Section IX. Bidding Forms
CHECKLIST ON INFRASTRUCTURE PROJECT
1
PROJECT
:
CONSTRUCTION OF SEWAGE TREATMENT FACILITY: CONSTRUCTED
WETLANDS
APPROVED BUDGET FOR THE CONTRACT: Php 6,700,000.00
NAME OF BIDDER: _______________________________________
CHECKLIST ON ELIGIBILITY AND TECHNICAL COMPONENTS
1st Envelope shall contain the following eligibility & technical documents
a)
Eligibility Documents –
Class “A” documents:
____ i.
____ ii.
____ iii.
Registration Certificates from SEC, DTI for sole proprietorship (Form 1)
Mayor’s permit from where the business is located. (Form 2)
Statement of all its ongoing & completed government & private contracts within
10 yrs from the submission of bids, including contracts awarded but not started,
If any. (Forms 3a & 3b) Statements shall include for each contract the following;
a.
Name, date & duration of the Contract,
b.
Name and address of the Owner,
c.
Nature of work,
d.
Contractor’s role: sole/subcontractor/partner & percentage of participation
e.
Total contract value at award,
f.
Date of completion or estimated completion time,
g.
Total contract value at completion, if applicable,
h.
Percentage of planned & actual accomplishments, if applicable,
i.
Value of outstanding works, if applicable,
j.
Statement of Notices of Award or NTP from the Owner
k.
Statement of CPES rating, Cert. of Completion & Owner’s Certificate of Final
Acceptance, if any.
Valid PCAB license for the type & cost of the contract for this project. (Form 4)
Latest audited financial statements, stamped received by the BIR. (Form 5)
NFCC computation or CLC in accordance with ITB Clause 5.5. (Form 6 or Form 7)
____ iv.
____ v.
____ vi.
Class “B” document;
____ vii.
b)
If applicable, valid JVA duly notarized. (Form 8)
Technical documents –
_____ i.
Bid Security , either of the following;
____________ Cash, Bank draft/Guarantee or irrevocable letter of credit
(Form 9) = Php_____, or
____________ Surety bond from accredited Insurance Co. (Form 9a)
= Php_________ , or
____________ Bid Securing Declaration (Form 9b)= Php_________
____ ii.
Project Requirements, specifically for the contract to be bid;
____ ii.1
Organizational chart, (Form 10)
2
____ ii.2
List of contractor’s personnel with complete qualification &
experience (Forms 11a, 11 b & 11c)
____ ii.3
List of contractor’s equipment units w/ certificate of
availability. (Form 12)
Sworn statement using the form prescribe in Section IX. Bidding Forms.
(Form 13)
Certificate of Site Inspection (Form 14)
Bid Bulletin, if any.
____ iii.
____ iv.
____v.
REMARKS on the above checklist: (
) Passed
(
) Failed
CHECKLIST ON FINANCIAL COMPONENTS
Note: Unless the checklist on eligibility & technical documents have been complied with
only then the financial documents can be opened and verified.
2nd Envelope shall contain the following financial documents
____ 1.
Bid Form in accordance with the form prescribed in Section IX. BID =
Php_______________ (Form 1)
_____ 2.
_____ 3.
_____ 4.
Duly signed Bid prices in the Bill of Quantities as prescribed in Section VIII. (Form 2)
Duly signed detailed estimate (in support of the Bill of Quantities (Form 3)
Duly signed Monthly Cash Flow & Payment Schedule. (Form 4)
Note: Any missing in the above-mentioned checklist is a ground for outright rejection of the bid.
Remarks on the financial documents: ( ) Passed
( ) Failed
Evaluated by: PSHS-MC BAC & TWG for infrastructure:
LEO ANDREI A. CRISOLOGO
Vice Chairman
VLADIMIR S. LOPEZ
Member
EFREN P. PAZ
ENGR. MARTY F. ABUZO
Member
Member
PAULINE M. REGIDOR
MELANIE J. M. REGALADO
Member
MA. VERONICA S. TORRALBA
Member
REMEDIOS C. CORDOVEZ
Member
ARCH. MARIVIC T. MORATA
Member
ENGR. JONATHAN ANTHONY G. JAVIER
TWG
DR. JOSE M. ANDAYA
Vice Chairman
BAC Chairman
FORM - 1
CERTIFICATE OF REGISTRATION
3
OF
BUSINESS NAME
THIS IS TO CERTIFY THAT
___________________________________________
as a business name, or firm or style was registered in this office on ________________________ by:
____________________________
which will expire on _________________, in accordance with the provisions of Act No. 3883 of the Philippine
Legislature approved on November 14, 1931 as amended by Act No. 4147, approved November 28, 1934, and
Republic Act No. 863, approved June 16, 1953, and in compliance with the rules and regulations prescribed by
the Department of Trade and Industry.
IN TESTIMONY WHEREOF, I have hereunto set my hand caused
the seal of the DEPARTMENT OF TRADE AND INDUSTRY to be
affixed at ___________________, Philippines, this _______ day of
________________, in the year of our Lord, ____________.
Logo of DTI
(Name of the Director)
AFFIX
Director, DTI
DOCUMENTARY
STAMP
NOTE: THIS IS NOT A LICENSE TO ENGAGE IN ANY KIND OF BUSINESS.
(VALID ONLY AT THE BUSINESS ADDRESS INDICATED HEREIN)
Note: Each Bidder or each member of a JV must fill this form.
4
[SAMPLE FORM]
FORM 2 - PAHINTULOT SA PANGANGALAKAL
(BUSINESS PERMIT)
MATALASTAS NG LAHAT:
(KNOW ALL MEN BY THESE PRESENTS:)
Na Si/Ang:
(That:) _________________________(Name of Bidder)______________________________
na matatagpuan at may pahatirang sulat sa
(with postal address at)
_____________________________(Address of the Bidder)___________________________
na itinatag ng may buong karapatan at umiiral sa ilalim ng mga batas ng
(duly organized and existing under the laws of the)
Republika ng Pilipinas, ay pinagkakalooban ng pahintulot na mangangalakal bilang
(Republic of the Philippines, is hereby granted the permit to operate as)
_____________________________________
ngayong ika - _______________________
(on this)
ng
_____________________
(day of)
Ang pahintulot na ito ay matatapos sa ika- __________________________
(This permit expires on)
Malibang ito’y maagang bawiin at walaing bisa.
(unless sooner revoked.)
O.R. BILANG
(OR No.)
__________
HALAGA
(Amount)
__________
PETSA
(Date)
__________
(Name of Head)
Business Permit Office
(Name of Mayor)
Punong Lungsod
(Mayor)
ITO AY DAPAT IPASKEL SA HAYAG NA POOK NG KALAKALAN AT DAPAT
(This must be posted on conspicuous place and)
IPAKITA SA SANDALING HINGIN NG MGA KINAUUKULANG MAYKAPANGYARIHAN.
(to be presented upon demand by proper authorities.)
Note: Each Bidder or each member of a JV must fill this form.
5
FORM 3a - STATEMENT OF ALL COMPLETED GOVERNMENT & PRIVATE CONSTRUCTION CONTRACTS
WHICH ARE SIMILAR IN NATURE FOR THE LAST TEN (10) YEARS
Business Name
: ___________________________________________________
Name of Contract
a.
b.
c.
Owner Name
Address
Telephone Nos.
Contractor’s Role
Nature of Work
Government
Private
Note: This statement shall be supported with:
1 Contract
2 CPES rating sheets and/or Certificate of Completion
3 Owner’s Certificate of Final Acceptance
Submitted by
: ___________________________________________________
Designation
Date
: ___________________________________________________
: ___________________________________________________
(Printed Name & Signature)
6
Description
%
a. Amount at Award
b. Amount at
Completion
c. Duration
a. Date Awarded
b. Contract Effectivity
c. Date Completed
FORM 3b - LIST OF ALL ONGOING GOVERNMENT & PRIVATE CONSTRUCTION CONTRACTS INCLUDING
CONTRACTS AWARDED BUT NOT YET STARTED
Business Name
: ___________________________________________________
Name of Contract/Location
Project Cost
a.
b.
c.
Owner Name
Address
Telephone Nos.
Contractor’s Role
Nature of Work
Description
%
a.
b.
c.
Date Awarded
Date Started
Date of Completion
% of Accomplishment
Planned
Government
Private
Note: This statement shall be supported with:
1 Notice of Award and/or Contract
2 Notice to Proceed issued by the owner
3 Certificate of Accomplishments signed by the owner or Project Engineer
Submitted by
: ___________________________________________________
Designation
Date
: ___________________________________________________
: ___________________________________________________
Total Cost
(Printed Name & Signature)
7
Actual
Value of
Outstanding
Works
[SAMPLE FORM]
FORM 4 - CONTRACTOR’S LICENSE
CONTRACTOR’S PARTICULARS
This certifies that
Authorized Managing Officer (name and signature)
Sole Proprietorship/Partnership/Corporation
NOT VALID
w/o
SIGNATURE
Head Officer Location (Region)
Taxpayer Identification Number (TIN)
LICENSE PARTICULARS
License First Issue Date and Number
No.
having complied with all the requirements for
licensure in accordance with Republic Act No.
4566, as amended, and its implementing rules
and regulations, is hereby authorized to engage
in the construction contracting business in the
Philippines, subject to limitations of license
validity period, classification and category as
prescribed under License Particulars in the box
to the right hereof and to the terms and
conditions annotated at the back hereof.
This further certifies that said licensee, subject
to the limitations of the above-prescribed license
validity period and registration validity period,
kind/s of project and size range/s as indicated
under Registration Particulars in the box to the
right hereof, is a PCAB registered contractor for
government projects.
Validity Period of this License/Renewal
to
Principal Classification and Category
Other Classification/s
REGISTRATION PARTICULARS
Registration Date and Number
No.
Validity Period of this Registration
to
Kinds of Project and Respective Size Ranges
Given at Metro Manila, Philippines, on
FOR THE BOARD:
________________
Officer-in-Charge
________________
Board Secretary
FORM _____________
IMPORTANT NOTICE: Filing schedule for license renewal application - <Insert Date> .
One of the legal requirements to be in the Technical Envelope of the prospective bidder is its valid PCAB
license and registration for the type and cost of contract to be bid. In the case of joint ventures, the
PCAB license should be that of the JV, not of its individual partners.
8
FORM 5 – AUDITED FINANCIAL STATEMENT (STAMPED “RECEIVED” BY
THE BIR OR ITS DULY ACCREDITED AUTHORIZED
INSTITUTIONS
AS ATTACHMENT
(Audited Financial Statement for the immediately preceding year which shall not be earlier than
two (2) years from the date of bid submission, showing among others the total assets and
liabilities)
Note: Each Bidder or each member of a JV must submit this requirement.
9
FORM 6 - COMPUTATION OF NET FINANCIAL CONTRACTING
CAPACITY (NFCC)
A. Summary of the Firm’s/Contractor’s assets and liabilities on the basis of the attached copy of
audited financial statement, stamped “RECEIVED” by the Bureau of Internal Revenue or BIR
authorized collecting agent, for the immediately preceding year and a certified copy of
Schedule of Fixed Assets particularly the list of construction equipment.
Year 20__
1.
2.
3.
4.
5.
6.
Total Assets
Current Assets
Total Liabilities
Current Liabilities
Total Net Worth (1-3)
Current Net Worth or Net Working
Capital (2-4)
B. The Net Financial Contracting Capacity (NFCC) based on the above data is computed as
follows:
NFCC = K (current asset – current liabilities) minus value of all outstanding contracts
including those awarded contracts but not yet started
NFCC = P _______________________________________
K = 10 for a contract duration of one year or less.
Submitted by:
________________________________________
Name of Firm / Contractor
_________________________________________
Signature of Authorized Representative
Date : _____________________________
NOTE:
1. If Partnership or Joint Venture, each Partner or Member Firm of Joint Venture shall submit the
above requirements.
10
FORM 7 - CREDIT LINE CERTIFICATE
Date:__________________
Name of the Head of the Procuring Entity
Name of the Procuring Entity
Address of the Procuring Entity
CONTRACT NAME
: ______________________________
COMPANY/FIRM
ADDRESS
:_______________________________
:_______________________________
________________________________
BANK/FINANCING INSTITUTION
ADDRESS
:_______________________________
:_______________________________
________________________________
AMOUNT
:_______________________________
This is to certify that the above Bank/Financing Institution with business address indicated
above, commits to provide the Contractor, if awarded the above-mentioned Contract, a credit line
in the amount specified above which shall be exclusively used to finance the performance of the
above-mentioned Contract, subject to our terms, conditions and requirements.
The credit line shall be available within three (3) calendar days after receipt by the
Contractor of the Notice of Award but not later than the signing of the Contract and such line of
credit shall be maintained until the project is completed by the Contractor.
This Certification is being issued in favor of said Contractor in connection with the bidding
requirement of the Philippine Science High School-Main Campus for the above-mentioned
Contract. We are aware that any false statements issued by us make us liable for perjury.
Name and Signature of Authorized
Financing Institution Officer
Official Designation
: _______________________
: _______________________
Concurred By:
Name & Signature of Contractor’s
Authorized Representative
Official Designation
Note:
The amount committed should be machine validated.
11
: _______________________
: _______________________
Form 7 (Continuation)
ACKNOWLEDGMENT
SUBSCRIBED AND SWORN TO before me this _________, day of ______ 20
, affiant exhibiting to me
his/her [Community Tax Certificate/Any valid/current Government ID/Passport] No. __________________
issued on ______________ at ______________________, Philippines.
Notary Public
Until 31 December 20____
PTR No._______________
Issued at:_______________
Issued on:_______________
TIN No. ________________
Doc. No. _______
Page No. _______
Book No. _______
Series of _______.
12
FORM 8 - JOINT VENTURE AGREEMENT
KNOW ALL MEN BY THESE PRESENTS:
That this JOINT VENTURE AGREEMENT is entered into by and between: ___________, of legal
age, __(civil status)__, owner/proprietor of _________________________ and a resident of
________________________.
- and _______________________, of legal age, __(civil status)__, owner/proprietor
____________________ a resident of ____________________________________.
of
That both parties agree to join together their capital, manpower, equipment, and other resources
and efforts to enable the Joint Venture to participate in the Bidding and Undertaking of the
hereunder stated Contract of the Philippine Science High School- Main Campus.
NAME OF PROJECT
CONTRACT AMOUNT
That both parties agree to be jointly and severally liable for their participation in the Bidding and
Undertaking of the said contract.
That both parties agree that ___________________ and/or __________________ shall be the
Official Representative of the Joint Venture, and are granted full power and authority to do,
execute and perform any and all acts necessary and/or to represent the Joint Venture in the
Bidding and Undertaking of the said contract, as fully and effectively and the Joint Venture may do
and if personally present with full power of substitution and revocation.
That this Joint Venture Agreement shall remain in effect only for the above stated Contracts until
terminated by both parties.
Done this _____ day of ______, in the year of our Lord _____.
13
FORM 9 – FORM OF BID SECURITY (BANK GUARANTEE)
WHEREAS, __(Name of Bidder)__ (hereinafter called “the Bidder”) has submitted his bid dated
__(Date)__ for the __(Name of Contract)__ (hereinafter called “the Bid”).
KNOW ALL MEN by these presents that We __(Name of Bank)__ of __(Name of Country)__
having our registered office at ________________________ (hereinafter called “the Bank” are
bound unto __(Name of Procuring Entity)__ (hereinafter called “the Entity”) in the sum of
_______________1 for which payment well and truly to be made to the said Entity the Bank binds
himself, his successors and assigns by these presents.
SEALED with the Common Seal of the said Bank this _____ day of _________ 20___.
THE CONDITIONS of this obligation are that:
if the Bidder withdraws his Bid during the period of bid validity specified in the Form of Bid; or
if the Bidder does not accept the correction of arithmetical errors of his bid price in accordance
with the Instructions to Bidder; or
if the Bidder having been notified of the acceptance of his bid and award of contract to him by the
Entity during the period of bid validity:
(a)
fails or refuses to execute the Form of Contract in accordance with the Instructions to
Bidders, if required; or
fails or refuses to furnish the Performance Security in accordance with the Instructions to Bidders;
we undertake to pay to the Entity up to the above amount upon receipt of his first written demand,
without the Entity having to substantiate its demand, provided that in his demand the Entity will
note that the amount claimed by it is due to the occurrence of any one or combination of the three
(3) conditions stated above.
The Guarantee will remain in force up to and including the date _______________2 days after the
deadline for submission of Bids as such deadline is stated in the Instructions to Bidders or as it
may be extended by the Entity, notice of which extension(s) to the Bank is hereby waived. Any
demand in respect of this Guarantee should reach the Bank not later than the above date.
DATE __________________
SIGNATURE OF THE BANK ______________________
WITNESS ____________________________ SEAL _________________________________
_____________________________________
(Signature, Name and Address)
1 The bidder should insert the amount of the guarantee in words and figures, denominated in the currency of the Entity’s
country. This figure should be the same as shown of the Instructions to Bidders.
2 Usually 28 days after the end of the validity period of the Bid. Date should be inserted by the Entity before the bidding
documents are issued.
14
FORM 9a - BID SECURITY: GSIS BOND
Republic of the Philippines
GOVERNMENT SERVICE INSURANCE SYSTEM
GENERAL INSURNCE FUND
GSIS Makati Building, Legaspi St.
Legaspi Village, Makati, Metro Manila
G ( ) GIF Bond _____
KNOW ALL MEN BY THESE PRESENTS:
That we, ____________(Name of Bidder)____________ represented by its
________________________________, as PRINCIPAL, and the GOVERNMENT SERVICE INSURANCE
SYSTEM as Administrator of the General Insurance Fund, a corporation duly organized and existing under
and by virtue of the laws of the Philippines, with head office at Manila, as SURETY, are held and firmly bound
unto the OBLIGEE, _____(Name of Procuring Entity)_____ in the sum of PESOS ________________
(Php_________), callable on demand, Philippine Currency, for the payment of which sum well and truly to be
made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally,
firmly by these presents.
WHEREAS, the above bonded PRINCIPAL will submit a bid for the ____(Name of the
Contract)_____ on the _______ day of ________, 20 ______ at _______am/pm.
WHEREAS, the conditions of aforementioned OBLIGEE require the BIDDER a bond for the said bid.
WHEREAS, the PRINCIPAL agrees to comply with all the terms and conditions of the said bid with
the aforementioned OBLIGEE;
NOW, THEREFORE, the conditions of this obligation are that:
1)
if the Principal withdraws his Bid during the period of bid validity specified in the Form of
Bid; or
2)
if the Principal does not accept the correction of arithmetical errors of his bid price in
accordance with the Instruction’s to Bidders: or
3)
if the Principal having been notified of the acceptance of his Bid and award of contract to
him by the Entity during the period of bid validity:
a)
fails or refuses to execute the Form of Contract in accordance with the
Instructions to Bidders, if required; or
b)
fails or refuses to furnish the Performance Security in accordance with the
Instructions to Bidders;
then the Entity shall call on the bond upon a written demand to the Surety, and the Surety shall pay the
Entity up to (_______________) amount of the Bond, upon receipt by the Surety of a written demand from
the Entity, without the Entity having to substantiate its demand, provided that in the demand, the Entity will
note that the sum claimed by it is due to the occurrence of any or combination of the three conditions stated
above. In this case, this obligation shall remain in full force and effect, otherwise it shall be null and void.
15
FORM 9a (Continuation)
PROVIDED HOWEVER, that the Surety shall not be:
a)
liable for a greater sum than the specified penalty of this bond, nor
b)
liable for a greater sum that the difference between the amount of the said
Principal’s Bid and the amount of the Bid that is accepted by the Entity.
WITNESS OUR HANDS AND
_____________________, Philippines.
SEALS
this
_______
day
of
_______,
20
_____,
at
GOVERNMENT SERVICE INSURANCE SYSTEM
General Insurance Fund
Principal
By:
By:
____________________
____________________
NOT VALID WITH ERASURES
SIGNED IN THE PRESENCE OF:
____________________
____________________
____________________
____________________
16
FORM 9b - BID SECURING DECLARATION
REPUBLIC
OF
THE
PHILIPPINES
CITY OF __________________________ ) S.S.
)
BID SECURING DECLARATION
Invitation to Bid/Request for Expression of Interest No.1: [Insert reference
number]
To: [Insert name and address of the Procuring Entity]
I/We2, 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 Declaration3, 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 Bid4, and I/we have furnished the performance
security and signed the Contract.
_____________________________
1
Select one and delete the other.
Select one and delete the other. Adopt same instruction for similar terms throughout the
document.
3 Issued by the GPPB through GPPB Resolution 03-2012 on 27 January 2012.
4 Select one and delete the other.
2
17
(FORM 9b Continuation)
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 before me this __ day of [month] [year] at [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
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 ____.
18
FORM 10 -CONTRACTOR’S ORGANIZATIONAL CHART FOR THE
CONTRACT
Submit Copy of the Organizational Chart that the Contractor intends to use to execute the Contract
if awarded to him to include in the chart, among others, the names of the required proposed Key
Personnel as indicated in ITB Clause 12.1(b) (ii.2) and other Key Engineering Personnel.
Attach the required Proposed Organizational Chart
for the Contract as stated above
Note: This organization chart should represent the “Contractor’s Organization” required for the Project, and not
the organizational chart of the entire firm.
19
FORM 11a - QUALIFICATION OF KEY PERSONNEL PROPOSED TO BE ASSIGNED TO THE CONTRACT
Business Name
Business Address
Project Manager
(Licensed Civil Engineer)
1
Name
2
Address
3
Date of Birth
4
Employed Since
5
Experience
6
Previous Employment
7
Education
8
PRC License
Project Engineer (Licensed
Sanitary Engineer)
Note:
Submitted by:
Designation
Date
20
Materials
Engineer I
Safety Engineer (Certified)
FORM 11b - KEY PERSONNEL
(FORMAT OF BIO-DATA)
Give the detailed information of the following personnel who are scheduled to be assigned as full-time field staff
for the project. Fill up a form for each person.
-
Authorized Managing Officer / Representative
Sustained Technical Employee
1.
Name
:
____________________________________________
2.
(2)
:
____________________________________________
3.
Nationality
:
____________________________________________
4.
Education and Degrees
:
____________________________________________
5.
Specialty
:
____________________________________________
6.
Registration
:
____________________________________________
7.
Length of Service with the Firm
:
_____
8.
Years of Experience
:
9.
If Item 7 is less than ten (10) years, give name and length of service with previous employers for a ten
(10)-year period (attached additional sheet/s), if necessary:
Date of Birth
Year from
____ (months) _____ (year)
To
____ (months) _____ (year)
____________________________________________
Name and Address of Employer
Length of Service
_________________________
_________________________
_________________________
10.
_____
_____
_____
year(s) from
year(s) from
year(s) from
_______ to ______
_______ to ______
_______ to ______
Experience:
This should cover the past ten (10) years of experience. (Attached as many pages as necessary to
show involvement of personnel in projects using the format below).
1.
2.
1.
2.
Name
Name and Address of Owner
Name and Address of the
Owner’s Engineer
(Consultant)
Indicate the Features of Project
(particulars of the project
components and any other particular
interest connected with the project)
:
____________________________________________
:
____________________________________________
:
____________________________________________
:
___________________________________________
21
FORM 11b (Continuation)
3.
Contract Amount Expressed in
Philippine Currency
:
____________________________________________
4.
Position
:
____________________________________________
5.
Structures for which the employee
was responsible
:
____________________________________________
:
:
from
to
6.
Assignment Period
_______ (months)
_______ (months)
_______ (years)
_______ (years)
___________________________
Name and Signature of Employee
It is hereby certified that the above personnel can be assigned to this project, if the contract is awarded to our
company.
___________________________________
(Place and Date)
____________________________________
(The Authorized Representative)
22
Form 11c - KEY PERSONNEL’S CERTIFICATE OF EMPLOYMENT
Issuance Date
Name of the Head of the Procuring Entity
Position of the Head of the Procuring Entity
Name of the Procuring Entity
Address of the Procuring Entity
Dear Sir / Madame:
I am __(Name of Nominee)_____ a Licensed _____ Engineer with Professional/Registered License
No. ______________ issued on __(date of issuance)__ at __(place of issuance)__.
I hereby certify that ___(Name of Bidder) has engaged my services as (Designation) for (Name of the
Contract), if awarded to it.
As ___(Designation)___, I supervised the following completed projects similar to the contract under
bidding):
NAME OF PROJECT
OWNER
COST
DATE COMPLETED
___________________
___________________
___________________
___________________
____________
____________
____________
____________
________
________
________
________
________________
________________
________________
________________
At present, I am supervising the following projects:
NAME OF PROJECT
OWNER
COST
DATE COMPLETED
___________________
___________________
___________________
___________________
____________
____________
____________
____________
________
________
________
________
________________
________________
________________
________________
In case of my separation for any reason whatsoever from the above-mentioned Contractor, I shall notify
the __(Name of the Procuring Entity)__ at least twenty one (21) days before the effective date of my separation.
As __(Designation)__, I know I will have to stay in the job site all the time to supervise and manage the
Contract works to the best of my ability, and aware that I am authorized to handle only one (1) contract at a time.
I do not allow the use of my name for the purpose of enabling the above-mentioned Contractor to qualify
for the Contract without any firm commitment on my part to assume the post of __(Designation)__ therefor, if the
contract is awarded to him since I understand that to do so will be a sufficient ground for my disqualification as
__(Designation)__ in any future __(Name of the Procuring Entity)__ bidding or employment with any Contractor
doing business with the __(Name of the Procuring Entity)__.
_____________________________
(Signature of Engineer)
DRY SEAL
23
FORM 11c (Continuation)
Republic of the Philippines )
____________________ )
S.S.
SUBSCRIBED AND SWORN TO before me this _________, day of ______ 200_, affiant exhibiting to me his/her
[Community Tax Certificate/Any valid/current Government ID/Passport] No. __________________ issued on
______________ at ______________________, Philippines.
Notary Public
Until December 31, 20___
Doc. No. ________;
Page No. ________;
Book No. ________;
Series of _________;
24
FORM 12 - LIST OF CONTRACTOR’S EQUIPMENT, OWNED OR LEASED AND/OR UNDER PURCHASE AGREEMENTS,
PLEDGED TO THE PROPOSED CONTRACT
Business Name
Business Address
: ___________________________________________________
: ___________________________________________________
___________________________________________________
Description
Model/Year
Capacity /
Performance /
Size
Plate No.
A. Owned
i.
ii.
iii.
iv.
v.
B. Leased
i.
ii.
iii.
iv.
v.
C. Under Purchase Agreements
i.
ii.
iii.
iv.
v.
List of minimum equipment required for the project:
Submitted by
Designation
Date
: ___________________________________________________
(Printed Name & Signature)
: ___________________________________________________
: ___________________________________________________
25
Motor No. /
Body No.
Location
Condition
Proof of Ownership
/ Lessor or Vendor
FORM 13 – OMNIBUS SWORN STATEMENT
REPUBLIC OF THE PHILIPPINES
CITY/MUNICIPALITY OF ______
)
) S.S.
AFFIDAVIT
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;
26
FORM 13c (Continuation)
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;
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].
IN WITNESS WHEREOF, I have hereunto set my hand this __ day of ___, 20__ at
____________, Philippines.
_____________________________________
Bidder’s Representative/Authorized Signatory
[JURAT]
27
FORM 14- CERTIFICATE OF SITE INSPECTION
Republic of the Philippines
Department of Science and Technology
PHILIPPINE SCIENCE HIGH SCHOOL MAIN CAMPUS
Agham Road, Diliman, Quezon City
CERTIFICATE OF SITE INSPECTION
PROJECT
:
CONSTRUTION OF SEWAGE TREATMENT FACILITY/
CONSTRUCTED WETLANDS
ABC
:
Php 6.7M
LOCATION
:
PSHS-MC, Agham Rd. Diliman, Q.C.
This
is
to certify that
______________________________________with
its
authorized representative, has inspected the location of the above-mentioned project on
_____________ at ____________ and therefore familiarize itself from the details of the work
to be undertaken in order to provide a reasonable & competitive bid.
________________________
Name & signature of
Contractor’s representative
Certified by:
ENGR. MALVAR I. PALIZA
Engineer IV
28
FINANCIAL FORM
FORM 1 - BID FORM
Date: ______________________
TO:
_________________________
_________________________
______________________
We, the undersigned, declare that:
(a) We have examined and have no reservation to the Bidding Documents, including Addenda, for
the Contract on the (PROJECT);
(b) We offer to execute the Works for this Contract in accordance with the Bid and Bid Data Sheet,
General and Special Conditions of Contract accompanying this Bid;
The total price of our Bid, excluding any discounts offered in item (d) below is: [insert
information];
The discounts offered and the methodology for their application are: [insert information];
(c) Our Bid shall be valid for a period of [insert number] days from the date fixed for the Bid
submission deadline in accordance with the Bidding Documents, and it shall remain binding upon
us and may be accepted at any time before the expiration of that period;
(d) If our Bid is accepted, we commit to obtain a Performance Security in the amount of [insert
percentage amount] percent of the Contract Price for the due performance of the Contract;
(e) We are not participating, as Bidders, in more than one Bid in this bidding process, other than
alternative offers in accordance with the Bidding Documents;
(f)
Our firm, its affiliates or subsidiaries, including any subcontractors or suppliers for any part of the
Contract, has not been declared ineligible by the Philippine Science High School Main Campus;
(g) We understand that this Bid, together with your written acceptance thereof included in your
notification of award, shall constitute a binding contract between us, until a formal Contract is
prepared and executed; and
We understand that you are not bound to accept the Lowest Evaluated Bid or any other Bid that you
may receive.
Name:
In the capacity of:
Signed:
Duly authorized to sign the Bid for and on behalf of:
Date: __________________________________
29
FORM 1 (Continuation)
ACKNOWLEDGMENT
SUBSCRIBED AND SWORN TO before me this _________, day of ______ 20 , affiant exhibiting to
me his/her [Community Tax Certificate/Any valid/current Government ID/Passport] No.
__________________ issued on ______________ at ______________________, Philippines.
Notary Public
Until 31 December 20____
PTR No._______________
Issued at:_______________
Issued on:_______________
TIN No. ________________
Doc. No. _______
Page No. _______
Book No. _______
Series of _______.
30
FINANCIAL FORM
FORM 2 – BID PRICES IN THE BILL OF QUANTITIES
(see attached Bill of Quantities after the Preamble)
31
PREAMBLE
1.
The Bid Form shall be read in conjunction with the General conditions, Special
Conditions of Contract, Technical Specifications, Contract Drawings and all other
related documents.
2.
The Works to be performed are described in the Contract Documents and shown on
the Contract Drawings. The Bid Form prices are a breakdown of the total value of
the works for the convenience of payment. The Contractor shall allow in the bid
prices for all the work of this Contract, whether specifically indicated in the Bid Form
or not.
3.
Payment made for each individual item of the Bid Form shall be the full and complete
compensation for all work related to the item, whether specifically stated, implied or
otherwise inferred elsewhere in the Contract Documents.
4.
All quantities included against the items in the Bid of Quantities are liable to
adjustment to actual measured quantities of work as ordered and approved by the
Engineer with the concurrence of the Philippine Science High School Main Campus.
Payment shall be made on the basis of field measured quantities at unit prices.
There will be no change in the unit prices due to a variation of actual measured
quantities from those indicated in the Bill of Quantities at the time of the bidding
except as provided for in Clause 48 – Price Adjustment of the General Conditions.
5.
No payment shall be made for any addition to the items and prices of the Bill of
Quantities, except for the work specifically ordered by the Engineer and to be paid for
as Extra Work under Clause 43 – Variation Orders of the General Conditions.
32
PHILIPPINE SCIENCE HIGH SCHOOL - MAIN CAMPUS
SAMPLE FORM
Agham Road, Diliman, Quezon City
PROJECT: CONSTRUCTION OF SEWAGE TREATMENT FACILITY/CONSTRUCTED WETLANDS
NAME OF CONTRACTOR: _________________________________________
FORM 3 - DETAILED COST ESTIMATES
1. ITEM NO.
2. ITEM NAME/DESCRIPTION
3. TOTAL QUANTITY AND UNIT
4. SEQUENCE OF OPERATION/ACTIVITIES
M
A
T
E
R
I
A
L
S
PRICE NO.
NAME/DESCRIPTION OF MATERIALS
UNIT
QUANTITY
UNIT COST
DESIGNATION/DESCRIPTION OF PERSONNEL
UNIT
NO. OF
HOURS
UNIT RATE (hourly)
NAME/DESCRIPTION OF EQUIPMENT
UNIT
NO. OF
HOURS
UNIT RATE (hourly)
AMOUNT
5. DIRECT MATERIALS COST
L
A
B
O
R
REF. NO.
AMOUNT
6. DIRECT LABOR COST
E
Q
U
I
P
M
E
N
T
REF. NO.
AMOUNT
7. DIRECT EQUIPMENT COST
WORK DAYS TO COMPLETE ITEM 3
8. ESTIMATED DIRECT COST (EDC) = (5 + 6 + 7 )
9. OVERHEAD CONTINGENCIES MISC.(OCM),
PROFIT =__ % of EDC
10. VAT (12% x [8 + 9])
AVERAGE OUTPUT/WORKDAY
TOTAL COST (8 + 9 + 10)
UNIT COST
Signature and Official Stamp of Bidder: _______________________________________________________ Date: __________________________
33
FINANCIAL FORM
Contract Name: ________________________________________________________
Location
:
_______________________________________________________
FORM 3 – MONTHLY CASH FLOW AND PAYMENT SCHEDULE
PARTICULAR
% WT.
1
2
ACCOMPLISHMENT
CASH FLOW
CUMULATIVE ACCOMPLISHMENT
CUMULATIVE CASH FLOW
Submitted by:
Name of the Representative of the Bidder
Position
Name of the Bidder
Date: _______________
3
4
Annexes – List of Contract Forms
Annex 1 - Form of Contract Agreement
THIS AGREEMENT, made this [insert date] day of [insert month], [insert year] between [name
and address of PROCURING ENTITY] (hereinafter called the “Entity”) and [name and address of
Contractor] (hereinafter called the “Contractor”).
WHEREAS, the Entity is desirous that the Contractor execute [name of contract] (hereinafter
called “the Works”) and the Entity has accepted the Bid for [insert the amount in specified currency in
numbers and words] by the Contractor for the execution and completion of such Works and the
remedying of any defects therein.
NOW THIS AGREEMENT WITNESSETH AS FOLLOWS:
1.
In this Agreement, words and expressions shall have the same meanings as are
respectively assigned to them in the Conditions of Contract hereinafter referred to.
2.
The following documents shall be attached, deemed to form, and be read and
construed as part of this Agreement, to wit:
(a)
General and Special Conditions of Contract;
(b)
Drawings/Plans;
(c)
Specifications;
(d)
Invitation to Bid;
(e)
Instructions to Bidders;
(f)
Bid Data Sheet;
(g)
Addendum and/or Supplemental/Bid Bulletins, if any;
(h)
Bid form, including all the documents/statements contained in the Bidder’s
bidding envelopes, as annexes;
(i)
Technical requirements, documents and/or statements;
(j)
Detailed Cost Estimates/Unit Price Analysis (UPA) including Summary Sheet
indicating unit prices for construction materials, labor rates and equipment
rentals consisting of 3 sheets (a. Material Canvass List, b. Computation of
Labor Rates and c. Hourly Equipment/Plant Rental Rates)
(k)
Performance Security;
(l)
Credit line issued by a licensed bank, if any;
(m)
Notice of Award of Contract and the Bidder’s conforme thereto;
(n)
Construction Schedule and S-Curve
(o)
Manpower Schedule
(p)
Construction methods
(q)
Equipment Utilization Schedule
(r)
Construction Safety and health Program approved by the Department of
Labor and Employment
(s)
PERT/CPM
(t)
Other contract documents that may be required by existing laws and/or the
Entity.
3.
In consideration of the payments to be made by the Entity to the Contractor as
hereinafter mentioned, the Contractor hereby covenants with the Entity to execute
and complete the Works and remedy any defects therein in conformity with the
provisions of this Contract in all respects.
4.
The Entity hereby covenants to pay the Contractor in consideration of the execution
and completion of the Works and the remedying of defects wherein, the Contract
Price or such other sum as may become payable under the provisions of this
Contract at the times and in the manner prescribed by this Contract.
IN WITNESS whereof the parties thereto have caused this Agreement to be executed the day
and year first before written.
Signed, sealed, delivered by
the
(for the Entity)
Signed, sealed, delivered by
the
(for the Contractor)
Binding Signature of PROCURING ENTITY
________________________________________________
Binding Signature of Contractor
_____________________________________________
[Addendum showing the corrections, if any, made during the Bid evaluation should be attached with this
agreement]
Annex 2 – Performance Security (Bank Guarantee)
To
:
_____________(Name of Procuring Entity)_____________
_____________(Address of Procuring Entity)____________
WHEREAS, _________(Name and Address of Contractor)_______ (hereinafter called “the
Contractor”) has undertaken to enter into a contract with you to execute __(Contract Name)_
(hereinafter called “the Contract”);
AND WHEREAS, it has been stipulated by you in the said Contract that the Contractor shall
furnish you with a Bank Guarantee by a recognized bank for the sum specified therein as security for
compliance with his obligations in accordance with the Contract;
AND WHEREAS, we have agreed to give the Contractor such a Bank Guarantee;
NOW THEREFORE, we hereby affirm that we are the Guarantor and responsible to you, on
behalf of the Contractor, up to a total of [Amount of Guarantee] proportions of currencies in which the
Contract Price is payable, and we undertake to pay you, upon your first written demand and without
cavil or argument, any sum or sums within the limits of [Amount of Guarantee] as aforesaid without
your needing to prove or to show grounds or reasons for your demand for the sum specified therein.
We hereby waive the necessity of your demanding the said debt from the Contractor before
presenting us with the demand.
We further agree that no change or addition to or other modification of the terms of the
Contract to be performed thereunder or of any of the Contract documents which may be made
between you and the Contractor shall in any way release us from any liability under this guarantee,
and we hereby waive notice of any such change, addition or modification.
This guarantee shall be valid until the date of issue of the Defects of Liability Certificate.
SIGNATURE AND SEAL OF THE GUARANTOR _________________________________
NAME OF BANK
_________________________________
ADDRESS
_________________________________
DATE
_________________________________