Checklist of Technical and Financial Documents

I. TECHNICAL COMPONENT ENVELOPE

Class “A” Documents

Legal Documents
(a) Valid PhilGEPS Registration Certificate (Platinum Membership) (all pages)
in accordance with Section 8.5.2 of the IRR;
Technical Documents
(b) Statement of the prospective bidder of all its ongoing government and private
contracts, including contracts awarded but not yet started, if any, whether
similar or not similar in nature and complexity to the contract to be bid; and
(c) Statement of the bidder’s Single Largest Completed Contract (SLCC) similar
to the contract to be bid, except under conditions provided for in Sections
23.4.1.3 and 23.4.2.4 of the 2016 revised IRR of RA No. 9184, within the
relevant period as provided in the Bidding Documents; and
(d) Original copy of Bid Security. If in the form of a Surety Bond, submit also a
certification issued by the Insurance Commission;
or
Original copy of Notarized Bid Securing Declaration; and
(e) Conformity with the Technical Specifications, which may include
production/delivery schedule, manpower requirements, and/or after-
sales/parts, if applicable; and
(f) Original duly signed Omnibus Sworn Statement (OSS);
and if applicable, Original Notarized Secretary’s Certificate in case of a
corporation, partnership, or cooperative; or Original Special Power of
Attorney of all members of the joint venture giving full power and authority
to its officer to sign the OSS and do acts to represent the Bidder.

Financial Documents
(g) The prospective bidder’s computation of Net Financial Contracting Capacity
(NFCC);
or
A committed Line of Credit from a Universal or Commercial Bank in lieu of
its NFCC computation.

Class “B” Documents

(h) If applicable, a duly signed joint venture agreement (JVA) in case the joint
venture is already in existence;
or
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.

Other documentary requirements under RA No. 9184 (as applicable)

 (i) [For foreign bidders claiming by reason of their country’s extension of
reciprocal rights to Filipinos] Certification from the relevant government
office of their country stating that Filipinos are allowed to participate in
government procurement activities for the same item or product.
(j) Certification from the DTI if the Bidder claims preference as a Domestic
Bidder or Domestic Entity.

25 FINANCIAL COMPONENT ENVELOPE

(a) Original of duly signed and accomplished Financial Bid Form; and
(b) Original of duly signed and accomplished Price Schedule(s).
 APPENDIX "1"

Bid Form for the Procurement of Goods

[shall be submitted with the Bid]

BID FORM
Date: ____________________
Project Identification No. ____________________

To: ___________________________
___________________________
___________________________

Having examined the Philippine Bidding Documents (PBDs) including the Supplemental or
Bid Bulletin Numbers [insert numbers], the receipt of which is hereby duly acknowledged, we, the
undersigned, offer to ______________________________________________________________
_______________________________________________________________________________
[supply/deliver/perform] [description of the Goods]
in conformity with the said PBDs for the sum of _________________________________________
________________________________________________________________________________
[total Bid amount in words and figures]
or the total calculated bid price, as evaluated and corrected for computational errors, and other
bid modifications in accordance with the Price Schedules attached herewith and made part of this
Bid. The total bid price includes the cost of all taxes, such as, but not limited to: [specify the
applicable taxes, e.g. (i) value added tax (VA T), (ii) income tax, (iii) local taxes, and (iv) other
fiscal levies and duties], which are itemized herein or in the Price Schedules,

If our Bid is accepted, we undertake:

a. to deliver the goods in accordance with the delivery schedule specified in the
Schedule of Requirements of the Philippine Bidding Documents (PBDs);

b. to provide a performance security in the form, amounts, and within the times
prescribed in the PBDs;

c. to abide by the Bid Validity Period specified in the PBDs and it shall remain
binding upon us at any time before the expiration of that period.

[Insert this paragraph if Foreign-Assisted Project with the Development Partner:

Commissions or gratuities, if any, paid or to be paid by us to agents relating to this Bid,
and to contract execution if we are awarded the contract, are listed below:

Name and address Amount and Purpose of

of agent Currency Commission or gratuity

_____________________________________________
_____________________________________________
_____________________________________________
(if none, state "None")]

Until a formal Contract is prepared and executed, this Bid, together with your written
acceptance thereof and your Notice of Award, shall be binding upon us.

GPPB Resolution No. 16-2020, dated 16 September 2020 Page 1 of 2

 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 [name of the bidder] as
evidenced by the attached [state the written authority].

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: _____________________________________________________________________________

GPPB Resolution No. 16-2020, dated 16 September 2020 Page 2 of 2

 Bid Securing Declaration Form
[shall be submitted with the Bid if bidder opts to provide this form of bid security]

REPUBLIC OF THE PHILIPPINES)

CITY OF ________________________ ),S.S.

BID SECURING DECLARATION

Project Identification No.: [Insert number]

To: ____________________________________
____________________________________
____________________________________

l/We, the undersigned, declare that:

1. l/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. l/We accept that: (a) I/we will be automatically disqualified from bidding for any procurement
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 No. 9184; without prejudice to other legal action the government may undertake.

3. l/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 am/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; and

c. I am/we are declared the bidder with the Lowest Calculated 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 [month] [year] at
[place of execution].

[Insert NAME OF BIDDER OR ITS AUTHORIZED

REPRESENTATlVE]
[Insert signatory's legal capacity]
Affiant

[Jurat1]
[Format shall be based on the latest Rules on Notarial Practice]

GPPB Resolution No. 16-2020, dated 16 September 2020 Page 1 of 1

 Omnibus Sworn Statement (Revised)
[shall be submitted with the Bid]

REPUBLIC OF THE PHILIPPINES )

CITY/MUNICIPALITY OF _________________ ) S.S.

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. [Select one, delete the other:]

[If a sole proprietorship:] I am the sole proprietor or authorized representative of [Name of

Bidder] with office address at [address of Bidder];

[If a partnership, corporation, cooperative, or joint venture:] I am the duly authorized and
designated representative of [Name of Bidder] with office address at [address of Bidder];

2. [Select one, delete the other:]

[If a sole proprietorship.1 As the owner and sole proprietor, or authorized representative 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 [Name of the Procuring Entity], as shown in the attached duly
notarized Special Power of Attorney;

[If a partnership, corporation, cooperative, or joint venture:) I am granted 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 [Name of the
Procuring Entity], as shown in the attached [state title of attached document showing proof of
authorization (e.g., duly notarized Secretary's Certificate, Board/Partnership Resolution, or
Special Power of Attorney, whichever is applicable;)];

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 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. [Name of Bidder] is authorizing the Head of the Procuring Entity or its duly authorized
representative(s) to verify all the documents submitted;

GPPB Resolution No. 16-2020, dated 16 September 2020 Page 1 of 3

6. [Select one, delete the rest]

[If a sole proprietorship:] 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;

[If a partnership or cooperative:] 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;

[If a corporation or joint venture.1 None of the officers, directors, and controlling stockholders
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;

7. [Name of Bidder] complies with existing labor laws and standards; and

8. [Name of Bidder] 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 [Name of the 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 arounds 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.

GPPB Resolution No. 16-2020, dated 16 September 2020 Page 2 of 3

IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of ______________, 20___ at
__________________________, Philippines.

[Insert NAME OF BIDDER OR ITS AUTHORIZED

REPRESENTATIVE]
[Insert signatory's legal capacity]
Affiant

{Jurat1

GPPB Resolution No. 16-2020, dated 16 September 2020 Page 3 of 3

 Performance Securing Declaration (Revised)
[if used as an alternative performance security but it is not required to be submitted with the Bid, as it shall be
submitted within ten (10) days after receiving the Notice of Award]

REPUBLIC OF THE PHILIPPINES)

CITY OF __________________ ) S.S.

PERFORMANCE SECURING DECLARATION

Invitation to Bid: [Insert Reference Number indicated in the Bidding Documents]

To: [Insert name and address of the Procuring Entity]

I/We, the undersigned, declare that:

1. I/We understand that according to your conditions to guarantee the faithful

performance by the supplier/distributor/manufacturer/contractor/consultant of its
obligations under the Contract, I/we shall submit a Performance Securing Declaration
within a maximum period of ten (10) calendar days from the receipt of the Notice of
Award prior to the signing of the Contract.

2. I/We accept that: I/we will be automatically disqualified from bidding for any
procurement contract with any procuring entity for a period of one (1) year for the first
offense, or two (2) years for the second offense, upon receipt of your Blacklisting
Order if I/We have violated my/our obligations under the Contract;

3. I/We understand that this Performance Securing Declaration shall cease to be valid
upon:

a. issuance by the Procuring Entity of the Certificate of Final Acceptance, subject to the
following conditions:

i. Procuring Entity has no claims filed against the contract awardee;

ii. It has no claims for labor and materials filed against the contractor; and
iii. Other terms of the contract; or

b. replacement by the winning bidder of the submitted PSD with a performance security
in any of the prescribed forms under Section 39.2 of the 2016 revised IRR of RA No.
9184 as required by the end-user.

IN WITNESS WHEREOF, I/We have hereunto set my/our hand/s this ____ day of [month] [year]
at [place of execution].

[Insert NAME OF BIDDER OR ITS AUTHORIZED

REPRESENTATIVE]
[Insert signatory's legal capacity]
Affiant

[Jurat1]
[Format shall be based on the latest Rules on Notarial Practice]

GPPB Resolution No. 16-2020, dated 16 September 2020 Page 1 of 1

 STATEMENT OF ALL GOVERNMENT AND PRIVATE CONTRACTS COMPLETED WHICH ARE SIMILAR IN NATURE

Business Name:
Business Address:

a. Amount at
a. Owner's Name Bidder's Role Award a. Date Awarded
Name of Contract/ Project Cost Nature of Work b. Amount at
b. Address Description % Completion b. Contract Effectivity
c.Telephone Nos. c. Duration c. Date Completed
Government

Private

Note: This statement shall be supported with:

1. Contract
2. Certificate of Completion
3. Certificate of Acceptance

Submitted by: ______________________________________

(Printed Name and Signature)

Designation:________________________________________
Date:_______________________________________________
LIST OF ALL ONGOING GOVERNMENT AND PRIVATE CONTRACTS INCLUDING CONTRACTS AWARDED BUT NOT YET STARTED

Business Name:
Business Address:

Bidder's Role a. Date % of Accomplishment

a. Owner's Name Awarded Value of
Outstanding
Nature of
Name of Contract/ Project Cost Planned Actual Works/
b. Address Work b. Date Started
Description % Undelivered
c. Date of Portion
c.Telephone Nos. Completion
Government

Private

Note: This statement shall be supported with: Total Cost

1. Notice of Award and/ or Contract
2. Notice to Proceed issued by owner
3. Certificate of Accomplishment signed by the owner or authorized representative

Submitted by: ______________________________________

(Printed Name and Signature)

Designation:________________________________________
Date:_______________________________________________
 Price Schedule for Goods Offered from Abroad
[shall be submitted with the Bid if bidder is offering goods from Abroad]
______________________________________________________________________________

For Goods Offered from Abroad

Name of Bidder _________________________ Project ID No._________ Page ___ of ___

1 2 3 4 5 6 7 8 9

Item Description Country Quantity Unit price CIF Total CIF Unit Price Unit price Total Price
of origin port of entry Delivered Delivered delivered
or CIP
(specify port) or Duty Unpaid Duty Paid DDP
price per
(DDU) (DDP) (col 4 x 8)
CIP named item
place
(col. 4 x
(specify border 5)
point or place of
destination)

Name: ___________________________________________________________________

Legal Capacity: ____________________________________________________________

Signature: ________________________________________________________________

Duly authorized to sign the Bid for and behalf of: __________________________________
 Price Schedule for Goods Offered from Within the Philippines
[shall be submitted with the Bid if bidder is offering goods from within the Philippines]
______________________________________________________________________________

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

Item Description Country Quantity Unit Transportation Sales and Cost of Total Total Price
of origin price and all other other Incidental Price, delivered
EXW costs taxes Services, if per unit Final
per incidental to payable if applicable, Destination
item delivery, per Contract per item (col
item is 5+6+7+ (col 9) x
awarded, 8) (col 4)
per item

Name: ___________________________________________________________________

Legal Capacity: ____________________________________________________________

Signature: ________________________________________________________________

Duly authorized to sign the Bid for and behalf of: __________________________________