Omnibus Sworn Statemen12

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OMNIBUS SWORN STATEMENT

REPUBLIC OF THE PHILIPPINES )


CITY OF SANTIAGO ) S.S

AFFIDAVIT

I, JINKEE LOU M. GADDI, of legal age, single Filipino, residing at Malvar Street, Victory Norte Santiago
City, after having been duly sworn in accordance with law, do hereby depose and state that:

1. I am the sole proprietor of JIJOMER CONSTRUCTION with office address at Capirpiriwan,


Cordon, Isabela.

2. As the owner and sole proprietor of JIJOMER CONSTRUCTION, I have full power and authority to
do, execute and perform any and all acts necessary to represent it in the bidding for REPAIR OF
CLASSROOM AT DIBUL ELEMENTARY SCHOOL OF SAGUDAY, QUIRINO.

3. JIJOMER CONSTRUCTION, is not “blacklisted or barred from bidding by the Government of the
Philippines or any of its agencies, offices, corporation, or Local Government Units, foreign
government/foreign or international financing institution whose blacklisting rules have been
recognized by the Government Procurement Policy Board, by itself or by relation, membership,
association, affiliation, or controlling interest with another blacklisted person or entity as
defined and provided for in the Uniform Guidelines on Blacklisting;

4. Each of the documents submitted in satisfaction of the bidding requirements is an authentic


copy of original, complete, and all statements and information provided therein are true and
correct.

5. JIJOMER CONSTRUCTION is authorizing the Head of Procuring Entity or its duly authorized
representative(s) to verify all the documents submitted.

6. I am not related to the Head of the Procuring Entity, members of the Bids and Awards
Committee (BAC), the Technical Working Group, and BAC Secretariat, the head of the Project
Management Office or the end-user unit, and the project consultants by consanguinity or
affinity up to the third civil degree;

7. JIJOMER CONSTRUCTION complies with existing labor laws and standards; and

8. JIJOMER CONSTRUCTION is aware of and has undertaken the following responsibilities as a


Bidder.

a). Carefully examine all of the Bidding Documents;

b). Acknowledge all conditions, local or otherwise, affecting the implementation of the Contract;

c). Made an estimate of the facilities available and needed for the contract to be bid, if any; and
9. d). Inquire or secure Supplemental/Bid Bulletin(s) for the REPAIR OF CLASSROOM AT DIBUL
ELEMENTARY SCHOOL OF SAGUDAY, QUIRINO.

9. JIJOMER CONSTRUCTION did not give or pay directly or indirectly, any commission, amount,
fee, or Form of Consideration, pecuniary or otherwise, to any person or official, personnel or
representative of the government in relation to any procurement project or activity.

10. In case advance payment was made or given, failure to perform or deliver any of the obligations
and undertakings in the contract shall be sufficient grounds to constitute criminal liability for
Swindling(Estafa) or the commission of fraud with unfaithfulness or abuse of confidence through
misappropriating or converting any payment received by a person or entity under an obligation
involving the duty to deliver certain goods or services, to the prejudice of the public and the
government of the Philippines pursuant to Article 315 of Act No. 3815 s. 1930, as amended, or
revised penal Code.
IN WITNESSOF, I have hereunto set my hands this 6th day of September at Santiago City, Philippines.

JINKEE LOU M. GADDI


Affiant

SUBSCRIBED AND SWORN to before me this 6th day of September at Santiago City, Philippines Affiant
exhibiting to me his Driver’s license card, with his photograph and signature appearing thereon, with No.
B01-88-012144 and her Community tax certificate No. 15441329 issued at Santiago city.

_________________________________
Notary Public

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