BIDS AND AWARDS COMMITTEE
TECHNICAL PROPOSAL
(FIRST ENVELOPE)
PROCUREMENT OF CANNED GOODS FOR RELIEF DISTRIBUTION FOR BARANGAYS
AFFECTED OF FLOODING DUE TO PREVIOUS TYPHOON AND HABAGAT, URDANETA CITY
Valid PhilGEPS Registration Certificate
in accordance with Section 8.5.2
of 2016 Revised IRR
(PLATINUM MEMBERSHIP)(ALL PAGES)
Statement of the prospective bidder of ALL its ongoing
government and private contracts, including
contracts awarded but not yet started, if any, whether or
not similar in nature and complexity to the contract
to be bid, within the relevant period in the bidding documents
STATEMENT OF ALL ON-GOING GOVERNMENT & PRIVATE CONTRACTS INCLUDING CONTRACTS AWARDED BUT NOT YET STARTED
Business Name:
Business Address:
Name of Contract Project Cost a. Owner's Name Nature of Work Bidder's Role a. Date Awarded % of Value of Outstanding
b. Address b. Date Started Accomplishment Works/Undelivered
c. Telephone Nos. c. Date of Completion Portion
Government: Description % Planned Actual
Private:
Note: This statement shall be supported with:
1. Notice of Award and Contract
2. Notice to proceed issued by the owner
3. Certificate of Accomplishment signed bythe owner or authorized representative
Submitted by :
(Printed Name & Signature)
Designation :
Date : _________________________________
STATEMENT OF SINGLE LARGEST
COMPLETED CONTRACT IN GOVERNMENT
AND PRIVATE CONTRACTS SIMILAR IN NATURE
STATEMENT OF SINGLE LARGEST COMPLETED CONTRACT IN GOVERNMENT & PRIVATE SIMILAR IN NATURE
Business Name:
Business Address:
a. Owner's Name a. Amount at Award a. Date Awarded
Name of Contract b. Address Nature of Work Bidder's Role b. Amount at Completion b. Contract Affectivity
c. Telephone Nos. c. Duration c. Date Completed
Government: Description %
Private:
Note:This statement shall be supported with:
1. Contract
2. Certificate of Completion
3. Certificate of Acceptance
Submitted by :
(Printed Name & Signature)
Designation :
Date : _____________________________
Bid Security
FORM OF BID
FORMSECURITY
OF BID SECURITY AMOUNT OF BID SECURITY
(Equal to Percentage of the ABC)
a.) Cash or cahier's/ manager's check issued
by a Universal or Commercial Bank.
b.) Bank draft/ guarantee or irrevocable letter Two percent (2%)
of credit issued by a Universal or Commercial
Bank: Provided, however, that it shall be confirmed
or authenticated by a Universal or Commercial
Bank, if issued by a foreign bank.
c.) Surety bond callable upon demand issued
by a surety or insurance company duly certified Five percent (5%)
by the Insurance Commission as authorized
to issue such security
d.) Any combination of the foregoing Proportionate to share of form with respect to
the total amount of security
e.) Bid-Securing Declaration No percentage required
REPUBLIC OF THE PHILIPPINES
CITY GOVERNMENT OF URDANETA
BID-SECURING DECLARATION
Invitation to Bid: Ref. No. _________________
To.
I/We, the undersigned, declare that:
1 I/We understand that, according to your conditions, bids must be supported by a Bid Security, which may be
in the form of a Bid-Securing Declaration.
2 I/We accept that: (a) I/We will be automatically disqualified from bidding for any contract with any procuring entity
for a period of two (2) years upon receipt of your Blacklisting Order; and , (b) I/We will pay the applicable fine
provided under Section 6 of the Guidelines on the Use of Bid Securing Declaration, within fifteen (15) days from receipt
of the written demand by the procuring entity for the commission of acts resulting to the enforcement of the bid
securing declaration under Sections 23.1 (b), 34.2, 40.1 and 69.1, except 69.1 (f) of the IRR of RA 9184;
without prejudice to other legal action the government may undertake.
3 I/We understand that this Bid-Securing Declaration shall cease to be valid on the following circumstances:
(a) Upon expiration of the bid validity period, or any extension thereof pursuant to your request;
(b) I a./we are declared ineligible or post-disqualified upon receipt of your notice to such effect, and (i) I/we
failed to timely file a request for reconsideration or (ii) I/we filed a waiver to avail of said right;
© I am/ we are declared as the bidder with the Lowest Calculated and Responsive Bid
, and I/we have furnished the performance security and signed the Contract.
IN WITNESS WHEREOF, I/WE have hereunto set my/our hand/s this ______day of _________, 20______
at ________________ Philippines.
Bidders Name/Signature
SUBSCRIBED AND SWORN to before me this _____ day of ___________, 20________ at
Philippines. Affiant/s is are personally known to me and was/were identified by me through competent evidence
of identify as defined in the 2004 Rules on National Practise (A.M. No. 02-8-13-SC). Affiant/s exhibited to me his/her
_________________________, with his/her photograph and signature appearing thereon, with no. ______________
and his/her Community Tax Certifictae No. ____________ issued on ________ at _____________.
Witness my hand and seal this ________ day of ________________. 20________
Doc No.____________________
Page No.___________________
Book No.___________________
Series No.__________________
Technical Specification which may include
Production/ Delivery Schedule, Manpower Requirements
and/or After Sales- Service/ Parts,
if applicable
TECHNICAL SPECIFICATIONS
Statement of
Item Specifications Compliance
"COMPLY" "NOT-COMPLY"
Prepared by:
PRODUCTION/DELIVERY SCHEDULE
The delivery schedule expressed as weeks/months stipulates hereafter a delivery date
which is the date of delivery to the project site.
Item Delivered,
Number
Description Quantity Total
Prepared by:
MANPOWER REQUIREMENTS
Category Month
1 2 3 4 5 6 7 8 9 10 11 12
Contractor’s Name: Name of the Procuring Entity: Contract Name:
Submitted by:
After-sales service/parts
(IF APPLICABLE)
Sworn statement by the prospective bidder or its
duly authorized representative in the form
prescribed by the GPBB
OMNIBUS SWORN STATEMENT
Republic of the Philippines
City/ Municipality __________________
AFFIDAVIT
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 that;
1. I am the sole proprietor of _____________________________________________________(Name of Bidder)
with office address at _______________________________________________________________________________
2. As the owner and sole proprietorship of _________________________________________________(Name of Bidder) ,
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 ______________________________________________________________
(Name of the Project), of the City Government of Urdaneta.
3. ___________________________________________ (Name of Bidder) 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 Governemnt 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. ___________________________________________(Name of Bidder) is authorizing the Head of the Procuring Entity
or its duly authorized representatives 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 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. ___________________________________(Name of Bidder) complies with existing labor laws and standards; and
8. ____________________________________(Name of Bidder) is aware of and has undertaken the following
responsibilities as a Bidder:
a.) carefully examine all 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
d.) Inquire or secure Supplemental/ Bid Bulletin(s) issued for the _______________________________________
__________________________________________________________________________________________.
9. _________________________________( Name of Bidder) 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 ause of confidence through misaappropriating 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 ______day of __________________ ,20_____
at ___________________________, Philippines.
Bidder's Representative/ Authorized Signatory
SUBSCRIBED AND SWORN to before me this _____ day of ___________, 20________ at
Philippines. Affiant/s is are personally known to me and was/were identified by me through competent evidence
of identify as defined in the 2004 Rules on National Practise (A.M. No. 02-8-13-SC). Affiant/s exhibited to me his/her
_________________________, with his/her photograph and signature appearing thereon, with no. ______________
and his/her Community Tax Certificate No. ____________ issued on ________ at _____________.
Witness my hand and seal this ________ day of ________________. 20________
Doc No.____________________
Page No.___________________
Book No.___________________
Series No.__________________
OMNIBUS SWORN STATEMENT
Republic of the Philippines
City/ Municipality __________________
AFFIDAVIT
I, ______________________________________(Name of Affiant) , of legal age, ____________________(Civil Status) ,
__________________________(Nationality) , and residing at _______________________________________________
Address of Affiant), after having been duly sworn in accorance with law, do hereby depose and state that;
1. I am the duly authorized and designated representative of __________________________________________________
(Name of Bidder), with office address at ___________________________________________________________________
(Address of Bidder).
2. I am granted full power and authority to do, execute and perform any and all acts necessary and/or to represent the
___________________________________________________(Name of Bidder) in the bidding as shown in the attached
____________________________________________________________________________(state title of attached
document showing proof of authorization)
3. ___________________________________________ (Name of Bidder) 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 Governemnt Procurement Policy Board;
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. ___________________________________________(Name of Bidder) is authorizing the Head of the Procuring Entity
or its duly authorized representatives to verify all the documents submitted;
6. None of the officers and members of ___________________________________________________(Name of Bidder)
is 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:
None of the officers, directors, and controlling stockholders of _______________________________________________
(Name of Bidder) is related to the Head of the Procuring Entity, members of the BAC, the Technical Working Group, and
the BAC Secretariat, the head of the Project Management Office or the end-userunit, and the project consultants by
consanguinity or affinity up to the third civil degree;
7. ____________________________________________________________________________(Name of Bidder)
complies with existing labor laws and standards; and
8. ____________________________________________________________________________(Name of Bidder)
is aware of and has undertaken the following responsibilities as a Bidder in compliance with the PBDs, 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 _______________________________________
__________________________________________________________________________________________.
______________________________________________________________________________(Name of Project)
9. _________________________________( Name of Bidder ) 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 unfaihtfulness 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 ______day of __________________ ,20_____
at ___________________________, Philippines.
Bidder's Representative/ Authorized Signatory
SUBSCRIBED AND SWORN to before me this _____ day of ___________, 20________ at
Philippines. Affiant/s is are personally known to me and was/were identified by me through competent evidence
of identify as defined in the 2004 Rules on National Practise (A.M. No. 02-8-13-SC). Affiant/s exhibited to me his/her
_________________________, with his/her photograph and signature appearing thereon, with no. ______________
and his/her Community Tax Certificate No. ____________ issued on ________ at _____________.
Witness my hand and seal this ________ day of ________________. 20________
Doc No.____________________
Page No.___________________
Book No.___________________
Series No.__________________
THE SUPPLIER'S AUDITED
FINANCIAL STATEMENTS
SHOWING, AMONG OTHERS, THE
SUPPLIER'S TOTAL AND CURRENT
ASSETS AND LIABILITIES,
STAMPED "RECEIVED" BY THR BIR
COMPUTATION OF NET FINANCIAL
CONTRACTING CAPACITY
or
COMMITTED LINE OF CREDIT
FINANCIAL DOCUMENTS FOR ELIGIBILITY CHECK
COMPUTATION OF NET FINANCIAL CONTRACTING CAPACITY (NFCC)
A. Summary of the applicant Supplier’s / Distributor’s / Manufacturer’s assets and liabilities on
the basis of the attached income tax return and audited financial statement, stamped
“RECEIVED” by the Bureau of Internal Revenue of BIR authorized collecting agent, for the
immediately preceding year and a certified copy of Schedule of Fixed Assets particularly the
list of construction equipment.
Year 20__
1. Total Assets
2. Current Assets
3. Total Liabilities
4. Current Liabilities
5. Net Worth (1-3 )
6. Net Working Capital (2-4)
B. The Net Financial Contracting Capacity ( NFCC ) based on the above data is computed as
follows:
NFCC = [(Current asset-current liabilities (15)] minus the value of all oustanding or uncompleted portions
of the projects under ongoing contracts, including awarded contracts yet to be started coinciding
with the contract to be bid.
NFCC= P
NFCC= P
K=15
Audited Financial Statements submitted to the BIR- for purposes of computing the foreign bidder's
NFCC, the value of the current assets and current liabilities shall be based on their Audited Financial
Statements prepared in accordance with international financing reporting standards.
or
Committed Line of Credit if awarded the contract in the amount of at least 10% of the proposed project to bid.
Name of Bank: ________________________________ Amount: Php. ______________________________
Herewith attached are certified true copies of the income tax return and audited financial
statement: stamped “RECEIVED” by the BIR or BIR authorized collecting agent for the
immediately preceding year or a certificate of commitment from a licensed bank to extend a credit line.
Submitted by:
Name of Supplier/Distributor/ Manufacturer
Signature of Authorized Representative
Valid joint venture agreement (JVA in case the
joint venture is already in existence. In the absence of a,
JVA duly notarized statements from all the potential joint
venture partners stating that they will enter into and abide
by the provisions of the JVA in the instance that the bid
is successful shall be included in the bid
IF APPLICABLE
FINANCIAL
PROPOSAL
(SECOND ENVELOPE)
PROCUREMENT OF CANNED GOODS FOR RELIEF DISTRIBUTION FOR BARANGAYS
AFFECTED OF FLOODING DUE TO PREVIOUS TYPHOON AND HABAGAT, URDANETA CITY
FINANCIAL BID FORM
Includes bid prices and the bill of quantities
and the applicable Price Schedules
BID FORM
Date:
To:
Gentlemen and/or Ladies:
Having examined the Philippine Bidding Documents PBDs including Reference Number _____________, the receipt of which
is hereby duly acknowledged, we, the undersigned , offer to
in conformity with the said PBDs for the sum of:
or the total calculated bid price, as evaluated and corrected
for computational errors, and other bid modifications in accordance with the Price Schedules attached this Bid.
ITEM UNIT BID
ITEM & DESCRIPTION QTY. UNIT BID AMOUNT
NO. PRICE
1 Sardines 155g, 100's per box 250 box
2 Corned Beef 150g, 48's per box 520 box
3 Tuna Flakes 125g, 48's per box 400 box
-
If our Bid is accepted, we undertake:
a. to deliver the goods in accordance with the delivery schedule aspecified in the Schedule of Requirements of the Philippine Bidding Documents (PBD's)
b. to provide a performance security in the form , amounts, and within the times prescribed in the PBD's.
c. to abide by the Bid Validity period specified in the PBD's and it shall remain binding upon us at any time before the expiration of that period.
Foreign-Assisted Project with the Development Partner. ("NONE")-
Until a formal Contract is prepared and executed , this Bid, together with your written acceptance thereof and your Nptice of Award, shall be binding upon us.
We understand that you are not bound to accept the Lowest Calculated Bid or any Bid you may receive.
We certify/confirm that we comply with the eligibility requirements pursuant to the PBDs.
The undersigned is authorized to submit the bid on behalf of _________________________________________ as evidenced by the attached _____________.
We acknowledge that failure to sign each and every page of this Bid Form, including the attached Schedule of Prices,
shall be a ground for the rejection of our bid.
Name: ______________________________________________________________
Legal capacity:________________________________________________________
Signature:___________________________________________________________
Duly authorized to sign the Bid for and behalf of: ___________________________
Date:_______________________________________________________________
For Goods Offered From Within the Philippines
Name of Bidder: Project ID No. ___________________ Page ____of ______
1 2 3 4 5 6 7 8 9 10
Transportation Sales and other
Cost of Incidental
and Insurance taxes payable if Total Price, Total Price delivered
Country Services, if
Item Description Quantity Unit price and all other Contract is per unit (col Final Destination (col
of origin applicable, per
costs incidental awarded, per 5+6+7+8) 9) x (col 4 )
item
to delivery, per item
of origin EXW per item exw per item other delivered Final
TOTAL BID PRICE
Name:
Legal Capacity:
Signature:
Duly authorized to sign the Bid for and behalf of:
