Affidavit of No Pending Case
Affidavit of No Pending Case
Affidavit of No Pending Case
PROPOSED DEMOLITION OF EXISTING SIX (6) STOREY OFFICE AND DESIGN & BUILD OF THIRTEEN
(13) STOREY OFFICE BUILDING WITH ROOF DECK LOCATED AT ROXAS BOULEVARD CORNER SAN LUIS STREET, PASAY CITY (LLFC-GAP-21-003)
REPUBLICOFTHEPHILIPPINES)
C I T Y O F_______________________________) S . S .
x----------------------------------------------------------------------x
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:
1. That I am the [State position in the company] of [Name of Company orBidder’s Name] with office
address at [State office address];
2. That no pending civil, criminal and/or administrative case/s has been filed by the Government of the
Republic of the Philippines against [Name of Company or Bidder]in any forum;
3. That I am executing this statement as part of the eligibility requirement for the project [State project
title]; and
4. That in the event of finding against the veracity hereof shall constitute a ground for the automatic
disqualification of [Name of Company or Bidder] for the project [State project title].
IN WITNESS WHEREOF, I have hereunto set my hand this day of , Philippines. _, 20__ at
SUBSCRIBED AND SWORN to before me this day of [month] [year] at [place of execution],
Philippines. Affiant/s is/are personally known to me and was/were 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/s
exhibited to me his/her [insert type of government identification card used], with his/her photograph and
signature appearing thereon, with no.
[150]
PROPOSED DEMOLITION OF EXISTING SIX (6) STOREY OFFICE AND DESIGN & BUILD OF THIRTEEN
(13) STOREY OFFICE BUILDING WITH ROOF DECK LOCATED AT ROXAS BOULEVARD CORNER SAN LUIS STREET, PASAY CITY (LLFC-GAP-21-003)
Doc. No._______________
Page No. _________
Book No________________
Series of ________________