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Bidding Forms
The Bidder shall use the Bidding Forms (BFs) listed below in preparing its Bid and, in case it is
awarded the contract, in preparing the documents required to perfect the contract.

Bid Form

Form of Bid Security: Bank Guarantee

Form of Bid Security: Irrevocable Letter of Credit

Form of Bid Securing Declaration

Contractor’s Organizational Chart for the Contract

List of Contractor’s Key Personnel to be Assigned to the Contract, with their Qualification and
Experience Data

List of Contractor’s Equipment Units to be Assigned to the Contract, Supported by Certificates of

Availability

Omnibus Sworn Statement Required by IRR Section 25.2b)iv)

Summary of Bid Prices

Cash Flow by Quarter

Bidder’s Checklist of Requirements for Its Bid, Including Technical and Financial Proposals
Requirement for Bidders

Performance Security: Irrevocable Letter of Credit

Performance Securing Declaration

Construction Methods

Construction Schedule in the form of PDM or Precedence Diagram Method and Bar Chart with
S-Curve and Cash Flow

Manpower Schedule

Major Equipment Utilization Schedule

Construction Safety and Health Program

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The content of each of these forms is given in the attached folder marked “Standard Bidding
Forms.” The bidder may download these forms from the DPWH website. The bidder may also
obtain from the Procuring Entity hard copies of these forms as part of the BDs for the contract.

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Department of Public Works and Highways

Contract ID:
Contract Name:
Location of the Contract:
----------------------------------------------------------------------------------------
BID FORM

Date:____________

Project Identification No. :____________

To: [name and address of Procuring Entity]

Having examined the Philippine Bidding Documents (PBDs) including the Supplemental
or Bid Bulletin Numbers [insert numbers], the receipt of which is hereby duly acknowledged,
we, the undersigned, declare that:

a. We have no reservation to the PBDs, including the Supplemental or Bid Bulletins, for
the Procurement Project: [insert name of contract];

b. We offer to execute the Works for this Contract in accordance with the PBDs;

c. The total price of our Bid in words and figures, excluding any discounts offered below
is: [insert information];

d. The discounts offered and the methodology for their application are: [insert
information];

e. The total bid price includes the cost of all taxes, such as, but not limited to: [specify the
applicable taxes, e.g. (i) value added tax (VAT), (ii) income tax, (iii) local taxes, and
(iv) other fiscal levies and duties], which are itemized herein and reflected in the
detailed estimates,

f. Our Bid shall be valid within the a period stated in the PBDs, and it shall remain
binding upon us at any time before the expiration of that period;

g. If our Bid is accepted, we commit to obtain a Performance Security in the amount of

[insert percentage amount] percent of the Contract Price for the due performance of
the Contract, or a Performance Securing Declaration in lieu of the the allowable forms
of Performance Security, subject to the terms and conditions of issued GPPB
guidelines12 for this purpose;

h. We are not participating, as Bidders, in more than one Bid in this bidding process,
other than alternative offers in accordance with the Bidding Documents;

i. We understand that this Bid, together with your written acceptance thereof included in
your notification of award, shall constitute a binding contract between us, until a formal
Contract is prepared and executed; and

j. We understand that you are not bound to accept the Lowest Calculated Bid or any other

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Bid that you may receive.

k. We likewise certify/confirm that the undersigned, is the duly authorized representative

of the bidder, and granted full power and authority to do, execute we have examined
and have no reservation on the Bidding Documents (BDs), including
Supplemental/Bid Bulletins, for the above stated Contract;

l. We acknowledge that failure to sign each and every page of this Bid Form, including
the Bill of Quantities, shall be a ground for the rejection of our bid.

Name: ___________________________________________________________________
Legal Capacity: ____________________________________________________________
Signature: ________________________________________________________________
Duly authorized to sign the Bid for and behalf of: __________________________________
Date: ___________________

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Department of Public Works and Highways

Contract ID:
Contract Name:
Location of the Contract:
----------------------------------------------------------------------------------------
FORM OF BID SECURITY: BANK GUARANTEE

WHEREAS, ___Name of Bidder__, hereinafter called “the Bidder,” has submitted its bid dated
_______ for the ___Contract ID and Name , hereinafter called “the Bid.”

KNOW ALL MEN by these presents that We, __Name of Bank of __Name of Country , having
our registered office at ________________________, hereinafter called “the Bank,” are bound unto
__Name of Procuring Entity , hereinafter called “the Entity,” in the sum of ________amount in
words and figures________ for which payment well and truly to be made to the said Entity the Bank
binds itself, its successors and assigns by these presents.

SEALED with the Common Seal of the said Bank this _____ day of _________ 20___.

THE CONDITIONS of this obligation are that:

1) if the Bidder withdraws the Bid during the period of bid validity specified in the Form
of Bid; or
2) if the Bidder does not accept the correction of arithmetical errors of its bid price in
accordance with the Instructions to Bidder; or
3) if the Bidder having been notified of the acceptance of the Bid and award of contract to
it by the Entity during the period of bid validity:
a) fails or refuses to submit the requirements for and to execute the Form of Contract
in accordance with the Instructions to Bidders, if required; or
b) fails or refuses to furnish the Performance Security in accordance with the
Instructions to Bidders;
We undertake to pay to the Entity up to the above amount upon receipt of its first written demand,
without the Entity having to substantiate its demand, provided that in its demand the Entity will note
that the amount claimed by it is due to the occurrence of any one or combination of the three (3)
conditions stated above.

The Guarantee will remain in force up to a period of _______________ days from the opening of
bids as stated in the Instructions to Bidders or as it may be extended by the Entity, notice of which
extension(s) to the Bank is hereby waived. Any demand in respect of this Guarantee should reach
the Bank within the said period.

Name and Signature of Bank’s Authorized Signatory Date:

_________________

Position

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Department of Public Works and Highways

Contract ID:
Contract Name:
Location of the Contract:
----------------------------------------------------------------------------------------
FORM OF BID SECURITY: IRREVOCABLE LETTER OF CREDIT

Date of Issuance

Name of Head of Procuring Entity

Position

Name of Procuring Entity

Address

Irrevocable Letter of Credit No. ______

For: Contract ID and Name____________________________

WHEREAS, Name of Bidder , hereinafter called the “Bidder,” has undertaken to submit to
you a bid for the abovestated Contract, and whereas you have stipulated in the Instructions to Bidders
for the said Contract that the Bidder shall furnish you with an irrevocable standby Letter of Credit
for a sum specified therein as Bid Security for the faithful compliance of the obligations of the
Bidder:

WHEREAS, the Conditions of this obligation are that:

4) if the Bidder withdraws the Bid during the period of bid validity specified in the Form
of Bid; or
5) if the Bidder does not accept the correction of arithmetical errors of its bid price in
accordance with the Instructions to Bidder; or
6) if the Bidder, having been notified of the acceptance of the Bid and award of contract
to it by the Entity during the period of bid validity:

c) fails or refuses to submit the requirements for and to execute the Form of Contract
in accordance with the Instructions to Bidders; or
d) fails or refuses to furnish the Performance Security in accordance with the
Instructions to Bidders;

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Department of Public Works and Highways

Contract ID:
Contract Name:
Location of the Contract:
----------------------------------------------------------------------------------------

we undertake to pay to the Entity up to the above amount upon receipt of its first written demand,
without the Entity having to substantiate its demand, provided that in its demand the Entity will note
that the amount claimed by it is due to the occurrence of any one or combination of the three (3)
conditions stated above.

WHEREAS, we have agreed to guarantee this obligation of the Bidder.

THEREFORE, we hereby affirm that we are guarantors and responsible to you, on behalf of the
Bidder, up to the total amount of amount of guarantee and we undertake to pay you, upon
first written demand declaring the Bidder to be in default under the Instructions to Bidders and
without cavil or argument, any sum or sums within the limits of _amount of guarantee as
aforesaid, without you needing to prove or show grounds or reasons for your demand for the sum
specified therein.

This irrevocable guarantee is valid until one hundred twenty (120) calendar days after the date of
opening of bids for the said Contract on date .

This certification is being issued in favor of the said Bidder in connection with your requirements of
the bidding for the said Contract. We are aware that any false statements issued by us make us liable
to perjury.

Name and Signature of Authorized Financing Institution

Official Designation

Concurred by:

Name and Signature of Bidder’s Authorized Representative

Official Designation

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Department of Public Works and Highways

Contract ID:
Contract Name:
Location of the Contract:
----------------------------------------------------------------------------------------
REPUBLIC OF THE PHILIPPINES )
CITY OF _______________________ ) S.S.
x-------------------------------------------------------x

BID-SECURING DECLARATION
Project Identification No.: [Insert number]

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

I/We, the undersigned, declare that:

1. I/We understand that, according to your conditions, bids must be supported by a Bid Security,
which may be in the form of a Bid Securing Declaration.

2. I/We accept that: (a) I/we will be automatically disqualified from bidding for any
procurement contract with any procuring entity for a period of two (2) years upon receipt of
your Blacklisting Order; and, (b) I/we will pay the applicable fine provided under Section 6
of the Guidelines on the Use of Bid Securing Declaration, within fifteen (15) days from
receipt of the written demand by the procuring entity for the commission of acts resulting to
the enforcement of the bid securing declaration under Sections 23.1(b), 34.2, 40.1 and 69.1,
except 69.1(f),of the IRR of RA No. 9184; without prejudice to other legal action the
government may undertake.

3. I/We understand that this Bid Securing Declaration shall cease to be valid on the following
circumstances:

(a) Upon expiration of the bid validity period, or any extension thereof pursuant to your
request;

(b) I am/we are declared ineligible or post-disqualified upon receipt of your notice to such
effect, and (i) I/we failed to timely file a request for reconsideration or (ii) I/we filed a
waiver to avail of said right; and

(c) I am/we are declared the bidder with the Lowest Calculated and Responsive Bid, and I/we
have furnished the performance security and signed the Contract.

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Department of Public Works and Highways

Contract ID:
Contract Name:
Location of the Contract:
----------------------------------------------------------------------------------------

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

[Insert NAME OF BIDDER OR ITS

AUTHORIZED REPRESENTATIVE]
[Insert signatory’s legal capacity]
Affiant

SUBSCRIBED AND SWORN to before me this __ day of [month] [year] at [place of execution],
Philippines. Affiant/s is/are personally known to me and was/were 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/s exhibited to me his/her [insert type of government identification card used], with
his/her photograph and signature appearing thereon, with no. ______ .
Witness my hand and seal this ___ day of [month] [year].

NAME OF NOTARY PUBLIC

Serial No. of Commission ___________
Notary Public for ______ until _______
Roll of Attorneys No. _____
PTR No. __, [date issued], [place issued]
IBP No. __, [date issued], [place issued]
Doc. No. ___
Page No. ___
Book No. ___
Series of ____.

Note: This must be dry-sealed.

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Department of Public Works and Highways

Contract ID:
Contract Name:
Location of the Contract:
----------------------------------------------------------------------------------------

1. CONTRACTOR’S ORGANIZATIONAL CHART FOR THE CONTRACT

Submit a copy of the Organizational Chart that the Contractor intends to use to execute the Contract
if awarded to it. Indicate in the chart the names of the Project Manager, Project Engineer, Structural
Engineer, Materials and Quality Control Engineer, Foremen, and other Key Personnel, as required
in the Instructions to Bidders (Bid Data Sheet). Include Sub-Contractors, if any.

Attach the required Proposed Organizational Chart for the Contract as stated above.

Name and Signature of Bidder’s Representative Date: _____________

Position

Name of Bidder

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Department of Public Works and Highways

Contract ID:
Contract Name:
Location of the Contract:
----------------------------------------------------------------------------------------

KEY PERSONNEL’S AFFIDAVIT OF COMMITMENT TO WORK ON THE

CONTRACT

Date of Issuance

Name of Head of Procuring Entity

Position
Name of Procuring Entity
Address

Dear Sir/Madame:

1. I confirm that Name of Contractor has engaged my services for the position of
in the above stated Contract if it is awarded to the Contractor.

1. I, therefore, commit to assume the said position in the above stated Contract once it is awarded
to the Contractor, and I shall employ the best care, skill, and ability to perform the duties of
such position in accordance with Conditions of Contract, Specifications, Drawings, and other
provisions of the Contract Agreement. I am aware that I have to stay in the jobsite for the
duration of my assignment.

2. I do not allow the use of my name to enable the Contractor to qualify for the above stated
Contract without my commitment to assume the said position, since I understand that to do so
shall be a sufficient ground for my disqualification from this Contract and future biddings of
DPWH.

3. I submit, and as certify true and correct, my bio-data as follows:

a. Name :
b. Date and Birth :
c. Nationality :
d. Educational Attainment :
e. Specialty :
f. PRC License No. and Date :
g. Tax Information No. (TIN) :
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h. Employment Record :

(DPWH-INFRA-14-2016)

Department of Public Works and Highways

Contract ID:
Contract Name:
Location of the Contract:
----------------------------------------------------------------------------------------

Name & Address of Position From To Total Period

Employer Mo./Yr. Mo./Yr. Yrs. & Mos.

i. Work Experience (Projects Handled):

i. Proj. Name & Location i. Proj. Description i. Part of Proj. I i. Start Date
ii. Owner’s Name & Address ii. Total Proj. Cost Handled ii. Compl. Date
iii. My Position ii. Cost of Part
Completed Projects:

On-going Projects:

(use another sheet, if necessary)

Very truly yours,

Name and Signature of Personnel

Noted by:

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Name and Signature of Contractor’s Authorized Representative

Department of Public Works and Highways

Contract ID:
Contract Name:
Location of the Contract:
----------------------------------------------------------------------------------------

REPUBLIC OF THE PHILIPPINES)

CITY OF )

SUBSCIBED and SWORN TO before me this _____day of _______________, 20____ at

_______________, affiant exhibiting to me his/ her Residence Certificate No. ________ issued
at ________________________ on ________________________.

_____________________
Notary Public

Doc. No. ______________________ Until ______________________

Page No. ______________________ PTR No. ______________________

Book No. ______________________ Issued at ______________________

Series No. ______________________ Issued on ______________________

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Department of Public Works and Highways

Contract ID:
Contract Name:
Location of the Contract:
-----------------------------------------------------------------------------
LIST OF CONTRACTOR’S KEY PERSONNEL TO BE ASSIGNED TO THE
CONTRACT, WITH THEIR QUALIFICATION DATA

Date of Issuance

Name of Head of Procuring Entity

Position

Name of Procuring Entity

Address

Dear Sir/Madame:

Supplementing our Organizational Chart for the abovestated Contract, we submit, and certify as true
and correct, the following information:

1. We have engaged the services of the following key personnel to perform the duties of the
positions indicated in the abovestated Contract if it is awarded to us:

Proposed Position (as Name Years of Experience

applicable)
Total (Similar Similar
Position
and Related)

Project Manager

Project Engineer

Materials Engineer

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Construction Safety Officer

Foreman

Others (specify)

Department of Public Works and Highways

Contract ID:
Contract Name:
Location of the Contract:
----------------------------------------------------------------------------------------

2. We submit the enclosed Curriculum Vitae and Affidavits of Commitment to Work on the
Contract of these key personnel.

3. We ensure that the abovementioned personnel shall employ their best care, skill, and ability in
performing the duties of their respective positions in accordance with the provisions of the
Contract, including the Conditions of Contract, Specifications, and Drawings, and that they shall
be personally present in the jobsite during the period of their assignment in the Contract.

4. In the event that we choose to replace any of the abovementioned key personnel, we shall submit
to you in writing at least fourteen (14) days before making the replacement, for your approval,
the name and biodata of the proposed replacement whose qualifications shall be equal to or
better than that of the person to be replaced.

5. We understand that any violation of the abovestated conditions shall be a sufficient ground for
us to be disqualified from this Contract and future biddings of the DPWH.

Very truly yours,

Name and Signature of Bidder’s Authorized Representative

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Department of Public Works and Highways

Contract ID:
Contract Name:
Location of the Contract:
LIST OF CONTRACTOR’S MAJOR CONSTRUCTION AND LABORATORY EQUIPMENT UNITS TO BE ASSIGNED TO THE
CONTRACT SUPPORTED BY CERTIFICATIONS OF AVAILABILITY
Business Name : __________________________
Business Address : ___________________________

Business Name : ___________________________________________________

a. Business : ___________________________________________________
Address
___________________________________________________

Description Model/Year Capacity / Plate No. Motor No. / Location Condition Proof of Ownership /
Performance / Size Body No. Lease/Purchase
A. Owned1
i.
ii.
iii.
iv.
v.

B. Leased2
i.
ii.
iii.
iv.
v.

C. Under Purchase Agreements3

i.
ii.
iii.
iv.
v.

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1Attached are copies of sales invoices / Registration Certificates from LTO.

2
Attached are the certifications from the lessors that the equipment units under B (Leased) shall be available for this contract.
3
Attached are the certifications from the vendors that the equipment units under C (Purchase Agreements) shall be available for this contract.

Minimum major construction equipment requirement as prescribed in the Bid Data Sheet: Minimum major laboratory equipment requirements as prescribed in Bid Data Sheet:
________________________________ ________________________________
______________________ _______________________________
______________________ ________________________________
________________________________

Name and Signature of Bidder’s Representative Date: _____________________

Position
Name of Bidder

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Department of Public Works and Highways

Contract ID:
Contract Name:
Location of the Contract:
-------------------------------------------------------------------------------------------------------------------
OMNIBUS SWORN STATEMENT
AS REQUIRED BY RA 9184-IRR SECTION 25.2b)iv)

REPUBLIC OF THE PHILIPPINES)

CITY/MUNICIPALITY OF ______) S.S.

AFFIDAVIT

I, [Name of Affiant], of legal age, [Civil Status], [Nationality], and residing at [Address of Affiant],
after having been duly sworn in accordance with law, do hereby depose and state that:

1. Select one, delete the other:

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

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

If a partnership, corporation, cooperative, or joint venture: I am the duly authorized and

designated representative of [Name of Bidder] with office address at [address of Bidder];

2. Select one, delete the other:

If a sole proprietorship: As the owner and sole proprietor or authorized representative of

[Name of Bidder], I have full power and authority to do, execute and perform any and all
acts necessary to participate, submit the bid, and to sign and execute the ensuing contract for
[Name of the Project] of the [Name of the Procuring Entity][insert “as shown in the attached
duly notarized Special Power of Attorney” for the authorized representative];

If a partnership, corporation, cooperative, or joint venture: I am granted full power and

authority to do, execute and perform any and all acts necessary to participate, submit the bid,
and to sign and execute the ensuing contract for [Name of the Project] of the [Name of the
Procuring Entity], as shown in the attached [state title of attached document showing proof
of authorization (e.g., duly notarized Secretary’s Certificate, Board/Partnership Resolution,
or Special Power of Attorney, whichever is applicable;)];

3. [Name of Bidder] is not “blacklisted” or barred from bidding by the Government of the
Philippines or any of its agencies, offices, corporations, or Local Government Units, foreign
government/foreign or international financing institution whose blacklisting rules have been
recognized by the Government Procurement Policy Board, by itself or by relation, membership,
association, affiliation, or controlling interest with another blacklisted person or entity as defined
and provided for in the Uniform Guidelines on Blacklisting;

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Department of Public Works and Highways

Contract ID:
Contract Name:
Location of the Contract:
-------------------------------------------------------------------------------------------------------------------

4. Each of the documents submitted in satisfaction of the bidding requirements is an authentic copy
of the original, complete, and all statements and information provided therein are true and
correct;

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

6. Select one, delete the rest:

[If a sole proprietorship:] The owner or sole proprietor is not related to the Head of the
Procuring Entity, members of the Bids and Awards Committee (BAC), the Technical GPPB
Resolution No. 16-2020, dated 16 September 2020 Page 31 of 39 Working Group, and the
BAC Secretariat, the head of the Project Management Office or the end-user unit, and the
project consultants by consanguinity or affinity up to the third civil degree;

[If a partnership or cooperative:] None of the officers and members of [Name of Bidder] is
related to the Head of the Procuring Entity, members of the Bids and Awards Committee
(BAC), the Technical Working Group, and the BAC Secretariat, the head of the Project
Management Office or the end-user unit, and the project consultants by consanguinity or
affinity up to the third civil degree;

[If a corporation or joint venture:] None of the officers, directors, and controlling
stockholders of [Name of Bidder] is related to the Head of the Procuring Entity, members of
the Bids and Awards Committee (BAC), the Technical Working Group, and the BAC
Secretariat, the head of the Project Management Office or the end-user unit, and the project
consultants by consanguinity or affinity up to the third civil degree;

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

8. [Name of Bidder] is aware of and has undertaken the following responsibilities as a Bidder:

a) Carefully examine all of the Bidding Documents;

b) Acknowledge all conditions, local or otherwise, affecting the implementation of the Contract;

c) Make 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 for the [Name of the Project]; and

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Department of Public Works and Highways

Contract ID:
Contract Name:
Location of the Contract:
-------------------------------------------------------------------------------------------------------------------

9. [Name of Bidder] did not give or pay directly or indirectly, any commission, amount, fee, or any
form of consideration, pecuniary or otherwise, to any person or official, personnel or
representative of the government in relation to any procurement project or activity.

10. In case advance payment was made or given, failure to perform or deliver any of the obligations
and undertakings in the contract shall be sufficient grounds to constitute criminal liability for
Swindling (Estafa) or the commission of fraud with unfaithfulness or abuse of confidence
through misappropriating or converting any payment received by a person or entity under an
obligation involving the duty to deliver certain goods or services, to the prejudice of the public
and the government of the Philippines pursuant to Article 315 of Act No. 3815 s. 1930, as
amended, or the Revised Penal Code.

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

[Insert NAME OF BIDDER OR ITS AUTHORIZED

REPRESENTATIVE]
[Insert signatory’s legal capacity]
Affiant

SUBSCRIBED AND SWORN to before me this __ day of [month] [year] at [place of execution],
Philippines. Affiant/s 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/her [insert type of government identification card used], with his/her
photograph and signature appearing thereon, with no. ______.

Witness my hand and seal this ___ day of [month] [year].

NAME OF NOTARY PUBLIC

Serial No. of Commission ___________
Notary Public for ______ until _______
Roll of Attorneys No. _____
PTR No. __, [date issued], [place issued]
IBP No. __, [date issued], [place issued]
Doc. No. ___
Page No. ___
Book No. ___
Series of ____.
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Department of Public Works and Highways

Contract ID:
Contract Name:
Location of the Contract:
-------------------------------------------------------------------------------------------------------------------

SUMMARY OF BID PRICES

(All Parts of Bill of Quantities or BOQ)

Instructions for completing the Summary of Bid Prices:

1. Part No. – Enter the “Part No.” for each section of the BOQ where unit prices are entered.

2. Part Description – Enter the “Part Description” corresponding to the “Part No.”

3. Total Amount – Enter the “Total Amount” in Pesos for all pages having the same “Part
Description”

Part No. Part Description Total Amount

Total of Amounts
a) Total of All Amounts in Words:
Pesos __________________________________________________________
_______________________________________________________________
_______________________________________________________________
and _______________________ centavos.

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Name ___________________________ in the capacity of _________________

Signed __________________________ Date ___________________________

Duly authorized to sign the Bid for and on behalf of _______________________

_________________________________________________________________

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Department of Public Works and Highways

Contract ID:
Contract Name:
Location of the Contract:
-----------------------------------------------------------------------------------------------------------------------------------------------------------------
CASH FLOW BY QUARTER

PARTICULAR TOTAL. YEAR _____ YEAR _____

1st Q 2nd Q 3rd Q 4th Q 1ST Q 2ND Q 3RD Q 4TH Q

ACCOMPLISHMENT, IN % 100.0%

CASH FLOW, IN PhP

CUMULATIVE ACCOMPLISHMENT, IN % 100.0%

CUMULATIVE CASH FLOW, IN PhP

PARTICULAR TOTAL. YEAR _____ YEAR _____

1st Q 2nd Q 3rd Q 4th Q 1ST Q 2ND Q 3RD Q 4TH Q

ACCOMPLISHMENT, IN %

CASH FLOW, IN PhP

CUMULATIVE ACCOMPLISHMENT, IN %

CUMULATIVE CASH FLOW, IN PhP

Submitted by:

Name and Signature of Bidder’s Representative Date: _______________

Position

Name of Bidder

DPWH Procurement Manual Volume II -Infrastructure 24 | 31

 21DE0004

Department of Public Works and Highways

Contract ID:
Contract Name:
Location of the Contract:
----------------------------------------------------------------------------------------------------------------------------- -------

REPUBLIC OF THE PHILIPPINES)

CITY/MUNICIPALITY OF ______) S.S.

AFFIDAVIT

PERFORMANCE SECURING DECLARATION

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

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

I/We, the undersigned, declare that:

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

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

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

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

a. issuance by the Procuring Entity of the Certificate of Final Acceptance, subject to the
following conditions:
i. Procuring Entity has no claims filed against the contract awardee;
ii. It has no claims for labor and materials filed against the contractor; and
iii. Other terms of the contract; or

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

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 21DE0004

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

[Insert NAME OF BIDDER OR ITS AUTHORIZED

REPRESENTATIVE]
[Insert signatory’s legal capacity]
Affiant

SUBSCRIBED AND SWORN to before me this __ day of [month] [year] at [place of execution],
Philippines. Affiant/s 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/her [insert type of government identification card used], with his/her
photograph and signature appearing thereon, with no. ______.

Witness my hand and seal this ___ day of [month] [year].

NAME OF NOTARY PUBLIC

Serial No. of Commission ___________
Notary Public for ______ until _______
Roll of Attorneys No. _____
PTR No. __, [date issued], [place issued]
IBP No. __, [date issued], [place issued]
Doc. No. ___
Page No. ___
Book No. ___
Series of ____.

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 21DE0004

Department of Public Works and Highways

Contract ID:
Contract Name:
Location of the Contract:
----------------------------------------------------------------------------------------------------------------------------- -------
PERFORMANCE SECURITY: BANK GUARANTEE

To : Name of Head of the Procuring Entity

Address

WHEREAS, _______Name and Address of Contractor_______, hereinafter called “the Contractor,”

has undertaken to enter into a contract with you to execute __Contract ID and Name_, hereinafter
called “the Contract;”

WHEREAS, you have stipulated in the said Contract that the Contractor shall furnish you with a
Bank Guarantee by a recognized bank for the sum specified therein as Performance Security for
compliance with his obligations in accordance with the Contract; and

WHEREAS, we have agreed to give the Contractor such a Bank Guarantee;

NOW THEREFORE, we hereby affirm that we are the Guarantor and responsible to you, on behalf
of the Contractor, up to a total of amount of guarantee, and we undertake to pay you, upon your first
written demand and without cavil or argument, any sum or sums within the limits of amount of
guarantee as aforesaid without your needing to prove or to show grounds or reasons for your demand
for the sum specified therein.

We hereby waive the necessity of your demanding the said debt from the Contractor before
presenting us with the demand.

We further agree that no change or addition to or other modification of the terms of the Contract to
be performed thereunder or of any of the Contract documents which may be made between you and
the Contractor shall in any way release us from any liability under this guarantee, and we hereby
waive notice of any such change, addition or modification.

The right to institute action on this guarantee pursuant to Act No. 3688 of any individual, firm,
partnership, corporation and association supplying the Contractor with labor and materials for the
prosecution of the works is hereby acknowledged and confirmed.

This guarantee shall be valid until the date of issuance to the Contractor of your Certificate of
Acceptance of the completed Contract works after the end of the one-year Defects Liability Period
of the Contract and upon the submission of the required Warranty Security.

SIGNATURE AND SEAL OF THE GUARANTOR _________________________________

NAME OF BANK _________________________________

ADDRESS _________________________________

DATE_________________________________
DPWH Procurement Manual Volume II -Infrastructure 27 | 31
 21DE0004

Department of Public Works and Highways

Contract ID:
Contract Name:
Location of the Contract:
----------------------------------------------------------------------------------------------------------------------------- -------
CONSTRUCTION METHODS
OUTLINE OF NARRATIVE DESCRIPTION

1.0 INTRODUCTION

Refer to the Bidding Documents and related materials.

2.0 BRIEF DESCRIPTION OF CONTRACT WORKS

State the general features of the contract works. Use tables and drawings as necessary.

3.0 CONSTRUCTION METHODS AND PROCEDURES

3.1 Methodology or General Approach

State the general approach in construction in terms of the use of equipment-intensive

or labor-based methods, any special techniques, methods or procedures to ensure
completion on time and quality of the materials, workmanship, and completed
structure, according to the approved specifications and drawings/plans.

3.2 Program of Work

Progress bar chart with S-curve of activities in the contract works.

3.3 Financial Program

Cash flow schedule, provision for working capital, schedule of receipts, etc.

Submitted by:

Name and Signature of Bidder’s Representative Date: _____________

Position
Name of Bidder

(DPWH-INFRA-45-2016)

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 21DE0004

Department of Public Works and Highways

Contract ID:
Contract Name:
Location of the Contract:
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Note: Entries are provided as illustrative example only.

M O N T H L Y A C C O M P L I S H M E N T
ITEM
DESCRIPTION UNIT QUANTITY UNIT COST TOTAL COST % WEIGHT 1st MONTH 2nd MONTH 3rd MONTH 4th MONTH 5th MONTH 6th MONTH 7th MONTH 8th MONTH 9th MONTH 10th MONTH 11th MONTH 12th MONTH 13th MONTH 14th MONTH
NO.
30 C.D. 60 C.D. 90 C.D. 120 C.D. 150 C.D. 180 C.D. 210 C.D. 240 C.D. 270 C.D. 300 C.D. 330 C.D. 360 C.D. 390 C.D. 420 C.D.

PART A FACILITIES FOR THE ENGINEER

Provide Temporary Field Office Laboratory and Living Quarters for the Engineer and ADB-PMO Staff (on Rental 0.011% 0.011% 0.011%
A.1.1(a) mo. 3.00 26,320.00 78,960.00 0.033%
Basis)
Operate and Maintain Temporary Field Office, Laboratory and Living Quarters for the Engineer and ADB-PMO 0.028% 0.028% 0.028%
A.1.1(b) mo. 3.00 67,352.88 202,058.64 0.083%
Staff
0.498% 0.498% 0.498%
A.1.1(c) Provide Combined Field Office and Laboratory Building for the Engineer and ADB-PMO Staff l.s. 1.00 3,626,951.70 3,626,951.70 1.494%
0.496% 0.496% 0.496%
A.1.1(d) Provide Living Quarters for the Engineer and ADB-PMO Staff l.s. 1.00 3,613,894.60 3,613,894.60 1.488%
Operate/Maintain Combined Field Office, Laboratory and Living Quarters for the Engineer and ADB-PMO Staff 0.071% 0.071% 0.071% 0.071% 0.071% 0.071% 0.071% 0.071% 0.071% 0.071% 0.071%
A.1.1(e) mo. 11.00 172,491.71 1,897,408.81 0.781%
(Schedule A)
Furnish Equipment, Furniture/Fixtures and Appliances for the Combined Field Office, Laboratory and Living 0.244% 0.244% 0.244%
A.1.1(f) l.s. 1.00 1,775,040.55 1,775,040.55 0.731%
Quarters for the Engineer and ADB-PMO Staff (Schedules B and C)
0.217% 0.217% 0.217%
A.1.1(g) Provide and Maintain Laboratory Testing Equipment and Apparatus (Schedule D) l.s. 1.00 1,579,701.70 1,579,701.70 0.650%
0.007% 0.007% 0.007% 0.007% 0.007% 0.007% 0.007% 0.007% 0.007% 0.007% 0.007% 0.007% 0.007% 0.007%
A.1.1(h) Provide and Maintain Communication Facility for the Engineer mo. 14.00 17,860.00 250,040.00 0.103%
Provide Supplies and Consumable Stores for Field Office, Laboratory and Living Quarters for the Engineer and 0.045% 0.045% 0.045% 0.045% 0.045% 0.045% 0.045% 0.045% 0.045% 0.045% 0.045% 0.045% 0.045% 0.045%
A.1.1(i) mo. 14.00 108,753.49 1,522,548.86 0.627%
ADB-PMO Staff (Schedules E & F)
Provide, Operate and Maintain Pick-up Type or its equivalent brand new diesel engine with complete accessories 0.244% 0.244% 0.244% 0.244% 0.244% 0.244% 0.244% 0.244% 0.244% 0.244% 0.244% 0.244% 0.244% 0.244%
A.1.2(a) veh-mo. 56.00 148,426.00 8,311,856.00 3.423%
for the Engineer (4 units)
0.015% 0.015% 0.015% 0.015% 0.015% 0.015% 0.015% 0.015% 0.015% 0.015% 0.015% 0.015% 0.015% 0.015%
A.1.3(a) Provide and Maintain Survey Instruments/Equipment for the Assistance to the Engineer (Schedule G) mo. 14.00 36,735.20 514,292.80 0.212%
0.041% 0.041% 0.041% 0.041% 0.041% 0.041% 0.041% 0.041% 0.041% 0.041% 0.041% 0.041% 0.041% 0.041%
A.1.3(b) Provision of Survey Personnel (Schedule H) mo. 14.00 100,674.00 1,409,436.00 0.580%
0.003% 0.003% 0.003% 0.003% 0.003% 0.003% 0.003% 0.003% 0.003% 0.003% 0.003% 0.003% 0.003% 0.003%
A.1.4 Progress Photographs set 14.00 6,448.40 90,277.60 0.037%

PART B OTHER GENERAL REQUIREMENTS

0.053% 0.053% 0.053% 0.053% 0.053% 0.053% 0.053% 0.053% 0.053% 0.053% 0.053% 0.053% 0.053% 0.053%
SPL-1 Construction Safety and Health l.s. 1.00 1,792,624.71 1,792,624.71 0.738%
0.026% 0.026% 0.026% 0.026% 0.026% 0.026% 0.026% 0.026% 0.026% 0.026% 0.026% 0.026% 0.026% 0.026%
SPL-2 Environmental and Social Safeguards l.s. 1.00 880,140.80 880,140.80 0.362%
0.022%
SPL-3 Project Billboard each 5.00 10,528.00 52,640.00 0.022%

PART C EARTHWORKS
0.156%
101(3) Removal of Existing Asphalt Concrete Pavement sq.m. 1,885.00 200.34 377,640.90 0.156%
0.114% 0.114% 0.114% 0.114% 0.114% 0.114% 0.114% 0.114% 0.038%
105(2) Subgrade Preparation (Existing Pavement) sq.m. 66,005.00 35.03 2,312,155.15 0.952%
0.290% 0.290% 0.290% 0.290% 0.290%
SPL108 Crack and Seat (Existing Portland Cement Concrete Pavement) sq.m. 5,000.00 703.83 3,519,150.00 1.449%

PART E SURFACE COURSES

cu.m. 0.337% 1.265% 1.265% 0.928%
300 Aggregate Surface Course Compacted in Place 9,901.00 931.01 9,217,930.01 3.796%
compacted in
0.030% 0.030%
301(1) Bituminous Prime Coat, MC-70 Cut-Back Asphalt tonne 2.00 72,942.46 145,884.92 0.060%
0.095% 0.286% 0.382% 0.382% 0.382% 0.382% 0.382% 0.331% 0.191% 0.191%
302(2) Bituminous Tack Coat, Emulsified Asphalt, SS-1 tonne 97.00 75,221.52 7,296,487.44 3.005%
1.329% 2.658% 2.658% 2.658% 2.658% 2.658% 1.949%
310(1) Bituminous Concrete Surface (Wearing) Course, Hot Laid (50mm thick) sq.m. 42,588.00 944.60 40,228,624.80 16.565%
2.549% 4.248% 4.248% 5.777% 5.777% 5.777% 5.777% 5.777% 4.248% 4.248%
310(2) Bituminous Concrete Surface (Wearing) Course, Hot Laid (80mm thick) sq.m. 89,483.00 1,314.24 117,602,137.92 48.427%
0.384% 0.384%
310(3) Bituminous Concrete Surface (Wearing) Course, Hot Laid (100mm thick) sq.m. 1,177.00 1,584.27 1,864,685.79 0.768%
0.017% 0.011%
SPL 312 Sealing of Cracks and Joints in Existing Portland Cement Concrete Pavement l.m. 500.00 135.78 67,890.00 0.028%
0.099% 0.296% 0.296% 0.296% 0.296% 0.296% 0.197%
SPL 313 Patching of Potholes in Existing Asphalt Concrete Pavement sq.m. 1,000.00 4,309.91 4,309,910.00 1.775%

PART F BRIDGE CONSTRUCTION (MACASOY)

0.612%
101(2) Removal of Concrete Bridge Structures each 1.00 1,485,575.35 1,485,575.35 0.612%
0.045%
101(3)a Removal of Existing Concrete Pavement (230mm) sq.m. 274.73 394.95 108,504.61 0.045%
0.054%
102(2)a Roadway Excavation (Surplus Common) cu.m. 865.66 150.19 130,013.48 0.054%
0.013%
103(1)a Structure Excavation (Common Soil) cu.m. 95.78 326.57 31,278.87 0.013%
0.122%
103(2)a Bridge Excavation (Soft Rock) cu.m. 236.54 1,252.57 296,282.91 0.122%
0.004%
105(1) Subgrade Preparation (Common Material) sq.m. 274.73 35.72 9,813.36 0.004%
0.052%
200 Aggregate Subbase Course cu.m. 82.42 1,521.63 125,412.74 0.052%
0.060% 0.181% 0.060%
400(4)a Precast Concrete Pile, Furnished (400mmx400mm-type B) l.m. 120.00 6,098.03 731,763.60 0.301%
0.146%
400(14)a Precast RC Piles, (Driven) l.m. 112.00 3,171.96 355,259.52 0.146%
0.034% 0.045%
400(16)a Test Piles, Furnished and Driven (400mm x 400mm) l.m. 30.00 6,333.57 190,007.10 0.078%
0.063% 0.013%
401(2) Concrete Railing Type (Double) l.m. 40.00 4,559.15 182,366.00 0.075%
0.183% 0.183% 0.229%
404(b) Reinforcing Steel Bar, Grade 60 Bridge Structures & Other Major Structures) kgs. 25,577.53 56.43 1,443,340.02 0.594%
0.055%
404(c) Reinforcing Steel Bar, Grade 40 (Minor Structures) kgs. 2,065.80 65.20 134,690.16 0.055%
0.328% 0.066%
405(b) Structural Concrete, Class A, Major Structures-Bridge Superstructures (fc'=28MPa) cu.m. 72.16 13,235.71 955,088.83 0.393%
0.456% 0.016%
405(c) Structural Concrete, Class A, Major Structures-Bridge Superstructures (fc'=20.7MPa) cu.m. 91.50 12,527.44 1,146,260.76 0.472%
0.210% 0.007%
405(d) Structural Concrete, Class A, Major Structures-Bridge Footing (fc'=20.7MPa) cu.m. 62.30 8,472.33 527,826.16 0.217%
0.015%
405(2)b Structural Concrete, Class B, (Lean Concrete) cu.m. 2.86 12,431.42 35,553.86 0.015%
0.132% 0.395% 0.395% 0.395% 0.395% 0.026%
406(1)c Prestressed Structural Concrete Members (Girder Type IV-25 meters) l.m. 4.00 1,054,892.27 4,219,569.08 1.738%
0.057%
412 Elastomeric Bearing Pad each 8.00 17,180.80 137,446.40 0.057%
0.772% 0.680%
505(6) Grouted Riprap, (Class B) cu.m. 584.67 6,029.94 3,525,525.02 1.452%
0.235%
506 Stone Masonry cu.m. 95.78 5,954.48 570,320.09 0.235%

PART H MISCELLANEOUS STRUCTURES

0.392%
605(1)a Warning Signs, Reflective each 40.00 23,801.64 952,065.60 0.392%
0.113%
605(2) Regulatory Signs, Reflective each 36.00 7,605.04 273,781.44 0.113%
0.110%
605(3) Informatory Signs, Reflective each 27.00 9,934.85 268,240.95 0.110%
2.519%
612(1) Reflectorized Thermoplastic Pavement Markings, (White) sq.m. 5,913.00 1,034.57 6,117,412.41 2.519%
0.411%
612(2) Reflectorized Thermoplastic Pavement Markings, (Yellow) sq.m. 934.00 1,069.03 998,474.02 0.411%
0.095% 0.473%
620 Chevron Signs each 230.00 5,999.11 1,379,795.30 0.568%

PART J MOBILIZATION AND DEMOBILIZATION

0.271% 0.271% 0.271%
SPL 800 Mobilization and Demobilization (1% Civil Work Cost) l.s. 1.00 1,974,000.00 1,974,000.00 0.813%

PART K DAYWORKS

SPL 900 Dayworks P.S 1.00 - - 0.000%

PART L PROVISIONAL SUM

SPL 1000 Provisional Sum P.S. 1.00 - - 0.000%

TOTAL 242,846,037.34 100.000%

MONTHLY (%) 2.220% 2.198% 6.342% 7.533% 9.0685% 10.806% 10.825% 10.819% 10.931% 10.309% 7.124% 6.683% 4.364% 0.776%
SCHEDULED ACCOMPLISHMENT
CUMULATIVE (%) 2.220% 4.418% 10.761% 18.294% 27.362% 38.169% 48.993% 59.812% 70.743% 81.053% 88.177% 94.860% 99.224% 100.000%
MONTHLY Php 5,391,262.64 5,338,622.64 15,401,606.36 18,293,852.31 22,022,523.38 26,242,933.81 26,287,107.38 26,274,164.00 26,545,168.55 25,036,055.26 17,300,637.37 16,229,788.18 10,596,736.83 1,885,578.62
SCHEDULED CASH FLOW
CUMULATIVE Php 5,391,262.64 10,729,885.28 26,131,491.65 44,425,343.96 66,447,867.34 92,690,801.15 118,977,908.53 145,252,072.52 171,797,241.08 196,833,296.34 214,133,933.70 230,363,721.89 240,960,458.72 242,846,037.34

DPWH Procurement Manual Volume II -Infrastructure 29 | 31

 21DE0004

Department of Public Works and Highways

Contract ID:
Contract Name:
Location of the Contract:

Manpower Schedule

Name of Contractor:

Entries are example only

MANPOWER 1st Month 2nd Month 3rd Month 4th Month 5th Month 6th Month 7th Month 8th Month 9th Month 10th Month 11th Month 12th Month 13th Month 14th Month

NO. CATEGORY 30 C.D. 60 C.D. 90 C.D. 120 C.D. 150 C.D. 180 C.D. 210 C.D. 240 C.D. 270 C.D. 300 C.D. 330 C.D. 360 C.D. 390 C.D. 420 C.D.
1 Project Manager 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2 Deputy Project Manager (Operation) 1 1 1 1 1 1 1 1 1 1 1 1 1 1
3 Deputy Project Manager (Administration) 1 1 1 1 1 1 1 1 1 1 1 1 1 1
4 Project Engineer 1 1 1 1 1 1 1 1 1 1 1 1 1 1
5 Bridge/Structural Engineer 1 1 1 1 1 1 1 1 1 1 1 1 1 1
6 Highway/Pavement Engineer 1 1 1 1 1 1 1 1 1 1 1 1 1 1
7 Materials/Quality Control Engineer 1 1 1 1 1 1 1 1 1 1 1 1 1 1
8 Safety Engineer 1 1 1 1 1 1 1 1 1 1 1 1 1 1
9 Construction Foreman 1 1 1 1 1 1 1 1 1 1 1 1 1 1
10 Geodetic Engineeer 1 1 1 1 1 1 1 1 1 1 1 1 1 1
11 Quantity Engineer 0 1 1 1 1 1 1 1 1 1 1 1 1 1
12 Office Engineer 1 1 1 1 1 1 1 1 1 1 1 1 1 1
13 Autocad Operator/Draftsman 1 1 1 1 1 1 1 1 1 1 1 1 1 0
14 Office Staff 0 1 1 1 1 1 1 1 1 1 1 1 1 0
15 Financing and Accounting 1 1 1 1 1 1 1 1 1 1 1 1 1 1
16 Purchasing and Supplying 1 1 1 1 1 1 1 1 1 1 1 1 1 0
17 Human Resources/Manpower 1 1 1 1 1 1 1 1 1 1 1 1 1 1
18 Camp Management/Security 2 4 4 6 6 6 6 6 6 6 5 5 4 2
19 Equipment In-Charge 1 1 1 1 1 1 1 1 1 1 1 1 1 1
20 Laboratory Technician 1 1 1 1 1 1 1 1 1 1 1 1 1 0
21 Laboratory Aide 1 1 1 1 1 1 1 1 1 1 1 1 1 0
22 Clerk Typist/Encoder 1 1 1 1 1 1 1 1 1 1 1 1 1 0
23 Instrumentman 1 1 1 2 2 2 2 2 2 2 2 1 1 0
24 Survey Aides 2 2 2 2 2 2 2 2 2 2 2 1 1 1
25 Health and Environment 0 1 1 1 1 1 1 1 1 1 1 1 1 1
26 First Aider/Health Personnel 1 1 1 1 1 1 1 1 1 1 1 1 1 1
27 Utility Personnel 1 1 1 1 1 1 1 1 1 1 1 1 1 1
28 Laundry Woman 1 1 1 1 1 1 1 1 1 1 1 1 1 1
29 Heavy Equipment Operator 4 8 8 10 10 15 15 15 15 15 15 8 6 4
30 Driver For Vehicles 3 5 7 8 8 8 8 8 8 8 8 8 7 3
31 Truck Driver 2 6 8 10 12 19 19 19 19 19 12 12 6 4
32 Skilled Laborer 3 8 8 12 16 16 16 16 16 16 16 12 8 6
33 Semi-Skilled Laborer 5 8 8 15 21 21 21 21 21 15 15 10 8 4
34 Unskilled Laborer 8 10 15 20 25 25 25 25 25 25 18 15 10 5
35 Field Watchmen 0 5 5 10 16 16 16 16 16 12 12 9 4 0
Total 52 82 91 120 143 155 155 155 155 145 130 106 80 48
DPWH Procurement Manual Volume II -Infrastructure 30 | 31
DPWH-INFR-47-2016
 21DE0004

Department of Public Works and Highways

Contract ID:
Contract Name:
Location of the Contract:

Major Equipment Utilization Schedule

Name of Contractor:
Entries are example only

EQUIPMENT 1st Month 2nd Month 3rd Month 4th Month 5th Month 6th Month 7th Month 8th Month 9th Month 10th Month 11th Month 12th Month 13th Month 14th Month

NO. DESCRIPTION MAKE/TYPE MIN. CAPACITY TOTAL 30 C.D. 60 C.D. 90 C.D. 120 C.D. 150 C.D. 180 C.D. 210 C.D. 240 C.D. 270 C.D. 300 C.D. 330 C.D. 360 C.D. 390 C.D. 420 C.D.
1 Concrete Batching Plant LQC-80-II 80 tons/hr 1 0 1 1 1 1 1 1 1 1 1 1 1 0 0
2 Aggregate Crusher PE750X1060 175 tons/hr 1 0 1 1 1 1 1 1 1 1 1 1 1 0 0
3 Washing and Screening Plant 4YZS2160 175 tons/hr 1 0 1 1 1 1 1 1 1 1 1 1 1 0 0
4 Asphalt Paver RP403 3-4.10m/75 Kw 2 0 1 1 2 2 2 2 2 2 2 2 1 0 0
5 Asphalt Distributor XLS50 12000L 1 0 1 1 1 1 1 1 1 1 1 1 1 0 0
6 Bulldozer with Ripper SD-32 W 320 Hp 1 1 1 1 1 1 1 1 1 1 1 1 0 0 0
7 Bulldozer with Ripper D20A-5 39 Hp 1 0 1 1 1 1 1 1 1 1 1 0 0 0 0
8 Crawler Dozer D6HL6P 165 Hp 2 0 1 1 1 2 2 2 2 1 1 1 0 0 0
9 Hydraulic Excavator MS180-8 0.80 cu.m. 1 0 1 1 1 1 1 1 1 1 1 1 0 0 0
10 Hydraulic Excavator XE335C 1.40 cu.m. 1 0 1 1 1 1 1 1 1 1 1 1 1 1 0
11 Wheel Loader 865-2 3.10 cu.m. 1 0 1 1 1 1 1 1 1 1 0 0 0 0 0
12 Wheel Loader 840-2 2.00 cu.m. 1 0 1 1 1 1 1 1 1 1 1 1 1 0 0
13 Wheel Loader 850-2 3.00 cu.m. 1 0 1 1 1 1 1 1 1 1 1 1 0 0 0
14 Crawler Loader ZY-65 C 2.60 cu.m. 1 0 1 1 1 1 1 1 1 1 1 1 1 0 0
15 Motor Grader GR180R 195 Hp 1 0 1 1 1 1 1 1 1 1 1 1 1 0 0
16 Motor Grader GD31-3H 135 Hp 1 0 1 1 1 1 1 1 1 1 1 0 0 0 0
17 Vibratory Tandem Roller XD111E 11 tons 2 0 1 2 2 2 2 2 2 2 2 1 1 0 0
18 Vibratory Drum Roller XS 142 14 tons 1 0 0 0 1 1 1 1 1 1 1 1 0 0 0
19 Pneumatic Tired Roller XP201 12-20 tons 2 0 1 2 2 2 2 2 2 2 2 2 1 0 0
20 Dump Truck EQ3121GLJ6 20 cu.m. 15 0 5 8 8 10 15 15 15 15 15 12 8 4 4
21 Dump Truck NKR58E-7109892 2.15 cu.m. 1 0 1 1 1 1 1 1 1 1 1 1 1 1 0
22 Dump Truck CXZ71J-3016497 11 cu.m. 1 0 0 1 1 1 1 1 1 1 1 1 0 0 0
23 Dump Truck CXZ19J-3008234 12 cu.m. 1 0 1 1 1 1 1 1 1 1 1 1 1 0 0
24 Dump Truck NKR58E-7143065 2.15 cu.m. 1 0 0 1 1 1 1 1 1 1 1 1 1 1 0
25 Water Truck with Pump CLW51116SST3 1000 Gals. 2 0 1 1 1 2 2 2 2 2 2 2 1 1 0
26 Generator Set 3Ø/380V-50HZ 40,000 W 1 0 0 1 1 1 1 1 1 1 1 1 1 1 0
27 Generator Set DCA45SPI 36,000 W 1 1 1 1 1 1 1 1 1 1 1 1 0 0 0
28 Generator Set SH100LDE3 100,000 W 1 0 0 0 1 1 1 1 1 1 1 1 1 1 0
Total 2 27 35 38 42 47 47 47 46 45 39 25 10 4

DPWH Procurement Manual Volume II -Infrastructure 31 | 31

DPWH-INFR-48-2016
 21DE0004

Department of Public Works and Highways

Contract ID:
Contract Name:
Location of the Contract:
----------------------------------------------------------------------------------------------------------------------------- -------

CONTRACTOR’S CONSTRUCTION SAFETY AND HEALTH PROGRAM

Date

To: Name of the Head of the Procuring Entity

Address

Pursuant to the provisions of Section 37.2.3 of the Implementing Rules and Regulations of Republic
Act No. 9184 and in accordance with the provisions of Department Order No. 129, series of 2014,
of the Department of Public Works and Highways (DPWH) and the provisions of the Memorandum
dated 17 July 2014 of the Department of Labor and Employment (DOLE), we hereby submit to you,
as part of the contract documents for the abovementioned contract awarded to us, our Construction
Health and Safety Program which, once approved by the DPWH and concurred in by the DOLE
Regional Office concerned, shall be implemented by us for the said contract.

Construction Safety and Health Committee: State of the composition of the Contractor’s
Construction Safety and Health Committee, if one has been formed. Otherwise, state an
undertaking of the Contractor to organize such committee and appoint its members before
the start of construction work at the project site
Specific Safety Policies: State the specific safety policies which the Contractor undertakes to
observe and maintain in its construction site, including the frequency of and persons
responsible for conducting toolbox and gang meetings.
Penalties and Sanctions: State the penalties and sanctions for violations of the Construction
Safety and Health Program.
Training: State the frequency, content and persons responsible for orienting, instructing, and
training all workers at the site with regard to the Construction Safety and Health Program
under which they operate.
Waste Disposal: State the manner of disposing waste arising from the construction.

Submitted by:

Name and Signature of Authorized Officer of the Bidder

Position

DPWH Procurement Manual Volume II -Infrastructure 32 | 31