PCAB Form No.

108

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

STE AFFIDAVIT
TALENS RONNIE RAMOS
I,____________________________________________________________________, Filipino, of legal age,
LAST NAME FIRST NAME COMPLETE MIDDLE NAME
born on 0 9 0 4 1 9 8 3 single/married to __________________________________________and
M M / D D/ Y Y Y Y
residing atMAHARLIKA HIGHWAY, ZULUETA DIST., CABANATUAN CITY
____________________________________________________________________ having duly sworn in
accordance with law depose and say:
CIVIL ENGINEER
1. That I am a duly licensed __________________________ 103822
and holder of PRC registration no. ___________
(PROFESSION)
valid up toSEPT 04, 2012 (copy of my PRC is attached at the back hereof);
_______________
2. That I hold aNEW
Bachelor's Degree in BACHELOR OF SCIENCE IN CIVIL ENGINEERING
_________________________________________________________ at
ERA UNIVERSITY MARCH 2005
______________________________________________________ given on _____________________;
(NAME OF SCHOOL)
3. That my Tax Identification Number (TIN) and Social Security No. are 2 4 2 - 4 3 1 - 0 1 0
and 0 2 - 2 2 9 9 1 8 2 - 9 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;
R. D. TALENS CONSTRUCTION AND TRADING
5. That I am employed by _________________________________________________________________
(NAME OF FIRM)
on regular and full-time basis with the position PROJECT ENGINEER / ME 1
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.
RONNIE R. TALENS
_________________________________
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)
X
New
Upgrading
Renewal
Others, pls. specify
_____________________
Revised 03/31/04
 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.

RONNIE R. TALENS
__________________________________________
Signature over Printed Name of the AMO
Date: _______________________
 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
R. D. TALENS CONSTRUCTION and TRADING
Maharlika Highway, Zulueta Dist. (Pob.), Cab. City
 NE Cakes And Restaurant GB Project Engineer 03 / 05 / 09 05 / 05 / 09
Waltermart, Sta. Maria, Bulacan
 Const of One-Storey Bldg. w/ Attic GB Project Engineer 02 / 24 / 09 04 / 10 / 09
Kapt. Pepe, Cabanatuan City
 Extension of NE Crossing Supermarket GB Project Engineer 02 / 19 / 09 05 / 19 / 09
Cabanatuan City
 Renovation of One-Storey Residential GB Project Engineer 01 / 30 / 09 03 / 31 / 09
Kapt. Pepe, Cabanatuan City
 Const. of Prep & Grade School Building GB Project Engineer 07 / 10 / 08 06 / 22 / 09
Sumacab Este, Cabanatuan City
 NE Cakes and Restaurant / Supermarket GB Project Engineer 10 / 10 / 07 01 / 30 / 08
Victory Norte, Santiago City

SUMITOMO MITSUI CONST. CORP. PHIL.

Paseo De Roxas, Makati City 02 / 01 / 2008 10 / 10 / 2008
 Design and Analysis of Sakamoto Office Bldg. GB Structural Engineer
Brgy. Aplaya, Bauan, Batangas
 Design and Analysis of Sakamoto RG
GB Structural Engineer
Filling Bldg.
Brgy. Aplaya, Bauan, Batangas
 Design and Analysis of HOGP Factory GB Structural Engineer
FPIP, Sto. Tomas, Batangas
 Design and Analysis of Covered Bagasse Yard GB Structural Engineer
Brgy. Labuagon, Kibawe, Bukidnon
 Design and Analysis of Power House Bldg. GB Structural Engineer
Brgy. Labuagon, Kibawe, Bukidnon
 Design and Analysis of Men’s and Ladies’ Dorm GB Structural Engineer
Surigao
 Design and Analysis of Vendor’s Dormitory GB Structural Engineer
Surigao
 Design and Analysis of R&D Project GB Structural Engineer
Rio Tuba, Bataraza, Palawan
 Various Foundation Design, Ethanol &
GB Structural Engineer
Cogeneration Power Plant
Brgy. Labuagon, Kibawe, Bukidnon
 Design of Sheet Pile GB Structural Engineer
Surigao

SUMITOMO MITSUI CONST. CORP. SINGAPORE

 Wafer Factory GB QA/QC Engineer 10 / 31 / 08 01 / 09 / 09
Tuas, Singapore

R.D. TALENS CONSTRUCTION and TRADING

Maharlika Highway, Zulueta, Cabanatuan City
 Two Storey Res. Bldg. GB Project Engineer 06 / 26 / 07 12 / 2007
Lakewood, Cabanatuan City
 Repair of School Bldg. GB Project Engineer 05 / 10 / 07 06 / 15 / 07
San Vicente, Jaen, Nueva Ecija
 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
 Two-Storey Residential Bldg. GB Project Engineer 05 / 04 / 07 09 / 2007
San Mariano, San Antonio, Nueva Ecija
 Construction of Multi-Purpose Bldg. GB Project Engineer 05 / 03 /07 06 / 25 / 07
Marawa, Jaen, Nueva Ecija
 Construction of Multi-Purpose Bldg. GB Project Engineer 04 / 21 / 07 06 / 15 / 07
Antonio, Jaen, Nueva Ecija
 Concreting of Barangay Road GE Project Engineer 04 / 18 / 07 05 / 01 / 07
Pamacpacan, Jaen, Nueva Ecija
 Concreting of Barangay Road GE Project Engineer 04 / 11 / 07 04 / 28 / 07
Marilao, Gapan City
 Construction of Multi-Purpose Bldg. GB Project Engineer 03 / 27 / 07 04 / 25 / 07
Sapang, Jaen, Nueva Ecija
 Gymnasium GB Project Engineer 03 / 19 / 07 04 / 27 / 07
Entablado, Cabiao, Nueva Ecija
 Concreting of Barangay Road GE Project Engineer 03 / 14 / 07 03 / 27 / 07
Alua, San Isidro, Nueva Ecija
 Concreting of Barangay Road GE Project Engineer 03 / 02 / 07 03 / 19 / 07
San Fernando Sur, Cabiao, Nueva Ecija
 Commercial Bldg. w/ Mezzanine (Royce) GB Project Engineer 02 / 16 /07 09 / 2007
Bucana, Gapan City
 Construction of 2 – Door Apartment GB Project Engineer 02 / 06 /07 06 / 03 / 07
Kapt. Pepe Subd., Cabanatuan City
 Drainage GE Project Engineer 02 / 05 / 07 03 / 15 / 07
St. Niño, Gapan City
 Construction of Multi-Purpose Bldg. GB Project Engineer 02 / 03 / 07 03 / 03 / 07
Malimba, Gapan City
 Concreting of Barangay Road GE Project Engineer 01 / 31 / 07 02 / 15 / 07
Polilio, Cabiao, Nueva Ecija
 Const. ERY FY 06 Barracks Building GB Project Engineer 12 / 2006 05 / 2007
Fort Magsaysay, Palayan City
 Gymnasium GB Project Engineer 09 / 2006 12 / 2006
Jaen, Nueva Ecija
 4 – Bedrooms Split Level Residence GB Project Engineer 05 /16 / 06 12 / 2006
Rio Chico, Gen. Tinio, Nueva Ecija
 Construction of H.E. Building GB Project Engineer 03 / 11 / 06 05 / 02 / 06
Sta. Rita, Cabiao, Nueva Ecija
 NE Cakes & Restaurant / Supermarket GB Project Engineer 02 / 2006 12 / 2006
Abar 2nd, San Jose City
 Construction of Barangay Hall GB Project Engineer 01 / 27 / 06 03 / 25 / 06
Peñaranda, Nueva Ecija
 Construction of Multi-Purpose Bldg. GB Project Engineer 01 / 08 / 06 03 / 22 / 06
Bagong Buhay, Cabiao, Nueva Ecija
 Duplex Residence w/ Attic Room GB Project Engineer 12 / 2005 04 / 2006
Golden Ville Subd., Cabanatuan City
 NE Village GB Project Engineer 12 / 2004 11 / 2005
Bakod Bayan, Cabanatuan City
 Gen. Natividad Breeding Farm Phase I GB Project Engineer 02 / 2004 09 / 2004
Brgy. Bravo, Gen. Natividad, Nueva Ecija
 Various Renovation/Restoration Projects GB Project Engineer Continuous Proj.
In N.E. Pacific Mall
 Various Renovation/Restoration Projects GB Project Engineer Continuous Proj.
In N.E. Outlets

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.
RONNIE R. TALENS
 _________________________________
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. __________________________
X
New
Upgrading
Renewal
Others, pls. specify
___________________________
Revised 03/31/04
 PCAB Form No. 110

SUSTAINING TECHNICAL EMPLOYEE (STE) PERSONAL APPEARANCE FORM

(To be accomplished fully by the STE)

RONNIE RAMOS TALENS

Name: ______________________________________________ MALE
Sex: __________________
Address: MAHARLIKA HIGHWAY, ZULUETA DIST., CABANATUAN CITY
____________________________________________________________________
CIVIL ENGINEER
Profession: __________________________________ 103822
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. 103822
____________________
SEPT 04, 2012
valid until ______________________
DRIVERS LICENSE NO. C05-02-019054
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: ____________________________
Republic of the Philippines )
Province of _____________ )
Municipality of ___________) S.S.

AFFIDAVIT OF STE CONSTRUCTION EXPERIENCE

RONNIE RAMOS TALENS
I, _________________________________,
Dist. (Pob.), Cab. Citysingle/married, Filipino, of legal age, with postal address at
Maharlika Highway, Zulueta
________________________________________________, 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
R. D. TALENS CONSTRUCTION and TRADING
Maharlika Highway, Zulueta Dist. (Pob.), Cab. City
 Four (4) Bedroom Residential Bldg. GB Project Engineer 03/01/2010 08/27/2010
La Fuente, Sta. Rosa, Nueva Ecija
 Construction of the NEECO II-AREA 1 GE Project Engineer 05/06/2010 08/19/2010
ZONE 1 Talavera District Office Bldg.
Calipahan, Talavera, Nueva Ecija

 Renovation of Renato Talens Residence GB Project Engineer 04/04/2010 08/12/2010

Andal Aliño, Talavera, Nueva Ecija
 AVON Cabanatuan GB Project Engineer 04/14/2010 06/10/2010
2nd Floor NE Mall, Zulueta, Cabanatuan City
 Renovation and Retrofitting of Existing GB Project Engineer 11/18/2009 05/15/2010
Nursing Building
Dagupan City, Pangasinan

 Pagkakaisa NE-Primary Multi-Purpose GB Project Engineer 12/23/2009 05/08/2010

Cooperative
Murcon, Llanera, Nueva Ecija

 Multi – Purposed Building GE Project Engineer 11/27/2009 01/09/2010

Camp. Tinio, Cabanatuan City
 Road Improvements ( Drainage, Sidewalk, GE Project Engineer 10/15/2009 12/22/2009
Curb & Gutter
Gen. M. Natividad, Nueva Ecija

 Covered Court GE Project Engineer 11/02/2009 12/17/2009

Las Piñas Elementary School, Peñaranda,
Nueva Ecija

 Hotel Sogo Cabanatuan ( Steel Trusses) GB Project Engineer 10/2009 11/2009

Circumferential Rd., Cabanatuan City
 Hotel Sogo Cabanatuan ( Masonry GB Project Engineer 09/2009 11/2009
Works)
Circumferential Rd., Cabanatuan City

 Renovation of Commercial Stall ( Dickies) GB Project Engineer 08/25/2009 10/15/2009

Mega Center The Mall, Cabanatuan City
 CIC – Grilles and Gate GB Project Engineer 08/25/2009 09/25/2009
Sumacab Este, Cabanatuan City
 Renovation of 2- Storey Residential Bldg. GB Project Engineer 08/17/2009 11/20/2009
La Fuente, Sta. Rosa, Nueva Ecija
 Renovation and Extension of ZAPP’S GB Project Engineer 07/29/2009 09/07/2009
Jet Bldg. H. Concepcion, Cabanatuan City