New Contractors License

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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 [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ [ [ [ [ [ [ [ [ [ [ [ ] ] ] ] [ ] ] ] ] ] [ ] ] ] ] ] [ ] 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); [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] 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 [ ] [ ] [ ] [ [ [ [ [ [ [ [ [ [ [ [ ] ] ] ] ] ] ] ] ] ] ] ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] [ ] 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 [ ] [ ] [ ] presented for authentication; E.4. Self-addressed, self-stamped large brown envelope or a prepaid courier pouch for mailing of license [ ] [ ] [ ] certificate; E.5. Self-stamped envelopes for verification of supporting documents (one (1) self-stamped envelope per [ ] [ ] [ ] supporting document); E.6. Documentary Stamp Tax for each original or certified true copy of Contractor’s License (Sections 173 and [ ] [ ] [ ] 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 [ ] [ ] [ ] 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 [ ] [ ] [ ] 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 ile d Pr esc re en er / D at e 2 3 4 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 K S 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