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Topics: SOCCSKSARGEN, South Cotabato, Provinces of the Philippines Pages: 2 (358 words) Published: June 18, 2013
Omnibus Sworn Statement
REPUBLIC OF THE PHILIPPINES
PROVINCE OF SARANGANI
AFFIDAVIT

I, Marites L. Mones, 44 years old, Married, Filipino, and residing at Poblacion Tantangan South Cotabato, after having been duly swom in accordance with law, does hereby depose and state that;

1. I am the sole proprietor of LAFORTEZA PHARMACY with office address at Osmeña Street Koronadal City;

2. As the owner and sole proprietor of LAFORTEZA PHARMACY, I have full power and authority to do, execute and perform any and acts necessary to represent it in the bidding of Drugs and Medicines.

3. LAFORTEZA PHARMACY 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;

4. Each of the document 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. LAFORTEZA PHARMACY is authorizing the Head of the Procuring Entity or its duly authorized representative 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. LAFORTEZA PHARMACY complies with existing labor laws and standards; and

8. LAFORTEZA PHARMACY is aware of and has undertaken the fallowing 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...
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