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Pcab Amo Affidavit

1. The document is an affidavit from an Authorized Managing Officer (AMO) providing personal and professional details. 2. It includes the AMO's name, address, educational background, at least two years of construction experience, and knowledge of relevant building and safety laws. 3. The AMO affirms that they are not involved in any construction issues involving negligence, incompetence, malpractice or other disciplinary matters, and have not been convicted of any crimes involving moral turpitude.

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Neil Allen
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1K views1 page

Pcab Amo Affidavit

1. The document is an affidavit from an Authorized Managing Officer (AMO) providing personal and professional details. 2. It includes the AMO's name, address, educational background, at least two years of construction experience, and knowledge of relevant building and safety laws. 3. The AMO affirms that they are not involved in any construction issues involving negligence, incompetence, malpractice or other disciplinary matters, and have not been convicted of any crimes involving moral turpitude.

Uploaded by

Neil Allen
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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AUTHORIZED MANAGING OFFICER (AMO) AFFIDAVIT

Note: Please accomplish this affidavit properly. Please use additional sheets if necessary.
2x2 Picture
Republic of the Philippines ) of AMO
Province of ______________)
City/Municipality of ________) S.S

Last Name First Name Ext. Name (Jr/Sr, if any) Middle Name
I,
Citizenship mm dd yyyy Single / Last Name First Name Middle Name
Born on
Married to
Room/Floor/Unit/Bldg. Name, Lot/Block/Phase No., Street, Subdivision, Barangay, City/Municipality, Province, Zip Code
and
residing at:
having duly sworn to in accordance with law depose and say:
1. That I am the Authorized Managing Officer of :
________________________________________________________________________________________
(Name of Firm)
with position of:
___________________________________________________________________________________________________
(Position in the Firm)
2. That I possess the following educational attainments (attach additional sheet if necessary)
Inclusive Dates
Name of School Address Course
From To

3. That I possess at least two (2) years experience in the construction industry as follows (Ref. Sec. 20 of IRR of R.A. 4566)
Dates of
Designation / Position Company / Nature of Business Address Job Description Employment
From To

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 (Ref. Sec. 20 of IRR of R.A. 4566):
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 (Section 4.2 of IRR of R.A. 4566)
6. That I have not been convicted by a court of competent jurisdiction of any offense involving moral turpitude (Section 4.2 of IRR
of R.A. 4566)
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 .
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.
____________________________________
Authorized Managing Officer (AMO)
(Signature over Printed Name)

SUBSCRIBED AND SWORN to before me this _____ day of __________________________________________________ 20___


at ___________________________________________________________________________; affiant exhibited his/her Community
Tax Certificate No. _____________ issued at _________________________________________ on ______________ 20________.

NOTARY PUBLIC
Until December 31, 20 ___
Doc. No.
Page No.
Book No.
Series of 20 ___

AMO must sign here:

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