PhilGEPS Sworn Statement

REPUBLIC OF THE PHILIPPINES

(CITY/MUNICIPALITY OF __________) S.S

AFFIDAVIT

I, ____________________(Name of Affiant), of legal age, ____________(Civil Status), (Nationality), and

residing at ________________________(Address of Affiant), after having been duly sworn in accordance
with law, do hereby depose and state that:

1. Select one, delete the other:

If s sole proprietorship: I am the sole proprietor or authorized representative of

______________(Name of Bidder) with office address at ___________________(Address of
Bidder);

If a partnership, corporation, cooperative, or joint venture: I am the duly authorized and

designated representative of ________________(Name of Bidder) with office address at
____________________(Address of Bidder);

2. As the owner and sole proprietor, or authorized representative of _________________________

(Name of Bidder), as shown in the attached
______________________________________________________________________________
(State title of attached document showing proof of authorization [e.g., duly notarized Secretary’s
Certificate, Board/Partnership Resolution, or Special Power of Attorney, whichever is
applicable;]), I have full power and authority to upload and maintain in the Philippine
Government Electronic Procurement System (PhilGEPS) a current and updated file of the
following Class “A” eligibility documents under Sections 23.1 (a) and 24.1 (a):

a) Registration Certificate;
b) Mayor’s/Business Permit or its Equivalent Document;
c) Tax Clearance; (BIR Form 17.14B “For Bidding Purposes”)
d) Philippine Contractors Accreditation Board (PCAB) license and registration (if applicable);
and
e) Audited Financial Statements;

3. If a foreign bidder submitting appropriate equivalent documents in a language other than

English: _____________________(Name of Bidder) is uploading and maintaining in the PhilGEPS
equivalent documents accompanied by a translation of the documents in English issued by the
relevant foreign government agency, the foreign government agency authorized to translate
documents, or a registered translator in the foreign bidder’s country; and shall be authenticated
by the appropriate Philippine foreign service establishment/post or the equivalent office having
jurisdiction over the foreign bidder’s affairs in the Philippines;
4. Each of the documents submitted is in satisfaction and compliance with the requirements for
PhilGEPS Platinum Membership and for participation in any Philippine government bidding;

5. Each document is an authentic copy of the original, complete, and all statements and
information provided therein are true and correct;

6. I assume responsibility and full accountability on the validity and authenticity of the documents
submitted;

7. I am authorizing the PS-PhilGEPS and the authorized representative(s) of the Procuring Entities
to verify all document submitted, if necessary; and

8. I am aware of and understood the following guidelines for the use of the Government of the
Philippines- Official Merchant Registry (GoP-OMR):

a. The PhilGEPS office shall not determine the eligibility of merchants. The PhilGEPS office’s
evaluation of the eligibility requirements shall be for the sole purpose of determining the
approval or disapproval of the merchant’s application for registration.

b. A merchant’s registration and membership in the GOP-OMR is neither contract specific nor
understood to be tantamount to a finding of eligibility. Neither shall the merchant’s
successful registration in the GOP-OMR be relied upon to claim eligibility for the purpose of
participation in any public bidding.

c. The determination of the eligibility of merchants, whether registered with the GOP-OMR or
not, shall remain with the Bids and Awards Committee (BAC). The BAC’s determination of
validity of the eligibility requirements shall be conclusive to enable the merchant to
participate in the public bidding process.

IN WITNESS WHEREOF, I have hereunto set my hand this____ day of ________, 20___at
____________, Philippines.

______________________________________
Bidder’s Representative/Authorized Signatory