REPUBLIC OF THE PHILIPPINES)

CITY OF ILOILO )S.S.

X----------------------X
AFFIDAVIT OF LOSS

I, KARLO JOHN C. MANGARAN, of legal age, single, Filipino and a resident of Brgy.
Calampitao, Miagao, Iloilo, Philippines, after having been duly sworn to in accordance with
law, do hereby depose and state THAT:

1. I am an Engineer of MGS Construction Inc. since 2014 until September 2018 with office
address at Las Piñas City, Metro Manila;
2. Sometime last year one of our suppliers, David Construction Supply submitted to my
office a Billing for the supply it delivered to us particularly the Reinforce Concrete
Pipe;
3. The said Billing contains the details of the Receiving Slip Number, Sales Invoice
Number and Delivery Receipt Numbers which are as follows:
a. Receiving Slip Number : 264882
b. Sales Invoice Number : 1229
c. Delivery Receipt Numbers : 2247, 2325, 2326, 2327, 2328, 2318 & 2319

4. The total amount in the Billing sent by David Construction Supply with regards to the
above-mentioned details amounted to One Hundred Thirty Two Thousand Eight
Hundred Twenty-Five Pesos (Php 132,825.00);
5. However, on October 3, 2018, it was discovered that the Billing in the amount of Php
132,825.00 in relation to the Reinforce Concrete Pipe that MGS Construction, Inc.
received from David Construction Supply can no longer be found despite the
incessant search made by us;
6. Hence, I consider the said Billing with the above-mentioned details lost and beyond
recovery; and
7. That I am executing this Affidavit to prove the foregoing facts and for whatever legal
purpose it may serves best.

IN WITNESS WHEREOF, I have hereunto signed my name this 22nd day of January in the
City of Iloilo, Philippines.

KARLO JOHN CEPIDA MANGARAN

Affiant
PRC Registration No.: 0129953

SUBSCRIBED AND SWORN to before me this 22nd day of July in the City of Iloilo, Philippines.
Affiant had exhibited to me his PRC ID CARD as above-indicated which is a genuine and
competent proof of her identity.

Doc No. 481;

Page No. 98;
Book No. V;
Series of 2019. KRISTINE A. CUTANDA-LARIOS
Notary Public for the Province and City of Iloilo
2nd Floor, Daclis Building, Bonifacio Drive, Iloilo City
Notarial Commission Reg. No. 58
Valid Until December 31, 2020
Roll No. 67235
IBP No. (Official Receipt on Process)
PTR No. 6437759 / January 9, 2019 / Iloilo City
MCLE Compliance No. VI-0010974 / Valid until April 14, 2022

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