Area :

C.O. –OUTDOOR Site Name :

Site ID :
Site Address :

AGREEMENT
KNOW ALL MEN BY THESE PRESENTS:

This Agreement is made and entered this ______ day of _____________ 2021 at ____________________
by and between:

________________________, a local government unit duly organized and existing under laws of
the Republic of the Philippines, with office address at Brgy
Hall_______________________________, Philippines, represented in this particular act by its
Punong Barangay HON. _________________, through Sangguniang Barangay Resolution No.
___, Series of 2021, hereinafter referred to as “BRGY. “_________________”.

- and -

CONVERGE INFORMATION AND COMMUNICATIONS TECHNOLOGY SOLUTIONS,

INCORPORATION, a domestic corporation duly enfranchised by a Legislative Act (RA 9707)
under the laws of the Republic of the Philippines, with office address at 99 E. Rodriguez Ave. (C5),
DOMINGO N. VILLAFUERTE, JR.

Barangay Ugong, Pasig City as represented by its Authorized Agent, MR. DOMINGO N.
VILLAFUERTE, JR., herein referred to as “CONVERGE”.

WITNESSETH:

WHEREAS, CONVERGE desires to construct and install its riser pole provision with base pad and all fiber
optic cables, and other facilities or equipment necessary for the activation of the broadband data facilities
located within the area of Brgy. __________________________;

WHEREAS, BRGY. ________________, agrees to allow, and permit CONVERGE to construct, install, set-
up, and maintain CONVERGE’s riser pole with base pad provision and all fiber optic cables and other
facilities or equipment;

NOW THEREFORE, for and in consideration of the foregoing premises, the parties have agreed and bind
themselves as follows:

1. TERM. This Agreement shall be for a period of TEN (10) years, commencing on 5 DECEMBER 2020
until 4 DECEMBER 2030 and may be renewed upon mutual agreement of both parties.

2. CONSIDERATION. CONVERGE shall pay the sum of ______________________ (PHP xxxxxxx) only
as one-time payment, for the construction and installation of Telecommunication equipment within the
area of BRGY. ____________________ and by virtue of the Barangay Resolution No._____, Series
of 2021, authorizing Brgy. Chairman Hon. ________________ to acknowledge the receipt of the said
amount, for and on behalf of BRGY. _____________;
_________________________

3. FACILITIES. CONVERGE shall provide and install, at its own expense, the construction of riser pole
provision with base pad and all fiber optic cables and other facilities or equipment necessary for the
activation of the broadband data, internet and other value-added service facility at located within the
area of Brgy._______________________;

4. ACCESS. BRGY. ________________, grants CONVERGE, its employees, contractors and authorized
agents, unhampered access to the CONVERGE facilities/equipment, twenty-four (24) hours a day,
seven (7) days a week, for the construction, installation, repair, maintenance, upgrade and operation
of its telecommunication facilities/equipment and/or related future expansion as well as service line
installations and maintenance;

5. RIGHT OF WAY. BRGY._______________, grants CONVERGE Right-of-Way ingress and egress to

the location/site, passageway for personnel, motor vehicles and other effects as may be deemed
necessary by CONVERGE for the construction, installation, repair, maintenance, upgrade and
operation of its telecommunication facilities/equipment and/or related appurtenances thereto, as well
as service line installations and maintenance. BRGY._____________, shall not impose any fee or
charges for the said Right of Way granted to CONVERGE;

6. SUCCESORS AND ASSIGNS. This Agreement shall be binding not only on the Party’s signatories to
this Agreement but shall likewise have full force and effect upon their respective successors,
administrators, and assigns.
IN WITNESS WHEREOF, the parties have hereunto signed this AGREEMENT this _______ day of
_________________ 2021 at the date and place first above-mentioned.

___________________________ CONVERGE INFORMATION

COMMUNICATIONS TECHNOLOGY
SOLUTIONS, INC.

By: By:

DOMINGO N. VILLAFUERTE, JR.

Barangay Chairman Authorized Agent

SIGNED IN THE PRESENCE OF:

___________________________ __________________________
Signature Over Printed Name Signature Over Printed Name

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES)

)S.S.

BEFORE ME, a Notary Public for and in _______________ this ___ day of ______________ 2021
personally came and appeared the following:

NAME GOVERNMENT ID DATE & PLACE ISSUED

September 9, 2016
Domingo N. Villafuerte, Jr. PASSPORT P0196229A
DFA NCR EAST

Known to me and by me known to be the same persons who executed the foregoing Agreement and they
acknowledged to me that the same is their free and voluntary act and deed as well as that of the
corporations/political unit represented herein.

This instrument consists of TWO (2) pages including where the acknowledgment is written and signed by
the parties.

WITNESS MY HAND AND SEAL on the date and in the place above mentioned.

Doc. No. ____; NOTARY PUBLIC

Page No. ____;
Book No.____;
Series of 2021

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