PCAB
PCAB
PCAB
I respectfully request that said Company be issued a Special License to prequalify for, bid on and undertake
the construction of the specific project described below:
Project Title
Project Location
Liang’ An, Bacolod, Lanao Del Norte Province
Implementing Agency
Department of Energy / Province of Lanao Del Norte
State if project is covered by:
Bilateral Agreement calling for international competitive Expanded BOT Law or other existing laws of similar
[ ] bidding [ / ] nature
Funded by
60% loan from the Development Bank of the Philippines, 40% private funding
Loan Agreement
Date “Notice to Bidders” was published or Date “Invitation to Bidders” was received by the applicant
Date of Bidding
The documents and information in support of this license application as per checklist are hereby submitted.
I hereby declare that all the information and documents contained in this application are true and correct of
my own personal knowledge. I am fully aware that I shall be personally held liable for any misrepresentation
that may be found herein.
Dai Longcai
Resident Alien Representative (RAR) /
Authorized Managing Officer (AMO)
(Signature over Printed Name)
Doc. No.
Page No.
Book No.
Series of 20 __.
NOTARY PUBLIC
Until December 20 ____
PCAB-PAD-SLF-NEW-F01
Revision No. 01, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 4 of 19
As frontrunners of nation-building, we acknowledge our major role and responsibility in ensuring that we carry out
our tasks guided by ethical standards and equipped with the necessary capability for the successful prosecution of
our contracts.
We will present only true qualifications to PCAB so that we may be evaluated properly and be given the
category and classification where we should rightfully belong;
We will uphold the dignity of the license and not be instruments for unlicensed contractors to undertake
construction projects through license lending nor through false joint ventures/consortium or pseudo
combinations which is inimical to the public safety/interest;
We will not employ unlicensed sub-contractors/specialty contractors which is a clear circumvention of the
requirement that all contractors must be licensed;
We will absolutely shun away from any form of collusion that destroys the very essence and integrity of
biddings;
We will not engage in bribery or do any act which constitutes graft or corrupt practice which is the root
cause of bloated contract amounts;
We will not use sub-standard materials which will in any way compromise the safety, reliability and
performance of the built environment;
We will not abandon our contracts and we will implement our projects faithfully in accordance with the
prescribed specifications thereof;
We will provide the necessary resources, financial and technical capability in carrying out our contractual
obligations, and as far as possible, within the stipulated time of completion;
We are aware that we will be imposed disciplinary action should we violate any of the commitments hereof
or the PCAB Code of Ethics or be found to be a party to corruption.
Dai Longcai
Resident Alien Representative (RAR) /
Authorized Managing Officer (AMO)
(Signature over Printed Name)
PUBLIC
Until December 31,
20 ____
Doc. No.
Page No.
Book No.
Series of 20 __.
PCAB-PAD-SLF-NEW-F01
Revision No. 01, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 5 of 19
Dai Longcai
Resident Alien Representative (RAR) /
Authorized Managing Officer (AMO)
(Signature over printed name)
PCAB-PAD-SLF-NEW-F01
Revision No. 01, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 6 of 19
RAR/AMO AFFIDAVIT Picture of
Note: Please accomplish this affidavit properly. Please use additional sheets if necessary. RAR/AMO
see Important
Republic of the Philippines ) Reminders
Province of ______________) (page 19, item
City/Municipality of ________) S.S no. 4) for
specification
Last Name First Name Ext. Name (Jr/Sr, if any) Middle Name
I,
Dai Longcai N/A N/A
Citizenship dd mm yyyy Single / Last Name First Name Middle Name
Born on 24 04 1984 Ye Chunlan
Chinese Married to
and residing Room/Floor/Unit/Bldg. Name, Lot/Block/Phase No., Street, Subdivision, Barangay, City/Municipality, Province, Zip Code
in the 1472 Calumpang Street, Dasmariñas Village, Makati City
Philippines
at:
having duly sworn to in accordance with law depose and say:
1. That I am the Resident Alien Representative (RAR) / Authorized Managing Officer (AMO) of :
Guangxi Hydro Electric Bureau
(Name of Firm)
with position of:
Authorized Managing Officer
(Position in the Firm)
empowered to render general management and administrative decisions.
2. That I possess the following educational qualifications (attach additional sheet if necessary)
Name of School Address Course Inclusive Dates
Hydraulic and Hydro-Power
Guizhou University Guiyang, Guizhou, China September 2003 - JULY 2007
Engineering
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)
(attach additional sheet if necessary)
Dates of
Designation / Position Company / Nature of Business Address Job Description
Employment
2 F, No.1715 Zhongshan North
China Energy Engineering Group Water Conservancy and
Engineer Road, Shanghai, 200061 China 2013-Present
Co., Ltd. Hydropower Engineering
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) (attach additional sheet if necessary):
Training/Seminar Conducted by Address Inclusive Dates of Training
Unit 204 Greenhills Mansion, 37
The National Constructors Association of
AMO Seminar
the Philippines, Inc.
Annapolis Street, Greenhills, San May 24-25, 2018
Juan, 1502 Metro Manila
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.
Dai Longcai
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-PAD-SLF-NEW-F01
Revision No. 01, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 7 of 19
This is to further certify that the following requirements under existing laws have been waived in the loan
agreement:
______________________________
Certifying Officer / Position
(Signature over Printed Name)
______________________________
Name of Agency
______________________________
Date
PCAB-PAD-SLF-NEW-F01
Revision No. 01, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 8 of 19
THE MANAGER
Bank of China Ltd.
Manila
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.
Name of Firm:
By:
Dai Longcai
Signature over Printed Name of
Resident Alien Representative /
Authorized Managing Officer or
Authorized Signatory with the Bank
Date:_______________________
PCAB-PAD-SLF-NEW-F01
Revision No. 01, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 9 of 19
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:
Dai Longcai
Signature over Printed Name of
Representative Alien Representative /
Authorized Managing Officer
Date:______________________
PCAB-PAD-SLF-NEW-F01
Revision No. 01, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 10 of 19
No Real Properties
in the Philippines
*LEGEND:
TCT – Transfer Certificate of Title
CCT – Condominium Certificate of Title
TD – Tax Declaration
CLT – Certificate of Land Title
Dai Longcai
Signature over Printed Name of
Resident Alien Representative/
Authorized Managing Officer
Date:________________________
PCAB-PAD-SLF-NEW-F01
Revision No. 01, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 11 of 19
16,660,536.06 16,660,536.06
OVERALL TOTAL VALUE
Dai Longcai
Signature over Printed Name of
Resident Alien Representative /
Authorized Managing Officer
Date:_________________________
PCAB-PAD-SLF-NEW-F01
Revision No. 01, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 12 of 19
SCHEDULE OF RECEIVABLES
Note: 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. Please use additional sheets if
necessary.
PRC Registration
Date Position
Name of STE License Date of
Employed in the Firm
Prof.
Number Registration Validity
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.
Dai Longcai
Signature over Printed Name of
Resident Alien Representative /
Authorized Managing Officer
Date:________________________
PCAB-PAD-SLF-NEW-F01
Revision No. 01, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 14 of 19
Last Name First Name Ext. Name (Jr/Sr, if any) Middle Name
I,
mm dd yyyy Single / Last Name First Name Middle Name
Born on
Married to
Room/Floor/Unit/Bldg. Name, Lot/Block/Phase No., Street, Subdivision, Barangay, City/Municipality, Province, Zip Code
and
residing at
Telephone / Mobile No. (required) Email Address (required)
with
having been duly sworn in accordance with law depose and say:
1. That I am a duly licensed ____________________________________________ and holder of PRC License No. __________
(Profession)
valid up to _______________, as evidenced by a copy of my PRC ID posted below;
Course / Profession
That I hold a Bachelor's Degree in
2. Name of School Inclusive Dates
Given at: Given on:
SUBSCRIBED AND SWORN to before me this _____ day of ___________________, 20___ at ___________________________;
affiant exhibited his/her Community Tax Certificate No. _____________ issued at __________________ on ______________ 20___.
(Front) (Back)
(photocopy) (photocopy)
PCAB-PAD-SLF-NEW-F01
Revision No. 01, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 15 of 19
c) Conviction by a court of competent jurisdiction of any offense involving moral turpitude; and
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.
Dai Longcai
Resident Alien Representative /
Authorized Managing Officer
(Signature over printed name)
__________________________________________
Date
PCAB-PAD-SLF-NEW-F01
Revision No. 01, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 16 of 19
That I authorize the PCAB to verify and investigate any or all information in this affidavit from whatever sources PCAB
may consider appropriate;
_________________________________
Affiant
NOTARY PUBLIC
Until December 31, 20 ___
Doc. No
Page No.
Book No.
Series of 20 _____.
PCAB-PAD-SLF-NEW-F01
Revision No. 01, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 17 of 19
Name of STE
Last Name First Name Ext. Name (Jr/Sr, if any) Middle Name
Present Employer
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:
Date of Date of
Previous Employers Position
Employment Resignation
4. Other Remarks:
_____________________________________________________________________________________
_____________________________________________________________________________________
-----------------------------------------------------------------------
To be filled out by PCAB/DTI ROG Personnel
STE’s Specimen Signature (during interview):
Dai Longcai
2.
B. Tomas Valencia/ Resident Agent
Tomas Valencia
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
3.
connection with the functions stated herein.
4. 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.
5.
2011 (copies of required documents are attached).
____________________________
Affiant
(Authorized Managing Officer of Firm)
NOTARY PUBLIC
Until December 31, 20 ___
Doc. No.
Page No.
Book No.
Series of 20 ___
PCAB-PAD-SLF-NEW-F01
Revision No. 01, 10/19/2017
This Form is NOT for sale. Reproduction is Allowed
Page 19 of 19
IMPORTANT REMINDERS
1. All required information in the application forms should be properly filled out. Do not leave an item blank. If an item is
not applicable, indicate “N/A”.
2. The recommended paper size in printing the application forms is 8.27” x 11.69” (A4 size).
3. Application forms and its corresponding supporting documents/attachments should be:
a. arranged according to page number with index tabs;
b. fasten in a long size folder.
4. The required picture specification for the RAR/AMO / STE / Authorized Representatives Affidavit as follows:
a. taken within the last three (3) months prior to filing of application;
b. Philippine passport size (4.5 cm x 3.5 cm or 1.78” x 1.38”);
c. colored, with white background and printed on good quality photo paper;
d. in standard close-up shot, taken in full-face view directly facing the camera;
e. in bare face (with no eyeglasses or any accessories that may cover the facial features), showing left and right
ears;
f. with handwritten (not computer-generated) name tag legibly showing signature over printed full name in the
format: First Name, Middle Initial, Last Name and Extension Name, if any;
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. 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).
7. Filing/submission of application/s can be done at PCAB Makati / CIAP Windows / DTI Regional or Provincial Offices /
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.ciap.dti.gov.ph.
9. Fee Structure:
New Special License – Foreign Application
Category
Fee Particulars AAA AA A B C D E/Trade
Filing Fee 1,200 1,200 1,200 1,200 1,200 1,200 1,200
Classification Fee
Principal 4,800 2,400 480 240 144 48 nil
Other/s (chargeable for
2,400 1,200 240 120 72 24 nil
each classification)
Categorization Fee 43,200 21,600 7,200 4,800 2,400 1,200 nil
License Fee 100 100 100 100 100 100 100
Documentary Stamp Tax 15 15 15 15 15 15 15
Legal Research Fund 12 12 12 12 12 12 12
Grand Total (P) 51,727 26,527 9,247 6,487 3,943 2,599 1,327
10. For further inquiries or clarifications, please communicate with us thru email or thru contact numbers below:
Note: Do not include this page in your application folder. For reference use only.