Transcript
PCAB FORM
PCAB-PAD-NEW-F01
Page 1 of 23
Effectivity Date 02/08/2013
Revision No. 04
This Form is NOT for sale. Reproduction is Allowed
Construction Industry Authority of the Philippines
PHILIPPINE CONTRACTORS ACCREDITATION BOARD
NEW CONTRACTOR’S LICENSE APPLICATION
REQUIRED ITEMS
The following pertinent documents and information shall be submitted in support to PCAB license application.(Applicant may
initially fill out the check boxes subject for final validation by PCAB/DTI-ROG pre-screener)
A. LEGAL
A.1. Affidavit of Attestation and General Information (page 3 of 23 and page 4 of 23);
A.1.1. For Sole Proprietorship: Certified true copy of Business Name Registration Certificate;
A.1.2. For Partnership or Corporation: Certified true copy of SEC Certificate of Registration and Articles of
Partnership/Incorporation and By-Laws with construction contracting as one of the purposes and
subsequent amendments thereto, if any;
A.2. Authorized Managing Officer (AMO) Nomination:
A.2.1. AMO Affidavit (page 5 of 23) with a passport size picture of AMO;
A.2.1.1. For Corporations only: Original Corporate Secretary's certificate as to the nomination of the
AMO (page 6 of 23);
A.2.2. Original NBI clearance of Filipino AMO (valid as of the date of filing);
A.2.3. If AMO is Non-Filipino (in addition to A.2.1):
A.2.3.1. Working Visa
A.2.3.2. Alien Certificate of Registration
A.2.3.3. NBI clearance if AMO has resided in the Philippines for six (6) months or longer if not,
equivalent clearance from AMO's home country duly authenticated by the Philippine Embassy;
Complied
Yes
No
NA
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For Corporations or Associations with foreign shareholders, the following documents shall be submitted:
1. Corporate Secretary’s Certification as follows:
a. List of stockholders showing their nationalities and shareholdings; and
b. List of Board of Directors showing their names and nationality.
2. Copy of latest General Information Sheet duly filed with SEC showing the names of stockholders and directors, nationality and
shareholdings.
a. The percentage control of the number of seats occupied by foreigners in the Board of Directors shall not exceed 40%.
B. FINANCIAL
B.1. Complete Financial Statements with accompanying Auditor’s notes dated within the last six (6) months
immediately preceding the filing of application (duly audited and signed on every page by an
Independent CPA with valid PRC-BOA accreditation) and a CD-R (compact disc recordable) containing
the firm’s Audited Balance Sheet & Income Statement in the prescribed template to be uploaded by the
CIAP-RID in CIAP database. The PCAB Financial Statement Forms A & B (A. Balance Sheet / B. Income
Statement) can be downloaded at DTI website www.dti.gov.ph;
B.1.1. For old companies, audited financial statements for the immediately preceding taxable year and
copy of the Quarterly or Annual Income Tax Return certified by the BIR;
B.1.2. Cash: Original copy of Bank Certification/Bank statement of account certified by Bank Manager of
cash deposits as of the Balance Sheet date; (NOTE: Amount in excess of ½ of 1% of the
minimum networth required for category applied for or P 50,000.00 whichever is higher,
reflected as “Cash” or “Cash on Hand” shall be deducted from the networth, if unsupported);
B.1.2.1. Authorization to Depository Bank (page 7 of 23);
B.1.3. List of Land and Building/Industrial Plants owned by the applicant and registered in its name (page
10 of 23);
B.1.3.1. Certified Copy of Transfer of Certificate of Title (TCT) including back page;
B.1.3.2. Deed of Sale or Certified Copy of Tax Declaration of Land / Building owned by the applicant;
B.1.4. List of Construction and/or Transportation/Delivery Vehicles/Equipment/Machineries/Plants owned
by the applicant and registered in its name (page 11 of 23);
B.1.4.1. Certified Copy by Land Transportation Office (LTO) of Certificate of Registration and
Current Official Receipt of Registration of Construction and/or Transportation/Delivery
Vehicles/Equipment reported;
B.1.4.2. Certified Copy of Deed of Sale or sales invoices/official receipts of other construction
equipment/machineries;
B.1.5. Documents to be submitted if the values of the applicant's Receivables and Inventories Accounts
exceed more than 50% & 20%,respectively, of the contractor’s networth, otherwise, the amount in
excess of said account shall be deducted for categorization purposes;
B.1.5.1. Schedule of Receivables duly signed by AMO and Certified by the firm’s PRC BOA
accredited CPA (page 13 of 23);
B.1.5.2. Schedule of Inventories duly signed by AMO and Certified by the firm’s PRC BOA
accredited CPA (page 13 of 23);
B.2. Authorization to verify documents from BIR & other agencies and/or quarterly income tax return to cover
income reported on interim financial statements.(page 8 of 23 and page 9 of 23);
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PCAB FORM
PCAB-PAD-NEW-F01
Page 2 of 23
Effectivity Date 02/08/2013
Revision No. 04
This Form is NOT for sale. Reproduction is Allowed
C. TECHNICAL
C.1. List of Sustaining Technical Employee/s - STE (page 12 of 23) supported by the following documents for
each STE:
C.1.1. STE Affidavit/s (page 14 of 23) with recent passport size picture/s;
C.1.2. Certified true copy of valid PRC ID of STE as licensed professional;
C.1.3. Original NBI Clearance/s of nominated STE/s;
C.1.4. STE Affidavit/s of Construction Experience (page 16 of 23);
C.1.5. Personal Appearance Form duly accomplished and signed by the STE/s appearing before the
designated officer of the PCAB or the nearest DTI regional/provincial office (page 17 of 23);
C.1.6. Affidavit of No Construction Activity (page 18 of 23);
D. GENERAL INFORMATION - fill out GI Sheet (page 4 of 23)
D.1. Membership with SSS, PHILHEALTH & PAG-IBIG;
D.2. Completion of:
D.2.1. 2-day AMO Seminar – to be completed by the AMO himself whether the firm be sole
proprietorship or corporate/partnership and the like;
D.2.2. 40-hour Safety Seminar (COSH, BOSH with Construction Safety Components) – to be
completed by the AMO himself in case of sole proprietorships or by any responsible/senior officer
of the corporation/partnership and the like;
D.3. E-mail Address;
E. OTHERS
E.1. Accomplished Affidavit for Firm’s Authorized Representatives (page 19 of 23);
Yes
No
N/A
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E.2. Original signature of AMO on each and every page of the application forms including supporting documents;
E.3. Certified documents. In lieu of certified copies, photocopies may be accepted provided original copies are
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presented for authentication;
E.4. Self-addressed, self-stamped large brown envelope or a prepaid courier pouch for mailing of license
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certificate;
E.5. Self-stamped envelopes for verification of supporting documents (one (1) self-stamped envelope per
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supporting document);
E.6. Documentary Stamp Tax for each original or certified true copy of Contractor’s License (Sections 173 and
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188 of the Tax Code of 1997 and Revenue Memorandum Circular No. 36-2012);
E.7. The Board may require the AMO interview and submission of pertinent documents/information other than
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the above in order to fully determine the qualifications of the applicants; and,
E.8. AMO Examination (Note: AMO/Applicants for TRADE category may no longer be required to take
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the AMO examination);
F. ARC APPLICATION
F.1. Application for registration in government projects should be accomplished in PCAB-PAD-ARC-F01 (Application for
Registration and Classification of Contractor for Government Infrastructure Projects) which may be filed simultaneously in a
separate folder with the PCAB License Application.
FOR PCAB / DTI-ROG USE ONLY
#
1F
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Prescreening Results
[ ] Comply lacking items as listed in the Remarks
[ ] Accepted
[ ] PCAB Makati [ ] DTI-ROG___________
[ ] Comply lacking items as listed in the Remarks
[ ] Comply lacking items as listed in the Remarks
[ ] Comply lacking items as listed in the Remarks
[ ] Accepted
[ ] Accepted
[ ] Accepted
[ ] PCAB Makati [ ] DTI-ROG___________
[ ] PCAB Makati [ ] DTI-ROG___________
[ ] PCAB Makati [ ] DTI-ROG___________
R
E
M
A
R
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Letter/Item Number:
Comments:
PCAB FORM
PCAB-PAD-NEW-F01
Page 3 of 23
Effectivity Date 02/08/2013
Revision No. 04
This Form is NOT for sale. Reproduction is Allowed
AFFIDAVIT OF ATTESTATION
In behalf of
(Name of Firm)
I hereby request that its application for Contractor's License be approved.
I certify to the completeness of the information/documents contained in this application appertaining to
the category/classification the company is applying for and that the information/documents are true and
correct.
I further certify that the business name and/or SEC registration of this firm is valid and existing.
I certify furthermore that the SSS, Pag-IBIG, and PhilHealth contributions were remitted in favor of the
employees of this firm.
I am fully aware that:
1. All documents submitted in support to this application are subject to verification before PCAB
action;
2. Any discovered misrepresentation of information and/or manifestations of fraud on the
application
documents
submitted
by
my
firm
applicant
or
its
Authorized
Representative/Agent/Liaison Officer shall be subjected to investigation which may result to the
disapproval of my application, denial/suspension/revocation of license and blacklisting of my firm
and myself as its Authorized Managing Officer; and
3. Unconfirmed information/documents submitted to support my firm's qualifications shall be
excluded for categorization/classification purposes.
4. The evaluation of my qualification shall be solely based on the documents submitted at the time
the application was filed/accepted by PCAB.
Authorized Managing Officer
(Signature over Printed Name)
Republic of the Philippines
)
Province of _________________)
City/Municipality of ___________) S.S
SUBSCRIBED AND SWORN to before me this ________ day of ___________________ 20____ at
______________________________________________; affiant exhibited to me his/her Community Tax
Certificate No. _______________ issued at ______________________ on _________________ 20 ___.
NOTARY PUBLIC
Until December 31, 20 ____
Doc. No.
Page No.
Book No.
Series of 20 __.
PCAB FORM
PCAB-PAD-NEW-F01
Page 4 of 23
Effectivity Date 02/08/2013
Revision No. 04
This Form is NOT for sale. Reproduction is Allowed
CONTRACTOR’S GENERAL INFORMATION
Note: Please use additional sheets if necessary.
Name of Firm: (as per SEC or DTI)
Telephone/Fax No. (include area code)
Office Address
If Provincial based, contact address in Manila, if any
Website
Mobile No.
E-mail Address
Type of Firm (please check only one)
Equity
[ ] Sole Proprietorship [ ] Partnership [ ] Corporation
Filipino:
%
Foreign:
%
Nationality:
International Organization for Standardization (ISO) Certification (please check)
[ ] ISO 14001:2004 [ ] OSHAS 18001:2007 [ ] ISO 9001:2008 [ ] Not Available
SEC / Business Name Registration No.
Firm’s SSS No.
Category Applied for
(please check only one)
[
[
[
[
] AAA
] AA
]A
]B
[ ]C
[ ]D
[ ] Trade
Registration Date (mm/dd/yyyy)
Tax Identification No.
Expiry Date (mm/dd/yyyy)
PhilHealth No.
Principal Classification Applied for
Other Classification/s Applied for
(please check only one)
[ ] General Engineering [ ] General Building
[ ] Trade [ ] Specialty (please specify below):
PAG-IBIG No.
(please check, if any)
[ ] General Engineering [ ] General Building
[ ] Specialty (please specify below):
2-day AMO Seminar
Participant
Host/Organizer
Inclusive Dates
Venue
40-hour Safety Seminar ( [ ] COSH / [ ] BOSH with Construction Safety Components )
Participant
Company Position
Course Provider
Inclusive Dates
Venue
Owners / Stockholders / Officers (for corporation / partnership)
NAME
POSITION
NATIONALITY
CAPITAL
SUBSCRIPTION
PAID-UP
CAPITAL
PERCENTAGE
Peso
value
Shares
Directors / Officers (for corporation only)
NAME
POSITION
NATIONALITY
ADDRESS
Certified correct by:
Authorized Managing Officer
(Signature over printed name)
PCAB FORM
PCAB-PAD-NEW-F01
Page 5 of 23
Effectivity Date 02/08/2013
Revision No. 04
This Form is NOT for sale. Reproduction is Allowed
AUTHORIZED MANAGING OFFICER (AMO) AFFIDAVIT
Note: Please accomplish this affidavit properly. Please use additional sheets if necessary.
Recent
Picture of AMO
Passport size
(4.5 cm x 3.5 cm)
Republic of the Philippines )
Province of ______________)
City/Municipality of ________) S.S
Last Name
I,
Citizenship
and
residing at:
Born on
First Name
dd
mm
yyyy
Ext. Name (Jr/Sr, if any)
Last Name
Single /
Married to
Middle Name
First Name
Middle Name
Room/Floor/Unit/Bldg. Name, Lot/Block/Phase No., Street, Subdivision, Barangay, City/Municipality, Province, Zip Code
having duly sworn to in accordance with law depose and say:
1. That I am the Authorized Managing Officer of :
________________________________________________________________________________________
(Name of Firm)
with position of:
___________________________________________________________________________________________________
(Position in the Firm)
2. That I possess the following educational attainments (attach additional sheet if necessary)
Name of School
Address
Course
Inclusive Dates
3. That I possess at least two (2) years experience in the construction industry as follows (Ref. Sec. 20 of IRR of R.A. 4566)
Designation / Position
Company / Nature of Business
Address
Job Description
Dates of
Employment
4. That I possess knowledge of the building, safety, health , & lien laws of the Republic of the Philippines & the rudimentary
administrative principles of construction contracting from my work experiences in item 3 above and from the following
training/seminars (Ref. Sec. 20 of IRR of R.A. 4566):
5. That I am not involved in any construction malperformance suggestive of negligence, incompetence or malpractice or any act of
omission liable for disciplinary action by myself or in collaboration with any other person (Section 4.2 of IRR of R.A. 4566)
6. That I have not been convicted by a court of competent jurisdiction of any offense involving moral turpitude (Section 4.2 of IRR
of R.A. 4566)
7. That I am fully aware that my failure to notify PCAB of my disassociation with my present employer shall cause my
disqualification to be an Authorized Managing Officer, a Sustaining Technical Employee or a license applicant with PCAB .
8. That I authorize the PCAB to verify and investigate any or all information in this instrument from whatever sources PCAB may
consider appropriate
9. That I certify under pain of perjury that all information on this affidavit are true and correct.
FURTHER AFFIANT SAYETH NAUGHT.
____________________________
Affiant
SUBSCRIBED AND SWORN to before me this _____ day of __________________________________________________ 20___
at ___________________________________________________________________________; affiant exhibited his/her Community
Tax Certificate No. _____________ issued at _________________________________________ on ______________ 20________.
Doc. No.
Page No.
Book No.
Series of 20 ___
NOTARY PUBLIC
Until December 31, 20 ___
PCAB FORM
PCAB-PAD-NEW-F01
Page 6 of 23
Effectivity Date 02/08/2013
Revision No. 04
This Form is NOT for sale. Reproduction is Allowed
SECRETARY’S CERTIFICATION
Note: For Corporations only
Republic of the Philippines )
Province of ______________)
City/Municipality of ________) S.S
Last Name
I,
and residing
at:
First Name
Ext. Name (Jr/Sr, if any)
Middle Name
Room/Floor/Unit/Bldg. Name, Lot/Block/Phase No., Street, Subdivision, Barangay, City/Municipality, Province, Zip Code
do hereby certify, in my capacity as the duly elected and incumbent Corporate Secretary of
______________________________________________________________________________________________
That during its regular meeting held on
dd
(Name of Firm)
mm
yyyy
held at
City / Municipality of Meeting
Wherein a quorum was present , the following resolution was unanimously approved, to wit:
AMO NOMINATION
"R E S O L V E as it is hereby resolved that
___________________________________________________________________,
(FIRSTNAME
MIDDLENAME
SURNAME)
a senior executive who has been granted the power to render general management and
administrative decision, be appointed as the firm's Authorized Managing Officer to act on all
matters concerning the requirements of the PCAB and implementation of R.A. 4566 as amended
by P.D. 1746."
IN WITNESS WHEREOF, I have hereunto affixed my hand this ___________ day of ___________________ 20___, in
______________________________, Philippines.
____________________________
Corporate Secretary
(Signature over Printed Name)
SUBSCRIBED AND SWORN to before me this ______ day of ______________________________________ 20___
at _____________________________________________________; affiant exhibited his/her Community Tax
Certificate No. ________________ issued at _________________________________ on ______________ 20______.
NOTARY PUBLIC
Until December 31, 20 ___
Doc. No.
Page No.
Book No.
Series of 20 ___
PCAB FORM
PCAB-PAD-NEW-F01
Page 7 of 23
Effectivity Date 02/08/2013
Revision No. 04
This Form is NOT for sale. Reproduction is Allowed
AUTHORITY TO VERIFY BANK ACCOUNT
THE MANAGER
_________________________________
_________________________________
_________________________________
Subject: Bank Account # _______________________
Sir:
Please provide the Philippine Contractors Accreditation Board (PCAB), a government agency
under the Department of Trade and Industry, any information they need regarding the subject
account with your bank.
I am applying for a contractor's license from PCAB and part of their evaluation process is the
verification of bank deposits and other assets of an applicant.
This will serve as your authorization to release any information that may be requested by PCAB
regarding the above subject account.
Thank you.
Very truly yours,
Name of Firm:
____________________________
____________________________
By: _________________________
Signature over Printed Name of
Authorized Managing Officer or
Authorized Signatory with the Bank
Date:_______________________
Type of Application: (Pls. check)
New
Upgrading
Renewal
Others, pls. specify
_______________________
PCAB FORM
PCAB-PAD-NEW-F01
Page 8 of 23
Effectivity Date 02/08/2013
Revision No. 04
This Form is NOT for sale. Reproduction is Allowed
AUTHORITY TO VERIFY ITR / AFS FROM B.I.R.
THE REVENUE DISTRICT OFFICER
_________________________________
_________________________________
_________________________________
Subject: Income Tax Return and Audited Financial Statement as of ______
Sir:
Please provide the Philippine Contractors Accreditation Board (PCAB), a government agency
under the Department of Trade and Industry, any information they need regarding the subject ITR
and AFS filed with your office.
I am applying for a contractor's license from PCAB and part of their evaluation process is the
verification of ITR and AFS, of an applicant.
This will serve as a waiver on the confidentiality provision of Section 270 of the National Internal
Revenue Code of 1997 (memorandum circular No.28, 2006 dated May 08, 2006) and your
authorization to release any information that may be requested by PCAB regarding the above
subject document/s.
Thank you.
Very truly yours,
____________________________
Signature over Printed Name
of Authorized Managing Officer
Date:____________________
Type of Application: (Pls. check)
New
Upgrading
Renewal
Others, pls. specify
_______________________
PCAB FORM
PCAB-PAD-NEW-F01
Page 9 of 23
Effectivity Date 02/08/2013
Revision No. 04
This Form is NOT for sale. Reproduction is Allowed
AUTHORITY TO VERIFY FROM GOVERNMENT AGENCY/IES
AUTHORIZATION
The Philippine Contractors Accreditation Board (PCAB) is hereby authorized to verify and
secure information and/or copies of documents submitted by or in the name of the firm to any or all of
the following agencies relative to its application filed with the PCAB:
1. Securities and Exchange Commission (SEC)
2. Land Registration Authority (LRA)
3. Land Transportation Office (LTO)
4. Social Security System (SSS)
5. Professional Regulation Commission (PRC)
6. Philippine Health Insurance Corporation (PhilHealth)
7. Home Development Mutual Fund (Pag-IBIG)
________________________
Signature over Printed Name
of Authorized Managing Officer
Date:______________________
Type of Application: (Pls. check)
New
Upgrading
Renewal
Others, pls. specify
_______________________
PCAB FORM
PCAB-PAD-NEW-F01
Page 10 of 23
Effectivity Date 02/08/2013
Revision No. 04
This Form is NOT for sale. Reproduction is Allowed
LIST OF CONSTRUCTOR’S REAL PROPERTIES
Note: Please use additional sheets if necessary.
REAL PROPERTIES OF THE FIRM AS OF THE BALANCE SHEET DATE
COMPLETE
DESCRIPTION
(Type of land/building)
*TCT-CLT/
CCT/TD
NUMBER
LOCATION
(Street No., Barangay,
Municipality/City, Province)
*LEGEND:
TCT – Transfer Certificate of Title
CCT – Condominium Certificate of Title
TD – Tax Declaration
CLT – Certificate of Land Title
________________________
Signature over Printed Name
of Authorized Managing Officer
Date:________________________
Type of Application: (Pls. check)
New
Upgrading
Renewal
Others, pls. specify
_______________________
ACQUISITION
COST
ACQUISITION
DATE
PCAB FORM
PCAB-PAD-NEW-F01
Page 11 of 23
Effectivity Date 02/08/2013
Revision No. 04
This Form is NOT for sale. Reproduction is Allowed
LIST OF CONSTRUCTOR’S PLANTS, VEHICLES AND EQUIPMENT
Note: Please use additional sheets if necessary.
A. DELIVERY AND TRANSPORTATION EQUIPMENT OF THE FIRM AS OF BALANCE SHEET DATE
COMPLETE DESCRIPTION
Vehicle Brand / Type
Plate No.
Year
Model
ACQUISITION
OR No. / Date
Date
Cost
(in Php)
Php
OVERALL TOTAL VALUE
BOOK
VALUE
(in Php)
Php
B. MACHINERIES/PLANTS AND OTHER CONSTRUCTION EQUIPMENT OF THE FIRM AS OF BALANCE
SHEET DATE
COMPLETE
DESCRIPTION
OVERALL TOTAL VALUE
________________________
Signature over Printed Name
of Authorized Managing Officer
Date:_________________________
Type of Application: (Pls. check)
New
Upgrading
Renewal
Others, pls. specify
_______________________
ACQUISITION
SERIAL NO.
BOOK
VALUE
(in Php)
Cost
(in Php)
Date
Php
Php
PCAB FORM
PCAB-PAD-NEW-F01
Page 12 of 23
Effectivity Date 02/08/2013
Revision No. 04
This Form is NOT for sale. Reproduction is Allowed
LIST OF NOMINATED SUSTAINING TECHNICAL EMPLOYEES
Name of STE
Previously Nominated
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
Newly Nominated
1.
2.
3.
4.
5.
6.
7.
8
9.
10.
________________________
Signature over Printed Name
of Authorized Managing Officer
Date:________________________
Type of Application: (Pls. check)
New
Upgrading
Renewal
Others, pls. specify
_______________________
Prof.
PRC Registration
Date of
License
Number Registration
Validity
Date
Position
Employed in the Firm
PCAB FORM
PCAB-PAD-NEW-F01
Page 13 of 23
Effectivity Date 02/08/2013
Revision No. 04
This Form is NOT for sale. Reproduction is Allowed
SCHEDULES
Note: Please use additional sheets if necessary.
RECEIVABLES
To be accomplished if the applicant's receivable accounts (accounts/contracts & other receivable) exceed 50% of the
total networth/equity as of the latest audited balance sheet submitted in support of its application.
Name of Projects
Amount Due for
Collection
Age
Client Name / Complete Address
Certified Correct by:
_______________________________________
Printed Name and Signature of External Auditor
______________________________
Printed Name and Signature of AMO
INVENTORIES
To be accomplished if the applicant's inventory accounts exceed 20% of the total networth/equity as of the
latest audited balance sheet submitted in support of its application.
Types
Amount
Age/Date
Acquired
Intended Use or
Purpose for
Storing
Physical
Condition
Place of Storage
Certified Correct by:
_______________________________________
Printed Name and Signature of External Auditor
______________________________
Printed Name and Signature of AMO
PCAB FORM
PCAB-PAD-NEW-F01
Page 14 of 23
Effectivity Date 02/08/2013
Revision No. 04
This Form is NOT for sale. Reproduction is Allowed
SUSTAINING TECHNICAL EMPLOYEE AFFIDAVIT
Note: Please accomplish this affidavit properly. Refer to the next page for STE qualification requirements.
Recent
Picture of STE
Passport size
(4.5 cm x 3.5 cm)
Republic of the Philippines )
Province of ______________)
City/Municipality of ________) S.S
Last Name
I,
Born on
dd
and
residing at:
mm
First Name
yyyy
Single /
Married to
Last Name
Ext. Name (Jr/Sr, if any)
Middle Name
First Name
Middle Name
Room/Floor/Unit/Bldg. Name, Lot/Block/Phase No., Street, Subdivision, Barangay, City/Municipality, Province, Zip Code
having duly sworn to in accordance with law depose and say:
1.
That I am a duly licensed ____________________________________________ and holder of PRC License No. __________
(PROFESSION)
valid up to _______________.
That I hold a Bachelor's Degree in
2.
Given at:
3.
4.
Name of School
6.
7.
8.
9.
10.
11.
Given on:
Inclusive Dates
That my Tax Identification Number is :
and my Social Security System Number:
Name of Firm
That I am employed on a regular and full-time
basis by:
Position in the Firm
With position of
5.
Course / Profession
CFY
as a STE for
That I am not presently employed by either a private company or any government office or government owned/controlled
corporation, nor a full time instructor, nor working abroad;
That I am not a holder of a valid contractor's license;
That I am not involved in any construction malperformance suggestive of negligence, incompetence or malpractice or any
act or omission liable for disciplinary action by myself or in collaboration with any other person;
That I have not been convicted by a court of competent jurisdiction of any offense involving moral turpitude;
That I am fully aware that my failure to notify the PCAB of my disassociation with my present employer shall cause my
disqualification to be a Sustaining Technical Employee or an Authorized Managing Officer or an applicant for a contractor’s
license with PCAB;
That I authorize the PCAB to verify and investigate any or all information in this affidavit from whatever sources PCAB may
consider appropriate;
That I am executing this affidavit to attest to the truth of the foregoing.
FURTHER AFFIANT SAYETH NAUGHT.
____________________________
Affiant
SUBSCRIBED AND SWORN to before me this _____ day of ___________________, 20___ at ___________________________;
affiant exhibited his/her Community Tax Certificate No. _____________ issued at __________________ on ______________ 20___.
Doc. No.
Page No.
Book No.
Series of 20 ___
NOTARY PUBLIC
Until December 31, 20 ___
PASTE
PASTE
PROF. I.D. CARD
PROF. I.D. CARD
VALID FOR
VALID FOR
CURRENT YEAR
CURRENT YEAR
(Front)
(photocopy)
(Back)
(photocopy)
PCAB FORM
PCAB-PAD-NEW-F01
Page 15 of 23
Effectivity Date 02/08/2013
Revision No. 04
This Form is NOT for sale. Reproduction is Allowed
QUALIFICATION REQUIREMENTS FOR STE
1.
A technology professional, such as engineer or architect, duly licensed by the Professional
Regulation Commission (PRC).
2.
Holder of a valid PRC I.D.
3.
With three (3) years minimum actual construction experience.
4.
A full-time employee of the nominating contractor, not associated professionally or by
employment with any other party, particularly a party engaged in construction or constructionrelated activities.
5.
Have none of the following disqualifications:
a) Involvement, in any capacity, in any construction malperformance of grave consequence,
suggestive of his negligence, incompetence and/or malpractice;
b) Involvement, by himself or in collaboration with any other person or firm, in any act or
omission liable for disciplinary action of which he/she is or the other person or firm was
found guilty by the PCAB Board ;
c) Conviction by a court of competent jurisdiction of any offense involving moral turpitude; and
d) If formerly a Sustaining Technical Employee or an Authorized Managing Officer of any
construction firm but disassociated there from, failure to notify the Board of his
disassociation in accordance with paragraph 5 and 6 of the Affidavit of Undertaking.
This is to certify that I have verified with PRC the abovestated professional eligibility/registration of
the Sustaining Technical Employee. Affiant herein and found the same to be true and correct.
__________________________________________
Authorized Managing Officer
(Signature over printed name)
__________________________________________
Date
Type of Application: (Pls. check)
New
Upgrading
Renewal
Others, pls. specify
_______________________
PCAB FORM
PCAB-PAD-NEW-F01
Page 16 of 23
Effectivity Date 02/08/2013
Revision No. 04
This Form is NOT for sale. Reproduction is Allowed
AFFIDAVIT OF STE CONSTRUCTION WORK EXPERIENCE
Note: Please use additional sheets if necessary.
Republic of the Philippines )
Province of ______________)
City/Municipality of ________) S.S
I, _________________________________, single/married, Filipino, of legal age, with postal address at
________________________________________________, having been duly sworn in accordance with law depose
and say that the projects enumerated below constitute my full & complete construction experience.
Name and
Complete Address of Employer/
Name & Location of Projects Undertaken
Work
Classification
(GE, GB, SP)
Nature/Scope of Work
Assignment
(Proj. Engr.)
Project Duration
(mm/dd/yyyy)
From
To
That I authorize the PCAB to verify and investigate any or all information in this affidavit from whatever sources PCAB
may consider appropriate;
That I am executing this affidavit to attest to the truth of the foregoing.
FURTHER AFFIANT SAYETH NAUGHT.
_________________________________
Affiant
SUBSCRIBED AND SWORN to before me this ________ day of ___________________________________ 20_____
at ______________________________________________________________; affiant exhibited his/her Community
Tax Certificate No. ______________ issued at ___________________________ on ____________________ 20___.
NOTARY PUBLIC
Until December 31, 20 ___
Doc. No
Page No.
Book No.
Series of 20 _____.
PCAB FORM
PCAB-PAD-NEW-F01
Page 17 of 23
Effectivity Date 02/08/2013
Revision No. 04
This Form is NOT for sale. Reproduction is Allowed
STE PERSONAL APPEARANCE
Note: To be accomplished by the STE
Name of STE
Last Name
First Name
Profession
Ext. Name (Jr/Sr, if any)
Middle Name
PRC ID No.
Expiration Date
Present Employer
I hereby confirm the following:
1. The veracity of the information reflected on the STE Affidavit and Affidavit of Construction Experience
that I executed in favor of the above present employer;
2. That I am fully aware that my failure to notify the PCAB of my disassociation from the above-stated
nominating firm and any misrepresentation in the attached forms shall cause my disqualification as
sustaining technical employee, or authorized managing officer, or a licensee applicant with PCAB per
Board Resolution No. 401, Series of 2001.
3. That I have been previously connected with the following companies and disassociated therefore:
Previous Employers
Date of
Employment
Date of
Resignation
Position
4. Other Remarks:
_____________________________________________________________________________________
_____________________________________________________________________________________
Valid I.D.(s) Presented:
1. ________________
No: ______________
2. ________________
No: ______________
________________________
STE’s Signature
________________________
Date Signed
----------------------------------------------------------------------To be filled out by PCAB/DTI Personnel
____________________________
Signature over Printed Name
PCAB / DTI Office:_______________
Date :__________________________
STE’s Specimen Signature (during interview):
____________________________
PCAB FORM
PCAB-PAD-NEW-F01
Page 18 of 23
Effectivity Date 02/08/2013
Revision No. 04
This Form is NOT for sale. Reproduction is Allowed
AFFIDAVIT OF NO CONSTRUCTION ACTIVITY FOR NEW LICENSE APPLICANTS
Republic of the Philippines )
Province of ______________)
City/Municipality of ________) S.S
I, ______________________________________ of legal age, Filipino, single/married, and residing at
___________________________________________, after having been sworn to in accordance with law,
depose and say that:
1. I am the Proprietor / AMO of _______________________________________________________
2. I am aware of the provisions of Section 35 of R.A 4566 (the Contractor’s License Law) that requires
a contractor to secure a license before engaging in the business of construction contracting in the
Philippines;
3. I have not undertaken any construction activity that requires a contractor’s license prior to the filing
of this application;
4. I will not engage or have not engaged in any construction activity that requires a contractor’s
license during the pendency of this application;
5. I am executing this affidavit to support my application for license and to attest to the truth of the
foregoing.
________________________
Affiant
SUBSCRIBED AND SWORN to before me this _________ day of ________________________ 20___ at
________________________________________________; affiant exhibiting to me his/her Community
Tax Certificate No. _______________ issued at _________________ on _______________ 20______.
NOTARY PUBLIC
Until December 31, 20 ____
Doc. No.
Page No.
Book No.
Series of 20 __.
IMPORTANT:
1. Submit this affidavit only if you have not undertaken any construction activity.
2. If construction has been undertaken prior to application or during the pendency of the application, inform the Public
Assistance Desk for assessment of Additional License Fee.
3. Misrepresentation in the application for a license may result in the disapproval thereof without prejudice to
administrative, civil, and criminal prosecution
PCAB FORM
PCAB-PAD-NEW-F01
Page 19 of 23
Effectivity Date 02/08/2013
Revision No. 04
This Form is NOT for sale. Reproduction is Allowed
AFFIDAVIT OF REPRESENTATIVES
Note: To be accomplished by the AMO.
Republic of the Philippines
)
Province of ______________)
City/Municipality of ________) S.S
Last Name
I,
born on
dd
mm
First Name
yyyy
Single /
Married to
Ext. Name (Jr/Sr, if any)
Middle Name
First Name
Middle Name
Last Name
Room/Floor/Unit/Bldg. Name, Lot/Block/Phase No., Street, Subdivision, Barangay, City/Municipality, Province, Zip Code
and
residing
at:
having duly sworn to in accordance with law depose and say:
Name of Firm
That I am the
Authorized
Managing
1.
Officer of :
with office
address at:
Room/Floor/Unit/Bldg. Name, Lot/Block/Ph. No., Street, Subdivision, Barangay, City/Municipality, Province, Zip Code
That I appoint two (2) representatives, whose pictures and signatures appear below:
Picture
Name of Representative
(Passport Size Photo - taken within the last
six months prior to application of PCAB
license)
Signature of Representative over
Printed Name
A.
2.
B.
3.
4.
5.
to transact business with PCAB; i.e, present for pre-screening my application for contractor’s license or any
application related thereto, file/follow-up, submit documents, receive notices/license in connection with the said
application and the like.
That I am aware that I am responsible/liable for any or all acts/representation made by my representatives in
connection with the functions stated herein.
That I undertake to notify PCAB in the event that this appointment is modified, amended or revoked.
That I have read and fully understood and complied with the requirements of PCAB Board Resolution No. 515 s.
2011 (copies of required documents are attached).
____________________________
Affiant
(Authorized Managing Officer of Firm)
SUBSCRIBED AND SWORN to before me this _________ day of ____________________________, 20_____ at
_____________________________________________________; affiant exhibited his/her Community Tax Certificate
No. _____________________ issued at _____________________________ on ________________ 20_________.
Doc. No.
Page No.
Book No.
Series of 20 ___
NOTARY PUBLIC
Until December 31, 20 ___
PCAB FORM
PCAB-PAD-NEW-F01
Page 20 of 23
Effectivity Date 02/08/2013
Revision No. 04
This Form is NOT for sale. Reproduction is Allowed
IMPORTANT REMINDERS
1. All required information in the application forms should be filled out. Do not leave an item
blank. If item is not applicable, indicate “N/A”.
2. Specify the paper size to 8.27” x 11.69” (A4 size) in printing the application forms.
3. Application forms and its corresponding supporting documents/attachments should be:
a.
b.
arranged according to the checklist of requirements with index tabs;
placed in a long size folder with fastener.
4. Only the Authorized Managing Officer or one of the two (2) Authorized Representatives of
the Firm is allowed to transact with PCAB (Board Resolution No. 515, s. 2011).
5. All applicants are required to pay non-refundable upfront fees for all types of license
applications upon acceptance (Board Resolution No. 313, s. 2011).
6. Avoid the rush and delay in the filing/processing of renewal application. Observe and follow
the staggered filing schedule (Board Resolution No. 118, s. 2011) as stated below:
Last Digit of License No.
0 and 1
2 and 3
4 and 5
6 and 7
8 and 9 and new license
approved from
January to June
Filing Month
February
March
April
May
June
7. Filing/submission of application/s can be done at PCAB Makati or thru the DTI
Regional/Provincial Offices or thru PCAB Accredited Contractors’ Associations &
Professional Organizations.
8. Application Forms (i.e. ARC, Amendments, Special License, etc.), Citizen’s Charter, Board
Resolutions, Advisories and other relevant information about PCAB application can be
downloaded at www.dti.gov.ph / websites of PCAB Accredited Contractors’ Associations &
Professional Organizations.
9. For further inquiries or clarifications, please communicate with us thru email or thru contact
numbers below:
Philippine Contractors Accreditation Board
5F Executive Building Center, 369 Sen. Gil J. Puyat Ave.,
Makati City 1209
Tel/TeleFax: 895-4258 / 895-4220
E-mail Address:
[email protected]
PCAB FORM
PCAB-PAD-NEW-F01
Page 21 of 23
Effectivity Date 02/08/2013
Revision No. 04
This Form is NOT for sale. Reproduction is Allowed
GUIDELINES FOR CLASSIFICATION AND CATEGORIZATION OF CONTRACTORS
1.
Classification means the area of operation that a contractor can engage is based on
the technical experience of his sustaining technical employee (STE). A contractor may apply for and be issued more than one
classification, one of which shall be designated as his principal classification.
2.
Category indicates the graded level of aggregate capability of a contractor with respect
to his principal classification and is based on predetermined qualification criteria which include financial capacity, experience
of STE, track record and equipment. Evaluation of category shall be based on the following criteria quantified by credit points
in scales as determined by the Board.
2.1 Financial capacity
Financial capacity shall be in term of Networth based on the latest audited financial statements submitted to the
Bureau of Internal Revenue (BIR), or paid-up capital based on the latest audited financial statements submitted to the
Securities and Exchange Commission (SEC), if a newly-organized partnership or corporation. PCAB has the right to
reject or reduce portion thereof if, upon verification, the reported assets of the contractor were found to be erroneous
or not adequately supported with appropriate documents. Corresponding credit points is 1 for every P100,000.00 of
the value of Networth/Stockholder’s Equity.
2.2 Equipment Capacity
Equipment capacity shall be in term of book value as reflected in the constructor’s latest audited financial statement
submitted to the BIR or the SEC, whichever is applicable, or equipment owned which are in operational condition and
applicable to construction of the classification in which the constructor is to be categorized. Said owned equipment
shall include units under installment and/or under lease purchase. Corresponding credit points is 1 for every
P100,000.00 of the NBV of the contractor owned equipment.
2.3 Experience of firm
Experience of firm shall be in terms of:
2.3.1 Aggregate number of years in which the constructor firm, under the same business identify, has been actively
engaged in construction contracting operation. Corresponding credit points is 10 for every year of actual
construction operation as a licensed contractor; and
2.3.2 Average annual value of work completed by the firm during the past three (3) years or, if constructor’s license
is less than three (3) years, since being licensed, based on the audited financial statements submitted to the
BIR. Corresponding credit points is one (1) for every P100,000.00 of the annual value of work
accomplishment.
2.4 Experience of technical personnel
Experience of technical personnel shall be the sum total of individual experience of each STE nominated to the
classification and shall be subject to the qualification requirement of each category as indicated in the PCAB
Classification and Categorization Table. Said individual experience of the STE shall be as defined and qualified
below:
2.4.1. The experience shall be in term of aggregate number of years in which the STE, in his present employment as
well as previous, has been involved in construction is to be categorized.
2.4.2. It shall include only the years in which he was performing in managerial/supervisory capacity bearing on
construction operation and/or contract implementation.
2.4.3. It shall be subject to a creditable ceiling of thirty (30) years, over which no excess shall be recognized.
Corresponding credit point is five (5) for every year of experience in construction.
The category of a contractor shall be determined on the basis of the number of points credited on the
aggregate/combined experience of all its qualified STE. Only STEs who meet the minimum individual experience
required shall be considered in determining aggregate experience and credit points. Thus, in order to qualify to the
technical capacity requirement for category “AAA”, the contractor must have qualified STEs whose individual
experience is not less than ten (10) years with a creditable ceiling of thirty (30) years and have an
aggregate/combined experience of at least sixty (60) years.
3.
In determining a contractor’s category, his qualification must satisfy all the minimum
requirements, corresponding to the classification and category applied for, qualified and rated according to equivalent credit
points and shall be the lowest sustainable by all three determinants as follows:
3.1
3.2
3.3
Financial Capacity
Experience of STE
Overall credit points based on the four qualification criteria referred to in item 2 of these guidelines.
PCAB FORM
PCAB-PAD-NEW-F01
Page 22 of 23
Effectivity Date 02/08/2013
Revision No. 04
This Form is NOT for sale. Reproduction is Allowed
CATEGORIZATION – CLASSIFICATION TABLE
CLASSIFICATION
C
A
T
E
G
O
R
Y
(2)
STE Min. Const.
Exp. Requirement
(1)
Financial Capacity
Stockholder’s
Equity
Credit
Points
(C.P.)
Req’d.
Individual
Aggregate
Min.
C.P.
Req’d.
(3)
Overall
Credit
Points
Required
P90,000,000.00
900.00
10
60
300
1,950.00
AA
45,000,000.00
450.00
10
50
250
915.15
A
9,000,000.00
90.00
7
21
105
265.00
B
4.500,000.00
45.00
5
10
50
122.50
GE-4 (Water Supply)
C
3,000,000.00
30.00
3
3
15
75.50
GE-5 (Port, Harbor or Offshore
Engineering)
D
900,000.00
9.00
3
3
15
24.00
P90,000,000.00
900.00
10
60
300
1,910.00
A. GENERAL ENGINEERING
GE-1 (Road, Highways, Pavement,
Railways, Airport Horizontal
Structure, and Bridges)
GE-2 (Irrigation or Flood Control)
GE-3 (Dam, Reservoir or Tunneling)
AAA
MINIMUM QUALIFICATION REQUIREMENTS
B. GENERAL BUILDING
AAA
GB-1 (Building or Industrial Plant)
AA
45,000,000.00
450.00
10
50
250
895.00
A
9,000,000.00
90.00
7
21
105
261.00
B
4,500,000.00
45.00
5
10
50
120.50
C
3,000,000.00
30.00
3
3
15
66.50
D
900,000.00
9.00
3
3
15
24.00
P90,000,000.00
900.00
10
60
300
1,510.00
AA
45,000,000.00
450.00
10
50
250
695.00
A
9,000,000.00
90.00
7
21
105
211.00
B
4,500,000.00
45.00
5
10
50
110.50
C
3,000,000.00
30.00
3
3
15
60.50
D
900,000.00
9.00
3
3
15
24.00
TRADE
45,000.00
0.40
none
none
none
0.45
GB-2 (Sewerage or Sewage System)
GB-3 (Water Treatment Plant & System)
GB-4 (Park, Playground or Recreational
Work)
C. SPECIALTY
SP-FW (Foundation Work)
AAA
SP-SS (Structural Steel Work)
SP-CC (Concrete Pre-casting, PreStressing or Post-tensioning)
SP-PS (Plumbing & Sanitary Work)
SP-EE (Electrical Work)
SP-ME (Mechanical Work)
SP-AC (Air-conditioning or Refrigeration)
SP-ES (Elevator or Escalator)
SP-FP (Fire Protection Work)
SP-WP (Waterproofing Work)
SP-PN (Painting Work)
SP-WD (Well-Drilling Work)
SP-CF (Communication Facilities)
SP-MS (Metal Roofing & Siding Installation)
SP-SD (Structural Demolition)
SP-LS (Landscaping)
SP-EM (Electro Mechanical Work)
SP-NF (Navigational Facilities)
D. SP-TRADE
* Minimum Qualification Requirements for Principal Classification
** For Other Classification/s, Minimum of 3 Years Actual Construction Experience
*** Overall credit points inclusive of Equipment Capacity (1 point/P100Th); Experience of Firm (10 points/year of active existence); &
1 point/P100Th of 3 year Average Annual Volume of Work Accomplished; and COMTCP points if STEs are COMTCP certified
PCAB FORM
PCAB-PAD-NEW-F01
Page 23 of 23
Effectivity Date 02/08/2013
Revision No. 04
This Form is NOT for sale. Reproduction is Allowed
PCAB LICENSING FEE STRUCTURE
CATEGORY
TYPES OF FEES
AAA
AA
A
B
C
D
TRADE
(Pesos)
(Pesos)
(Pesos)
(Pesos)
(Pesos)
(Pesos)
(Pesos)
600
600
600
600
600
600
600
2,400
1,200
240
120
72
24
exempt
1,200
600
120
60
36
12
exempt
21,600
10,800
3,600
2,400
1,200
600
exempt
50
50
50
50
50
50
50
600
600
600
600
600
600
600
14,400
7,200
2,400
1,800
960
480
exempt
License Renewal Fee
50
50
50
50
50
50
50
Surcharge for late Renewal
20
20
20
20
20
20
20
Special License
a. New Application
Filling Fee
600
600
600
600
600
600
600
License Fee (per project basis)
50
50
50
50
50
50
50
21,600
10,800
3,600
2,400
1,200
600
exempt
600
600
600
600
600
600
600
50
50
50
50
50
50
50
14,400
7,200
2,400
1,800
960
480
exempt
1,200
600
120
60
36
12
N/A
50
50
50
50
50
50
N/A
21,600
10,800
3,600
2,400
1,200
600
N/A
50
50
50
50
50
50
N/A
Change of AMO
50
50
50
50
50
50
50
Change of Business Name/Status
License Revision (for each type of
petition)
License Replacement/Reprint
50
50
50
50
50
50
50
50
50
50
50
50
50
50
60
60
60
60
60
60
60
New Application
Filing Fee
Classification Fee
Principal Classification
Other Classification/s
(chargeable for each
classification)
Categorization Fee
License Fee
Renewal Application
Filing Fee
Category Review
Categorization Fee (per CFY basis)
b. Renewal Application
Filling Fee
License Fee
Categorization Fee
Additional Classification
Principal Classification License
Revision/Re-issue
Upgrading of Category
Categorization Fee
License Revision/Re-issue
Other Types of Petitions