*CLIENT/CONTRACTOR TO ACCOMPLISH THIS FORM

INTO 4-COPIES TOGETHER WITH APPROVED LAYOUT

FUNCTION ROOM WORK PERMIT FORM

THIS PERMIT WILL BE FORWARDED TO SECURITY PRIOR TO START OF WORK:
EVENT / FUNCTION NAME: DATE APPLIED:
DECEMBER 3 TO 6, 2023
PCS ANNUAL CONVENTION
FUNCTION ROOM:
COMPANY / CONTRACTOR NAME:
ESTIMATED DURATION:
RBGM MEDICAL EXPRESS SALES INC. 12:00AM TO 3:00AM
COMPANY/CONTRACTOR SUPERVISOR: CONTACT NO:
ARJAY JHOSEP S. GONZALES 0917 177 3221
14 10 11

JOB TO BE DONE: VALIDITY : PERIOD VALIDATION

DECEMBER 3, 2023 FROM TO
INGRESS - BOOTH SET UP DATE: DEC. 3, 2023 DATE: DEC. 6, 2023
DECEMBER 6, 2023 TIME: 12:00AM TIME: 8:00PM
EGRESS - BOOTH PULL OUT
WORKPLACE SAFETY PRECAUTIONS/
PERSONAL PROTECTIVE EQUIPMENT
LIST OF MATERIALS, TOOLS AND EQUIPMENTS TO BE USED: c fire extinguisher c safety belts
please see attached file please see attached file c fireblanket c safety gloves
c warning signs c face mask/shield
c cordons c safety gloves
c goggles/glasses c safety shoes/boots
c lighting c coveralls
c helmet c apron
c goggles/glasses c others
c safety harness
ELECTRICAL REQ'T PRIOR TAPPING TO HOTEL POWER SOURCE: c BANAP manual discussed to undersigned contractor/client
* Wires shall be ROYAL CORD IMPORTANT! SAFETY PRECAUTIONS!
c 60A (Qty: ____) / Wire Size: _______ Strictly, No open flame or flammable materials
c 40A (Qty: ____) / Wire Size: _______ allowed.
c Others: Please keep the area safe & clean at all times.
CRITICAL EQUIPMENT(S) TO BE USED: Fasten cable safely.
c SMOKE/HAZE MACHINE c IMPAIRMENT PERMIT Validity of this permit should not exceed 7 calendar
c GENERATOR c CO2/CRYOGENIC TANK days
PEOPLE ON THE JOB: Please check, if present Please check, if present
Name Date Name Date
1. ARJAY JHOSEP S. GONZALES 7. DAVE NIEVES
2. ALLYSSA BUENAVENTURA 8. EFREN BANDONG
3. EVERT CASTRO 9. REYNZO DOMINGO
4. JEFF UBALDO 10.
5. GERMAN RODIL 11.
6. DENMARK FERNANDEZ 12.

Terms: The company/contractor hereby agree to indemnify and keep indemnified the Hotel from any and all claims, threats, demands, suit, damages, penalties, liability,
costs and expense incurred, suffered or expended by or threatened against the Hotel as a result of any theft or loss or damage to the goods, materials, tools and
equipment howsoever occurring whilst in the Hotel premises. The company/contractor acknowledges that the items are brought and retained in the Hotel premise at their
sole risk and shall not hold the Hotel liable for any loss and damage of items howsoever occurring.

CO./CONTRACTOR SUPERVISOR EVENTS MGR IN-CHARGE LIFE & SAFETY ENGR DIRECTOR OF ENG'G SECURITY MANAGER
I agree to above terms and I have reviewed and proper I have checked & certified that all I am aware of the Job to be I have checked with the Area-in-
confirm that the safety coordination has been precautions established are done and the precautions to be charge for any security
precautions specified will be conducted adequate taken requirements

ARJAY JHOSEP GONZALES

Note: Person In-Charge shall appear when securing work permit. Otherwise, re-approval by Duty Engineer is required. Person In-Charge shall be
knowledgeable of the whole set-up including technical equirements.
GUIDELINES PRIOR TAPPING TO HOTEL'S POWER SOURCE
(REQUIREMENTS FOR LOADS MORE THAN THE CAPACITY OF CONVENIENCE OUTLET)

1. Organizer is required to secure tapping permit from the Engineering Office prior to the event.

2. Organizer shall follow below guidelines prior to tapping:

a) Client/contractor shall submit to Duty Engineer (DE) the load schedule and wirings prior to tapping to Hotel power
source. DE shall assess and evaluate the power requirement.

b) Client/contractor shall provide their own disconnecting circuit breaker (CB) from the Hotel’s Electrical Panel (tapping
point). Refer below for respective function space electrical requirement:

CB
Function Space Qty Minimum Wire Size Requirement
Requirement
Tower Wing

Isla 1 to 3 60A, 2-Pole 2 sets Royal Cord, 3-conductors, 14mm2 (#6 AWG)

Palawan 1 to 3 60A, 2-Pole 1-set Royal Cord, 3-conductors, 14mm2 (#6 AWG)

Basilan & Boracay 1 & 2 40A, 2-Pole 1-set Royal Cord, 3-conductors, 5.5mm2 (#10 AWG)

Batanes 1 & 2 40A, 2-Pole 2 sets Royal Cord, 3-conductors, 5.5mm2 (#10 AWG)

Mactan 1 & 2 40A, 2-Pole 1-set Royal Cord, 3-conductors, 5.5mm2 (#10 AWG)

Lubang 40A, 2-Pole 1-set Royal Cord, 3-conductors, 5.5mm2 (#10 AWG)

Dapitan

Bohol
NO TAPPING POINT. CONVENIENCE OUTLET ONLY
Sulu

Marquee

Garden Wing

Rosal

Sampaguita
NO TAPPING POINT. CONVENIENCE OUTLET ONLY
Kamia 1 & 2

Santan 1 & 2

Garden Ballroom 1 to 4 60A, 2-Pole 1-set Royal Cord, 3-conductors, 14mm2 (#6 AWG)

Conforme: Noted By:

ARJAY JHOSEP S. GONZALES

Client/Contractor Person In-Charge Hotel's Duty Engineer
(Signature above printed name) (Signature above printed name)