‘Contract 1D:
Contract Name:
Location of the Contract:
Department oF Public Works and Highways
PRELIMINARY EXAMINATION OF TECHNICAL COMPONENT OF THE BID
Date of Submission/Opening of Bids:
Name of Contractor:
‘Approved Budget for the Contract (ABC):
Total Amount of Bid:
Implementing Unt
Imerter
—
Iserer
lac Cmurpersen
[Fab. Ko.
-T. PhIGEPS Certificate of Registration and Membership
2, 2 Submit the following Class A and 8 Documents not covered by PhIGEPS
- Certificate
<2) SCAB License and Registration
--Q) Statement of All Ongoing Government and Private Projects
43) SLCC
(4) NECC Computation and Statement of Total Assets and Liabilities
45) VA, i applicable
If enrolled in CWR: Class A and B Documents in CWR, any, to be updated.
|B. {Bid Security in the, ———
a.| [Acceptable [cash, Cashier's Check, |Bank OratGuarantee, [Surety Band callable upon
|Forms: |Manager’s Check, [or Irrevocable Letter of /demand issued by @ surety
issued by 2 Universal [Crt sued bya or ingurance company uly
or commer Bark. (2% weal nme eer by the Insurance
Jor asc) pane i esved OY Icammssion as authorized to}
lor autenveats bya [SUE Such secunty (5% of
erst or Commerc JABC)
tone at ot a
Form Submitted
by Contractor
Required:
JAmount
Submitted by () Sufficent (Insufficient
(Contractor:
| |Waneity Perea:
|Company/Bank:[rab no,
repementing Une
[i Security in Prescbed Form, Amount and Vaidity Period.
~ Project Reauirerrarts:
32. [Orpanzatonal Chart for the conan fo be bd
st of Contactors Key Personnel, (see Cause 142a(3K), B05) To bel
Jassgned to the projec, wth thei Complete qualification data sheet.
]US of Conractors pledged exuipments bath Mayor and anor Construction)
[Equipments os required in the Project's Program of Work and the Minimum)
Matera! testng aooraory Aaperatus requires under LO. 11 sens of 2017
ler category of Contractor supported by Proof of Ownershinor Lease/or
[Purchase Order:
For ownership reGureTieN Sal alinched he Tolowng
‘Authenticated machine Copy Tom the updated orginal Gy of the OF
and CR:
Cette Gf avalabity Oe requred Consrcion equa Fanp
{ie POW. and Laeraory Acparatis per category o te PEAB License]
wit good runing concn fer the whole dureten oe projet.
[2 For Purchase Order shal attached the folowing:
3 Cartiicaton of avatabiy of conatration equipment pe POW,
‘equrements an the Laboratory Apperatus per PCAB License category
for te whole duration of the prose.
Copy ofthe nga PC, cr authenicaled machine copy of PO, fom te]
5 For lease contrac shal stached tre Teliowng
1 Contract of tase of ay Waka daly regitared nthe Gover
‘a CTERTOR oF avoTBDIRY The Tease uapment O apparatin om
the lessor wth god running condition forthe whole convact duration
of the project including the speticabor/esertion of equipment set
fe ]enstruction Methods (Use Form Gower INFRAB)
[Constrction Scheauiew tre Yorn of Standard PERT/CPM Bagram or
Jrecedence Diagram and Bar Chart with S-Curve and Cash Flow per
Memorandum dated February 10, 2012 (Use Form DPWH-INFR-46)
AT [Rann Schade (Uae Fern BPWH-TIERAT,
a]
[Ecce Uulzation Schedve (Use Form DPWH-INFR AB),
_-[iv berairacin Seay and lan Program (CSAP) (Use Fo ORWRINFRS
9)
[Fey Laie income Tax and Business Retus Guy Striped and received by
BIR and duly valdated with te tax payments mage
'B Tax Cicerance fom the Bik to prove fal and bel payment oT Taree
[omnes Sworn Staternent ute form prescribe by GPP - 9 tems
¥
(Submit an ANTI TRAFFICKING TN PEREON (TI) Management Pan in
Icomptance to Department Ore No, 111 series of 2056
DP WHINFR- 29-2016
Revised dated 04022020Vr
10” [The Contractors must cover the Bang Dacian De alan
eran 35 ay be rented by ie Paci En whch are aad necssry a5] STRIDE
lgovernment
Note ‘ny ming, incomplete or patent nse. document Whe above]
mentioned check i @ ground for outa rejection ofthe bd.
Overatt Rating: ( ) Passed —() Fatied
DPWH.INER-20-2015
Revised dated 040272020