ATTESTATION FORM OF CHD/FICT/MST VALIDATORS

I, Jerome Victor G. Boligao [Full Name of Validator], Clinic Head [Position], a duly
authorized representative of Aventus Medical Care, Inc, [CHD/FICT/MST] do hereby declare
and attest to the following:

1. That the submission of Aventus Medical Care, Inc - Ortigas Pasig Branch[Name of
Facility] in NCR-Pasig [Region] had undergone thorough verification and validation by
the management of this facility as manifested in their
attestation form.

2. That this submission through the Health Emergency Allowance Processing System
(HEAPS) had been validated based solely on the information made available by the facility
and guided by the provisions of Republic Act No. 11712 (Public Health Emergency
Benefits and Allowance for Health Care Workers Act), its implementing rules and
regulations and supplemental guidelines. Should the actual facts be different from the
information contained in the submitted CREC report to which this CHD/FICT/MST is not
in position or no capacity to verify, the facility shall bear sole responsibility therewith.

3. That proper exercise of diligence had been observed in the validation of this submission
and in consideration of the presumption of regularity.

Done this 26 day of May, 2023 in Ortigas-Pasig City.

By:

Jerome Victor G. Boligao, RMT

[SIGNATURE OVER FULL NAME OF VALIDATOR]

AMCI - Ortigas Clinic Head