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02 Company Profile

ERC COC form for company profile that entities with self-generating facilities (SGFs) with less than 1 MW aggregate installed capacity

Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: FORM NO. 2
COC No._________________
Application No. ___________

COMPANY PROFILE
Date of initial submission: _________
1. Company Name: _____________________________________________________
‫ ٱ‬Owner & Operator
‫ ٱ‬Owner
‫ ٱ‬Operator
Type of Organization : ______________________________________________
2. Office Address: _______________________________________________________
_______________________________________________________
_______________________________________________________
Telephone Numbers
FAX Number
Cellular Phone Numbers
E-mail Address

:
:
:
:

_______________________________________
_______________________________________
_______________________________________
_______________________________________

3. Plant Address: _______________________________________________________
_______________________________________________________
_______________________________________________________
Telephone Numbers
FAX Number
Cellular Phone Numbers
E-mail Address
Tax Identification No.

:
:
:
:
:

______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________

4. Registrations/Accreditations/Compliance Certificates/etc.:
Government Agency Document Issued
Reference No.
DOE
SEC
BOI
DENR
1. ECC
2. PTO
PEZA
Others (pls. specify)

5. Number of Regular Employees:
1) Management
2) Supervisory
3) Technical
4) Non-Technical/Administrative

______________
______________
______________
______________

TOTAL

______________
1

Date Issued

FORM NO. 2

6. Board of Directors
Name

Cit.

Designation

Complete
Address

Interests in Other
Electric Related
Business

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.

7. Corporate and other Senior Officers
(President to Department Heads)
Name

Cit.

Designation

Complete
Address

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Note: Please provide additional sheet(s) if necessary.

2

Interests in Other
Electric Related
Business

FORM NO. 2
8. Record of Stockholders
Name

Citizenship

Class of Stocks

Number of
Shares owned

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
Note: Please provide additional sheet(s) if necessary.
9. Latest Financial Profile :
No. of Shares
Authorized Capital Stocks
Total Subscribed Capital
Total Paid-up Capital

10. Business Affiliate(s) Abroad:
3

Par/Stated Value

Amount (PhP)

FORM NO. 2
Name of
Affiliate(s) Abroad

Contact Person

Address

E-Mail Address

11. Summary of existing business activities within the electric industry in the
Philippines and other countries.
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

Note: Please provide additional sheet(s) if necessary.

------------------------------------------------------------------------------------------------------------

Name of person who provided the above information: _______________________
Signature: __________________
Date Accomplished: ______________
Res. Cert. No. / Passport (if Foreigner): _______________
Date Issued : ________________
Place Issued: ________________

MEBG/JSJ/MACB_C:\Documents and Settings\elaine 4 sept13\coc forms\coprofileform2_amended.doc

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