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MGS General Insurance Agency Services Inc.

2f Starmall Annex Bldg. cor. Doña Manuela Ave., Pamplona Alabang Zapote Rd. Las Piñas City
Tel Nos.: 8750494 8744126
0998-5888831 0917-8898748

MGS TENANTS’ CONSTRUCTION ALL RISK INSURANCE (CARI) PACKAGE


APPLICATION FORM

Project: All4u Unlimited Grill and Shabu Shabu

Owner: Micah Abalos Gatuslao

Contact number: ____+63 927 044 6325

Email address: jokilll@naver.com

Contract amount: Php. 99,382.50

Trade Name: MRKR Restaurant

Exact location: Vista Mall Sta. Rosa – Tagaytay Rd. Don Jose Sta. Rosa, Laguna

Contractor: All4u Unlimited Grill and Shabu Shabu (Engineering)

Address of Contractor: Kalayaan Ave. Cor. Salamanca St. Makati Ave., Makati _

Start date: October 7, 2019

Duration: 2weeks

Scope of works: Demolition of rise flooring/ Corrective Maintenance of Sanitary


Line/ Water Proofing / Installation of Rise Flooring and Rectification of Comfort Room.

Note: Please attach copy of Bill of Materials to this form.

Signature over printed name

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