CONSTRUCTION INDUSTRY ARBITRATION COMMISSION

2/F Executive Building Center, 369 Gil J. Puyat Ave. cor. Makati Ave., Makati City
Telefax Nos. 897-0853/897-9313; Email: ciac_ciap@yahoo.com

AGREEMENT TO ARBITRATE
CIAC-F-SVD-002a || Rev. 0 || 19/11/2018
Use this form if there is only ONE respondent.

We,

______ __________________________________________________________________________
(Name of Company)

and

________ _________________________________________________________________________
(Name of Company)

Notwithstanding our contract for the construction of

_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_____________________________________________________________ _____ _
(Name of Project)

Stipulating for the arbitration/settlement of dispute distinct from what is provided for in Executive Order No.
1008, hereby submit ourselves to the jurisdiction of the Construction Industry Arbitration Commission (CIAC) and
request the CIAC to Arbitrate our dispute in said project.

_____________________ __________ ___ ____ _______________________________

(Name of Company/Contractor) (Name of Company/Owner)

By: By:

________ __________________________ ___________ ________________________

Signature over Printed Name of Signature over Printed Name of
Authorized Representative Authorized Representative