CAGAYAN DE ORO CITY WATER DISTRICT Bids and Awards ... · The Cagayan de Oro City Water District...

20
Republic of the Philippines CAGAYAN DE ORO CITY WATER DISTRICT Corrales Avenue, Cagayan de Oro City Telefax: (088) 852-1629 Bids and Awards Committee INVITATION FOR NEGOTIATED PROCUREMENT Supply and Delivery of 1 Lot Galvanized Steel Service Connection Fittings and Materials (Lot No.10) & 1 Lot Instrumentation Box (Lot No.17) 1. In view of the two (2) failed public biddings, the Cagayan de Oro City Water District Bids and Awards Committee (BAC) invites interested bidders to participate in the negotiation for the Supply and Delivery of the following lots listed below. Bidders shall have the option of submitting a proposal on any or all lots and evaluation and contract award will be undertaken on a per lot basis. Lots shall not be divided further into sub-lots for the purpose of bidding, evaluation, and contract award. Lot No. Description Approved Budget for the Contract (ABC) 10 1 Lot Galvanized Steel Service Connection Fittings and Materials P8,639,646.00 17 1 Lot Instrumentation Box P2,772,000.00 This is in accordance with Section 53.1 of the Implementing Rules and Regulations of Republic Act No. 9184, otherwise known as the “Government Procurement Reform Act.” For more details on this project, please refer to attached Schedule of Requirements (Annex A) and Technical Specifications (Annex B). 2. The following eligibility and technical documents as well as the Financial Proposal Form (Annex C for Lot 10 and Annex D for Lot 17) shall be submitted on or before November 29, 2016, 9:00 a.m. at the BAC Office, 4 th Floor COWD Admin. Building, Corrales Avenue, Cagayan de Oro City: a) Securities and Exchange Commission/Department of Trade and Industry Registration Certificate; b) Valid Mayor’s Permit; c) Tax Clearance per Executive Order 398, Series of 2005, as finally reviewed and approved by the BIR. d) Bid security either in the following forms and amount: i. 2% of the ABC, if cash or cashier’s/manager’s check issued by a Universal or Commercial bank; ii. Bid Securing Declaration (Annex E) e) Schedule of Requirement; f) Technical Specifications; g) Product Literature/Brochure (in English) h) Omnibus Sworn Statement (Annex G); and i) Certification of PhilGEPS Registration. 3. Opening of the eligibility documents, technical documents and financial proposal will be on November 29, 2016, 9:00 a.m. 4. The Cagayan de Oro City Water District reserves the right to accept or reject any offer, to annul the negotiation process, and to reject all offers at any time prior to contract award, without thereby incurring any liability to affected firms. 5. The complete schedule of activities is listed as follows: ACTIVITIES SCHEDULE 1. Issuance of Request for Quotation November 17, 2016, Wednesday 2. Pre-Bid Conference November 23, 2016, 9:00 a.m., Wednesday 3. Opening of Bids November 29, 2016, 9:00 a.m., Tuesday 6. For further information, you may call the COWD-BAC Secretariat at (088) 850-1629 from 8:00 a.m. – 12:00 noon and 1:00 p.m – 5:00 p.m. (SIGNED) ENG. BIENVENIDO V. BATAR, JR. BAC A Chairman

Transcript of CAGAYAN DE ORO CITY WATER DISTRICT Bids and Awards ... · The Cagayan de Oro City Water District...

Page 1: CAGAYAN DE ORO CITY WATER DISTRICT Bids and Awards ... · The Cagayan de Oro City Water District reserves the right to accept or reject any offer, to annul the negotiation process,

Republic of the Philippines

CAGAYAN DE ORO CITY WATER DISTRICT Corrales Avenue, Cagayan de Oro City

Telefax: (088) 852-1629

Bids and Awards Committee INVITATION FOR NEGOTIATED PROCUREMENT

Supply and Delivery of 1 Lot Galvanized Steel Service Connection Fittings and Materials (Lot No.10)

& 1 Lot Instrumentation Box (Lot No.17)

1. In view of the two (2) failed public biddings, the Cagayan de Oro City Water District Bids and Awards Committee (BAC) invites interested bidders to participate in the negotiation for the Supply and Delivery of the following lots listed below. Bidders shall have the option of submitting a proposal on any or all lots and evaluation and contract award will be undertaken on a per lot basis. Lots shall not be divided further into sub-lots for the purpose of bidding, evaluation, and contract award.

Lot No.

Description Approved Budget for the

Contract (ABC)

10 1 Lot Galvanized Steel Service Connection Fittings and Materials P8,639,646.00

17 1 Lot Instrumentation Box P2,772,000.00

This is in accordance with Section 53.1 of the Implementing Rules and Regulations of Republic Act No. 9184, otherwise known as the “Government Procurement Reform Act.” For more details on this project, please refer to attached Schedule of Requirements (Annex A) and Technical Specifications (Annex B).

2. The following eligibility and technical documents as well as the Financial Proposal Form (Annex C for Lot 10 and Annex D for Lot 17) shall be submitted on or before November 29, 2016, 9:00 a.m. at the BAC Office, 4th Floor COWD Admin. Building, Corrales Avenue, Cagayan de Oro City:

a) Securities and Exchange Commission/Department of Trade and Industry Registration Certificate; b) Valid Mayor’s Permit; c) Tax Clearance per Executive Order 398, Series of 2005, as finally reviewed and approved by the BIR. d) Bid security either in the following forms and amount:

i. 2% of the ABC, if cash or cashier’s/manager’s check issued by a Universal or Commercial bank; ii. Bid Securing Declaration (Annex E)

e) Schedule of Requirement; f) Technical Specifications; g) Product Literature/Brochure (in English) h) Omnibus Sworn Statement (Annex G); and i) Certification of PhilGEPS Registration.

3. Opening of the eligibility documents, technical documents and financial proposal will be on November 29,

2016, 9:00 a.m. 4. The Cagayan de Oro City Water District reserves the right to accept or reject any offer, to annul the

negotiation process, and to reject all offers at any time prior to contract award, without thereby incurring any liability to affected firms.

5. The complete schedule of activities is listed as follows:

ACTIVITIES SCHEDULE

1. Issuance of Request for Quotation November 17, 2016, Wednesday

2. Pre-Bid Conference November 23, 2016, 9:00 a.m., Wednesday

3. Opening of Bids November 29, 2016, 9:00 a.m., Tuesday

6. For further information, you may call the COWD-BAC Secretariat at (088) 850-1629 from 8:00 a.m. – 12:00

noon and 1:00 p.m – 5:00 p.m. (SIGNED)

ENG. BIENVENIDO V. BATAR, JR. BAC A Chairman

Page 2: CAGAYAN DE ORO CITY WATER DISTRICT Bids and Awards ... · The Cagayan de Oro City Water District reserves the right to accept or reject any offer, to annul the negotiation process,

Annex A

SCHEDULE OF REQUIREMENTS

The delivery schedule expressed as calendar days stipulates hereafter a delivery which is the date of delivery to

the project site.

Lot No. Description Quantity Unit

Delivery Schedule

10 GALVANIZED STEEL SERVICE CONNECTION

FITTINGS AND MATERIALS

1 lot 30 Calendar Days

17 INSTRUMENTATION BOX 1 lot 30 Calendar Days

Page 3: CAGAYAN DE ORO CITY WATER DISTRICT Bids and Awards ... · The Cagayan de Oro City Water District reserves the right to accept or reject any offer, to annul the negotiation process,

Annex B

TECHNICAL SPECIFICATIONS

DESCRIPTIONS/SPECIFICATIONS

STATEMENT OF

COMPLIANCE

(State “Comply or

not Comply” for each

item description and

specifications and

attach your company

shop/drawing and or

brochures / and or

Literatures)

PR No. 16-05-09-0111 – SUPPLY AND DELIVERY OF THE MATERIALS FOR NRW REDUCTION PROGRAM.

The following images are provided for reference only. We are not specifying/endorsing any particular brand of

equipment/material/fittings. IT IS STRONGLY ADVISED TO STRICTLY FOLLOW THE TABLE OF MATERIAL (with

dimension and end connection specifications) AND MATERIAL SPECIFICATIONS PROVIDED.

General Specifications

Materials At a minimum, the materials to be purchased shall conform

with the international standards mentioned below and other

equivalent.

All materials in contact with potable water shall not have

detrimental effects on the properties of the water.

When used under conditions for which they are designed,

pipe materials shall not constitute a toxic hazard; shall not

support microbial growth nor give rise to unpleasant taste or

odor, cloudiness or discoloration of the water.

The concentrations of substances, chemicals and biological

agents leached from pipe materials and the measurements of

relevant organoleptic/physical parameters shall not exceed

the maximum values recommended by the Department of

Health in its publication Philippine National Standards for

Drinking Water.

Certificates of compliance from independent testing institutes

as well as declarations concerning suitability for the use with

potable water shall be provided.

LOT NO. 10 - GALVANIZED STEEL SERVICE CONNECTION FITTINGS AND MATERIALS

Anchor bolt (bolt & nut)

Material Type Galvanized Steel

Dimension 1,020 sets 12mmØ x 100mm

Others Bolts, anchor bolts, nuts and washers shall be of low carbon

steel, Grade B of ASTM A307.

Threads and tapping for all bolts and nuts respectively shall

conform to ISO 261

Bolt head and nut shapes shall be hexagonal and shall

conform to ISO 272.

Page 4: CAGAYAN DE ORO CITY WATER DISTRICT Bids and Awards ... · The Cagayan de Oro City Water District reserves the right to accept or reject any offer, to annul the negotiation process,

Washers shall be provided under nuts and under the heads of

bolts.

Bolts, anchor bolts, nuts and similar threaded fasteners, after

being properly cleaned, shall be galvanized in accordance

with the requirements of ASTM A153.

Bolts & Nuts

Material Type Galvanized Steel

Dimension 770 sets 12mmØ x 50mm

Others Bolts, anchor bolts, nuts and washers shall be of low carbon

steel, Grade B of ASTM A307.

Threads and tapping for all bolts and nuts respectively shall

conform to ISO 261

Bolt head and nut shapes shall be hexagonal and shall

conform to ISO 272.

Washers shall be provided under nuts and under the heads of

bolts.

Bolts, anchor bolts, nuts and similar threaded fasteners, after

being properly cleaned, shall be galvanized in accordance

with the requirements of ASTM A153.

Bushing

Material Type Galvanized Steel

End Connection MTE X FTE

Dimensions 206 pieces 15mmØ x 9.5mmØ (1/2” x 3/8”)

2,000 pieces 20mmØ x 15mmØ (1/2” x 3/4”), 4mm wall

thickness (minimum)

Page 5: CAGAYAN DE ORO CITY WATER DISTRICT Bids and Awards ... · The Cagayan de Oro City Water District reserves the right to accept or reject any offer, to annul the negotiation process,

Coupling

Material Type Galvanized Steel

End Connections FTE X FTE

Dimension 250 pieces 20mmØ, 6mm wall thickness (minimum)

End Plug

Material Type Galvanized Steel

End Connection MTE

Dimension 4,000 pieces 15mmØ, 4mm wall thickness (minimum)

Galvanized Bolts & Nuts Full Thread with washers

Material Type Galvanized Steel

Dimensions 10,137 sets 16mmØ x 75mm

Page 6: CAGAYAN DE ORO CITY WATER DISTRICT Bids and Awards ... · The Cagayan de Oro City Water District reserves the right to accept or reject any offer, to annul the negotiation process,

12,096 sets 20mmØ x 100mm

3,864 sets 24mmØ x 100mm

Ladder Rung 20mmØ (Manhole Step)

Material Type Galvanized Steel

Dimension 170 pieces 20mmØ

Others shall be 20mm diameter steel and hot-dip galvanized in

accordance with ASTM A153.

The step shall have serrated drop section surface designed for

non-slip use and fixed at 150mm from the vertical surface 0f

the wall to which it is attached.

Each rung when fixed in place shall support 450kg.

Nipple

Material Type Galvanized Steel

End Connection MTE X MTE

Dimensions 5,779 pieces 15mmØ x 100mm (1/2” x 4”)

Page 7: CAGAYAN DE ORO CITY WATER DISTRICT Bids and Awards ... · The Cagayan de Oro City Water District reserves the right to accept or reject any offer, to annul the negotiation process,

7,298 pieces 15mmØ x 500mm (1/2” x 20”)

25 pieces 50mmØ x 200mm

100 pieces 50mmØ x 50mm

1,031 pieces 50mmØ x 100mm

234 pieces 50mmØ x 150mm

122 pieces 50mmØ x 500mm

Others Base pipe shall be manufactured in accordance with ASTM

A53.

Pipe material shall be seamless (Type S) or electric-resistance

welded (Type E) pipes in accordance with ASTM A53, Grade A

or B.

Pipes and nipples shall have dimensions in accordance with

ISO 65, medium series. The thickness shall be Schedule 40 at

a minimum.

Pipes and nipples, unless otherwise specified, shall be zinc-

coated internally and externally by hot-dip process in

accordance with ASTM A53.

Pipes and nipples shall be male threaded on both ends with

right-hand tapered threads in accordance with ISO 7/ ISO

228.

Threading shall be made after galvanizing.

Pipe

Material Type Galvanized Steel

End Connection PE X PE

Dimension 91 pieces 100mmØ x 6m

Others Base pipe shall be manufactured in accordance with ASTM

A53.

Pipe material shall be seamless (Type S) or electric-resistance

welded (Type E) pipes in accordance with ASTM A53, Grade A

or B.

Page 8: CAGAYAN DE ORO CITY WATER DISTRICT Bids and Awards ... · The Cagayan de Oro City Water District reserves the right to accept or reject any offer, to annul the negotiation process,

Pipes and nipples shall have dimensions in accordance with

ISO 65, medium series. The thickness shall be Schedule 40 at

a minimum.

Pipes and nipples, unless otherwise specified, shall be zinc-

coated internally and externally by hot-dip process in

accordance with ASTM A53.

Pipes and nipples shall be male threaded on both ends with

right-hand tapered threads in accordance with ISO 7/ ISO

228.

Threading shall be made after galvanizing.

Reducer

Material Type Galvanized Steel

End Connection FTE X FTE

Dimension 456 pieces 20mmØ x 15mmØ, 5.5mm wall thickness

(minimum – both ends)

Seal Tape (PTFE tape or plumber's tape)

Material Type PTFE

Dimensions 2,994 rolls 15mmØ X 10M length (normal thickness)

4,685 rolls 25mmØ X 10M length (normal thickness)

Page 9: CAGAYAN DE ORO CITY WATER DISTRICT Bids and Awards ... · The Cagayan de Oro City Water District reserves the right to accept or reject any offer, to annul the negotiation process,

Street Elbow/Bend

Material Type Galvanized Steel

End Connection MTE X FTE

Dimension 2,980 pieces 15mmØ x 15mmØ

Wall Thickness 6mm (minimum) – Female End

4mm (minimum) – Male End

Tee

Material Type Galvanized Steel

End Connection All FTE

Dimension 145 pieces 50mmØ, 9mm wall thickness (minimum)

Page 10: CAGAYAN DE ORO CITY WATER DISTRICT Bids and Awards ... · The Cagayan de Oro City Water District reserves the right to accept or reject any offer, to annul the negotiation process,

Tee, Cross

Material Type Galvanized Steel

End Connection All FTE

Dimension 333 pieces 50mmØ, 10mm wall thickness (minimum)

Weather proof durable padlock

Material Type Hardened Steel Body and Shackle

Dimension 179 pieces 8mmØ shackle dimension

LOT NO. 17 - INSTRUMENTATION BOX Fiber reinforced plastic box

Quantity 154 sets

Size L=450mm; W= 250mm; H=500mm

Thickness 6mm

Others One-50mmØ-hole FRP

Electromagnetic meter converter/data logger adjustable hook

and slot

Page 11: CAGAYAN DE ORO CITY WATER DISTRICT Bids and Awards ... · The Cagayan de Oro City Water District reserves the right to accept or reject any offer, to annul the negotiation process,
Page 12: CAGAYAN DE ORO CITY WATER DISTRICT Bids and Awards ... · The Cagayan de Oro City Water District reserves the right to accept or reject any offer, to annul the negotiation process,
Page 13: CAGAYAN DE ORO CITY WATER DISTRICT Bids and Awards ... · The Cagayan de Oro City Water District reserves the right to accept or reject any offer, to annul the negotiation process,

Annex C

Bid Form

(Lot No. 10)

Date:

To: Cagayan de Oro City Water District

Corrales, Avenue, Cagayan de Oro City

Gentlemen and/or Ladies:

Having examined the Bidding Documents including Bid Bulletin Numbers [insert numbers], the receipt of

which is hereby duly acknowledged, we, the undersigned, offer to [supply/deliver/perform] [description of the

Goods] in conformity with the said Bidding Documents for the sum of [total bid amount in words and figures] or

such other sums as may be ascertained in accordance with the Schedule of Prices attached herewith and made

part of this Bid.

We undertake, if our Bid is accepted, to deliver the goods in accordance with the delivery schedule specified

in the Schedule of Requirements.

If our Bid is accepted, we undertake to provide a performance security in the form, amounts, and within the

times specified in the Bidding Documents.

We agree to abide by this Bid for the Bid Validity Period specified in BDS provision for ITB Clause 18.2 and

it shall remain binding upon us and may be accepted at any time before the expiration of that period.

Until a formal Contract is prepared and executed, this Bid, together with your written acceptance thereof

and your Notice of Award, shall be binding upon us.

We understand that you are not bound to accept the lowest or any Bid you may receive.

We certify/confirm that we comply with the eligibility requirements as per ITB Clause 5 of the Bidding

Documents.

Dated this ________________ day of ________________ 20___.

________________________

Company Name

________________________

Authorized Signature

_______________________

Printed Name

_______________________

Position

Annex D

Page 14: CAGAYAN DE ORO CITY WATER DISTRICT Bids and Awards ... · The Cagayan de Oro City Water District reserves the right to accept or reject any offer, to annul the negotiation process,

Bid Form

(Lot No. 17)

Date:

To: Cagayan de Oro City Water District

Corrales, Avenue, Cagayan de Oro City

Gentlemen and/or Ladies:

Having examined the Bidding Documents including Bid Bulletin Numbers [insert numbers], the receipt of

which is hereby duly acknowledged, we, the undersigned, offer to [supply/deliver/perform] [description of the

Goods] in conformity with the said Bidding Documents for the sum of [total bid amount in words and figures] or

such other sums as may be ascertained in accordance with the Schedule of Prices attached herewith and made

part of this Bid.

We undertake, if our Bid is accepted, to deliver the goods in accordance with the delivery schedule specified

in the Schedule of Requirements.

If our Bid is accepted, we undertake to provide a performance security in the form, amounts, and within the

times specified in the Bidding Documents.

We agree to abide by this Bid for the Bid Validity Period specified in BDS provision for ITB Clause 18.2 and

it shall remain binding upon us and may be accepted at any time before the expiration of that period.

Until a formal Contract is prepared and executed, this Bid, together with your written acceptance thereof

and your Notice of Award, shall be binding upon us.

We understand that you are not bound to accept the lowest or any Bid you may receive.

We certify/confirm that we comply with the eligibility requirements as per ITB Clause 5 of the Bidding

Documents.

Dated this ________________ day of ________________ 20___.

________________________

Company Name

________________________

Authorized Signature

_______________________

Printed Name

_______________________

Position

Annex E

Page 15: CAGAYAN DE ORO CITY WATER DISTRICT Bids and Awards ... · The Cagayan de Oro City Water District reserves the right to accept or reject any offer, to annul the negotiation process,

CAGAYAN DE ORO CITY WATER DISTRICT PR No. 16-05-09-0111–SUPPLY AND DELIVERY OF THE MATERIALS FOR THE

NRW REDUCTION PROGRAM (NEGOTIATED PROCUREMENT FOR LOT NOS.

10 & 17).

Bid Form 2

PR No. 16-05-09-0111 (Negotiated Procurement of Lot Nos. 10 & 17)

LOT NO. 10 – GALVANIZED STEEL SERVICE CONNECTION FITTINGS AND MATERIALS

ITEM

NO. QTY. UNIT DESCRIPTION UNIT COST TOTAL COST

1 1,020 set 12mmØ x 100mm Anchor bolt (bolt &

nut)

2 770 set 12mmØ x 50mm Bolts & nuts

3 206 piece 15mmØ x 9.5mmØ Bushing

(1/2” x 3/8”)

4 2,000 piece 20mmØ x 15mmØ Bushing

(1/2" x 3/4")

5 250 piece 20mmØ Coupling

6 4,000 piece 15mmØ End Plug

7 10,137 set 16mmØ x 75mm Galvanized Bolts &

Nuts Full Thread with washers

8 12,096 set 20mmØ x 100mm Galvanized Bolts &

Nuts Full Thread with washers

9 3,864 set 24mmØ x 100mm Galvanized Bolts &

Nuts Full Thread with washers

10 170 piece 20mmØ Ladder Rung 20mmØ (Manhole

Step)

11 5,779 piece 15mmØ x 100mm Nipple

12 7,298 piece 15mmØ x 500mm Nipple

13 25 piece 50mmØ x 200mm Nipple

14 100 piece 50mmØ x 50mm Nipple

15 1,031 piece 50mmØ x 100mm Nipple

16 234 piece 50mmØ x 150mm Nipple

17 122 piece 50mmØ x 500mm Nipple

18 91 piece 100mmØ x 6m Pipe

19 456 piece 20mmØ x 15mmØ Reducer

20 2,994 roll

15mmØ x 10M length (normal

thickness) Seal Tape (PTFE tape or

plumber's tape)

21 4,685 roll

25mmØ x 10M length (normal

thickness) Seal Tape (PTFE tape or

plumber's tape)

22 2,980 piece 15mmØ x 15mmØ Street Elbow/Bend

Page 16: CAGAYAN DE ORO CITY WATER DISTRICT Bids and Awards ... · The Cagayan de Oro City Water District reserves the right to accept or reject any offer, to annul the negotiation process,

23 145 piece 50mmØ Tee

24 333 piece 50mmØ Tee, Cross

25 179 piece 8mmØ shackle dimension Weather

proof durable padlock

LOT NO. 17 – INSTRUMENTATION BOX

ITEM

NO. QTY. UNIT DESCRIPTION UNIT COST TOTAL COST

26 154 set

Fiber reinforced plastic box(L=450mm;

W= 250mm; H=500mm); Thickness=

6mm; electromagnetic meter converter

/data logger adjustable hook & slot

Total Bid Pice: (Delivered DDP COWD Warehouse) in Figures:

In Words:

Brand and Model:

Price Validity:

Terms: Payment shall be made as stipulated in the Purchase Order.

Delivery: Delivery shall be the following:

Thirty (30) calendar days from receipt of Purchase Order for Lot No. 10 & 17

Submitted by:

________________________________

Company Name

________________________________

Printed Name / Signature

________________________________

Tel. No. /Cell Phone No.

______________________

DATE

Annex F

Page 17: CAGAYAN DE ORO CITY WATER DISTRICT Bids and Awards ... · The Cagayan de Oro City Water District reserves the right to accept or reject any offer, to annul the negotiation process,

REPUBLIC OF THE PHILIPPINES )

CITY OF _______________________ ) S.S.

BID-SECURING DECLARATION

Invitation to Bid/Request for Expression of Interest No. [Insert reference number]

To: Cagayan de Oro City Water District

Corrales Avenue, Cagayan de Oro City

I/We, the undersigned, declare that:

1. I/We understand that, according to your conditions, bids must be supported by a Bid Security, which may be in the form of a Bid-Securing Declaration.

2. I/We accept that: (a) I/we will be automatically disqualified from bidding for any contract with any procuring entity for a period of two (2) years upon receipt of your Blacklisting Order; and, (b) I/we will pay the applicable fine provided under Section 6 of the Guidelines on the Use of Bid Securing Declaration, if I/we have committed any of the following actions:

(i) Withdrawn my/our Bid during the period of bid validity required in the Bidding Documents; or

(ii) Fail or refuse to accept the award and enter into contract or perform any and all acts necessary to the execution of the Contract, in accordance with the Bidding Documents after having been notified of your acceptance of our Bid during the period of bid validity.

3. I/We understand that this Bid-Securing Declaration shall cease to be valid on the following circumstances:

(a) Upon expiration of the bid validity period, or any extension thereof pursuant to your request;

(b) I am/we are declared ineligible or post-disqualified upon receipt of your notice to such effect, and (i) I/we failed to timely file a request for reconsideration or (ii) I/we filed a waiver to avail of said right;

(c) I am/we are declared as the bidder with the Lowest Calculated and Responsive Bid/Highest Rated and Responsive Bid, and I/we have furnished the performance security and signed the Contract.

IN WITNESS WHEREOF, I/We have hereunto set my/our hand/s this ____ day of [month] [year] at [place of execution].

[Insert NAME OF BIDDER’S

AUTHORIZED REPRESENTATIVE]

[Insert signatory’s legal capacity]

Affiant

SUBSCRIBED AND SWORN to [place of execution], Philippines. Affiant/s is/are personally known to me and was/were identified by me through competent evidence of identity as defined in the 2004 Rules on Notarial Practice (A.M. No. 02-8-13-SC). Affiant/s exhibited to me his/her [insert type of government identification card

Page 18: CAGAYAN DE ORO CITY WATER DISTRICT Bids and Awards ... · The Cagayan de Oro City Water District reserves the right to accept or reject any offer, to annul the negotiation process,

used], with his/her photograph and signature appearing thereon, with no. ______ and his/her Community Tax Certificate No. _______ issued on ______ at ______.

Witness my hand and seal this ___ day of [month] [year].

NAME OF NOTARY PUBLIC Serial No. of Commission ___________ Notary Public for ______ until _______ Roll of Attorneys No. _____ PTR No. __, [date issued], [place Issued] IBP No. __, [date issued], [place issued]

Doc. No. ___

Page No. ___

Book No. ___

Series of ____

Page 19: CAGAYAN DE ORO CITY WATER DISTRICT Bids and Awards ... · The Cagayan de Oro City Water District reserves the right to accept or reject any offer, to annul the negotiation process,

Annex G

Omnibus Sworn Statement

REPUBLIC OF THE PHILIPPINES )

CITY/MUNICIPALITY OF ______ ) S.S.

A F F I D A V I T

I, [Name of Affiant], of legal age, [Civil Status], [Nationality], and residing at [Address of Affiant], after

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

1. Select one, delete the other: If a sole proprietorship: I am the sole proprietor of [Name of Bidder] with office address at [address of

Bidder];

If a partnership, corporation, cooperative, or joint venture: I am the duly authorized and designated

representative of [Name of Bidder] with office address at [address of Bidder];

2. Select one, delete the other: If a sole proprietorship: As the owner and sole proprietor of [Name of Bidder], I have full power and

authority to do, execute and perform any and all acts necessary to represent it in the bidding for [Name

of the Project] of the [Name of the Procuring Entity];

If a partnership, corporation, cooperative, or joint venture: I am granted full power and authority to do,

execute and perform any and all acts necessary and/or to represent the [Name of Bidder] in the bidding

as shown in the attached [state title of attached document showing proof of authorization (e.g., duly

notarized Secretary’s Certificate issued by the corporation or the members of the joint venture)];

3. [Name of Bidder] is not “blacklisted” or barred from bidding by the Government of the Philippines or any of its agencies, offices, corporations, or Local Government Units, foreign government/foreign or international financing institution whose blacklisting rules have been recognized by the Government Procurement Policy Board;

4. Each of the documents submitted in satisfaction of the bidding requirements is an authentic copy of the original, complete, and all statements and information provided therein are true and correct;

5. [Name of Bidder]is authorizing the Head of the Procuring Entity or its duly authorized representative(s) to verify all the documents submitted;

6. Select one, delete the rest: If a sole proprietorship: I am not related to the Head of the Procuring Entity, members of the Bids and

Awards Committee (BAC), the Technical Working Group, and the BAC Secretariat, the head of the

Project Management Office or the end-user unit, and the project consultants by consanguinity or affinity

up to the third civil degree;

If a partnership or cooperative: None of the officers and members of [Name of Bidder] is related to the

Head of the Procuring Entity, members of the Bids and Awards Committee (BAC), the Technical Working

Group, and the BAC Secretariat, the head of the Project Management Office or the end-user unit, and

the project consultants by consanguinity or affinity up to the third civil degree;

If a corporation or joint venture: None of the officers, directors, and controlling stockholders of [Name of

Bidder] is related to the Head of the Procuring Entity, members of the Bids and Awards Committee

(BAC), the Technical Working Group, and the BAC Secretariat, the head of the Project Management

Office or the end-user unit, and the project consultants by consanguinity or affinity up to the third civil

degree;

Page 20: CAGAYAN DE ORO CITY WATER DISTRICT Bids and Awards ... · The Cagayan de Oro City Water District reserves the right to accept or reject any offer, to annul the negotiation process,

7. [Name of Bidder] complies with existing labor laws and standards; and

8. [Name of Bidder] is aware of and has undertaken the following responsibilities as a Bidder: a) Carefully examine all of the Bidding Documents; b) Acknowledge all conditions, local or otherwise, affecting the implementation of the Contract; c) Made an estimate of the facilities available and needed for the contract to be bid, if any; and d) Inquire or secure Supplemental/Bid Bulletin(s) issued for the [Name of the Project].

9. [Name of Bidder] did not give or pay directly or indirectly, any commission, amount, fee, or any form of consideration, pecuniary or otherwise, to any person or official, personnel or representative of the government in relation to any procurement project or activity.

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

_____________________________________

Bidder’s Representative/Authorized Signatory

[JURAT]