PCAB Form No.

101
APPLICATION FOR CONTRACTOR'S LICENSE
with the PHILIPPINE CONTRACTOR'S ACCREDITATION BOARD
The following pertinent documents and information are to be submitted in support of the license application of said firm:
Checklist for New License Application
A. Legal
[ ] 1. General Information (PCAB Form Nos. 101a and 102);
[ ] 1.1 • For Sole Proprietorship: Certified true copy of BTRCP Certificate of Registration with pertinent
BTRCP Form No. 16;
• For Partnership or Corporation: Certified true copy of SEC Certificate of Registration and Articles of
Partnership/Incorporation and By-Laws showing Construction as Primary Purpose and subsequent
amendments thereto;
[ ] 2. Authorized Managing Officer (AMO) Nomination:
[ ] 2.1 AMO Affidavit (PCAB Form No. 103) with a passport size picture of AMO;
• For corporations only: Original Corp. Secretary's certificate as to the nomination of the AMO
(PCAB Form No. 104);
[ ] 2.2 Original NBI clearance of Filipino AMO;
[ ] 2.3 If AMO is Non-Filipino (in addition to 2.1):
[ ] 2.3.1 Working visa
[ ] 2.3.2 Alien Certificate of Registration;
[ ] 2.3.3 NBI clearance if AMO has resided in the Philippines for six (6) months or longer if not,

equivalent clearance from AMO's home country duly authenticated by the Philippine embassy.
Note:
• For Corporations or Associations with foreign shareholders, the following documents must be submitted:
1. Corporate Secretary’s Certification as follows:
a. List of stockholders showing their nationalities and shareholdings; and
b. List of Board of Directors showing their names and nationality.
2. Copy of latest General Information Sheet duly filed with SEC showing the names of stockholders and
directors, nationality and shareholdings.
• The percentage control of the number of seats occupied by foreigners in the Board of Directors must not
exceed the percentage of foreign shareholdings.
B. Financial
[ ] 3. Financial Statements dated within the last six (6) months immediately preceding the filing of application (duly
audited and signed on every page by an Independent and PRC-BOA accredited external auditor) and a
diskette/CD (compact disc) containing the firm’s Audited Balance Sheet & Income Statement in the prescribed
template (PCAB Financial Statement Forms A & B downloadable from the DTI website at www.dti.gov.ph
together with pertinent application forms).
[ ] 3.1 For old companies, copy of the Quarterly or Annual Income Tax Return certified true by the BIR,
covering the income reported in the Audited Income Statement submitted for the quarter or taxable year
immediately preceding the filing of application, whichever is applicable;
[ ] 3.2 Cash :Original copy of Bank Certification/Bank statement of account certified by Bank Manager of cash
deposits as of the Balance Sheet date;
Note: (Amount in excess of ½ of 1% of the minimum networth required for category applied for or P 50,000.00
whichever is higher, reflected as “Cash” or “Cash on Hand” will be deducted from the networth, If insupported.)
[ ] 3.2.1 Authorization to Depository Bank (PCAB Form No. 105);
[ ] 3.3 List of Land and Building/s owned by the company and registered in its name (PCAB Form No. 106a);
[ ] 3.3.1 Certified true copy of TCT including back page;
[ ] 3.3.2 Deed of Sale or Certified True Copy (CTC) of Tax Declaration of Land / Bldg., owned by the firm.
[ ] 3.4 List of Construction and/or Transportation/Delivery Vehicles/Equipment/Machineries/Plants owned by
the company and registered in its name (PCAB Form No. 106b);
[ ] 3.4.1 Certified true copy by the LTO of the LTO Certificate of Registration and current Official Receipt
of Registration of registrable Construction and/or Transportation/Delivery Vehicles/Equipment
reported;
[ ] 3.4.2 Certified true copy of Deed of Sale or sales invoices/official receipts for non-registrable
construction equipment/machineries/plants;
[ ] 3.5 Additional documents to be submitted only if the values of each of the applicant's Inventories and
Receivables Accounts exceed more than 20% of the contractor’s Networth, otherwise, the amount in
excess of said account shall be deducted from networth.
[ ] 3.5.1 Schedule of Inventories. (PCAB Form 107);
[ ] 3.5.2 Schedule of Receivables. (PCAB Form 107);
[ ] 4. Authorization to BIR & other agencies (PCAB Form No. 105a);
C. Technical
[ ] 5. List of Sustaining Technical Employee/s - STE (PCAB Form No. 106c) supported by the following documents
for each STE:
[ ] 5.1. STE Affidavit/s (PCAB Form No. 108) with a passport size picture/s of the nominated STE/s;
[ ] 5.1.1 Certified true copy by PRC of valid PRC ID of STE as licensed professional or original
Certification of Good Standing from PRC;
[ ] 5.1.2 Original NBI Clearance/s of newly nominated STE/s;
[ ] 5.2 STE Affidavit/s of Construction Experience (PCAB Form No. 109);
[ ] 5.3 Personal Appearance Form duly accomplished and signed by the STE/s appearing before the designated
officer of the PCAB or the nearest DTI regional/provincial office (PCAB Form No. 110)
D. Original Signature of AMO on each and every page of the application forms including
supporting documents (except item 5.3)
• The Board may require the AMO interview and submission of pertinent documents/information other than the above in order
to fully determine the qualifications of the applicants;
• AMO/Applicants for TRADE category may no longer be required to take the AMO examinations.
• Photocopies of documents, in lieu, of certified copies are accepted provided the original copies are presented for
authentication
DO NOT FILL (For PCAB use only)
Total No. of Pages Submitted: _______ Checklisted by: ________________________________
[ ] Self-stamped envelopes * (no. ______ ) Signature Over Printed Name/Date
Remarks: _________________________________ ___________________________________

Applicants interested to participate in government projects should accomplish Form. No. 601 (Application for Registration and Classification of
Government Projects) and file the same together with the PCAB Application Form.
Revised 11/16/07
Not for sale . May be reproduced for additional sheets
Not for sale . May be reproduced for additional sheets
 PCAB Form No. 101a

In behalf of ____________________________________________________________,
(Name of Firm)

I hereby request that its application for Contractor's License be approved.

I hereby certify to the completeness of the information/documents contained in this

application appertaining to the category/classification the company is applying for
and that they are true and correct.

I am fully aware that:

1. all documents submitted in support of this application are subject to
verification before PCAB action;
2. any discovered misrepresentation of information and/or manifestations of
fraud on the application documents submitted by my firm applicant or its
Authorized Representative/Agent/Liaison Officer shall be subjected to
investigation which may result to the disapproval of my application,
denial/suspension/revocation of license and blacklisting of my firm and myself
as its Authorized Managing Officer; and
3. unconfirmed information/documents submitted to support my firm's
qualifications will be excluded for categorization/classification purposes.
4. the evaluation of my application's qualification shall be solely based on the
documents submitted at the time the application was filed/accepted by PCAB.

_______________________________
Authorized Managing Officer
(Signature over Printed Name)

Republic of the Philippines)

______________________)S.S.

SUBSCRIBED AND SWORN TO before me this ________ day of ___________________ 20____ at

______________________; affiant exhibited to me his Community Tax Certificate No. _______________
issued at __________________ on _________________ 20 ___.

DOC. NO. _______________;

PAGE NO._______________;
BOOK NO._______________; __________________________
NOTARY PUBLIC
(Until December 31, _______)

Not for sale. May be reproduced for additional sheets

 PCAB Form No. 102

GENERAL INFORMATION
A. CONTRACTOR’S IDENTIFICATION
Name of Firm:

Office Address: Tel./Fax No.:

If Provincial based, contact address in Manila, if any: Tel./Fax No.:

Website: E-mail Address:

Type of Organization (Please Check):.

[ ] Corporation [ ] Partnership [ ] Sole Proprietorship [ ] Joint Venture
SEC/BTRCP Registration No.: Date of Registration: SEC/BTRCP Expiry Date:

SSS Employer’s I.D.No.: Tax Identification No.:

CATEGORY
APPLIED FOR CLASSIFICATION/S
APPLIED FOR: Principal Classification:
______________ Other Classification/s :

B. OWNERS/STOCKHOLDERS/OFFICERS* (For Corporation, Partnership and Joint Venture)

Capital Paid-Up
Name Position Nationality Subscription Capital

C. DIRECTORS / OFFICERS

Tax Identification No. for

Name Position Nationality Filipinos/ Passport No. for
Foreigners

CERTIFIED CORRECT BY:

____________________________________
 Authorized Managing Officer
(Signature over Printed Name)
Not for sale . May be reproduced for additional sheets
PCAB Form No. 103
Passport size
Picture of
AMO
Republic of the Philippines )
Province of ______________ )
Municipality of ___________ ) S.S.

AMO AFFIDAVIT
I, __________________________________________________________________________________________,
LAST NAME FIRST NAME COMPLETE MIDDLE NAME
Filipino, of legal age, born on ____________________________________________________________ single/married
to ________________________________________________________________________________________________
LAST NAME FIRST NAME COMPLETE MAIDEN NAME
and residing at __________________________________________________________________________ having duly
sworn in accordance with law depose and say:
1. That I am the Authorized Managing Officer (AMO) of ________________________________________ empowered
to render general management and administrative decisions.
2. That I possess the following educational qualifications:
INCLUSIVE DATES
NAME OF SCHOOL ADDRESS DEGREE EARNED OF ENROLLMENT

3. That I possess at least two (2) years of experience in the construction industry as follows (Sec. 20, R.A. 4566):
COMPANY/ DATES OF
POSITION NATURE OF BUSINESS ADDRESS JOB DESCRIPTION EMPLOYMENT

(use additional sheet if necessary)

4. That I possess knowledge of the building, safety, health , & lien laws of the Republic of the Philippines & the
rudimentary administrative principles of construction contracting from my work experiences in item 3 above and
from the following training/seminars (Sec. 20, RA 4566):

INCLUSIVE DATES
TRAINING/SEMINAR CONDUCTED BY ADDRESS OF TRAINING

5. That I am not involved in any construction malperformance suggestive of negligence, incompetence or malpractice or
any act of omission liable for disciplinary action by myself or in collaboration with any other person (Rule 4, Section
4.2)
6. That I have not been convicted by a court of competent jurisdiction of any offense involving moral turpitude (Rule 4,
Section 4.2)
7. That I am fully aware that my failure to notify PCAB of my disassociation with my present employer shall cause my
disqualification to be an Authorized Managing Officer, a Sustaining Technical Employee or a license applicant with
PCAB (For corporations and partnerships only)
8. That I authorize the PCAB to verify and investigate any or all information in this instrument from whatever sources
PCAB may consider appropriate;
9. That I certify under pain of perjury that all information on this affidavit are true and correct.
FURTHER AFFIANT SAYETH NAUGHT.
_________________________________
Affiant

SUBSCRIBED and sworn to before me this _____ day of _________________, 200 ___ affiant exhibited his/her
Community Tax Certificate No. __________ issued at _____________________ on ________________.
Doc. No. __________;
Page No. __________;
Book No. __________; Notary Public
Series of 200 __. Until December 200__
Not for sale . May be reproduced for additional sheets
 PCAB Form No. 104

For Corporations Only

AMO NOMINATION

I ____________________________________________________, Filipino, of legal age, single/married and residing at

-____________________________________________________________ do hereby certify, in my capacity as the duly elected
and incumbent Board Secretary of __________________________________________________________________________,
(Name of Firm)
that during the regular board/partners' meeting held on ___________________ wherein a quorum was present, the following
resolution was unanimously approved, to wit:

"R E S O L V E as it is hereby resolved that

_________________________________________________________________,
(Surname, First Name, Middle Name)
a senior executive who has been granted the power to render general management and
administrative decision, be appointed as the firm's authorized sole management
representative to act on all matters concerning the requirements of the PCAB and
implementation of R.A. 4566 as amended by P.D. 1746."
In WITNESS WHEREOF, I have hereunto affixed my hand this ______________ day of ___________________
200___, in ______________________________, Philippines.

_________________________________
Board Secretary
(Signature Over Printed Name)

SUBSCRIBED and sworn to before me this ________ day of ______________________________________ at

__________________________________________________, affiant exhibited to me his/her Community Tax Certificate. No.
____________ issued on _________________________ at ______________________________________________.

Doc. No. __________

Page No. __________
Book No. __________
Series of 200 __. NOTARY PUBLIC
Until December 200 ____

Revised 10/01/2007

Not for sale . May be reproduced for additional sheets

 PCAB Form No. 105

THE MANAGER
_________________________________
_________________________________
_________________________________

Subject: Account # _______________________

Sir:

Please provide the Philippine Contractors Accreditation Board (PCAB), a government agency under the
Department of Trade and Industry, any information they need regarding the subject account with your bank.

I am applying for a contractor's license from PCAB and part of their evaluation process is the verification of
bank deposits and other assets of an applicant.

This will serve as your authorization to release any information that may be requested by PCAB regarding the
above subject account.

Thank you.

Very truly yours,

___________________________________
Signature over Printed Name

__________________________________
Company Name

___________________________________
Date

Note: To be submitted in two (2) copies.

Revised 10/01/2007

Not for sale . May be reproduced for additional sheets

 PCAB Form No. 105a

AUTHORIZATION

The Philippine Contractors Accreditation Board (PCAB) is hereby authorized to verify

and secure information and/or copies of documents submitted by or in the name of the firm to any or all
of the following agencies relative to its application filed with the PCAB:

1.Bureau of Internal Revenue

2.Securities and Exchange Commission
3.Land Registration Authority
4.Land Transportation Office
5.Social Security System

Name of Applicant Firm

_____________________________________

By:

_____________________________________
Signature over Printed Name of Proprietor
or Authorized Managing Officer

Date: _________________________________

Not for sale . May be reproduced for additional sheets

Revised 10/01/2007
 PCAB Form No. 106a

LIST OF LAND, BUILDING AND OTHER IMPROVEMENTS OWNED BY AND REGISTERED IN THE
NAME OF THE COMPANY AS OF THE BALANCE SHEET DATE

COMPLETE TCT/CCT LOCATION ACQUISITION ACQUISITION

DESCRIPTION NUMBER (St. #, Barangay, COST DATE
(Type of land/building Municipality/ City, Province)
and area)

Please reproduce if additional sheets are needed. Revised 10/01/2007

_________________________________________
Signature over Printed Name of AMO

_________________________________________
Company Name

_________________________________________
PCAB License No. (If applicable)

________________________________________
Date Signed

CFY ___________________
Type of Application: (Pls. check)
-

New
Upgrading
Renewal
Others, pls. specify
_______________________

Not for sale . May be reproduced for additional sheets

 PCAB Form No. 106b

LIST OF DELIVERY AND TRANSPORTATION EQUIPMENT OWNED BY AND REGISTERED IN THE NAME
OF THE COMPANY ASOF THE BALANCE SHEET DATE

COMPLETE DESCRIPTION ACQUISITION BOOK

VALUE
Plate Chassis Engine M.V. File CR No. Date Cost
No. No. No. No.

P P

TOTAL P P

LIST OF MACHINERIES/PLANTS AND OTHER CONSTRUCTION EQUIPMENT OWNED BY THE

COMPANY AS OF THE BALANCE SHEET DATE
COMPLETE ACQUISITION BOOK
DESCRIPTION SERIAL NO. VALUE
Date Cost

P P

TOTAL P P
Please reproduce if additional sheets are needed.
Revised 10/01/2007

_________________________________________
Signature over Printed Name of AMO

_________________________________________
Company Name

_________________________________________
PCAB License No. (If applicable)

________________________________________
Date Signed

CFY _________________
Type of Application: (Pls. check)
New
Upgrading
Renewal
Others, pls. Specify
__________________________
Not for sale . May be reproduced for additional sheets
 PCAB Form No. 106c

LIST OF NOMINATED SUSTAINING TECHNICAL EMPLOYEES OF THE COMPANY

PRC REGISTRATION
Date Position
NAME Employed in the Firm
Number Date Profession

Please reproduce if additional sheets are needed. Revised 10/01/2007

_______________________________________
Signature over Printed Name of AMO

_______________________________________
Company Name

_______________________________________
PCAB License No. (If applicable)

______________________________________
Date Signed

CFY __________________
Type of Application: (Pls. check)

New
Upgrading
Renewal
Others, pls. Specify
__________________________

Not for sale . May be reproduced for additional sheets

 PCAB Form No. 107
SCHEDULE OF RECEIVABLES

To be accomplished if the applicant's receivable accounts (accounts/contracts & other receivable) exceed 20% of the total
networth/equity as of the latest audited balance sheet submitted in support of its application.
TYPES AMOUNT AGE NAME/ADDRESS OF DEBTOR/CLIENTS

Notes: * All receivable accounts must be substantiated by confirmation of debtors/clients

Please use additional sheets if necessary

Certified Correct by:

_______________________________ ___________________________
Printed Name and Signature of External Auditor Printed Name and Signature of AMO

SCHEDULE OF INVENTORIES

To be accomplished if the applicant's inventory accounts exceed 20% of the total networth/equity as of the latest audited balance
sheet submitted in support of its application.
Intended Use or
Types Amount Age/Date Physical Place of Storage
Purpose for
Acquired Storing Condition

Please use additional sheets if necessary

Certified Correct by:

_______________________________ ___________________________
Printed Name and Signature of External Auditor Printed Name and Signature of AMO

* The above schedules should be certified by the firm’s external auditor and signed by the authorized managing officer.l

Not for sale . May be reproduced for additional sheets

PCAB Form No. 108

Passport size
Picture of STE
Republic of the Philippines )
Province of _____________ )
Municipality of ___________) S.S.

STE AFFIDAVIT
I,____________________________________________________________________, Filipino, of legal age,
LAST NAME FIRST NAME COMPLETE MIDDLE NAME
born on single/married to __________________________________________and
M M / D D/ Y Y Y Y
residing at ____________________________________________________________________ having duly sworn in
accordance with law depose and say:
1. That I am a duly licensed __________________________ and holder of PRC registration no. ___________
(PROFESSION)
valid up to _______________ (copy of my PRC is attached at the back hereof);
2. That I hold a Bachelor's Degree in _________________________________________________________ at
______________________________________________________ given on _____________________;
(NAME OF SCHOOL)
3. That my Tax Identification Number (TIN) and Social Security No. are - -
and - - respectively;
4. That I am not presently employed in any government office or government owned/controlled corporation, nor a full time
instructor, nor working abroad;
5. That I am employed by _________________________________________________________________
(NAME OF FIRM)
on regular and full-time basis with the position of _________________________________and presently being
nominated as Sustaining Technical Employee for CFY _____________;
6. That I am not a holder of a contractor's license;
7. That I am not involved in any construction malperformance suggestive of negligence, incompetence or malpractice or
any act of 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 with my present employer shall cause
my disqualification to be sustaining technical employee or authorized managing officer or a license applicant 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.
_________________________________
Affiant
SUBSCRIBED and sworn to before me this _____ day of ___________________, 200___ affiant exhibited his/her
Community Tax Certificate No. _____________ issued at ___________________ on ______________.

Doc. No. __________;

Page No. __________;
Book No. __________; Notary Public
Series of 200 _______. Until December 200 ___

CFY ___________________
Type of Application: (Pls. check)
New
Upgrading
Renewal
Others, pls. specify
_____________________
Revised 10/01/2007

Not for sale . May be reproduced for additional sheets

 INSTRUCTIONS ON FILLING UP PCAB FORM NO. 108

QUALIFICATION REQUIREMENTS OF SUSTAINING TECHNICAL EMPLOYEE

1. A technology professional, such as engineer or architect, duly licensed by the Professional Regulation Commission.

2. Holder of a Professional I.D. valid for current year.

3. Possesses at least three (3) years of experience in implementation of construction to which he is to be nominated

4. A full-time employee of the nominating contractor, not associated professionally or by employment with any other
party, particularly a party engaged in construction or construction-related activities

5. Have none of the following disqualifications:

a) Involvement, in any capacity, in any construction malperformance of grave consequence, suggestive of his
negligence, incompetence and/or malpractice;

b) Involvement, by himself or in collaboration with any other person or firm, in any act or omission liable for
disciplinary action of which he is or the other person or firm was found guilty by the Board;

c) Conviction by a court of competent jurisdiction of any offense involving moral turpitude; and

d) If formerly a Sustaining Technical Employee or an Authorized Managing Officer of any construction firm but
disassociated therefrom, failure to notify the Board of his disassociation in accordance with paragraph 5 and 6
of the Affidavit of Undertaking.
6. Not a holder of a Contractor’s License.

If you meet the above requirements, kindly accomplish this affidavit. Erasure must be properly initialled.

All statements are subject to verification and any false statement or willful misrepresentation of a material fact in
obtaining a license shall be grounds for disapproval of this application.

PASTE PASTE

PROF. I.D. CARD PROF. I.D. CARD

VALID FOR VALID FOR

CURRENT YEAR CURRENT YEAR

(Back)
(Front) (xerox copy)
(xerox copy)

This is to certify that I have verified with PRC the abovestated professional eligibility/registration of the
Sustaining Technical Employee. Affiant herein and found the same to be true and correct.

__________________________________________
Signature over Printed Name of the AMO
Date: _______________________

Not for sale . May be reproduced for additional sheets

 PCAB Form No. 109
Republic of the Philippines )
Province of _____________ )
Municipality of ___________) S.S.

AFFIDAVIT OF STE CONSTRUCTION EXPERIENCE

I, _________________________________, single/married, Filipino, of legal age, with postal address at
________________________________________________, having been duly sworn in accordance with law depose and
say that the projects enumerated below constitute my full & complete construction experience.

NAME and Work Nature/Scope of PROJECT

COMPLETE ADDRESS of EMPLOYER/ Classification Work Assignment DURATION
NAME & LOCATION of PROJECTS UNDERTAKEN (GE, GB, SP) (Proj. Engr.) (mm/dd/yy)
From To

That I authorize the PCAB to verify and investigate any or all information in this affidavit from whatever sources PCAB
may consider appropriate;
That I am executing this affidavit to attest to the truth of the foregoing.
FURTHER AFFIANT SAYETH NAUGHT.
_________________________________
Affiant
SUBSCRIBED and sworn to before me this _____ day of _________________, 200__ affiant exhibited his/her Community
Tax Certificate No. ______________ issued at ____________________ on ____________________.

Doc. No. __________;

Page No. __________;
Book No. __________; Notary Public
Series of 200 _______. Until December 200 ___
CFY ___________________ Company Name ____________________________
Type of Application: (Pls. check) PCAB License No. __________________________
New
Upgrading
Renewal
Others, pls. specify
___________________________
Revised 10/01/2007

Not for sale . May be reproduced for additional sheets

 PCAB Form No. 110

SUSTAINING TECHNICAL EMPLOYEE (STE) PERSONAL APPEARANCE FORM

(To be accomplished fully by the STE)

Name: ______________________________________________ Sex: __________________

Address: ____________________________________________________________________
Profession: __________________________________ PRC Reg. :_____________
Nominating Firm: ____________________________________________________________
Contractor's License No.: ______________________

I hereby confirm the following:

1. The veracity of the information reflected on the STE Affidavit and Affidavit of Construction Experience
(PCAB Form Nos. 107 & 108, copies attached) that I executed in favor of the above firm;
2. That I am fully aware that my failure to notify the PCAB of my disassociation from the above-stated
nominating firm and any misrepresentation in the attached forms shall cause my disqualification as
sustaining technical employee, or authorized managing officer, or a licensee applicant with PCAB per
Board Resolution No. 401, Series of 2001.

3. That I have been previously connected with the following companies:

Date of Date of
Previous Employers Employment Resignation Position

4. Other Remarks:
___________________________________________________________________________
______________________________________________________________________
_____

______________________________
STE's Signature

Date Signed: _______________________

Identification Documents Presented:

PRC ID No. ____________________
valid until ______________________

1. ______________________________

Personal Appearance and Presentation

of Two (2) Identification Documents
attested by PCAB designated staff or
DTI Regional/Provincial Staff

_______________________________
Signature over Printed Name/Position

DTI Office Address: ______________________________________________

Date: ____________________________
Not for sale . May be reproduced for additional sheets
 PCAB Form 111-A
(For sole proprietorship)

Republic of the Philippines) s.s.

______________________)

AFFIDAVIT

I, _______________________________, of legal age, Filipino, married/single with postal address at

____________________________________, after having been sworn to in accordance with law, hereby depose
and say:

1. That I am the Proprietor/Authorized Managing Officer (AMO) of

__________________________________________________________;
(Name of Firm)

2. That I appoint ____________________________, whose picture and signature appear below, to transact
business with PCAB; i.e, present for pre-screening my application for contractor’s license or any application
related thereto, file/follow-up, submit documents, receive notices/license in connection with the said
application and the like.

Passport size ______________________________

Picture of (Signature over Printed Name)
Representative
______________________________

__________ ______________________________
HOME /MAILING ADDRESS

3. That I am aware that I am responsible/liable for any or all acts/representation made by my representative in
connection with the functions stated herein.

4. That I undertake to notify PCAB in the event that this appointment is modified, amended or revoked.

_______________________________________
AFFIANT

SUBSCRIBED and sworn to before me this ______ day of ____________, 20___, affiant exhibited his/her
Community Tax Certificate No. _______________ issued at ___________ on ___________________.

Doc No. __________ Notary Public

Page No. _________ Until December 200 ___
Book No. _________
Series of _________

(Note: Please submit original and one duplicate to PCAB. Keep another copy for presentation everytime you transact
with PCAB)

Not for sale . May be reproduced for additional sheets

 PCAB Form 111-B
(For corporation.,partnership,cooperative joint venture or consortium)

Republic of the Philippines) s.s.

______________________)

AFFIDAVIT

I, _______________________________, of legal age, Filipino, married/single with postal address at

____________________________________, after having been sworn to in accordance with law, hereby depose
and say:

1. That I am the Authorized Managing Officer (AMO) of __________

________________________________________;
(Name of firm)

2. That the abovestated firm had duly appointed ____________________________, whose picture and
signature appear below, to transact business with PCAB; i.e, present for pre-screening its application for
contractor’s license or any application related thereto, file/follow-up, submit documents, receive
notices/license in connection with the said application and the like.

______________________________
Passport size (Signature over Printed Name)
Picture of
Representative
______________________________

______________________________
HOME /MAILING ADDRESS

3. That we are aware that we are responsible/liable for any or all acts/representation made by the above
representative in connection with the functions stated herein.

4. That the firm undertakes to notify PCAB in the event that this appointment is modified, amended or revoked.
________________________
AFFIANT

SUBSCRIBED and sworn to before me this ______ day of ______________, 20__ affiant exhibited his/her
Community Tax Certificate No. _______________ issued at ___________ on ___________________.

Doc No. __________ Notary Public

Page No. _________ Until December 200 ___
Book No. _________
Series of _________

(Note: Please submit original and one duplicate to PCAB. Keep another copy for presentation everytime you
transact with PCAB)

Not for sale . May be reproduced for additional sheets

Not for sale . May be reproduced for additional sheets
 ARC Form 601

Application for REGISTRATION AND CLASSIFICATION

OF CONTRACTOR FOR GOVERNMENT INFRASTRUCTURE PROJECTS
with the Philippine Contractors Accreditation Board

In behalf of ____________________________________________________________
(Name of Firm)
a contractor duly licensed with the Philippine Contractors Accreditation Board. I hereby request for registration pursuant to the
implementing Rules and Regulations of PD 1594, as amended.

I hereby certify that the information and documents contained in this application are true and correct
of my own personal knowledge. I am fully aware that I shall be held personally liable for any
misrepresentation that may be found herein.

____________________________________
Authorized Managing Officer
(Signature over Printed Name)

Republic of the Philippines}

_______________________} s.s.

SUBSCRIBED AND SWORN to before me this _______ day of ___________________ 200 ___ at
___________________________________ affiant exhibited to me his Community Tax Certificate No.
______________ issued at _________________________ on ________________ 200 ____.
Doc. No. :
Page No. :
Book No. : NOTARY PUBLIC
Series of : Until December 31, 200 ___
The following documents and information are hereby submitted in support of this registration
application:
]

Checklist of Registration Application:

ζ 1. General Information (PCAB Form No. 602).
ζ 2. List of Single Largest Contract completed by the contractor of each Project Kind
being applied for (PCAB Form No. 603).
ζ 3. Copy of Contract Agreement listed in PCAB Form No. 603 of each Project Kind
being applied for duly authenticated by the tendering agency or project owner or in
case of subcontract by the prime/main contractor.
ζ 4. Copy of Certificate of Acceptance/Completion from Tendering Agency/Project
Owner of each Contract Agreement submitted duly authenticated by the tendering
agency or project owner or in case of subcontract by the prime/main contractor.
ζ 5.Copy of Certificate of Creditable Income Tax Withheld (Form
1743.1/1743.750/2307),
stamped-received by BIR for each private contracts and sub-contracts.
NOTE: Application for registration and supporting documents must be submitted in a folder and
signed on each and every page by the Proprietor/Authorized Managing Officer.
Do not fill, for PCAB use only:
Total no. of pages submitted ________ Checklisted by: ___________________________________
(Signature over Printed Name)
Remarks: __________________________________________________ _________________
__________________________________________________ (Date)
(Revised 032601_GSD)
Note: Only citizens or entities with at least 75% Filipino equity may apply

Not for sale . May be reproduced for additional sheets

 PCAB Form No. 602

GENERAL INFORMATION SHEET

Contractors Particulars
FIRM NAME
:
OFFICE ADDRESS: TEL, NO.:

TYPE OF ORGANIZATION:
 Corporation  Partnership  Sole Proprietorship
EQUITY: Filipino: % Foreign: %

License Particulars
Contractor’s License No.: Date Issued: Last Renewal:
CFY _____ - _____
Principal Classifications: Present Category:

Other Classification(s):
_____________________________________________________________________
_____________________________________________________________________
Type of application for PCAB License amendment, if any: Ref. No.:

Government Registration Particulars

PRESENT REGISTRATION VALIDITY PERIOD, if applicable: from _______________ to ________________
APPLICATION APPLIED FOR:
 New Registration  Re-registration  Upgrading  Additional Project Kind
SIZE RANGE
Please indicate if:
Small A, Small B, KIND OF PROJECT
Medium A, Medium B, (Please check)
Large A, Large B
__________________ GENERAL ENGINEERING
__________________  GE-1 Road, Highway pavement, Railways, Airport horizontal structures, & Bridges
__________________  GE-2 Irrigation and Flood Control
__________________  GE-3 Dam, Reservoir, and Tunneling
__________________  GE-4 Water Supply
 GE-5 Port, Harbor, and Offshore Engineering
__________________ GENERAL BUILDING
__________________  GB-1 Building and Industrial Plant
__________________  GB-2 Sewerage and Sewage Treatment/Disposal Plant
__________________  GB-3 Water Treatment Plant and System
 GB-4 Park, Playground, and Recreational Work
SPECIALTY
__________________  SP-1 Foundation Work
__________________  SP-2 Structural Steel Work
__________________  SP-3 Concrete Pre-casting and Pre-stressing
__________________  SP-4 Plumbing and Sanitary Work
__________________  SP-5 Electrical Work
__________________  SP-6 Mechanical Work
__________________  SP-7 Air-conditioning and Refrigeration Work
__________________  SP-8 Elevator and Escalator Work
__________________  SP-9 Fire Protection Work
__________________  SP-10 Waterproofing Work
__________________
 SP-11 Painting Work
__________________
__________________  SP-12 Well Drilling Work
__________________  SP-13 Navigational Facilities
 SP-14 Communications Facilities

CERTIFIED CORRECT BY:

_______________________________
Authorized Managing Officer/ Proprietor
(Signature over Printed Name)

Not for sale . May be reproduced for additional sheets

 PCAB Form No. 603
TRACK RECORD FORM (Only complete form & supporting documents will be considered)
_________________________________________________________________________ __________________
Name of Firm License No.

SINGLE LARGEST CONTRACTS COMPLETED

For ________________________________________
Project Kind applied for (e.g. Road, Building etc.)

I. CONTRACT
Project Title:
________________________________________________________
_______________________________________________________
________________________________________________________
Project Location:
________________________________________________________
Project Owner:
________________________________________________________
Date of Contract:___________________ Amount of Contract: P _________________
Name of Main Contractor or Joint Venture, if any: _________________________________
Percent (%) share of the applicant in the contract: ____________ %
II. ACCEPTANCE
Date of Document________________________ Date Accepted: __________________
Name of Signatory: _________________________ Position: _______________________
III. WITHHOLDING TAX (for subcontract and non-government contract)
Withholding agent: ________________________________________________________
Name of the withholding agent's signatory: _____________________________________
Received and Stamped by:
{ BIR { BANK
RDO No._______________________ Name: ________________________
Address:_______________________ Address: ______________________
_______________________________ _____________________________
Date: __________________________ Date: _________________________
INSTRUCTIONS:
1.Attach at the back of this form clear & legible copies of the following documents:
a) Contract agreement duly authenticated by the tendering agency/project owner/ prime contractor in
case
of subcontract.
b) Letter or certificate of acceptance duly authenticated by the tendering agency/ project owner/prime
contractor in case of subcontract.
c) Certificate of creditable income tax withheld of source (BIR Form 1743.1, 1743.750 or 2307) duly
stamped-received by the BIR or Bank Collecting Agent for subcontracts & non-government or private
contracts)
2.Submit only one track record for each project kind.

_______________________________________________
Authorized Managing Officer/Proprietor
(Signature over Printed Name)

Not for sale . May be reproduced for additional sheets