Affidavit Commitment To Work Safety

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Department of Public Works and Highways (DPWH)

KEY PERSONNEL’S AFFIDAVIT OF COMMITMENT TO WORK ON THE CONTRACT

The BAC Chairman


Department of Public Works and Highways

Dear Sir:

1. I conform that ST. RAYMUND CONSTRUCTION INC. has engaged my services for the position of Safety
Officer in the above stated contract if it awarded to the contractor.

2. I therefore, commit to assume the said position in the above stated Contract once it is awarded to the
Contractor, and I shall employ the best care, skill, and ability to perform the duties of such position in
accordance with the Conditions of Contract, Specification, Drawings, and other provision of the Contract
Agreement. I am aware that I have to stay in the jobsite for the duration of my assignment.

3. I do not allow the use of my name to enable the contractor to qualify for the above stated Contract
without my commitment to assume the said position, since I understand that to do so shall be a sufficient
ground for my disqualification from this Contract and future biddings of the DPWH.

4. I submit and certify as true and correct, my bio-data as follows:

a. Name : Aylen Pigar dela Rama


b. Date of Birth : August 14,1970
c. Nationality : Filipino
d. Educational Attainment : BS ED
e. Specialty : Safety Officer
f. PRC No. : None
g. Employment Record : ST. RAYMUND CONSTRUCTION INC.

Name & Address of Employer Position From To Total Period Yrs &
(Mo./Yr.) (Mo./Yr.) Mos.

Safety Officer January 1994 Present 25 years


ST. RAYMUND CONSTRUCTION
INC.

I. Project Name & Location I. Project Description I. Part of Project I. Start Date
II. Owner`s Name & Address II. Total Project Cost I Handled II. Completion Date
III. My Position II. Cost of Part

I. Construction of One(1) Unit-Two(2) Storey I. Buildings/Industrial I. 100% I. 9/17/15


Classroom School Building at Mabini NHS, Plant-LOW Rise II.Php8,028,114.18 II. 3/02/16
Escalante City, Neg. Occ.(15GK0091) II. Php8,028,114.18
II. DPWH Negros Occidental 1st
Engineering District
II.Safety Officer
I. Concreting of Purok Santan-Walingwaling I. Roads- I. 100% I. 10/04/15
Sampaguita FMR at Brgy. Canlamay, Ilog, New Construction - II.Php32,382,014.40 II. 12/28/16
Neg. Occ. PCCP
II.Municipality of Ilog II.Php32,382,014.40
III. Safety Officer

I. Improvement/Rehabilitation of I. Roads- I. 100% I. 11/3-/09


Brgy. Nanca-Brgy. Alacaygan Rehabilitation - II.Php9,317,196.85 II. 01/29/10
Road E.B. Magalona, Negros Gravel
Occidental II. Php9,317,196.85
II.DPWH Negros Occidental 1st
Engineering District
III. Safety Officer

I. Construction of Flood Control/ I. Flood Control/ I. 100% I. 01/29/10


Riverbank Canmoros- Nabuswag Hydraulics/River II.Php9,334,734.41 II. 06/28/10
River, Brgy. Canmoros,Binalbagan Control
II.DPWH Negros Occidental 2nd II. Php9,334,734.41
Engineering District
III. Safety Officer

I. Concreting BGA. Bante-Polot-an I. Roads- I. 100% I. 01/06/11


Road, Pototan, Iloilo Rehabilitation- II.Php9,594,228.31 II. 06/05/11
II. DPWH Iloilo 2nd Engineering PCCP
District II. Php9,594,228.31
III. Safety Officer

I. Concreting of Road along D.S. I. Roads- I. 100% I. 03/25/10


Benedicto-Spur 16- CalatravaRoad Rehabilitation- II.Php13,701,357.60 II. 07/08/10
II. DPWH Negros Occidental 1st PCCP
Engineering District II. Php13,701,357.60
III. Safety Officer

I. Concreting of Kabangkalan I. Roads- I. 100% I. 03/24/10


Junction Salong Tapi Dacongcogon Rehabilitation- II.Php31,933,113.50 II. 02/07/11
Bantayan Road Asphalt
II. DPWH Negros Occidental 3rd II. Php31,933,113.50
Engineering District
III. Safety Officer

Very truly yours,

RAYMUND I. TONGSON
Project Manager

Noted by:

RAYMUND I. TONGSON
Authorized Managing Officer

REPUBLIC OF THE PHILIPPINES)


PROVINCE OF NEGROS OCCIDENTAL) S.S.
CITY OF BACOLOD) S. S.

SUBSCRIBED AND SWORN to before me this at City of Bacolod, Negros Occidental,


Philippines. Affiant exhibiting to me his/her Community Tax Certificate No. 05800479 issued at City of Himamaylan
on January 4, 2019.

Doc No. _____


Page No. ____ Notary Public
Book No. _____
Series of 2019

DPWH-INFR-39-062106
Department of Public Works and Highways (DPWH)

Contract ID: 16GB0141 (Re-bid)


Contract Name: Construction of 1-Storey Two (2) Classroom SB at Latazon PS
Location of the Contract: San Jose, ANTIQUE

PROJECT ENGINEER’S AFFIDAVIT OF COMMITMENT TO WORK ON THE CONTRACT

Date: _________

The BAC Chairman


Department of Public Works and Highways
Antique District Engineering Office
San Jose, Antique

Dear Sir:

1. I conform that ST. RAYMUND CONSTRUCTION INC. has engaged my services for the
position of Project Engineer in the above stated contract if it awarded to the contractor.

2. I therefore, commit to assume the said position in the above stated Contract once it is
awarded to the Contractor, and I shall employ the best care, skill, and ability to perform the
duties of such position in accordance with the Conditions of Contract, Specification,
Drawings, and other provision of the Contract Agreement. I am aware that I have to stay in
the jobsite for the duration of my assignment.

3. I do not allow the use of my name to enable the contractor to qualify for the above stated
Contract without my commitment to assume the said position, since I understand that to
do so shall be a sufficient ground for my disqualification from this Contract and future
biddings of the DPWH.

4. I submit and certify as true and correct, my bio-data as follows:

a. Name : Rudy Gasataya Taquiso


b. Date of Birth : October 23,1945
c. Nationality : Filipino
d. Educational Attainment : BS Civil Engineering
e. Specialty : Project Engineer
f. PRC No. : 0012169
g. Employment Record : ST. RAYMUND CONSTRUCTION INC
DPWH-INFR-39-062106

Name & Address of Employer Position From To Total Period Yrs &
(Mo./Yr.) (Mo./Yr.) Mos.

Februaru 2010 Present 7 years


ST. RAYMUND CONSTRUCTION Project Engineer
INC.

I. Project Name & Location I. Project Description I. Part of Project I. Start Date
II. Owner`s Name & Address II. Total Project Cost I Handled II. Completion Date
III. My Position II. Cost of Part

I. Construction of Two (2) Storey Six(6) I. Buildings/Industrial I. 100% I. 2/7/16


Classroom at Sum-ag National HS Plant-HIGH Rise II.Php8,171,159.60 II. 3/4/16
II. Php8,171,159.60

Very truly yours,

RUDY TAQUISO
Project Engineer

Noted by:

RAYMUND I. TONGSON
Authorized Managing Officer

REPUBLIC OF THE PHILIPPINES)


PROVINCE OF NEGROS OCCIDENTAL) S.S.
CITY OF BACOLOD) S. S.

SUBSCRIBED AND SWORN to before me this at City of Bacolod, Negros Occidental, Philippines.
Affiant exhibiting to me his/her Community Tax Certificate No. 20168192issued at City of Himamaylan on January
10, 2017.

Doc No. _____


Page No. ____ Notary Public
Book No. _____
Series of 2017

Department of Public Works and Highways (DPWH)

Contract ID: 16GB0141 (Re-bid)


Contract Name: Construction of 1-Storey Two (2) Classroom SB at Latazon PS
Location of the Contract: San Jose, ANTIQUE

MATERIALS QUALITY CONTROL ENGINEER’S AFFIDAVIT OF COMMITMENT


TO WORK ON THE CONTRACT

Date: __________

The BAC Chairman


Department of Public Works and Highways
Antique District Engineering Office
San Jose, Antique

Dear Sir:

1. I conform that ST. RAYMUND CONSTRUCTION INC. has engaged my services for the
position of Materials Quality Control Engineer in the above stated contract if it awarded to
the contractor.

2. I therefore, commit to assume the said position in the above stated Contract once it is
awarded to the Contractor, and I shall employ the best care, skill, and ability to perform the
duties of such position in accordance with the Conditions of Contract, Specification,
Drawings, and other provision of the Contract Agreement. I am aware that I have to stay in
the jobsite for the duration of my assignment.

3. I do not allow the use of my name to enable the contractor to qualify for the above stated
Contract without my commitment to assume the said position, since I understand that to
do so shall be a sufficient ground for my disqualification from this Contract and future
biddings of the DPWH.

4. I submit and certify as true and correct, my bio-data as follows:

h. Name : Rogelio Q. Tongson


i. Date of Birth : December 10, 1939
j. Nationality : Filipino
k. Educational Attainment : BS Civil Engineering
l. Specialty : Materials Quality Control Engineer
m. PRC No. : 0006708
n. Employment Record : ST. RAYMUND CONSTRUCTION INC.

Name & Address of Employer Position From To Total Period Yrs &
(Mo./Yr.) (Mo./Yr.) Mos.

June 2008 Present 9 years


ST. RAYMUND CONSTRUCTION Materials Quality
INC. Control Engineer

I. Project Name & Location I. Project Description I. Part of Project I. Start Date
II. Owner`s Name & Address II. Total Project Cost I Handled II. Completion Date
III. My Position II. Cost of Part

I. Construction of Modified 1-Unit 1- I. Buildings/Industrial I. 100% I. 10/29/09


Classroom School Building Plant-LOW Rise II.Php1,344,171.06 II. 12/14/09
(Cluster II) II. Php1,344,171.06
II. DPWH Negros Occidental 1st
Engineering District
III. Materials Quality Control Engr.

DPWH-INFR-39-062106

I. Reconstruction of Hinigaran- I. Roads- I. 100% I. 02/24/10


Isabela Road, Hinigaran Rehabilitation - II.Php8,713,548.20 II. 04/11/10
Sta.54+4000 to Sta.64+600 PCCP
II.DPWH Negros Occidental 2nd II.Php8,713,548.20
Engineering District
III. Materials Quality Control Engr.

I. Improvement/Rehabilitation of I. Roads- I. 100% I. 11/3-/09


Brgy. Nanca-Brgy. Alacaygan Rehabilitation - II.Php9,317,196.85 II. 01/29/10
Road E.B. Magalona, Negros Gravel
Occidental II. Php9,317,196.85
II.DPWH Negros Occidental 1st
Engineering District
III. Materials Quality Control Engr.

I. Construction of Flood Control/ I. Flood Control/ I. 100% I. 01/29/10


Riverbank Canmoros- Nabuswag Hydraulics/River II.Php9,334,734.41 II. 06/28/10
River, Brgy. Canmoros,Binalbagan Control
II.DPWH Negros Occidental 2nd II. Php9,334,734.41
Engineering District
III. Materials Quality Control Engr.

I. Concreting BGA. Bante-Polot-an I. Roads- I. 100% I. 01/06/11


Road, Pototan, Iloilo Rehabilitation- II.Php9,594,228.31 II. 06/05/11
II. DPWH Iloilo 2nd Engineering PCCP
District II. Php9,594,228.31
III. Materials Quality Control Engr.

I. Concreting of Road along D.S. I. Roads- I. 100% I. 03/25/10


Benedicto-Spur 16- CalatravaRoad Rehabilitation- II.Php13,701,357.60 II. 07/08/10
II. DPWH Negros Occidental 1st PCCP
Engineering District II. Php13,701,357.60
III. Materials Quality Control Engr.

I. Concreting of Kabangkalan I. Roads- I. 100% I. 03/24/10


Junction Salong Tapi Dacongcogon Rehabilitation- II.Php31,933,113.50 II. 02/07/11
Bantayan Road Asphalt
II. DPWH Negros Occidental 3rd II. Php31,933,113.50
Engineering District
III. Materials Quality Control Engr.

Very truly yours,

ROGELIO Q. TONGSON
Materials Quality Control Engineer

Noted by:

RAYMUND I. TONGSON
Authorized Managing Officer

REPUBLIC OF THE PHILIPPINES)


PROVINCE OF NEGROS OCCIDENTAL) S.S.
CITY OF BACOLOD) S. S.

SUBSCRIBED AND SWORN to before me this at City of Bacolod, Negros Occidental, Philippines.
Affiant exhibiting to me his/her Community Tax Certificate No. 07928984issued at City of Himamaylan on January 4,
2017.

Doc No. _____


Page No. ____ Notary Public
Book No. _____
Series of 2017

DPWH-INFR-39-062106

Department of Public Works and Highways (DPWH)

Contract ID: 16GB0141 (Re-bid)


Contract Name: Construction of 1-Storey Two (2) Classroom SB at Latazon PS
Location of the Contract: San Jose, ANTIQUE

SAFETY OFFICER’S AFFIDAVIT OF COMMITMENT TO WORK ON THE CONTRACT

Date:______________

The BAC Chairman


Department of Public Works and Highways
Antique District Engineering Office
San Jose, Antique

Dear Sir:

1. I conform that ST. RAYMUND CONSTRUCTION INC. has engaged my services for the
position of Safety Officer in the above stated contract if it awarded to the contractor.

2. I therefore, commit to assume the said position in the above stated Contract once it is
awarded to the Contractor, and I shall employ the best care, skill, and ability to perform the
duties of such position in accordance with the Conditions of Contract, Specification,
Drawings, and other provision of the Contract Agreement. I am aware that I have to stay in
the jobsite for the duration of my assignment.

3. I do not allow the use of my name to enable the contractor to qualify for the above stated
Contract without my commitment to assume the said position, since I understand that to
do so shall be a sufficient ground for my disqualification from this Contract and future
biddings of the DPWH.

4. I submit and certify as true and correct, my bio-data as follows:

a. Name : Aylen Dela Rama


b. Date of Birth : August 14,1970p
c. Nationality : Filipino
d. Educational Attainment : BS ED
e. Specialty : Safety Officer
f. PRC No. : None
g. Employment Record : ST. RAYMUND CONSTRUCTION INC.

Name & Address of Employer Position From To Total Period Yrs &
(Mo./Yr.) (Mo./Yr.) Mos.

January 1994 Present 23 years


ST. RAYMUND CONSTRUCTION Safety Officer
INC.

I. Project Name & Location I. Project Description I. Part of Project I. Start Date
II. Owner`s Name & Address II. Total Project Cost I Handled II. Completion Date
III. My Position II. Cost of Part

I. Construction of Modified 1-Unit 1- I. Buildings/Industrial I. 100% I. 10/29/09


Classroom School Building Plant-LOW Rise II.Php1,344,171.06 II. 12/14/09
(Cluster II) II. Php1,344,171.06
II. DPWH Negros Occidental 1st
Engineering District
III. Safety Officer

DPWH-INFR-39-062106

I. Reconstruction of Hinigaran- I. Roads- I. 100% I. 02/24/10


Isabela Road, Hinigaran Rehabilitation - II.Php8,713,548.20 II. 04/11/10
Sta.54+4000 to Sta.64+600 PCCP
II.DPWH Negros Occidental 2nd II.Php8,713,548.20
Engineering District
III. Safety Officer

I. Improvement/Rehabilitation of I. Roads- I. 100% I. 11/3-/09


Brgy. Nanca-Brgy. Alacaygan Rehabilitation - II.Php9,317,196.85 II. 01/29/10
Road E.B. Magalona, Negros Gravel
Occidental II. Php9,317,196.85
II.DPWH Negros Occidental 1st
Engineering District
III. Safety Officer

I. Construction of Flood Control/ I. Flood Control/ I. 100% I. 01/29/10


Riverbank Canmoros- Nabuswag Hydraulics/River II.Php9,334,734.41 II. 06/28/10
River, Brgy. Canmoros,Binalbagan Control
II.DPWH Negros Occidental 2nd II. Php9,334,734.41
Engineering District
III. Safety Officer

I. Concreting BGA. Bante-Polot-an I. Roads- I. 100% I. 01/06/11


Road, Pototan, Iloilo Rehabilitation- II.Php9,594,228.31 II. 06/05/11
II. DPWH Iloilo 2nd Engineering PCCP
District II. Php9,594,228.31
III. Safety Officer

I. Concreting of Road along D.S. I. Roads- I. 100% I. 03/25/10


Benedicto-Spur 16- CalatravaRoad Rehabilitation- II.Php13,701,357.60 II. 07/08/10
II. DPWH Negros Occidental 1st PCCP
Engineering District II. Php13,701,357.60
III. Safety Officer
I. Concreting of Kabangkalan I. Roads- I. 100% I. 03/24/10
Junction Salong Tapi Dacongcogon Rehabilitation- II.Php31,933,113.50 II. 02/07/11
Bantayan Road Asphalt
II. DPWH Negros Occidental 3rd II. Php31,933,113.50
Engineering District
III. Safety Officer

Very truly yours,

AYLEN DELA RAMA


Safety Officer

Noted by:

RAYMUND I. TONGSON
Authorized Managing Officer

REPUBLIC OF THE PHILIPPINES)


PROVINCE OF NEGROS OCCIDENTAL) S.S.
CITY OF BACOLOD) S. S.

SUBSCRIBED AND SWORN to before me this at City of Bacolod, Negros Occidental, Philippines.
Affiant exhibiting to me his/her Community Tax Certificate No. 07928984issued at City of Himamaylan on January 4,
2017.

Doc No. _____


Page No. ____ Notary Public
Book No. _____
Series of 2017

DPWH-INFR-39-062106

Department of Public Works and Highways (DPWH)

Contract ID: 16GB0141 (Re-bid)


Contract Name: Construction of 1-Storey Two (2) Classroom SB at Latazon PS
Location of the Contract: San Jose, ANTIQUE

GENERAL FOREMAN’S AFFIDAVIT OF COMMITMENT TO WORK ON THE CONTRACT

Date: ___________

The BAC Chairman


Department of Public Works and Highways
Antique District Engineering Office
San Jose, Antique

Dear Sir:

1. I conform that ST. RAYMUND CONSTRUCTION INC. has engaged my services for the
position of General Foreman in the above stated contract if it awarded to the contractor.

2. I therefore, commit to assume the said position in the above stated Contract once it is
awarded to the Contractor, and I shall employ the best care, skill, and ability to perform the
duties of such position in accordance with the Conditions of Contract, Specification,
Drawings, and other provision of the Contract Agreement. I am aware that I have to stay in
the jobsite for the duration of my assignment.

3. I do not allow the use of my name to enable the contractor to qualify for the above stated
Contract without my commitment to assume the said position, since I understand that to
do so shall be a sufficient ground for my disqualification from this Contract and future
biddings of the DPWH.

4. I submit and certify as true and correct, my bio-data as follows:

a. Name : Eustaquio P. Pigar


b. Date of Birth : February 3, 1975
c. Nationality : Filipino
d. Educational Attainment : Secondary Graduate
e. Specialty : General Foreman
f. PRC No. : Not Applicable
g. Employment Record : ST. RAYMUND CONSTRUCTION INC.

Name & Address of Employer Position From To Total Period Yrs &
(Mo./Yr.) (Mo./Yr.) Mos.

Jan.2005 Present 12 years


ST. RAYMUND CONSTRUCTION General Foreman
INC.

I. Project Name & Location I. Project Description I. Part of Project I. Start Date
II. Owner`s Name & Address II. Total Project Cost I Handled II. Completion Date
III. My Position II. Cost of Part

I. Construction of Modified 1-Unit 1- I. Buildings/Industrial I. 100% I. 10/29/09


Classroom School Building Plant-LOW Rise II.Php1,344,171.06 II. 12/14/09
(Cluster II) II. Php1,344,171.06
II. DPWH Negros Occidental 1st
Engineering District
III. General Foreman

DPWH-INFR-39-062106

I. Reconstruction of Hinigaran- I. Roads- I. 100% I. 02/24/10


Isabela Road, Hinigaran Rehabilitation - II.Php8,713,548.20 II. 04/11/10
Sta.54+4000 to Sta.64+600 PCCP
II.DPWH Negros Occidental 2nd II.Php8,713,548.20
Engineering District
III. General Foreman

I. Improvement/Rehabilitation of I. Roads- I. 100% I. 11/3-/09


Brgy. Nanca-Brgy. Alacaygan Rehabilitation - II.Php9,317,196.85 II. 01/29/10
Road E.B. Magalona, Negros Gravel
Occidental II. Php9,317,196.85
II.DPWH Negros Occidental 1st
Engineering District
III. General Foreman

I. Construction of Flood Control/ I. Flood Control/ I. 100% I. 01/29/10


Riverbank Canmoros- Nabuswag Hydraulics/River II.Php9,334,734.41 II. 06/28/10
River, Brgy. Canmoros,Binalbagan Control
II.DPWH Negros Occidental 2nd II. Php9,334,734.41
Engineering District
III. General Foreman

I. Concreting BGA. Bante-Polot-an I. Roads- I. 100% I. 01/06/11


Road, Pototan, Iloilo Rehabilitation- II.Php9,594,228.31 II. 06/05/11
II. DPWH Iloilo 2nd Engineering PCCP
District II. Php9,594,228.31
III. General Foreman

I. Concreting of Road along D.S. I. Roads- I. 100% I. 03/25/10


Benedicto-Spur 16- CalatravaRoad Rehabilitation- II.Php13,701,357.60 II. 07/08/10
II. DPWH Negros Occidental 1st PCCP
Engineering District II. Php13,701,357.60
III. General Foreman

I. Concreting of Kabangkalan I. Roads- I. 100% I. 03/24/10


Junction Salong Tapi Dacongcogon Rehabilitation- II.Php31,933,113.50 II. 02/07/11
Bantayan Road Asphalt
II. DPWH Negros Occidental 3rd II. Php31,933,113.50
Engineering District
III. General Foreman

Very truly yours,

EUSTAQUIO P. PIGAR
General Foreman

Noted by:

RAYMUND I. TONGSON
Authorized Managing Officer

REPUBLIC OF THE PHILIPPINES)


PROVINCE OF NEGROS OCCIDENTAL) S.S.
CITY OF BACOLOD) S. S.

SUBSCRIBED AND SWORN to before me this at City of Bacolod, Negros Occidental, Philippines.
Affiant exhibiting to me his/her Community Tax Certificate No. 07928984issued at City of Himamaylan on January 4,
2017.

Doc No. _____


Page No. ____ Notary Public
Book No. _____
Series of 2017

DPWH-INFR-39-062106

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