OMNIBUS SWORN STATEMENT

Republic of the Philippines )

CITY/MUNICIPALITY OF CALOOCAN )

Affidavit

I, EDGARDO A. ABRENICA, of legal age, Married, Filipino, and residing at Blk. 12

Lot 6&7 Phase 3D Dagat-Dagatan Ave. Extn., Caloocan City. After having been duly sworn in
accordance with law, do hereby depose and state that:

1. I am the sole proprietor of JORDAN LEATHER AND GENERAL MERCHANDISE

with office address at Blk. 12 Lot 6&7 Phase 3D Dagat-Dagatan Ave. Extn.,
Caloocan City;

2. As the owner and sole proprietor of JORDAN LEATHER AND GENERAL

MERCHANDISE, I have full power and authority to do, execute and perform any
and all acts necessary to represent it in bidding for the PURCHASE OF DUTY RIG
BELT of the Manila International Airport Authority;

3. JORDAN LEATHER AND GENERAL MERCHANDISE is not “blacklisted” or

barred from bidding by the Government of the Philippines or any of its agencies,
offices, corporations, or Local Government Units, foreign government/foreign or
international financing institution whose blacklisting rules have been recognized by
the Government Procurement Policy Board;

4. Each of the documents submitted in satisfaction of the bidding requirements is an

authentic copy of the original, complete, and all statements and information provided
therein are true and correct;

5. JORDAN LEATHER AND GENERAL MERCHANDISE is authorizing the Head if

the Procuring Entity or its duly authorized representative(s) to verify all the
documents submitted;

6. I am not related to the Head if the Procuring Entity, members of the Bids and Awards
Committee (BAC), the Technical Working Group, and the BAC Secretariat, the head
of the Project Management Office or the end-user unit, and the project consultants by
consanguinity of affinity up to the third civil degree;

7. JORDAN LEATHER AND GENERAL MERCHANDISE complies with existing

labor laws and standards; and

8. JORDAN LEATHER AND GENERAL MERCHANDISE is aware of and has

undertaken the following responsibilities as a Bidder;
 a. Carefully examine all the Bidding Documents;

b. Acknowledge all conditions, local or otherwise, effecting the implementation

of the Contract.

c. Made an estimate of the facilities available and needed for the contract to be
bid, if any; and

d. Inquire or secure Supplemental/Bid Bulletin(s) issued PURCHASE OF

DUTY RIG BELT).

9. JORDAN LEATHER AND GENERAL MERCHANDISE did not give or pay

directly or indirectly, any commission, amount, fee, or any form of consideration,
pecuniary or otherwise, to any procurement project or activity.

IN WITNESS WHEREOF, I hereunto affixed my signature this 24th day of September

2019 at Caloocan City, Philippines.

_______________________
EDGARDO A. ABRENICA

SUBSCRIBED AND SWORN to before me this 24th day of September 2019 at

Caloocan City, Philippines. Affiant is personally known to me and was identified by me through
competent evidence of identity as defined in the 2004 Rules on Notarial Practice (A.M. No. 02-
8-13-SC). Affiant exhibited to me his Driver’s License with, with his photograph and signature
appearing thereon, with License No. N04-90-160229 and his Community Tax Certificate No.
CCI201807740594 issued on 1st of January 2017 at Caloocan City.

Witness my hand and seal this 24th day of September 2019.

Doc. No.: __________

Page No.: __________
Book No.: __________
Series of __________
Notary Public
Until: __________
PTR No.:__________
Date: __________
Place: __________
TIN: __________