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02 Company Profile
ERC company profile for COC independent power producer/DU owned power plant
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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