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AFFDAVIT OF DISCLOSURE OF NO RELATIONSHIP I Julie Mae D Piloton of legal age single Filipino and residing at Zone 1 Sambulawan Agusan Cagayan de Oro City under oath hereby depose and say 1

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AFFDAVIT OF DISCLOSURE OF NO RELATIONSHIP I Julie Mae D Piloton of legal age single Filipino and residing at Zone 1 Sambulawan Agusan Cagayan de Oro City under oath hereby depose and say 1 Powered By Docstoc
					AFFDAVIT OF DISCLOSURE OF NO RELATIONSHIP I, Julie Mae D. Piloton, of legal age, single, Filipino, and residing at Zone 1 Sambulawan, Agusan, Cagayan de Oro City, under oath, hereby depose and say: 1. That I am the authorized representative of Ford Cagayan de Oro, with office address at Km. 3 National Highway, Kauswagan, Cagayan de Oro City. 2. That the firm/partnership/joint venture/corporation, or any of its officers, directors, controlling stockholders and members, I represent for the bidding of delivery of one (1) unit service vehicle, is not related by consanguinity or affinity up to the third civil degree to the head of the agency, to the BAC, TWG, or Secretariat members, or to any Procuring Entity Official, who directly or indirectly took part in the bidding process; 3. That I am making this statement in compliance with Section 47 of the Implementing Rules and Regulations of Republic Act 9148, and in accordance with the requirements of the City Government of Cagayan de Oro – BAC. IN FAITH WHEREOF, I hereunto set my hands this ______ of March 2009 in the City of Cagayan de Oro, Philippines.

Julie Mae D. Piloton Affiant ______________________________ ______________________________

SUBSCRIBED AND SWORN TO before me this _______ day of March 2009 in the City of Cagayan de Oro City, Philippines.

_______________________ Notary Public

Doc. No. ________________ Page No. ________________ Book No. ________________ Series of _________________


				
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