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Sustaining Technical Employee (Ste) Affidavit of Undertaking

The document is an affidavit form for a Sustaining Technical Employee. It requires the STE to provide personal details and affirm that they meet the qualifications to be an STE, including their employment and licensure status. The form collects contact information, education history, and requires the STE to authorize verification of the information.

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KITE Corpuz
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520 views1 page

Sustaining Technical Employee (Ste) Affidavit of Undertaking

The document is an affidavit form for a Sustaining Technical Employee. It requires the STE to provide personal details and affirm that they meet the qualifications to be an STE, including their employment and licensure status. The form collects contact information, education history, and requires the STE to authorize verification of the information.

Uploaded by

KITE Corpuz
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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Renewal of Regular Contractor’s License Application (Sole Proprietorship)

PCAB-F-SVD-002a. Revision No. 00, 11/19/2018


This Form is NOT for sale. Reproduction is Allowed
Page 16 of 24

SUSTAINING TECHNICAL EMPLOYEE (STE) AFFIDAVIT OF UNDERTAKING


Note: Please accomplish this affidavit properly. Refer to the next page for STE qualification requirements.
2x2 Picture
Republic of the Philippines ) of STE
Province of ______________)
City/Municipality of ________) S.S

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:

That my Tax Identification Number is :


3.
and my Social Security System Number:
That I am employed on a regular and full-time Name of Firm
basis by:
4.
Position in the Firm Contracting Fiscal Year (CFY)
With the position of as STE for
20___ - 20___
5. That I am not presently employed by either a private company or any government office or government owned/controlled
corporation, nor a full time instructor, nor working abroad;
6. That I am not a holder of a valid contractor's license;
7. That I am not involved in any construction malperformance suggestive of negligence, incompetence or malpractice or any
act or omission liable for disciplinary action by myself or in collaboration with any other person;
8. That I have not been convicted by a court of competent jurisdiction of any offense involving moral turpitude;
9. That I am fully aware that my failure to notify the PCAB of my disassociation from my present employer within 30 days from
such disassociation shall cause my disqualification from being a Sustaining Technical Employee, an Authorized Managing
Officer and an applicant for a contractor’s license with PCAB;
10. That I authorize the PCAB to verify and investigate any or all information in this affidavit from whatever sources PCAB may
consider appropriate;
11. That I am executing this affidavit to attest to the truth of the foregoing.
FURTHER AFFIANT SAYETH NAUGHT.
_____________________________
Sustaining Technical Employee (STE)
(Signature over Printed Name)

SUBSCRIBED AND SWORN to before me this _____ day of ___________________, 20___ at ___________________________;
affiant exhibited his/her Community Tax Certificate No. _____________ issued at __________________ on ______________ 20___.

Doc. No. NOTARY PUBLIC


Page No. Until December 31, 20 ___
Book No.
Series of 20 ___

-PASTE HERE- -PASTE HERE-

ACTUAL SIZE clear copy of ACTUAL SIZE clear copy of


valid PRC ID CARD valid PRC ID CARD
(Front) (Back)

AMO must sign here:

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