STATEMENT OF ONGOING GOVERNMENT & PRIVATE CONTRACTS INCLUDING CONTRACTS AWARDED BUT NOT YET STARTED

Business Name : ____________________________________________________________________________________________________________

Business Address : ____________________________________________________________________________________________________________

Name of Contract/Location a. Owner Name Contractor’s Role a. Date Awarded % of Accomplishment Value of Outstanding
Project Cost b. Address Nature of Work Description b. Date Started Works/Uncompleted
c. Telephone Nos. % c. Date of Completion Planned Actual Portion

Government

Private

*Continue in a separate sheet if necessary..

Total Cost
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 : ____________________________________________________
(Printed Name and Signature)
Designation : ____________________________________________________
Date : ____________________________________________________