__ for
qualification as Customs Electronic GSP-Equipped Barrier Seal Service Provider
(CEGBSSP).
IN TRUTH WHEREOF, I hereby affix my signature this _____ day of _____, 20___
at _____________, Philippines.
___________________________________
Name, Position & Signature of Authorized Signatory
(Notary Public)
Doc. No.
Page No.
Book No.
Series of 2011