Republic of the Philippines

DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS

OFFICE OF THE DISTRICT ENGINEER
Ilocos Norte 2nd District Engineering Office
San Pablo, San Nicolas, Ilocos Norte

Sir/Madam,
MRRM Trading and Construction, requested a Sixty (60) days Time Extension for the
Construction/Completion
of
Multi-Purpose
Building,
Batac
Cultural
Center,
Government Center,Callaguip National Highway, Batac City, Ilocos Norte, due to the
Time Suspension introduced into the project.
As Contractor's Bondsman (copy of the issued performance bond attached), we would like to
secure "CONFORMITY" to the requested Sixty (60) days Time Extension.
Please manifest your adherence by signing your name on the space provided below.
Attached is a copy of the request for your reference.

Very truly yours,

SUSAN P. SIMEON
Project Engineer

Conforme:

Extension for the

Cultural
Center,
Norte, due to the

d), we would like to

below.

Republic of the Philippines

(__________________) S.S.

AFFIDAVIT OF QUIT CLAIM

I, Ma. Rosa S. Mandani, of legal age, married, Filipino and residing at B18L13 Mahogany St., Greenfield I, Kaligayahan,
Quezon City , after having duly sworn in accordance with tha law, do hereby depose and state, that:

1. That I am the Owner/Manager of MRRM Trading & Construction with office address at #5 Int. 2 Urbano St.,
Bagbag, Novaliches, Quezon City.
2. That MRRM Trading & Construction , had entered into a contract with the Department of Public Works and
Highways - Ilocos Norte 2nd District Engineering Office, San Pablo, San Nicolas, Ilocos Norte, for the
Construction/Completion of Multi-Purpose Building, Batac Cultural Center, Government Center, Callaguip,
National Highway, Batac City, Ilocos Norte.

3. That MRRM Trading & Construction hereby release the Department of Public Works and Highways from the
monetary claim relative to the approval of time suspension without prejudice to all our other claims.

4. That this affidavit is being executed in compliance with the requirements in the approval of the aforementioned
time suspension request.
IN WITNESS WHEREOF, I have hereunto set my hands this _______ day of ______________ 2016 at
________________________.
Ma. Rosa S. Mandani
General Manager
MRRM Trading & Construction
Affiant
SUBSCRIBED AND SWORN TO beforeme this _____ day of _____________ 2016 affiant exhibiting to me this Community Tax
certificate No. _____________________ issued on ________________ at _________________, Philippines.

Doc. No.
Page No.
Book No.
Series of 2016

, Greenfield I, Kaligayahan,

ess at #5 Int. 2 Urbano St.,

tment of Public Works and

las, Ilocos Norte, for the
nment Center, Callaguip,

rks and Highways from the

ther claims.

oval of the aforementioned

f ______________ 2016 at

Mandani
anager
& Construction
nt
to me this Community Tax

pines.

Construction/Completion of Multi-Purpose Building, Batac Cultural Cent

atac Cultural Center, Government Center, Callaguip National Highway, Batac Ci

Highway, Batac City, Ilocos Norte