CUSTOMER : .

PROJECT : Name of Project

LOCATION : Project Location

SCOPE OF WORKS : Scope of Work

CERTIFICATION

This is to certify that the above-mentioned project have been completed and accepted
satisfactorily in accordance with the plans, specifications, terms and conditions of the project as of date
of completion, the date of its completion as reported by our inspection team.

It is understood that the issuance of this certificate does not relieve the contractor of his
obligation and responsibility of undertaking repair works and any failure that may occur in any section of
the project within three hundred sixty five (365) days from the date of issuance of this certificate, as
provided for in the contract, specifically the testing of water piping and electrical system. And neither
does it relieve the contractor of his obligation and responsibility pursuant to the provisions of P.D. 1759.

Turned-over by: Accepted by:

Name of Contractor/ Supplier

Supplier/ Contractor Owner/Developer

Name of Representative
Position