QUALIFICATION OF KEY PERSONNEL PROPOSED TO BE ASSIGNED TO THE CONTRACT

Business Name : Holy Fam Construction & Suuply

Business Address : Sual, Pangasinan

PROJECT CONSTRUCTION SAFETY OTHER POSITION DEEMED

MATERIALS ENGINEER FOREMAN AND HEALTH PERSONNEL REQUIRED BY THE
MANAGER/ENGINEER
APPLICANT FOR THIS
PROJECT
1. Name LEOPOLDO V. CASIPIT JERRY LIM RODELIO BAUTISTA
2. Adress Lingayen, Pangasinan Mangaldan, Pangasinan Lingayen Pangasinan
3. Date of Birth October 6 1958 29-May-85 2-May-71
4. Employed Since 1990 2008 2000
5. Experience Horizontal / Vertical Horizontal / Vertical Horizontal / Vertical
6. Previous Employment CTC DPWH CTC
7. Education BSCE BSCE High School Grad.
8. PRC License , 0032266 109 224

Minimum Requirements: Project Manager/Engineering

: Materials Engineer
: Foreman

Submitted by : Leopoldo V. Casipit

(Printed Name & Signature)
Designation : General Manager
Date : July 4 2011
LIST OF EQUIPMENT, OWNED OR LEASED AND/OR UNDER PURCHASED AGREEMENT, PLEDGE TO THE PROPOSED CONTRACT

Business Name : CASIPIT Trading and Construction

Business Address: Lingayen, Pangasinan

DESCRIPTION MODEL/YR CAPACITY PLATE No. MOTOR No. LOCATION CONDITION PROOF OF OWNERSHIP/
PERFORMANCE/SIZE BODY No. LESSOR OR VENDOR
A. Owned
i.1-unit Mini Dumb Truck 2004 3 cum. VEC- 584 4BEI-1989743 Sual, Pangasinan GOOD OR/ CR
Ii1-Unit Compactor 1999 plate N/A N/A Sual, Pangasinan GOOD OR
Iii1- Unit Boom Truck 1999 One bagger N/A N/A Sual, Pangasinan GOOD OR
iv.
v.

B. Leased
i. 1- Unit Dump Truck
Ii1- Unit Water Truck
Iii1- Unit Backhoe
iv.
v.

C. Under Purchase Agreement

List of minimum equipment required for the project: NOTE:

______________________ ________________________ Pledge equipment for the contract, which are owned (supported by proof of ownership), leased,
______________________ ________________________ and /or under purchase agreement (with corresponding engine, chasis number and/or serial
______________________ ________________________ number), supported by certification of availability of equipment from the equipment lessor/
______________________ ________________________ vendor for the duration of the project.

Submitted by : LEOPOLDO V. CASIPIT

Designation : General Manager
Date : July 4, 2011