Affidavit Commitment To Work Safety
Affidavit Commitment To Work Safety
Affidavit Commitment To Work Safety
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.
Name & Address of Employer Position From To Total Period Yrs &
(Mo./Yr.) (Mo./Yr.) Mos.
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
RAYMUND I. TONGSON
Project Manager
Noted by:
RAYMUND I. TONGSON
Authorized Managing Officer
DPWH-INFR-39-062106
Department of Public Works and Highways (DPWH)
Date: _________
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.
Name & Address of Employer Position From To Total Period Yrs &
(Mo./Yr.) (Mo./Yr.) Mos.
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
RUDY TAQUISO
Project Engineer
Noted by:
RAYMUND I. TONGSON
Authorized Managing Officer
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.
Date: __________
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.
Name & Address of Employer Position From To Total Period Yrs &
(Mo./Yr.) (Mo./Yr.) Mos.
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
DPWH-INFR-39-062106
ROGELIO Q. TONGSON
Materials Quality Control Engineer
Noted by:
RAYMUND I. TONGSON
Authorized Managing Officer
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.
DPWH-INFR-39-062106
Date:______________
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.
Name & Address of Employer Position From To Total Period Yrs &
(Mo./Yr.) (Mo./Yr.) Mos.
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
DPWH-INFR-39-062106
Noted by:
RAYMUND I. TONGSON
Authorized Managing Officer
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.
DPWH-INFR-39-062106
Date: ___________
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.
Name & Address of Employer Position From To Total Period Yrs &
(Mo./Yr.) (Mo./Yr.) Mos.
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
DPWH-INFR-39-062106
EUSTAQUIO P. PIGAR
General Foreman
Noted by:
RAYMUND I. TONGSON
Authorized Managing Officer
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.
DPWH-INFR-39-062106