REPUBLIC OF THE PHILIPPINES )

_____________________________ )
_____________________________ ) S.S.

AFFIDAVIT

I, VICENTE S. DUMADAG, JR., of legal age, with postal address c/o P-3 Batangan,
Valencia City, Bukidnon, after having duly sworn to in accordance with the law, hereby depose and
say:

That I am the General Manager of DL BUILDERS AND REAL PROPERTIES DEV'T. INC.,
a Filipino corporation duly organized under the existing laws of the Republic of the
Philippines with business address at P-3 Batangan, Valencia City, Bukidnon;

That the DL BUILDERS AND REAL PROPERTIES DEV'T. INC. has a Contract with the
Republic of the Philippines under the Department of Public Works and Highways (DPWH)
Region 10;

That the said Contract is for Contract ID No. 18KO0261: Construction / Repair /
Rehabilitation / Improvement of Various Infrastructure including Local Projects, Road
Concreting, Sitio Buco to Sitio Pantaron, Brgy. Banlag, Valencia City;

That in compliance with Department Circular No. 17 Series of 1996, the DL BUILDERS
AND REAL PROPERTIES DEV'T. INC., hereby states the gross receipts have been declared
with Bureau of Internal Revenue for Income Tax purposes;

That, we have submitted our Monthly Certificate of Payment No. 2 for our construction
works for the period covering August 01, 2018 - September 30, 2018;

That we have not given any money or gift, nor made promises of anything to any persons,
employees or officer of the Department of Public Works and Highways in connection to the
said project;

That DL BUILDERS AND REAL PROPERTIES DEV'T. INC. has fully paid all
workers/laborers, subcontractor, suppliers and all persons or parties who have done or
finished materials supplied, supplied services, and other inputs on work accomplished on the
project as of September 30, 2018 and such payments were all in accordance with law;

That this affidavit is being executed to support our claim for the Nature of Claim for work
accomplished anent above said project and to comply with the legal requirements.

IN WITNESS WHEREOF, I have unto affixed my signature this ___

__ day of ____________
, at _______________.

VICENTE S. DUMADAG, JR.

General Manager

SUBSCRIBED AND SWORN to before me this ____day of _________ at

_________________________ Affiant exhibition to me his Res. Cert. No. __________ issued on
_______________ at ____________.

Doc. No. : __________________

Page No. : __________________
Book No. : __________________
Series of : _________________
__________________
Notary Public