Professional Documents
Culture Documents
001
(Revised January 2006)
Republic of the Philippines
Department of Trade and Industry
Construction Industry Authority of the Philippines
CONSTRUCTION INDUSTRY ARBITRATION COMMISSION
RESPONDENT
NAME OF COMPANY : _______________________________________________________________________________________
AUTHORIZED
REPRESENTATIVE : _______________________________________________________________________________________
BUSINESS ADDRESS : _______________________________________________________________________________________
TELEPHONE NUMBER : _______________________________________________________________________________________
III. Choice of Arbitrators: Maximum of Six [6] Nominees (By Order of Preference)
1. ______________________________________ 4. ___________________________________
2. ______________________________________ 5. ___________________________________
3. ______________________________________ 6. ___________________________________
VI. Documents Required : Please submit the following in: 5 copies if Tribunal / 3 copies if Sole Arbitrator
[ ] Complaint/Narration of Facts
[ ] Construction contract
[ ] Agreement to arbitrate
[ ] Documents establishing the circumstances of the case
[ ] In case of government contract, communications made with the highest authority for exhaustion
of administrative remedies.
_______________________________________
Date Filed : ____________________________ Signature of Authorized Representative
Case Number : ____________________________
Deposit Paid : ____________________________
O.R. No. : ____________________________ CTC No. : ____________________________
Date Issued : ____________________________ Issued at : _____________________________
Remarks : ____________________________ Issued at : _____________________________
________________________________________________ TIN : _____________________________