MGB Form No.

08-2

Republic of the Philippines

Department of Environment and Natural Resources
MINES AND GEOSCIENCES BUREAU
North Avenue, Diliman, Quezon City

INDUSTRIAL SAND AND GRAVEL PERMIT

ISAG No. : ___________________

Date Issued : _____________, 19 ___
Permit Holder : ___________________

WHEREAS, on __________________, 19_____, _________________________

(Applicant)
with the address of _____________________________________________________,
filed Industrial Sand and Gravel Permit Application No.____________ to extract and
dispose of sand and gravel and other unconsolidated materials authorized under
Philippine Mining Act of 1995 and the Revised Implementing Rules and Regulations for
industrial purposes from the permit area situated in:

Sitio of _____________________________
Barangay of _____________________________
Municipality of _____________________________
Province of _____________________________
Island of _____________________________

and more particularly described in metes and bounds, to wit:

(TECHNICAL DESCRIPTION)

containing _________________ hectares.

WHEREAS, the aforesaid application, ISAG No. _________, appears to be

prima facie well founded;

WHEREFORE, this Industrial Sand and Gravel Permit to extract and dispose of
sand and gravel and other unconsolidated materials for industrial purposes from the area
above-described, is hereby granted to:

Name : _______________________________________________
Address : _______________________________________________

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subject to the provisions of the Philippine Mining Act of 1995 and the Revised
Implementing Rules and Regulations and the following terms and conditions:

1. This Permit is for a period of five (5) years from ______________, 19 _____ to
___________, 19 ______, inclusive, renewable for like periods but in no case
shall exceed a total of twenty-five (25) years; Provided, that the application for
renewal shall be filed before the expiry date thereof, and that the Permit Holder
has complied with the provisions of the Philippine Mining Act of 1995 and the
Revised Implementing Rules and Regulations promulgated thereunder, and the
terms and conditions of this Permit;

2. The Permit shall be for the exclusive use and benefit of the Permit Holder and
not, directly or indirectly, for the benefit of any other person whether natural or
juridical, and that the area covered by this Permit shall be used for the purpose
only of extracting and disposing the materials herein authorized;

3. The Permit can not be assigned, transferred or conveyed, in whole or in part,

without prior approval of the Regional Director concerned;

4. The extraction or removal of materials shall not be allowed within the distance of
one (1) kilometer from the boundaries of reservoirs established for public water
supply, archeological and historical sites, or of any public or private works or
structures, unless with prior clearance of the agency or owner concerned is
obtained. No extraction, removal and/or disposition of materials shall likewise be
allowed in offshore areas within five hundred (500) meters distance from the coast
and two hundred (200) meters from the mean low tide level along the beach;

5. The Permit Holder shall, before the issuance of this Permit, execute a bond in the
form and amount prescribed by the regulations, and with a surety or sureties
satisfactory to the Regional Director to guarantee the performance of the Permit
Holder's obligations and faithful compliance with the provisions of Republic Act
7942 and the Revised Implementing Rules and Regulations promulgated
thereunder. The bond in the applicable amount shall be maintained throughout the
corresponding term of this Permit and until the Government shall order its
cancellation;

6. The total quantity of materials authorized to be extracted and disposed of under,

and during the term of this Industrial Permit shall be discretionary with the
Permit Holder, but may be limited, when public interest so demands;

7. The Permit Holder shall, within ten (10) days after the end of each quarter,
submit to the MGB Regional Director personally/representative or by registered
mail quarterly production reports in the prescribed form stating the quantity of
materials extracted, removed and/or disposed under the Permit and the amounts of
fees paid therefor, copy of which shall be furnished the Municipal Treasurers
where the Permit area is situated and under operation. At the end of the term, the
Permit Holder shall submit to the concerned Regional Office a final report with the
detailed list of activities and the corresponding expenditures;

8. The Regional Director or his/her duly authorized representative/s may, at any

time during the effectivity of this Permit, inspect the operations and the books of
accounts and other relevant data of the Permit Holder in which shall be entered
the quantity of materials removed or disposed of, the amount of fees paid, the
selling price, and the names and addresses of the persons to whom the same were
sold;

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9. The extraction and removal of quarry resources under this Permit shall be
confined within the area specified herein, the boundaries of which according to
the application have been well established according to survey rules and
regulations. This Permit shall exclude areas closed to mining location as provided
in Sec. 19 of the Act;

10. The Permit Holder or his/her representative shall keep the Permit/Permit Area,
available at all times for inspection and examination by the duly authorized
representative/s of the concerned MGB Regional Office;

11. The Permit Holder shall pay to the Government an excise tax pursuant to Sec.
151 of the National Internal Revenue Code, as amended; such excise tax shall be
due and payable upon the removal of the quarry resources extracted from the area
embraced by his/her Permit, pursuant to the provisions of the National Internal
Revenue Code, as amended;

12. This Permit may be revoked or canceled at any time by the Regional Director
concerned when in his/her opinion public interest so requires, or upon failure of
the Permit Holder to comply with the provisions of the Philippine Mining Act of
1995 and the Revised Implementing Rules and Regulations promulgated
thereunder, as well as with the terms and conditions specified herein; Provided,
that if the Permit is canceled, or otherwise terminated, the Permit Holder shall be
liable for all unpaid fees and taxes due up to the time of the termination or
cancellation of the Permit;

13. The Permit Holder shall assume full responsibility and be liable for damages to
private and/or public property(ies) that may be occasioned by its operations under
the Permit;

14. The Permit Holder shall manage its operations in a technically and environmentally
responsible manner to achieve a safe, non-polluting and self-sustaining post
disturbance landform;

15. The Permit Holder shall not discriminate on the basis of gender and that the Permit
Holder shall respect the right of women workers to participate in policy and
decision-making processes affecting their rights and benefits;

16. The Permit Holder shall conform to laws, rules and regulations regarding, among
others, labor, safety and health standards;

17. The Permit Holder shall not interfere with the rights of other Permit
Holders/Operators/Contractors;

18. The Permit Holder shall recognize and respect the rights, customs and traditions of
local communities, particularly Indigenous Cultural Communities;

19. The Permit Holder shall immediately stop digging and extracting materials the
moment man-made articles or artifacts are found. It shall notify the Director of the
National Museum of such findings, in which case, the digging shall be under the
supervision of the National Museum until said artifacts are recovered;

20. The Permit Holder shall not, by virtue of the Permit, acquire any title over the permit
area, without prejudice to its acquisition of the land/surface rights through any mode
of acquisition provided by law;

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21. The Permit Holder shall pay fees, taxes and other obligations in accordance with
existing laws, rules and regulations;

22. The Permit Holder shall comply with its obligations under its ECC, Environmental
Protection and Enhancement Program (EPEP) and Annual EPEP, including the
allocation of the prescribed annual environmental expense pursuant to Section 171 of
the Revised Implementing Rules and Regulations;

23. The statements made in the application or those made later in support thereof,
shall be considered as condition and essential parts of this Permit, and any
misrepresentation therein stated shall be a cause for the cancellation of this
Permit; and

24. The Permit Holder further binds itself to comply with the provisions of RA No.
7942 and the Revised Implementing Rules and Regulations promulgated
thereunder, and such other terms and conditions not inconsistent with the
Constitution, the Act and the Revised Implementing Rules and Regulations, as well
as those which the concerned Regional Director may deem to be for the national
interest and public welfare.

____________________, Philippines, ________________, 19 ______.

For The Republic of the Philippines:

(Grantor)

____________________________
Regional Director

I hereby accept the terms and conditions of this Industrial Sand and Gravel
Permit as above stated.

________________________
Permit Holder

Signed in the presence of:

__________________________ __________________________
(Signature over Printed Name) (Signature over Printed Name)

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MGB Form No. 08-2

ACKNOWLEDGEMENT

Republic of the Philippines )

Province of ________________ )s.s.
City/Municipality of _________ )

Before me appeared ___________________ exhibiting to me his/her Community

Tax Certificate No. _________ issued at _____________ on ___________ known to me
and to me known to be the same person who executed the foregoing document, and
acknowledged that same is his/her free and voluntary act, and deed as Permit Holder, and
for the purposes therein specified. The said instrument, consisting of 3 pages, including
this acknowledgment page, is an Industrial Sand and Gravel Permit to extract and dispose
of sand and gravel and other unconsolidated materials therein specified for industrial
purposes from the area herein mentioned.

WHEREFORE, I have hereunto set my hand and affixed my notarial seal this
_________ day of ____________, 19 ________, in ________________________.

_________________________
NOTARY PUBLIC
Until Dec. 31, 19 ____
PTR No. ___________
Doc. No. ________
Page No. ________
Book No. ________
Series of ________