| A/11 Prerna Ashish Soc., Sangeeta Wadi, Shiv Mandir Road, Dombivii(East)- 421201. @ [ +491 8879048910 / 8879048927 @ CORPORATION SR.NO. FSU/2023/205 Date: 13/07/2023 FORM A Certified that we have executed the work towards compliance in relation to Fire Prevention and Life Safety Measures to be provided and performed other related activities required to be carried out, in the following building or premises, as required under the provisions of the Maharashtra Fire Prevention and Life Safety Measures Act, 2006 (Mah. 111 of 2007). Description and Location of Building or Premises MIS. BALAJI CONSTRUCTION Plot No-14, Sector -20 Ulwe. ‘The details of the work and related activities which we have executed or performed are mentioned in the list appended herewith. Place: Dombivli Date: 13/07/2023 Digitally signed /ORPO, YASH potanaares (PERS SATISH — THAKKAR aa) oa(POmsrv 5) Date: 2023.07.13, Sf THAKKAR 12:14:33 +05'30" xf License No. MFS / LA / RF#199 / RD-185 /RP-42 License Agency (Directorate of Maharashtra Fire Services) Government of Maharashtra a @ scanned with OKEN ScannerA/11 Prerna Ashish Soc,, Sangeeta Wadi, Shiv Mandir Road, Dombivli(East) 421201, @ +91 8879048910 / 8879048927 @ ION CORPORATI NER MIS. BALAJI CONSTRUCTION Plot No-14, Sector -20 Ulwe. Sr.No. ‘Material Installed Qty. Unit ‘Wooden Solid Core Flush Door Treated ; 1 | with Fire Retardant, 2020 x 1100 with 06 No’s thickness 45 mm, Fire Retardant- 120 Minutes. Date: 13/07/2023, Place: Dombivli YASH Digitally signed SATISH —THAKKAR THAKKAR 12:15:22 40530" License No. MFS / LA / RF-199 / RD-185 / RP-42 @ scanned with OKEN ScannerGovt. of Maharashtra Directorate of Maharashtra Fire Service \Vidyanagri, Hans Bhugra Marg, Santacruz (East) ‘Mumbai ~ 400 098, Tel-022-26677855, Fax-022-26677666 ‘www. mahatireservce.gov.in FORM N [( See section 9 (3) and rule 14] License to act as a License Agency for the purpose of Fire Prevention and Life Safety Measure License No. MFS / LA/ RF-199 / RD-185 / RP-42 Date: 13.04.2023, License is hereby renewed under the provisions of sub-section (3) of section 9 of the Maharashtra Fire Prevention and Life Safety Measure Act, 2006 (Mah. III of 2007) to Wis. FSI Corporation having their registration office at A-11, 2% Floor, Prema Ashish CHS, Shivmandir Rd, Dombivali (E), 421201 and their contact details are Office Number: 8879048910 and Email ID: fsicorpo@gmai.com with PAN registration No. ALPPP4219A and GST No. 27ALPPP4219A1Z5 to act as a License Agency for the purpose ofthe said Act for execution of the fire prevention and life safety measures in relation to 4, Fire Fighting and Sprinkler System: Class C 2, Detection and Fire Suppression System: Class D 3. Passive System: Class C ‘Mis. FSI Corporation shall not issue Form A or Form B under sub-section (3) of section 3 regarding the compliance of the fire prevention and life safety measures or ‘maintenance thereof in good repair and efficient condition, without there being actual such compliance or maintenance failing which license granted / renewed shall be suspended or cancelled as per sub section (4) of section 9 and shall be liable for penalty under section 36 of the Act. ‘Subject to the provision of sub section (4) of section 9 of the said Act and rule 14 of the Maharashtra Fire Prevention and Life Safety Measures Rules, 2009, the license will be valid for a period from 13.04.2023 to 12.04.2024 Santosh eutysoatty Shridhar owe Warick = isiowae (S'S Warick ) Director Maharashtra Fire Service @ scanned with OKEN Scanner