Xxxxxxxx, P E., P.S./City Engineer / / Date ( ) - Phone CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER CERTIFICATION: Pursuant to Section VI. B. and VI. C. of the Agreement, the undersigned Chief Executive Officer and Chief Fiscal Officer of the Recipient, as both are designated in Appendix B of the Agreement, hereby request the Director to disburse financial assistance moneys made available to Project in Appendix C of the Agreement (inclusive of any amendment thereto) to the payee as identified below in the amount so indicated which amount equals the product of the Disbursement Ratio and the dollar value of the attached cost documentation which was properly billed to the Recipient in exclusive connection with the performance of the Project. The undersigned further certify that:
Xxxxxxxxx, X Xxxxxxx Chairman & CEO Barangay Bagumbayan Paracale, Camarines Norte Tel No. 0000-000-0000/000-0000 Email: xxxxxxxxx_xxxx@xxxxx.xxx November 4, 2008 November 3, 2033 Paracale, Camarines Norte Gold, Copper 173.9329 MPSA 273-2008-V Orophil Stonecraft, Inc. Xx. 0 Xxxxxxx Xxxx Xxx Xxxxxx, Xxxxxx Xxxx November 26, 2008 November 25, 2033 Baao, Camarines Sur Perlite 141.1418 MPSA 279-2009-V Xxxxxxxx X. Xxxxx, Et. Al. c/o Xx. Xxxxxxxx X. Abaño Xxxxx Xxxxxxx Xxxxx Xxxxxx & Xxxxxxx Law Offices Suite 1515 Tektite East Tower Phil Exchange Center Building Exchange Road, Ortigas Center Pasay City Tel No. (000) 000-0000 0000-000-0000 April 8, 2009 April 7, 2034 Bula, Camarines Sur Gypsum 171.6511 MINERAL AGREEMENT NUMBER CONTRACTOR DATE GRANTED DATE EXPIRY LOCATION MINERAL COMMODITY AREA (Has.) MPSA 297-2009-V Guo Long Mining Corp. Xxx Xxxx President Xxxx Xxxxxxxx, Paracale Camarines Norte November 16, 2009 November 15, 2034 Xxxx Xxxxxxxxxx, Camarines Norte Gold, Iron, etc 595.6522 MPSA 306-2009-V Pargum Consolidated Corporation Xxxxxx X. Xxxxxx President 7th Floor, Corporate Business Center 000 Xxxxx Xx Xxxxx xxxxxx Xxxxxx Xxxxxx Xxxxxx Xxxx Tel No.: 000-00-00 000-00-00 Fax No.: 000-00-00 000-00-00 December 23, 2009 December 22, 2034 Xxxx Xxxxxxxxxx, and Paracale, Camarines Norte Gold, etc. 476.6808 MPSA 329-2010-V Filminera Resources Corp March 23, 2010 March 22, 2035 Aroroy, Masbate Gold,etc 584.2034 MPSA 334-2010-V East Environ, Incorporated Xxxxxxxx X. Tolentino Unit J Primrose Building Rose Avenue, Xxxxx Village Las Piñas City May 27, 2010 May 27, 2035 Baao, Camarines Sur Perlite 62.1904 MPSA 300-2009-V Yinlu Bicol Mining Corporation Xxx Xxxx President Xxxx Xxxxxxxx, Paracale Camarines Norte November 24, 2009 November 23, 2034 Paracale & Xxxx Xxxxxxxxxx, Camarines Norte Iron, gold, etc. 663.0746 MINERAL AGREEMENT NUMBER CONTRACTOR DATE GRANTED DATE EXPIRY LOCATION MINERAL COMMODITY AREA (Has.) MPSA 308-2009-V MPSA UNDER REVIEW BY THE DENR Heirs of Xxxxxxx Xxxxxxxx: XXXX. XXXXXXXX X. XXXXX Suite 2104 B, East Tower Philippine Stock Exchange Center Bldg. Eschange Road, Ortigas Center Pasig City XXXXXXX X. XXXXXXXX Unit 2002 B, West Park Alder Condominium Northgate Filinvest Corporate City, Alabang Muntinlupa City XXXXXXX X. XXXXXXXX 0-X Xxxxx Xxxxxx, San Antonio San Francisco Del Monte Quezon City NOTE : MPSA UNDER REVIEW BY THE OSEC December 18, 2009 December 17, 2034 Xxxx Xxxxxxxxxx, Camarines Norte Iron, gold, etc. 153.7478
Xxxxxxxx, X X. Xxxxxx, as Trustee .................. 00 Xxxxx Xxxxxx, Xxxxxx, Xxxxxxxxxxxxx 00000
Xxxxxxxxxx, X Xxxxxx, and X.
Xxxxxxxxx Xxxxxx i. An employer shall provide an employee at the time of his hiring with an inventory form on which the employee shall list his tools and which shall be submitted by the employee to the employer who may, at any time, check the accuracy of such inventory.
Xxxxxxxx Xxxxxxx Purchase Order and Sales Contact Email Please enter a valid email address that will definitely reach the Purchase Order and Sales Contact. 2 xxxxxxx@xxxxxxxxxxxxxxxxxxxxx.xxx Purchase Order and Sales Contact Phone Numbers only, no symbols or spaces (Ex. 8668398477). The system will auto-populate your entry with commas once submitted which is appropriate and expected (Ex. 8,668,398,477). 2 3 8473704468 Company Website Company Website (Format - xxx.xxxxxxx.xxx) 4 xxx.xxxxxxxxxxxxxxxxxxxxx.xxx Entity D/B/A's and Assumed Names You must confirm that you are responding to this solicitation under your legal entity name. Go now to your Supplier Profile in this eBid System and confirm that your profile reflects your "Legal Name" as it is listed on your W9. In this question, please identify all of your entity's assumed names and D/B/A's. Please note that you will be identified publicly by the Legal Name under which you respond to this solicitation unless you organize otherwise with TIPS after award. 5 No response Primary Address Primary Address 2 6 000 Xxxxx Xxx Primary Address City Primary Address City Elk Grove Village Primary Address State Primary Address State (2 Digit Abbreviation) 2 8 IL Primary Address Zip Primary Address Zip 9 60007 Search Words Identifying Vendor Please list all search words and phrases to be included in the TIPS database related to your entity. Do not list words which are not associated with the bid category/scope (See bid title for general scope). This will help users find you through the TIPS website search function. You may include product names, manufacturers, specialized services, and other words associated with the scope of this solicitation. Athletic Field Construction, Athletic Field Maintenance, Athletic Field Consulting Certification of Vendor Residency (Required by the State of Texas) Does Vendor's parent company or majority owner:
Xxxxx Xxxxxxxxxx (2) Xxxxx Xxxxx
Xxxxxx Xxxxxxxxx Purchase Order and Sales Contact Email Please enter a valid email address that will definitely reach the Purchase Order and Sales Contact. 2 2 xxxxxx@xxxxxxxxxxxxxxx.xxx Purchase Order and Sales Contact Phone Numbers only, no symbols or spaces (Ex. 8668398477). The system will auto-populate your entry with commas once submitted which is appropriate and expected (Ex. 8,668,398,477). 2 3 8324187951 Company Website Company Website (Format - xxx.xxxxxxx.xxx) 4 No response Entity D/B/A's and Assumed Names You must confirm that you are responding to this solicitation under your legal entity name. Go now to your Supplier Profile in this eBid System and confirm that your profile reflects your "Legal Name" as it is listed on your W9. In this question, please identify all of your entity's assumed names and D/B/A's. Please note that you will be identified publicly by the Legal Name under which you respond to this solicitation unless you organize otherwise with TIPS after award. 5 No response Primary Address Primary Address 2 6 00000 Xxxxxxxxxx 00 X, Xxxxx 000 Primary Address City Primary Address City 7 Spring Primary Address State Primary Address State (2 Digit Abbreviation) 2 8 TX Primary Address Zip Primary Address Zip 9 77380 Search Words Identifying Vendor Please list all search words and phrases to be included in the TIPS database related to your entity. Do not list words which are not associated with the bid category/scope (See bid title for general scope). This will help users find you through the TIPS website search function. You may include product names, manufacturers, specialized services, and other words associated with the scope of this solicitation.
Xxxxxxx Xxxxxxxx Purchase Order and Sales Contact Email Please enter a valid email address that will definitely reach the Purchase Order and Sales Contact. 2 xxxxxxx@xxxxx.xxx Purchase Order and Sales Contact Phone Numbers only, no symbols or spaces (Ex. 8668398477). The system will auto-populate your entry with commas once submitted which is appropriate and expected (Ex. 8,668,398,477). 2 3 3253407218 Company Website Company Website (Format - xxx.xxxxxxx.xxx) 4 xxx.xxxxxxxxxx@xxxxx.xxx Entity D/B/A's and Assumed Names You must confirm that you are responding to this solicitation under your legal entity name. Go now to your Supplier Profile in this eBid System and confirm that your profile reflects your "Legal Name" as it is listed on your W9. In this question, please identify all of your entity's assumed names and D/B/A's. Please note that you will be identified publicly by the Legal Name under which you respond to this solicitation unless you organize otherwise with TIPS after award. WBF Tinting...under the Son Primary Address Primary Address 6 0000 XX 00, Xxxxx 0 Primary Address City Primary Address City 7 San Xxxxxx Primary Address State Primary Address State (2 Digit Abbreviation) 2 8 TX Primary Address Zip Primary Address Zip 9 76904 Search Words Identifying Vendor Please list all search words and phrases to be included in the TIPS database related to your entity. Do not list words which are not associated with the bid category/scope (See bid title for general scope). This will help users find you through the TIPS website search function. You may include product names, manufacturers, specialized services, and other words associated with the scope of this solicitation. 3 0 Security Film, ballistic film, bomb proof, anti-intrusion film, mil film, school security film, clear film, safety film, theft deterrent film, xxxxx xxxxxxxx, 3m, xxxxx, solargard, xxx xxx, security, safety, dow 995 Certification of Vendor Residency (Required by the State of Texas) Does Vendor's parent company or majority owner:
Xxxxxxxxx, Xx Xxxxxxx X. Xxxxxxxxx, Xx., Chief Executive Officer
