Subic Bay Metropolitan Authority

SUBIC BAY METROPOLITAN AUTHORITY Departmental Quality Form LABOR DEPARTMENT LBD-SCO-ARA-1-45-17 SERVICE CONTRACTING OFFICE Revision No. 02 Bldg. 255, Rm. 210, Barryman Road, Subic Bay Freeport Zone, Phils. 2222 Effectivity Date: 09-04- ☎Telephone (6347) 252-4861/4542 Facsimile (6347) 252-4494 2017

Application for the Renewal of Certificate of Accreditation Name of firm:

Company Address:

Contact Person Tel No.: Fax No.:

Nature of Business (Pls describe specific type of activity you intent to renew) SECURITY SERVICES Requirements for Renewal:

 List of Clients served within SBFZ

 Latest Audited Financial Statement

 Certificate of Good Standing / Service Agreement with Subic Bay Freeport client  Payroll for the last 12 mos. of operation with corresponding daily time records (DTR)

 Proof of 13th Month Pay and / or SIL Payment  Latest SSS ,Pag-ibig, Philhealth remittances

 PNP-SOSIA license  Surety Bond

 Law Enforcement Dept. Clearance (Bldg. 657 1st Floor)

 Public Health and Safety Clearance (Bldg. 280) 252-4502

 Ecology Dept. Clearance (Regulatory Bldg.) 252-4435

 Intelligence Office Clearance (Bldg. 657 2nd Floor) 252-4509

Application & Accreditation Fee: US$200.00 /year (or equivalent in Phil. Peso at current exchange rate)

Schedule of Payment: (Please check one)  One (1) Year Accreditation - $200.00  Two (2) Years Accreditation - $400.00  Three (3) Years Accreditation - $600.00

Note: The Certificate of Accreditation that will be issued is without prejudice to inspection if circumstances warranted and maybe revoked or cancelled by the SBMA for commission or violation on the terms and conditions, policy guidelines for accreditation, or any laws or orders of the Republic of the Philippines.

I understand that this application for accreditation is subject to evaluation & approval of the SBMA and therefore subject myself to its existing and future policies, rules and regulations. Any false/fraudulent statement made herein as well as violations on my part of any said policies, rules and regulations shall be sufficient grounds for denial of Accreditation Certificate or revocation of the same.

Printed Name: ______

Signature: ______

Date: ______