AFFIDAVIT

I, JOHNNIE M. UY, of legal age, married, Filipino, and residing at Purok 3, Mabini, Gamu,
Isabela, after having been duly sworn in accordance with law, do hereby depose and state that:

1. I am the sole proprietor of JMU CONSTRUCTION with office address at Purok 3, Mabini,
Gamu, Isabela;
2. As the owner and sole proprietor of JMU CONSTRUCTION I have full power and
authority to do, execute and perform any and all acts necessary to represent it in the
bidding for the Construction and Rehabilitation of Guibang Barangay Health Station
and Day Care Center (additional works);
3. That payment of wages for laborers for the period as stated in the Statement of Work
Accomplished (SWA) of the above-mentioned project has been made;
4. Likewise, payment for materials purchased of the same has also been made;
5. That this affidavit has been made for the purpose of billing and collection for the said
project.

IN WITNESS WHEREOF, I have hereunto set my hand at ____________, Philippines, on

this ____________ day of ___________, 2020.

JOHNNIE M. UY
ID No.:
Issued on:
Issued at:

ACKNOWLEDGEMENT
Republic of the Philippines )
Province of Isabela )
City of Ilagan ) s.s

BEFORE ME, a Notary Public for and in the Province of Isabela, this _________________
at Ilagan, Isabela, personally appeared the party, exhibiting to me competent evidence of his
identity as above- indicated, represented to me that voluntarily affixed his signature on the
foregoing deed and declared that he executed the same as his free voluntary act and deed.

WITNESS MY HAND AND NOTARIAL SEAL.

Doc. No: _________;

Page No.: ________;
Book No.: ________;
Series of 2020.