EEI CORPORATION

MAKATI MEDICAL CENTER PROJECT

Construction Division R

Job # 7022

Date : August 23, 2008

To : JP Parada
From : SAFETY DEPARTMENT
Subject : ACCIDENT REPORT

PERSONAL CIRCUMSTANCES:

PERSON INVOLVED : DOMINGO FOGATA (Finishing Mason)

DATE/TIME OF ACCIDENT: August 22, 2008 / 8:20 P.M.
PLACE OF ACCIDENT : Rear side, Annex Bldg.
EXTENT OF INJURY : Cut @ right thumb finger

DESCRIPTION OF ACCIDENT:
On August 22, 2008, at around 8:20 P.M. Mr. Domingo Fogata suffered a cut on
his right thumb finger.

RELATED FACTS:

1) At the given date and time, while Domingo Fogata was dismantling the
garbage cute located at the rear side of the Annex Bldg., a G.I. sheet he
was then hauling off the cute accidentally hit his right hand.
2) Mr. Domingo Fogata sustained laceration on his right thumb finger.

RECOMMENDATION:

1.) To be referred to St. Patrick Clinic for further medication

2.) To be discussed in the next toolbox meeting.

For your information.

J.S. Jocson
Safety Engineer