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COC Checklist Form

1. The document outlines the requirements for securing a Certificate of Compliance from the Department of Energy's Oil Industry Management Bureau for operating a retail fuel outlet. It details the application process and required supporting documents for both new applications and renewals. 2. Applicants must provide information about their business and retail outlet location, a notice of undertaking liability, documents demonstrating a valid fuel supply agreement, design plans and equipment lists, photographs, and clearance of any pending cases. 3. The checklist is to be filled out by DOE officers and includes sections on prior notice, initial application requirements, renewal requirements, annual reporting obligations, and the corresponding application fees. Proper submission of all original or certified documents is necessary

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Muhammad Hasher Anjalin
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338 views

COC Checklist Form

1. The document outlines the requirements for securing a Certificate of Compliance from the Department of Energy's Oil Industry Management Bureau for operating a retail fuel outlet. It details the application process and required supporting documents for both new applications and renewals. 2. Applicants must provide information about their business and retail outlet location, a notice of undertaking liability, documents demonstrating a valid fuel supply agreement, design plans and equipment lists, photographs, and clearance of any pending cases. 3. The checklist is to be filled out by DOE officers and includes sections on prior notice, initial application requirements, renewal requirements, annual reporting obligations, and the corresponding application fees. Proper submission of all original or certified documents is necessary

Uploaded by

Muhammad Hasher Anjalin
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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OMB/COR#017-COCDrev1

CHECKLIST OF REQUIREMENTS
FOR SECURING CERTIFICATE OF COMPLIANCE
As provided for in DOE Department Circular DC2017-11-0011
TO BE FILLED-OUT BY DOE-OIMB LIQUID FUELS OFFICERS ONLY
Type of Application: New Renewal Reportorial Change dealer/name
(Previous dealer/name)
Business Name: Name of RO:
Dealer/Retailer: Start of Operation:
Complete Address of Retail Outlet:
Oil Company: Independent: Name of Supplier/s:
Remarks
REQUIREMENTS
(Date of Submission)

I. PRIOR NOTICE
1. Filled-out and notarized application form complete with the following information:
a. Business name, address, telephone number, fax number and e-mail address of the business office;
b. Location and complete address of the Retail Outlet; and
c. Name of dealer/retailer or authorized representative if partnership/corporation/cooperative.
2. A Notice of Undertaking on liability in case of violations committed by dealer, operator, owner or proprietor
II. SUPPORTING DOCUMENTS FOR 1st ISSUANCE
1. Authenticated copy of the valid Supply Agreement or original Supplier’s Certificate from an OIMB-registered
distributor/supplier
2. Notarized Statement that the facility design and operation of the Retail Outlet is PNS-compliant signed by the
Engineering Procurement Construction Contractor and dealer/owner of the Retail Outlet
3. List of dispensing pumps/hoses and underground storage tank/s with corresponding capacity/ies
4. Scaled lay-out plan showing the island/dispensing pumps, underground storage tanks, cashier’s booth and
other facilities (with measurement)
5. Accomplished DOE Form on Undertaking
6. Latest photographs (in 5R size) showing:
Full/front, right, and left side views Price display board
of the retail outlet
Required stickers/labels for RON, Safety and informational signs
E10 and B2, among others
7. DOE SCC/COC Clearance of No Pending Case, as applicable
8. Payment of fee
III. SUPPORTING DOCUMENTS FOR RENEWAL *Application MUST be filed a month before COC expiration
1. Accomplished DOE Form on Undertaking
2. Authenticated copy of the valid Supply Agreement or original Supplier’s Certificate from an OIMB-registered
distributor/supplier
3. DOE SCC/COC Clearance of No Pending Case, as applicable
4. Photocopy of previous COC
5. Payment of fee
IV. REPORTORIAL REQUIREMENTS (Under oath; submitted every 30th day of January)
1. Data on Purchase, Sales and Inventory in Volume
2. Authenticated copy of the valid Supply Agreement or original Supplier’s Certificate from an OIMB-registered
distributor/supplier
NOTE: ALL DOCUMENTS MUST BE IN ITS ORIGINAL FORMS UNLESS OTHERWISE STATED
V. CORRESPONDING FEES
1. Acknowledgement of Notice/Engagement on the DOI ₱ 500.00 Official Receipt
2. COC for Retail Outlet for 5 years (New Application) ₱ 3,000.00 No.:

3. COC for Retail Outlet for 5 years (Renewal) ₱ 2,500.00 Date:

IMPORTANT: Amount:
For Mailed Application: We ONLY ACCEPT Postal Money Order (PMO) / Manager’s Cheque (MC) payable to
the DEPARTMENT OF ENERGY

All applications must be addressed to: Director, Oil Industry Management Bureau
Department of Energy
Energy Center, 3rd Floor, PNOC Bldg. 5, BGC, Taguig City
Assessed by: Recommendation: Forwarded to OBD
Returned to applicant
(Printed Name and Signature)

Energy Center, Rizal Drive, Bonifacio Global City, Taguig City, Philippines
Tel. No. 479-2900 loc. 376/840-2184, Website: www.doe.gov.ph, E-mail: [email protected]

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