CERTIFICATION

FIRE SAFETY MAINTENANCE REPORT

This is to certify that all fire safety issues are addressed and that all required fire safety systems
are installed and maintained as prescribed in RA 9514 and its RIRR and other applicable laws of the 69th
Storey ATM tower located at 69th st. Maligaya, Brgy. Pinagnasahan, Quezon City , Attached herewith the
updated record of the regular inspection, scheduled testing and/or regular preventive maintenance to
ensure proper operation condition.

__________________ __________________

Engr. Dela Cruz Engr Juan Dela Cruz

Bldg Administrator/Owner Fire Safety Practitioner
Civil Engineer COC No. 0006920
PRC No. Date Issued:
Date Issued: