OMNIBUS SWORN STATEMENT
REPUBLIC OF THE PHILIPPINES)
CITY OF TAGUM) S.S.
PROVINCE OF DAVAO DEL NORTE
AFFIDAVIT
I, GERRY R. RANA, of legal age, married, Filipino, and residing at Purok 3
Brgy. Luna, Kapalong, Davao del Norte, after having been duly sworn in accordance
with law, do hereby depose and state that:
l. I am the sole proprietor or authorized representative of LIRA CONSTRUCTION
and SUPPLIES with office address at Dr. 1, Lim Residence, Pk. 3, Luna, Kapalong,
Davao del Norte;
2. As the owner and sole proprietor, or authorized representative of LIRA
CONSTRUCTION and SUPPLIES, I have full power and authority to do, execute
and perform any and all acts necessary to participate, submit the bid, and to sign and
execute the ensuing contract for 1 set SOUND SYSTEM of Barangay Lagab,
Compostela, Davao de Oro;;
3. LIRA CONSTRUCTION and SUPPLIES is not "blacklisted" or barred from bidding
by the Government of the Philippines or any of its agencies, offices, corporations, 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 the original, complete, and all statements and information provided
therein are true and correct;
5. LIRA CONSTRUCTION and SUPPLIES is authorizing the Head of the Procuring
Entity or its duly authorized representative(s) to verify all the documents submitted;
6. The owner or sole proprietor is not related to the Head of the Procuring Entity,
members of the Bids and Awards Committee (BAC), the Technical Working Group,
and the 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. LIRA CONSTRUCTION and SUPPLIES complies with existing labor laws and
standards; and
8. LIRA CONSTRUCTION and SUPPLIES is aware of and has undertaken the
responsibilities as a Bidder in compliance with the Philippine Bidding Documents,
which includes:
a. Carefully examining all of the Bidding Documents;
b. Acknowledging all conditions, local or otherwise, affecting the implementation
of
the Contract;
c. Making an estimate of the facilities available and needed for the contract to be
bid,
if any; and
d. Inquiring or securing Supplemental/Bid Bulletin(s) issued for the
1 set SOUND SYSTEM of Barangay Lagab, Compostela, Davao de Oro;
9. LIRA CONSTRUCTION and SUPPLIES did not give or pay directly or indirectly,
any commission, amount, fee, or any 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 the
Revised Penal Code.
IN WITNESS WHEREOF, I have hereunto set my hand this
____________________ at Tagum City, Davao del Norte, Philippines.
GERRY R. RANA
Affiant
SUBSCRIBED AND SWORN to before me this ________________ at Tagum
City, Davao del Norte, Philippines. Affiant is personally known to me and was
identified by me through competent evidence of identity as defined in the 2004 Rules on
Notarial Practice (A.M. No. 02-8-13-SC). Affiant exhibited to me his Driver’s License,
with his photograph and signature appearing thereon, with no. L06-09-000712.
Witness my hand and seal this ________________.
Doc. No. _____
Page No. _____
Book No. _____
Series of 2021
