(f) Within a non-extendible period of ten (10) calendar days from receipt
of the verified position paper, the Head of the Procuring Entity shall
decide whether or not to terminate this Contract. It shall serve a
written notice to the Supplier of its decision and, unless otherwise
provided, this Contract is deemed terminated from receipt of the
Supplier of the notice of decision. The termination shall only be based
on the ground(s) stated in the Notice to Terminate;
(g) The Head of the Procuring Entity may create a Contract Termination
Review Committee (CTRC) to assist him in the discharge of this
function. All decisions recommended by the CTRC shall be subject to
the approval of the Head of the Procuring Entity; and
(h) The Supplier must serve a written notice to the Procuring Entity of its
intention to terminate the contract at least thirty (30) calendar days
before its intended termination. The Contract is deemed terminated if it
is not resumed in thirty (30) calendar days after the receipt of such
notice by the Procuring Entity.
28. Assignment of Rights
The Supplier shall not assign his rights or obligations under this Contract, in whole or
in part, except with the Procuring Entity’s prior written consent.
29. Contract Amendment
Subject to applicable laws, no variation in or modification of the terms of this
Contract shall be made except by written amendment signed by the parties.
55
30. Application
These General Conditions shall apply to the extent that they are not superseded by
provisions of other parts of this Contract.
56
Section V. Special Conditions of Contract
57
Special Conditions of the Contract
GCC Clause
1.1(g) The Procuring Entity is Poro Point Management Corporation.
1.1(i) The Supplier is [to be inserted at the time of contract award].
1.1(j) The Funding Source is:
The Government of the Philippines (GOP) through PPMC 2010
Corporate Budget in the amount of Five Hundred Twenty Six
Thousand Nine Hundred Thirty Pesos (Php526,930.00).
1.1(k) The Project Site is the Poro Point Freeport Zone, Gov. Joaquin Ortega
Avenue (formerly Pennsylvania Avenue), Poro Point, San Fernando
City, La Union.
5.1 The Procuring Entity’s address for Notices is:
Ms. Maria Victoria de Guzman-Soriano
Vice President for Human Resources and Administration
Poro Point Management Corporation
Gov. Joaquin L. Ortega Avenue
Poro Point Freeport Zone
Poro, City of San Fernando 2500, La Union
Tel. Nos. (63 72) 2420684
Facsimile No. (63 72 2420683)
www.poropointfreeport.org
The Supplier’s address for Notices is:
[Insert address including, name of contact, fax and telephone
number]
6.2 No further instructions.
9 For the given scope of work in this Contract as awarded, all bid prices
are considered fixed prices, and therefore not subject to price
escalation during contract implementation, except under extraordinary
circumstances and upon prior approval of the GPPB in accordance
with Section 61 of R.A. 9184 and its IRR-A.
10.1 No further instructions.
10.4 No further instructions.
13.1 No further instructions.
13.4 No further instructions.
13.4(c) No further instructions.
16.1 No further instructions.
17.3 No further instructions.
17.4 and 17.5 No further instructions.
19.1 The applicable rate is one tenth (1/10) of one (1) percent of the cost of
the unperformed portion for every day of delay.
The maximum deduction shall be ten percent (10%) of the amount of
58
contract. Once the cumulative amount of liquidated damages reaches
ten percent (10%) of the amount of the contract, the procuring entity
shall rescind the contract, without prejudice to other courses of action
and remedies open to it.
20.4 In the case of a dispute between the Procuring Entity and the
Supplier, the dispute shall be resolved in accordance with Republic
Act 9285 (“R.A. 9285”), otherwise known as the “Alternative Dispute
Resolution Act of 2004.”
59
Section VI. Schedule of Requirements
60
FORM 3a
PROVISION OF HEALTH INSURANCE COVERAGE FOR PPMC EMPLOYEES
AND DIRECTORS
The Provision of Health Insurance Coverage for PPMC Employees and Directors shall cover
the period October 8, 2010 to October 7, 2011. The specific details of the coverage are as
follows:
I. MINIMUM REQUIREMENTS
1.1 Room and Board Limit - Private
1.2 Dreaded Disease Limit - Php250,000 per illness per year
1.3 Out-Patient Benefits
• Unlimited consultation including specialists evaluation necessary
• X-ray Laboratory Examinations and Diagnostic Procedures
• First Aid Treatment of accidental injuries
• Minor surgeries
• Immunization except cost of vaccine
1.4 In-Patient Benefits
• Daily room and board
• Services of physicians, specialists and surgeons
• General nursing services
• Use of emergency, operating and recovery rooms
• Drugs, medicines, anesthesia and oxygen
• Laboratory tests, x-ray and other diagnostic procedures
• Dressing, casts and other necessary medical supplies
• Transfusion of blood and other blood elements
• All other items directly related to the medical management of the patient
• Assistance in administrative requirements through liaison officers
1.5 Coverage of pre-existing illnesses and permanent lifetime exclusion
1.6 Accredited Hospitals shall include the following:
In La Union
a. Bethany Hospital
b. Lorma Medical Center
c. La Union Medical & Diagnostic Center & Hospital
61
Baguio
a. SLU Hospital/Sacred Heart Hospital
b. Notre Dame De Chartres Hospital
Manila
a. Any two of the following:
a.1 Asian Hospitals and Medical Center
a.2 Cardinal Santos Medical Center
a.3 Makati Medical Center
a.4 Saint Luke’s Medical Center
a.5 The Medical City
a.6 Capitol Medical Center
a.7 Perpetual Help Medical Center
1.7 Emergency Care Services
• Emergency Care Services in accredited hospital, non-accredited hospitals
(80% reimbursement of reasonable and customary charges not to exceed
Php20,000 per disability), and in areas without accredited hospitals including
outside the Philippines (80% reimbursement of reasonable and customary
charges not to exceed Php20, 000 per disability).
1.8 Annual Physical Examination
• General/Comprehensive physical examination and medical history taking
• General consultation and counseling on health habits
• Chest X-ray examination
• Urinalysis examination
• Fecalysis examination
• Complete Blood Count
• ECG for those 35 years old and above
• Pap Smear for female, 35 years old and above
1.9 Dental Benefits
• Dental consultation including orthodontic and aesthetic
• Annual oral prophylaxis including polishing and cleaning
• Any number of temporary filing
• Any number of non-surgical tooth extraction
• Recementation of jackets, crowns, inlays and onlays
• Minor adjustment of dentures
• Relief of acute dental pain
• Emergency desensitization of hypersensitive teeth
• Care of oral lesions, wounds and burns
1.10 Special Services or Procedures
62
• Lithotripsy 80% up to Php40,000
• Laparoscopy Cholecystectomy 80% up to Php40,000
• Coverage of Thallium Scintigraphy
• Coverage of MRI/ Isotope Scan
• Coverage of CT Scan
• Therapy (speech and physical) up to 12 sessions
• Dialysis up to 12 sessions
• Chemotherapy up to 12 sessions
• Pre and post natal consultations up to 14 consultations
• Ambulance Service (on reimbursement) Php2,000 per conduction
• Coverage of work related injuries
II. COVERAGE
2.1 The coverage shall include the following PPMC Directors and Employees:
NAME POSITION DATE OF
1. Aguilar, Danilo B. Security Officer 31-Aug-53
2. Aquino, Marc Lawrence P. Land & Assets Development Assistant 14-Sep-81
3. Bada, Josefa Catherine T. Vice President for Airport Operations 25-Jun-64
4. Balagot, Iñigo T. Information Technology Officer 18-Nov-82
5. Balanon, Abigael R. Executive Secretary 26-Sep-81
6. Bautista, Jaime Joseph E. Property Assistant 12-May-68
7. Buccat, Saturnino Land & Assets Development Officer 9-Jul-67
8. Cabiladas, Troadio C. Senior Security Officer 1-Mar-53
9. Canlas, Jose F. Vice President for Finance 23-Oct-53
10. Caringal, Joel G. Vice President for Regulatory Services 1-Oct-55
11. Cariño, Rolando T. Firefighter 16-May-57
12. Cella, Fernando L. Driver/Messenger 18-Dec-60
13. Corpuz, Cerila A. Infrastructure Manager 18-Mar-76
14. Dequito, Norie V. Cottage Attendant 15-Aug-70
15. Dulay, Ernie B. Ramp Marshal 23-Nov-76
16. Entrada, Demetrio V. Driver/Messenger 11-Apr-52
17. Espiritu, Sonia G. Electro-Mechanical Officer 31-Aug-75
18. Flores, Nelson M. Firefighter 3-Apr-69
19.Galvan, Benjamin Q., Jr. Administrative Officer 12-Jun-70
20. Galvez, Joselito V. Procurement Assistant 29-Jul-59
21. Garcia, Jonnalyn C. Finance Analyst 5-Mar-85
22. Garcia, Leonida G. Cottage Attendant 25-Feb-57
23. Gongora, Karie B. Procurement Officer 4-Jan-78
24. Hidalgo, Anthony C. Crew Chief 11-Jul-75
25. Hufana, Jonathan B. Firefighter 12-May-75
26. Hullana, Ronel P. Security Officer 3-Mar-71
27. Jacla, Crisanta A. Enterprise Regulations Officer 23-Nov-64
28. Judan, Lenima B. Accountant 28-May-78
29. Mabutas, Greg I. Firefighter 5-Feb-78
30. Marquez, Antonio D. Electro-Mechanic Technician 15-Mar-59
31. Membrere, Lilito J. Security Officer 8-Oct-56
32. Mendoza, Mennen C. Terminal Operations Officer 13-Nov-68
63
33. Monsod, Eliza P. Business Development Officer concurrent
Executive Secretary
17-Mar-82
34. Moya, Isaias T. Driver/Mechanic 31-Jan-52
35. Navidad, Garry A. Firefighter 17-Jan-78
36. Opinaldo, Mharlani Apple
G
HR Assistant 24-Oct-85
37. Pacio, Allan L. Ground Handling Officer 22-May-72
38. Pacio, Edgardo P. Electro-Mechanical Technician 23-Aug-65
39. Panit, Florante E. Security Officer 26-Mar-77
40. Petran, Rogelio E. Firetruck Operator 23-Apr-66
41. Quibral, Salvador A., Jr. Firefighter 2-May-73
42. Salayog, Virgilio M. Vice President for Corporate Planning,
Business Development & Infrastructure
Management
1-Feb-63
43. Soriano, Maria Victoria
Redempta De Guzman
Vice President for Human Resources and
Administration
28-Aug-70
44. Tangalin, Michael A. Firefighter 21-Sept-76
45. Valido, Jovito A. Driver/Messenger 29-Aug-75
46. Vera, Jessie C. Enterprise Regulations Assistant 20-Dec-60
47. Villareal, Franklin C. Airport Assistant 17-Sept-68
BOARD OF DIRECTORS
48. Agno, Myrna N. Corporate Secretary 30-Jul-67
49. Aspiras, Amparo M. Director 8-Jan-26
50. Barias, Geary L. Director 1-Mar-54
51. De Guzman, Joselito M. Director 28-Jul-39
52. Itchon, Maria Carmencita Director 3-Jun-64
53. Lim, Emma B. Director 19-Oct-67
54. Manguiat, Anthony C. Executive Vice President & COO 11-Apr-68
55. Nisce, Ives Q. Director 15-Oct-53
56. Ortega, Mary Jane C. Director 30-May-41
57. Racadio, Felix S. President & CEO 29-Jul-52
58. Tiongson, Virgilio A. Director 12-Dec-38
• PPMC can increase the number of insured upon written notification.
• The computation of premium cost for each additional member shall be based on the
premium cost stated in the financial proposal of the insurance company.
• The proponent company may submit more superior specification or additional
benefits without incurring additional cost on the part of PPMC.
Name of Company: ________________________________________________
Submitted by: ____________________________________________________
Signature over Printed name of Authorized Representative
64
Section VII. Technical Specifications
65
FORM 3b
TECHNICAL SPECIFICATIONS
Proposal shall include at least the following:
The bidder hereby certifies to comply with the following technical specifications for the
Provision of Health Insurance Coverage for PPMC Employees and Directors:
I. MINIMUM REQUIREMENTS
1.1 Room and Board Limit - Private
1.2 Dreaded Disease Limit - Php250,000 per illness per year
1.3 Out-Patient Benefits
• Unlimited consultation including specialists evaluation necessary
• X-ray Laboratory Examinations and Diagnostic Procedures
• First Aid Treatment of accidental injuries
• Minor surgeries
• Immunization except cost of vaccine
1.4 In-Patient Benefits
• Daily room and board
• Services of physicians, specialists and surgeons
• General nursing services
• Use of emergency, operating and recovery rooms
• Drugs, medicines, anesthesia and oxygen
• Laboratory tests, x-ray and other diagnostic procedures
• Dressing, casts and other necessary medical supplies
• Transfusion of blood and other blood elements
• All other items directly related to the medical management of the
patient
• Assistance in administrative requirements through liaison officers
1.5 Coverage of pre-existing illnesses and permanent lifetime exclusion
1.6 Accredited Hospitals shall include the following:
In La Union
a. Bethany Hospital
b. Lorma Medical Center
c. La Union Medical & Diagnostic Center & Hospital
66
Baguio
a. SLU Hospital/Sacred Heart Hospital
b. Notre Dame De Chartres Hospital
Manila
a. Any two of the following:
a.1 Asian Hospitals and Medical Center
a.2 Cardinal Santos Medical Center
a.3 Makati Medical Center
a.4 Saint Luke’s Medical Center
a.5 The Medical City
a.6 Capitol Medical Center
a.7 Perpetual Help Medical Center
1.7 Emergency Care Services
• Emergency Care Services in accredited hospital, non-accredited
hospitals (80% reimbursement of reasonable and customary charges
not to exceed Php20,000 per disability), and in areas without
accredited hospitals including outside the Philippines (80%
reimbursement of reasonable and customary charges not to exceed
Php20, 000 per disability).
1.8 Annual Physical Examination
• General/Comprehensive physical examination and medical history
taking
• General consultation and counseling on health habits
• Chest X-ray examination
• Urinalysis examination
• Fecalysis examination
• Complete Blood Count
• ECG for those 35 years old and above
• Pap Smear for female, 35 years old and above
1.9 Dental Benefits
• Dental consultation including orthodontic and aesthetic
• Annual oral prophylaxis including polishing and cleaning
• Any number of temporary filing
• Any number of non-surgical tooth extraction
• Recementation of jackets, crowns, inlays and on lays
• Minor adjustment of dentures
• Relief of acute dental pain
• Emergency desensitization of hypersensitive teeth
• Care of oral lesions, wounds and burns
67
1.10 Special Services or Procedures
• Lithotripsy 80% up to Php40,000
• Laparoscopy Cholecystectomy 80% up to Php40,000
• Coverage of Thallium Scintigraphy
• Coverage of MRI/ Isotope Scan
• Coverage of CT Scan
• Therapy (speech and physical) up to 12 sessions
• Dialysis up to 12 sessions
• Chemotherapy up to 12 sessions
• Pre and post natal consultations up to 14 consultations
• Ambulance Service (on reimbursement) Php2,000 per conduction
• Coverage of work related injuries
II. COVERAGE
2.1 The coverage shall include the following PPMC Directors and Employees:
NAME POSITION DATE OF
1. Aguilar, Danilo B. Security Officer 31-Aug-53
2. Aquino, Marc Lawrence P. Land & Assets Development Assistant 14-Sep-81
3. Bada, Josefa Catherine T. Vice President for Airport Operations 25-Jun-64
4. Balagot, Iñigo T. Information Technology Officer 18-Nov-82
5. Balanon, Abigael R. Executive Secretary 26-Sep-81
6. Bautista, Jaime Joseph E. Property Assistant 12-May-68
7. Buccat, Saturnino Land & Assets Development Officer 9-Jul-67
8. Cabiladas, Troadio C. Senior Security Officer 1-Mar-53
9. Canlas, Jose F. Vice President for Finance 23-Oct-53
10. Caringal, Joel G. Vice President for Regulatory Services 1-Oct-55
11. Cariño, Rolando T. Firefighter 16-May-57
12. Cella, Fernando L. Driver/Messenger 18-Dec-60
13. Corpuz, Cerila A. Infrastructure Manager 18-Mar-76
14. Dequito, Norie V. Cottage Attendant 15-Aug-70
15. Dulay, Ernie B. Ramp Marshal 23-Nov-76
16. Entrada, Demetrio V. Driver/Messenger 11-Apr-52
17. Espiritu, Sonia G. Electro-Mechanical Officer 31-Aug-75
18. Flores, Nelson M. Firefighter 3-Apr-69
19.Galvan, Benjamin Q., Jr. Administrative Officer 12-Jun-70
20. Galvez, Joselito V. Procurement Assistant 29-Jul-59
21. Garcia, Jonnalyn C. Finance Analyst 5-Mar-85
22. Garcia, Leonida G. Cottage Attendant 25-Feb-57
23. Gongora, Karie B. Procurement Officer 4-Jan-78
24. Hidalgo, Anthony C. Crew Chief 11-Jul-75
25. Hufana, Jonathan B. Firefighter 12-May-75
26. Hullana, Ronel P. Security Officer 3-Mar-71
27. Jacla, Crisanta A. Enterprise Regulations Officer 23-Nov-64
28. Judan, Lenima B. Accountant 28-May-78
29. Mabutas, Greg I. Firefighter 5-Feb-78
30. Marquez, Antonio D. Electro-Mechanic Technician 15-Mar-59
68
31. Membrere, Lilito J. Security Officer 8-Oct-56
32. Mendoza, Mennen C. Terminal Operations Officer 13-Nov-68
33. Monsod, Eliza P. Business Development Officer concurrent
Executive Secretary
17-Mar-82
34. Moya, Isaias T. Driver/Mechanic 31-Jan-52
35. Navidad, Garry A. Firefighter 17-Jan-78
36. Opinaldo, Mharlani Apple
G
HR Assistant 24-Oct-85
37. Pacio, Allan L. Ground Handling Officer 22-May-72
38. Pacio, Edgardo P. Electro-Mechanical Technician 23-Aug-65
39. Panit, Florante E. Security Officer 26-Mar-77
40. Petran, Rogelio E. Firetruck Operator 23-Apr-66
41. Quibral, Salvador A., Jr. Firefighter 2-May-73
42. Salayog, Virgilio M. Vice President for Corporate Planning,
Business Development & Infrastructure
Management
1-Feb-63
43. Soriano, Maria Victoria
Redempta De Guzman
Vice President for Human Resources and
Administration
28-Aug-70
44. Tangalin, Michael A. Firefighter 21-Sept-76
45. Valido, Jovito A. Driver/Messenger 29-Aug-75
46. Vera, Jessie C. Enterprise Regulations Assistant 20-Dec-60
47. Villareal, Franklin C. Airport Assistant 17-Sept-68
BOARD OF DIRECTORS
48. Agno, Myrna N. Corporate Secretary 30-Jul-67
49. Aspiras, Amparo M. Director 8-Jan-26
50. Barias, Geary L. Director 1-Mar-54
51. De Guzman, Joselito M. Director 28-Jul-39
52. Itchon, Maria Carmencita Director 3-Jun-64
53. Lim, Emma B. Director 19-Oct-67
54. Manguiat, Anthony C. Executive Vice President & COO 11-Apr-68
55. Nisce, Ives Q. Director 15-Oct-53
56. Ortega, Mary Jane C. Director 30-May-41
57. Racadio, Felix S. President & CEO 29-Jul-52
58. Tiongson, Virgilio A. Director 12-Dec-38
• PPMC can increase the number of insured upon written notification.
• The computation of premium cost for each additional member shall be based on the
premium cost stated in the financial proposal of the insurance company.
• The proponent company may submit more superior specification or additional
benefits without incurring additional cost on the part of PPMC.
III. PERIOD OF COVERAGE
• October 8, 2010 to October 7, 2011
Name of Company: ________________________________________________
Submitted by: ____________________________________________________
Signature over Printed name of Authorized Representative
69
Section VIII. Bidding Forms
70
TABLE OF CONTENTS
STATEMENT OF ONGOINGGOVERNMENT&PRIVATE CONTRACTS (FORM 1).....................71
STATEMENT OF ALL GOVERNMENT&PRIVATE CONTRACTS (FORM 2) ..............................72
OMNIBUS SWORN STATEMENT (FORM 4) ...............................................................................73
FINANCIAL BID FORM (FORM 5).............................................................................................75
FINANCIAL PROPOSAL FORM(FORM6).....................................................................77
CONTRACT AGREEMENT FORM..............................................................................................78
71
FORM 1
Statement of all Ongoing Government & Private Contracts including contracts awarded but not yet
started
Business Name : ___________________________________________________
Business
Address
: ___________________________________________________
Bidder’s Role
% of Accomplishment
Name of Contract/
Project Cost
a. Owner’s
Name
b. Address
c. Telephone
Nos.
Nature of
Work
Description %
a. Date Awarded
b. Date Started
c. Date of
Completion
Planned Actual
Value of
Outstanding
Works /
Undelivered
P i
Submitted by : ___________________________________________________
Printed Name and Signature of Bidder’s Representative/Authorized
Signatory
Designation : ___________________________________________________
Date : ___________________________________________________
72
FORM 2
Statement of all Government & Private Contracts completed which are similar in nature
Business Name
: ___________________________________________________
Business
Address
: ___________________________________________________
Bidder’s Role
Name of Contract
a. Owner’s Name
b. Address
c. Telephone Nos.
Nature of Work
Description %
a. Amount at Award
b. Amount at
Completion
c. Duration
a. Date Awarded
b. Contract Effectivity
c. Date Completed
Submitted by : ___________________________________________________
Printed Name and Signature of Bidder’s Representative/Authorized Signatory
Designation : ___________________________________________________
Date : ___________________________________________________
73
FORM 4
Omnibus Sworn Statement
REPUBLIC OF THE PHILIPPINES )
CITY/MUNICIPALITY OF ______ ) S.S.
AF F IDAVI T
I, [Name of Affiant], of legal age, [Civil Status], [Nationality], and residing at [Address
of Affiant], after having been duly sworn in accordance with law, do hereby depose and state
that:
1. Select one, delete the other:
If a sole proprietorship: I am the sole proprietor of [Name of Bidder] with office
address at [address of Bidder];
If a partnership, corporation, cooperative, or joint venture: I am the duly authorized
and designated representative of [Name of Bidder] with office address at [address of
Bidder];
2. Select one, delete the other:
If a sole proprietorship: As the owner and sole proprietor of [Name of Bidder], I have
full power and authority to do, execute and perform any and all acts necessary to
represent it in the bidding for [Name of the Project] of the [Name of the Procuring
Entity];
If a partnership, corporation, cooperative, or joint venture: I am granted full power
and authority to do, execute and perform any and all acts necessary and/or to
represent the [Name of Bidder] in the bidding as shown in the attached [state title of
attached document showing proof of authorization (e.g., duly notarized Secretary’s
Certificate issued by the corporation or the members of the joint venture)];
3. [Name of Bidder] is not “blacklisted” or barred from bidding by the Government of
the Philippines or any of its agencies, offices, corporations, or Local Government
Units, foreign government/foreign or international financing institution whose
blacklisting rules have been recognized by the Government Procurement Policy
Board;
4. Each of the documents submitted in satisfaction of the bidding requirements is an
authentic copy of the original, complete, and all statements and information provided
therein are true and correct;
74
5. [Name of Bidder] is authorizing the Head of the Procuring Entity or its duly
authorized representative(s) to verify all the documents submitted;
6. Select one, delete the rest:
If a sole proprietorship: I am not related to the Head of the Procuring Entity,
members of the Bids and Awards Committee (BAC), the Technical Working Group,
and the BAC Secretariat, the head of the Project Management Office or the end-user
unit, and the project consultants by consanguinity or affinity up to the third civil
degree;
If a partnership or cooperative: None of the officers and members of [Name of
Bidder] is related to the Head of the Procuring Entity, members of the Bids and
Awards Committee (BAC), the Technical Working Group, and the BAC Secretariat,
the head of the Project Management Office or the end-user unit, and the project
consultants by consanguinity or affinity up to the third civil degree;
If a corporation or joint venture: None of the officers, directors, and controlling
stockholders of [Name of Bidder] is related to the Head of the Procuring Entity,
members of the Bids and Awards Committee (BAC), the Technical Working Group,
and the BAC Secretariat, the head of the Project Management Office or the end-user
unit, and the project consultants by consanguinity or affinity up to the third civil
degree;
7. [Name of Bidder] complies with existing labor laws and standards; and
8. [Name of Bidder] is aware of and has undertaken the following responsibilities as a
Bidder:
a) Carefully examine all of the Bidding Documents;
b) Acknowledge all conditions, local or otherwise, affecting the implementation of
the Contract;
c) Made an estimate of the facilities available and needed for the contract to be bid,
if any; and
d) Inquire or secure Supplemental/Bid Bulletin(s) issued for the [Name of the
Project].
IN WITNESS WHEREOF, I have hereunto set my hand this __ day of ___, 20__ at
____________, Philippines.
_____________________________________
Printed Name and Signature of Bidder’s Representative/Authorized Signatory
75
FORM 5
Financial Bid Form
Date:
Invitation to Bid1 No:
To: [name and address of Procuring Entity]
Gentlemen and/or Ladies:
Having examined the Bidding Documents including Bid Bulletin Numbers [insert
numbers], the receipt of which is hereby duly acknowledged, we, the undersigned, offer to
[supply/deliver/perform] [description of the Goods] in conformity with the said Bidding
Documents for the sum of [total Bid amount in words and figures] or such other sums as may
be ascertained in accordance with the Schedule of Prices attached herewith and made part of
this Bid.
We undertake, if our Bid is accepted, to deliver the goods in accordance with the
delivery schedule specified in the Schedule of Requirements.
If our Bid is accepted, we undertake to provide a performance security in the form,
amounts, and within the times specified in the Bidding Documents.
We agree to abide by this Bid for the Bid Validity Period specified in BDS provision
for ITB Clause 18.2 and it shall remain binding upon us and may be accepted at any time
before the expiration of that period.
Commissions or gratuities, if any, paid or to be paid by us to agents relating to this Bid,
and to contract execution if we are awarded the contract, are listed below:2
Name and address
of agent
Amount and
Currency
Purpose of
Commission or gratuity
(if none, state “None”)
Until a formal Contract is prepared and executed, this Bid, together with your written
acceptance thereof and your Notice of Award, shall be binding upon us.
1 If ADB, JBIC and WB funded projects, use IFB.
2 Applicable only if the Funding Source is the ADB, JBIC or WB.
76
We understand that you are not bound to accept the lowest or any Bid you may receive.
We certify/confirm that we comply with the eligibility requirements as per ITB Clause
5 of the Bidding Documents.
Dated this ________________ day of ________________ 20______.
[signature] [in the capacity of]
Duly authorized to sign Bid for and on behalf of ____________________________
77
FINANCIAL PROPOSAL Form 6
PROVISION OF HEALTH INSURANCE COVERAGE FOR PPMC EMPLOYEES
AND DIRECTORS
BID AMOUNT INWORDS IN PESOS:
BID AMOUNT IN FIGURES:
Php_______________________________________________________________________
PREMIUM COST PER INDIVIDUAL INWORDS:
PREMIUM COST PER INDIVIDUAL IN FIGURES:
Php_______________________________________________________________________
Name of Firm: _____________________________________________________
Name of Authorized Representative:___________________________________
Signature of Authorized Representative:________________________________
78
CONTRACT FOR THE PROVISION OF HEALTH INSURANCE COVERAGE FOR
PPMC EMPLOYEES AND DIRECTORS
KNOW ALL MEN BY THESE PRESENTS:
This CONTRACT entered into this ___ day of _________ , 2010 by and
between:
The PORO POINT MANAGEMENT CORPORATION (PPMC), a
government-owned and controlled corporation registered and operating by
virtue of laws of the Republic of the Philippines, with office address at
Gov. Joaquin L. Ortega Avenue, Barangay Poro, San Fernando City, La
Union, duly represented herein by its President & CEO, ATTY. FELIX S.
RACADIO, herein after referred to as “PPMC”;
- and -
The ____________________________, a corporation duly organized
under and by virtue of the laws of the Philippines, with principal office and
place of business at __________________________, represented herein
by its _____________________________ , ____________________,
duly authorized for this purpose pursuant to the Secretary’s Certificate,
hereto attached and made an integral part hereof as Annex “A”, herein
after referred to as the “HEALTH INSURANCE PROVIDER”.
WITNESSETH: That
WHEREAS, the Provision of Health Insurance Coverage for PPMC Employees and
Directors is pursuant to PPMC Resolution No.2003-75, dated October 18, 2003 and
PPMC Resolution No.2006-11-04, dated November 13, 2006, respectively;
WHEREAS, the HEALTH INSURANCE PROVIDER is engaged in the business of
providing Health Insurance Coverage;
WHEREAS, in response to the Invitation to Apply for Eligibility and to Bid posted on the
G-EPS and PPMC Website from ___________________________, the HEALTH
INSURANCE PROVIDER submitted its bid for the Provision of Health Insurance
Coverage for PPMC Employees and Directors;
WHEREAS, the PPMC Board of Directors in its Board Resolution No. ________
approved the award of this CONTRACT to the HEALTH INSURANCE PROVIDER;
NOW THEREFORE, for and in consideration of the foregoing premises and the mutual
covenants, agreements and stipulations herein contained, the parties hereby bind
themselves and agree to the following:
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1. PRODUCT SERVICES
The services to be rendered are specified in Annex “B” which is made an integral
part of this CONTRACT.
2. CORPORATE HEALTH CARE PROGRAM CONTRACT AND ENDORSEMENT
The Corporate Health Care Program Contract and Endorsement of HEALTH
INSURANCE PROVIDER in Annex “C” is made an integral part of this
CONTRACT.
3. CONTRACT PERIOD
The CONTRACT period shall be for a period of one (1) year from October 8,
2010 to October 7, 2011.
4. CONTRACT COST
PPMC hereby covenants to pay the HEALTH INSURANCE PROVIDER the
amount of __________________________(Php______________) specifically
described in Financial Proposal Form 1, hereto attached as Annex “D,” in
consideration of the complete and satisfactory completion of the Provision of
Health Insurance Coverage for PPMC Employees and Directors.
5. PERFORMANCE SECURITY
The HEALTH INSURANCE PROVIDER shall secure and post in favor of PPMC
a Performance Security, which must be in compliance with the requirements of
R.A. 9184 and its Implementing Rules and Regulations (IRR):
5.1Performance Security- To guarantee performance of HEALTH INSURANCE
PROVIDER’S obligations under the contract prepared in accordance with the
bidding documents. The Performance Security shall be in accordance
with the following schedule:
a. 5% of total contract price if in the form of Cash, certified check, cashier’s
check, Manager’s check, Bank Draft or Irrevocable Letter of Credit;
b. 5% of total contract price if in the form of Bank Guarantee;
c. 30% of total contract price if in the form of a surety bond.
6. DELIVERIES
a. Services to be provided shall be as indicated in Annex “B”.
7. REVOCATION AND TERMINATION OF CONTRACT
a. PPMC reserves the right to cancel this CONTRACT on the following grounds:
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1. Any serious attempts or unlawful act to defraud the government;
2. Any undue influence exerted upon any PPMC’s employee through
intimidation, bribery or unlawful means;
3. Non- delivery for reasons beneficial only to HEALTH INSURANCE
PROVIDER; and
4. Any breach by the HEALTH INSURANCE PROVIDER of the terms and
conditions of this contract including its Annexes.
8. MANNER OF PAYMENT
PPMC hereby agrees to pay the HEALTH INSURANCE PROVIDER cost and
price of the services are specified in Annex “B” upon issuance of a Certificate of
Coverage.
9. OTHER PROVISIONS
a. The parties agree that in case of litigation, the venue of action for any cause
or causes of action that may arise from this CONTRACT shall be exclusively
filed in proper courts of San Fernando City, La Union or Pasig City at the
exclusion of other courts.
b. Should PPMC be constrained to resort to court action to enforce or safeguard
its rights and interest under this contract, the HEALTH INSURANCE
PROVIDER shall be liable to PPMC attorney’s fees in an amount equivalent
to TWENTY FIVE PERCENT (25%) of the total claims, exclusive interest,
damages, and expenses of litigation.
c. The HEALTH INSURANCE PROVIDER hereby warrants that it has not given
nor promised to give money, gift or any material favor/ consideration to any
official or employees of PPMC to secure this contract and that any violation of
this warranty shall be sufficient ground for PPMC to revoke or cancel the
same without necessity of judicial action by giving written notice to that effect
to the HEALTH INSURANCE PROVIDER. It is clearly understood that any
payment of failure of PPMC to demand compliance with any terms and
conditions of this contract or any act of liberality on the part of PPMC shall not
be construed or considered as a waiver on the part of PPMC for the
enforcement of this Contract nor shall it relieve the HEALTH INSURANCE
PROVIDER of any of its obligations provided hereunder.
10. EFFECTIVITY OF THE CONTRACT
This CONTRACT shall be binding after the same shall have been signed by the
parties hereto.
11. OGCC REVIEW
This CONTRACT may be reviewed by the Office of the Government Corporate
Counsel and its comments, suggestions and directives shall form part thereof.
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12. AMENDMENTS
No modification of this CONTRACT or any of its provision shall be made except
by written amendments, which shall be signed by both parties hereto.
IN WITNESS WHEREOF, the parties hereunto set their hands and affixed their
signatures this ____ day of _______ 2010 in the City of San Fernando, La Union.
PORO POINT MANAGEMENT _____________________________
CORPORATION
By: By:
ATTY. FELIX S. RACADIO ______________________________
President & CEO
SIGNED IN THE PRESENCE OF
________________________ _______________________
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ACKNOWLEDGMENT
REPUBLIC OF THE PHILIPPINES ))
SS.
BEFORE ME, a Notary Public, in and for the above jurisdiction, personally
appeared:
Name CTC No. Date/Place Issued
ATTY. FELIX S. RACADIO
PORO POINT MANAGEMENT CORP.
Known to me, and to me known to be the same persons who executed and
signed the foregoing CONTRACT and they acknowledged to me that the same is the
product of their true, voluntary act and deed and that of the corporation and sole
proprietorship that the parties represent.
I further certify that the foregoing CONTRACT consists of five (5) pages including
this page on which this acknowledgment is written and duly signed by the parties and
their instrumental witnesses on each and every page hereof.
IN WITNESS WHEREOF, I have hereunto affixed my signature and notarial seal
this _____day of __________, 2010 in the City of San Fernando, La Union, Philippines.
NOTARY PUBLIC
Doc. No. _____;
Page No. _____;
Book No. _____;
Series of 2009