Standard Form Number: SF-GOOD-13b Reference: BRTTH IB NO.

01-2018
Revised on: July 28, 2004 Description: Treatment, storage and disposal of Hazardous Wastes
Statement of all Government & Private Contracts which are similar in nature (Single Largest Completed Contract)

Business Name
Business
Address
Name of Contract a. Owner’s Name Bidder’s Role a. Amount at Award d. Date Awarded
b. Address Nature of Work Description b. Amount at Completion e. Contract Effectivity
%
c. Telephone Nos. c. Duration f. Date Completed
Government

Private

Note: This statement shall be supported with:

1 Contract
2 Certificate of Completion/Acceptance
3 Official Receipt

Submitted by
(Printed Name & Signature)
Designation
Date