[EXECUTED]

IN WITNESS WHEREOF, the Parties, acting through their respective duly authorized representatives, have caused this Agreement to be signed under their respective names on the date and at the place first above-written.

LGU NAME

[NAME OF WINNING BIDDER]

By: 

By:

Name:____________

Name:_______________

Title:_____________

Title:________________

APPROVED BY:

Local Sanggunian of______________

Resolution No.____, series of____.