Republic of the Philippines )

Province of Benguet………)
Municipality of La Trinidad )

AFFI DAV I T

I, ROY M. BALAY-ODAO of legal age, Filipino and a resident of Pilando, Gambang,

Bakun after having sworn in accordance with law, depose and state;

1. That I was awarded a contract by the Provincial Government of Benguet for the
furnishing of labor, materials and equipment for the Construction of Slope Protection at
Batanes Primary School, Gambang, Bakun, Benguet.

2. That I have finished the work in accordance with the plan and specifications which was
accepted by the Provincial Engineer

3. That I have paid all labor and materials incident thereto and all taxes due to the
Provincial Government of Benguet;

4. That I am executing this Affidavit to attest to the truth of all foregoing and for the
purpose of collecting the contract amount.

IN WITNESS WHEREOF, I have hereto set my hand this ______ day of

____________________________ at _______________________.

ROY M. BALAY-ODAO
(Affiant)

SUBSCRIBED AND SWORN to before me at ________________________ this _____

day of _____________________________. Affiant exhibited to me this Community Tax
Certificate No. ______________________ issued at ______________ on
____________________________.

Doc. No. ____________________ ________________________

Book No. ___________________ ________________________
Page No. ____________________ ________________________
Series No. ___________________