application form for the renewal of certificate

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Department of Public Works and Highways
ACCREDITATION OF CONTRACTORS’/CONSULTANTS’
MATERIALS ENGINEERS
APPLICATION FORM FOR THE RENEWAL OF CERTIFICATE
AND REINSTATEMENT OF ACCREDITATION
Materials Engineer II
2" x 2" Photo
Materials Engineer I
Accreditation Number
Name
(Last)
PRC License Number
:
Home Address
:
Mailing Address
:
Office Name
:
Office Address
:
Position Title
:
Home Tel. No.
:
Nationality
:
(First)
(Middle)
Valid Until
Office Tel. No.
Birthday
Mobile No.
Sex
Civil Status
I certify to the correctness of the foregoing.
_________________________________
Signature over printed name
____________________________
Date
Requirements for the Renewal of Certificate of Accreditation of Contractors’ and
Consultants’ Materials Engineers after Three (3) Years from the Date it was Issued, and
the Reinstatement of Accreditation of Previous Government Materials Engineers
The following documents shall be submitted to:
The Chairman
Accreditation Committee for the Contractors’ and Consultants’ Materials Engineers
Attention:
1.
The Director
Bureau of Quality and Safety
DPWH, Bonifacio Drive, Port Area, Manila
For Renewal of Certificate of Accreditation*
b. Request letter of the concerned Materials Engineer signifying intention to renew his
certificate of accreditation.
c. Original/Renewed Certificate of Accreditation.
d. A duly signed Certification of Employment from the current employer, if there is
any, indicating the date of employment and/or
e. Affidavit attesting that the applicant is not connected/involved or employed with any
government office.
f. Copy of the latest PRC ID and accreditation card as Materials Engineer.
g. Duly accomplished application form for the renewal of certificate.
*The Certificate of Accreditation, which is given to all accredited materials engineers,
unless revoked or suspended for cause, shall be valid for three (3) years from the date
it was issued, and shall be renewed thereafter. The certificate can be renewed, upon
submission of the required documents, subject to the evaluation and approval of the
Accreditation Committee.
2.
For Reinstatement of Accreditation as Materials Engineer**
a. Request letter of the concerned Materials Engineer signifying intention to reinstate
his accreditation as Materials Engineer.
b. Original/Renewed Certificate of Accreditation.
c. A duly signed Certification of Separation (resignation or retirement) indicating date
of separation signed by the Head of Office or Administrative Officer of his previous
government office.
d. Certification of Employment from the current employer, if there is any, indicating
the date of employment.
e. Copy of the latest PRC ID and accreditation card as Materials Engineer.
f. Duly accomplished application form for the reinstatement of accreditation.
**The accreditation previously issued to all DPWH and other government Materials
Engineers which was revoked under D.O. No. 60, series of 2003, can be
reinstated, upon submission of the required documents, subject to the evaluation
and approval of the Accreditation Committee
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