Republic of the Philippines

ENERGY FORM: LS-CL-RATE CASE-PSA

REGULATORY
COMMISSION

CHECKLIST OF PRE-FILING REQUIREMENTS FOR

POWER SUPPLY AGREEMENT (PSA) CASES

PRE-FILING DATE/S

APPLICANTS

The information contained in the documents required in the list below are
considered public, excluding those prayed for as confidential by Applicants. Any act of
fraud or false representation in any document submitted before the Commission may
be a ground for outright dismissal of the Application once filed without prejudice to all
other administrative, civil, or criminal actions that may be filed against Applicants, its
officers, employees, and authorized representatives responsible for such fraud or
misrepresentation.

Compliance with the pre-filing requirements, as set forth below, is

MANDATORY. Acceptance of the Application for filing does not estop the Commission
from further determining whether Applicants have complied with all the procedural
and substantial requirements of the Commission, or whether the documents
submitted herein are true and correct.

LEGAL REQUIREMENTS

REQUIREMENT DETAILS REMARKS

CERTIFICATE OF EMAIL
CER No:
REGISTRATION NO.
1. ELECTRONIC (If not yet available) Reference No. of CER application:
PRE-FILING
Date of Execution:
VERIFIED DECLARATION (Y/N)
Executed by:
DATE
SIGNED BY COUNSEL Y/N?
2. APPLICATION NO. OF HARD COPIES (3)
[N/A FOR ELECTRONIC PRE-FILING]
NO. OF SOFT COPIES (3)
[N/A FOR ELECTRONIC PRE-FILING]
DATE NOTARIZED
Type of Government ID:

3. VERIFICATION ID No.
(VERIF) ID PRESENTED
Date of Issuance:

Date of Expiry:

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ENERGY
REGULATORY
COMMISSION

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DATE NOTARIZED

4. CERTIFICATION Type of Government ID:

AGAINST FORUM ID No.
SHOPPING (CAFS) ID PRESENTED
Date of Issuance:
Date of Expiry:

Board Reso No.:

BOARD RESO; or Date of Board Reso.

5. AUTHORITY OF
Name of Authorized Counsel as indicated in the
COUNSEL TO FILE
Board Reso:
THE SUBJECT
APPLICATION Date Issued:
SEC. CERT. Name of Authorized Counsel as indicated in the
Sec. Cert:

Board Reso No.:

6. AUTHORITY OF BOARD RESO. (Y/N); or Date of Board Reso.

AFFIANT TO
EXECUTE VERIF/ Name of Authorized Person to execute the
CAFS FOR THE VERIF/CAFS as indicated in the Board Reso:
SUBJECT
APPLICATION Date Issued:
SEC. CERT. (Y/N)
Name of Authorized Person to execute the
VERIF/CAFS as indicated in the Sec. Cert:

A) CERTIFICATIONS FROM GOVERNOR, CITY OR MUNICIPAL MAYOR AND

SANGGUNIANG PANLALAWIGAN, PANLUNGSOD OR BAYAN
LGU OF: Date of the Certification:
LGU OF: Date of the Certification:
7. SERVICE TO LGU OF: Date of the Certification:
LOCAL Date of the Certification:
LGU OF:
GOVERNMENT
UNITs (LGUs) OF Please provide additional information in the Other Remarks, if necessary.
THE PROVINCE,
CITY OR B) IN THE ABSENCE OF CERTIFICATION
MUNICIPALITY
LGU OF:
WHERE
APPLICANT AFFIDAVIT OF SERVICE Date of the Affidavit:
PRINCIPALLY
OPERATES APPLICATION WITH STAMP
Date Received by the LGU:
“RECEIVED”/ ACKNOWLDGEMENT
LGU OF:
AFFIDAVIT OF SERVICE Date of the Affidavit:

APPLICATION WITH STAMP

Date Received by the LGU:
“RECEIVED”/ ACKNOWLDGEMENT
LGU OF:
AFFIDAVIT OF SERVICE Date of the Affidavit:

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ENERGY
REGULATORY
COMMISSION

REQUIREMENT DETAILS REMARKS

APPLICATION WITH STAMP

Date Received by the LGU:
“RECEIVED”/ ACKNOWLDGEMENT

Please provide additional information in the Other Remarks, if necessary.

C) IF NOT RECEIVED, REASON AND/OR PROOF OF REFUSAL

LGU OF: REASON/PROOF:
LGU OF: REASON/PROOF:
LGU OF: REASON/PROOF:
Please provide additional information in the Other Remarks, if necessary.

Date of the Affidavit:

AFFIDAVIT OF PUBLICATION
Name of the Publication:
• NEWSPAPER
8. PUBLICATION IN Date of the Publication:
A NEWSPAPER OF
GENERAL NEWPAPER ISSUE CONTAINING
CIRCULATION THE PUBLICATION
WITHIN
APPLICANT'S • APPLICATION Page where the Application can be found:
FRANCHISE AREA • VERIFICATION (VERIF) Verif is included in the Publication: Y/N?
• CERTIFICATION AGAINST FORUM
CAFS is included in the Publication: Y/N?
SHOPPING (CAFs)
PROOF OF EXEMPTION FROM THE CONDUCT OF CSP (IF APPLICABLE)
CERTIFICATE OF EXEMPTION ISSUANCE DATE:
ISSUED BY THE DOE:

ANNEX ___ OF THE APPLICATION

COOPERATION PERIOD:
(Please specify the Annex/es where
9. EXEMPTION this/these document/s can be found)
FROM
COMPETITIVE
SELECTION DATE OF EXECUTION:
PROCESS1
EMERGENCY POWER SUPPLY COOPERATION PERIOD: Same as the Certificate of
AGREEMENT (EPSA) Exemption: Y/N?
If (N), specify the new Cooperation Period:
(Please specify the Annex/es where
this/these document/s can be found)
With Certification/approval from the DOE of the
different Cooperation Period: Y/N?

PROOF OF CONDUCT OF CSP

10. COMPETITIVE
SELECTION 1ST CSP SUCCESSFUL (Y/N):
BRIEF DESCRIPTION OF CSP
PROCESS2
CONDUCTED: 2ND CSP SUCCESSFUL (Y/N):

1
Pursuant to Department of Energy (DOE) Circular Nos. DC 2018-02-0003 and DC 2021-09-0030. The
requirements may be amended or supplemented pursuant to relevant laws, including rules and
regulations on Competitive Selection Process (CSP) which may be issued subsequently by the DOE.
2 Ibid.

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ENERGY
REGULATORY
COMMISSION

REQUIREMENT DETAILS REMARKS

2 FAILED CSPs, DIRECT NEGOTIATION (Y/N):
PARS. ________ OF THE
APPLICATION RELEVANT ALLEGATIONS IN THE
APPLICATION:
(Please specify the paragraph CSP THROUGH COMPETITIVE PUBLIC BIDDING
numbers where the CSP description (Y/N):
are alleged in the Application)
CSP THROUGH ALTERNATIVE MODE OF
PROCUREMENT (Y/N):

DOE/NEA TPBAC APPROVAL (Y/N):

MOA FOR THE JOINT TPBAC OF AGGREGATED

DUs (Y/N):

TPBAC LATEST AND REVIEWED DDP WITH PROOF OF

SUBMISSION TO DOE (Y/N):

PSPP CONSISTENT WITH THE LATEST AND

REVIEWED DISTRIBUTION AND
DEVELOPMENT PLAN (DDP) WITH PROOF OF
SUBMISSION TO DOE (Y/N):

BID DOCUMENTS/PROCESS
TERMS OF REFERENCE (TOR) OF DU
BASED ON THE RECENT AND REVIEWED
POWER SUPPLY PROCUREMENT PLAN
(PSPP) SUBMISSION AS PUBLISHED
1. GENERAL SUPPLY DESCRIPTION:

2. TERMS OF SUPPLY SERVICES:

DOCUMENTS PERTAINING TO THE

CSP UNDERTAKEN: 3. COST AND TARIFF STRUCTURE:

ANNEX _____ OF THE

APPLICATION
4. PAYMENT MODALITIES:
(Please specify the Annex/es where
this/these document/s can be found)
5. OUTAGE ALLOWANCE:

6. REPLACEMENT POWER:

7. FORCE MAJEURE:

8. GROUNDS FOR CONTRACT TERMINATION:

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ENERGY
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COMMISSION

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9. LIQUIDATED DAMAGES:

10. REDUCTION OF CONTRACT CAPACITY:

11. OBLIGATIONS OF THE DU:

12. BIDDER’S QUALIFICATIONS:

INVITATION TO BID AS PUBLISHED

(Please provide the information on the following

based on what was published. Please use the Other
Remarks Box for additional information, if
necessary.)

A) COOPERATION PERIOD/CONTRACT YEAR:

B) DEMAND AND ENERGY FOR CSP:

C) ELIBILITY REQUIREMENTS:

D) SCHEDULE AND DEADLINES FROM THE

ISSUANCE OF CERTIFICATE OF POSTING
(COP):

E) TERMS OF REFERENCE (TOR)

INSTRUCTION TO BIDDERS

A) CORPORATE PROFILE OF THE BIDDERS:

B) TECHNICAL PROPOSAL’S REQUIREMENTS:

C) FINANCIAL PROPOSAL’S REQUIREMENTS:

D) METHOD AND CRITERIA FOR

EVALUATION:

E) BIDDING PROCEDURE:

F) AWARDING, SIGNING OF CONTRACT, AND

NOTICE OF IMPLEMENTATION:

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ENERGY
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G) ACCEPTABLE FORM OF BID AND

PERFORMANCE SECURITIES:

H) PROPOSED TIMELINES OR MILESTONES:

I) POWER SUPPLY AGREEMENT (PSA)

TEMPLATE:

J) NOTARIZED STATEMENT ATTESTING TO

THE INFORMATION SUBMITTED FOR THE
BID:

K) PROTEST MECHANISM:

L) OTHER DOCUMENTS REQUIRED AND

MANDATED BY ANY GOVERNMENT
AGENCIES:

PUBLICATION AND POSTING

DOE CERTIFICATE OF POSTING (COP) FOR THE

PUBLICATION OF INVITATION TO BID (Y/N):

POSTING OF TOR, INVITATION TO BID AND ALL

BID BULLETINS AND RELATED
ANNOUNCEMENTS IN THE DOE CSP E-
BASED PORTAL AND DU’s WEBSITE, IF
AVAILABLE:

PUBLICATION OF INVITATION TO BID,

INCLUDING TOR, IN A NEWSPAPER OF
GENERAL CIRCULATION ONCE WEEKLY FOR
TWO (2) CONSECUTIVE WEEKS:

INVITATION FOR CSP OBSERVERS AT THE

FF. STAGES:
PRE-BID CONFERENCES (Y/N):
SUBMISSION AND OPENING OF BIDS (Y/N):
BID EVALUATION (Y/N):
POST-QUALIFICATION (Y/N):
AWARDING (Y/N):
CONTRACT SIGNING (Y/N):

WRITTEN COMMENTS/ RECOMMENDATIONS

FROM CSP OBSERVERS, IF ANY:

CSP OBSERVER’S REPORT of DOE and/or NEA:

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ENERGY
REGULATORY
COMMISSION

REQUIREMENT DETAILS REMARKS

PRE-BID CONFERENCE

SUPPLEMENTAL/BID BULLETINS:

SUBMISSION, RECEIPT AND OPENING OF

BIDS

BIDS/PROPOSALS/OFFERS RECEIVED:

BIDDER JOINT VENTURE/CONSORTIUM

AGREEMENT, IF APPLICABLE:

TPBAC EVALUATION REPORT (Y/N):

PRE-QUALIFICATION REPORT:

POST-QUALIFICATION REPORT:

TPBAC RESOLUTION RECOMMENDING TO

BOD OF THE DU THE AWARD OF THE
CONTRACT:

BOARD RESO. CONFIRMING TPBAC

EVALUATION (Y/N):

AWARDING AND CONTRACT SIGNING

NOTICE OF AWARD TO THE WINNING

BIDDER (Y/N):

REQUIRED DOCUMENTS/PROCEDURE IN CASE

THE WINNING BIDDER IS A JOINT
VENTURE/ CONSORTIUM:

SUPPORTING DOCUMENTS ALLOWING A

SUPPLIER, OTHER THAN THE CSP WINNING
BIDDER AS DECLARED BY TPBAC, TO ENTER
INTO A POWER SUPPLY AGREEMENT WITH
DU:

CORPORATE PROFILE OF THE WINNING

BIDDER AND/OR THE SUPPLIER INDICATED
IN THE PSA:

DOE AND/OR NEA NOTICE TO PROCEED

(Y/N):

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ENERGY
REGULATORY
COMMISSION

REQUIREMENT DETAILS REMARKS

DOE AND NEA CERTIFICATE OF
COMPLIANCE WITH THE CSP
REQUIREMENTS (Y/N):

AFFIDAVIT OF TPBAC FOR THE CONDUCT

OF CSP (Y/N):

CSP COMPLETED WITHIN 180 CALENDAR

DAYS FROM POSTING/PUBLICATION OF
INVITATION TO BID UNTIL THE AWARD
AND SIGNING OF PSA (Y/N):

PROTEST MECHANISM: REQUEST FOR RECONSIDERATION

AND/OR PROTESTS RECEIVED, if any:
ANNEX _____ OF THE
APPLICATION
TPBAC RESOLUTION AND/OR BOD
DECISION:
(Please specify the Annex/es where
this/these document/s can be found)

OTHER REMARKS: