LETTER OF INTENT TO APPLY FOR THE

SAFETY SEAL CERTIFICATION PROGRAM

November 3, 2021

JOSEPH FRANCISCO R. ORTEGA

Regional Director
DOT Region 1
Oasis Country Resort Hotel, Nat’l Highway,
Brgy. Sevilla, San Fernando City 2500 La Union

Dear Director Ortega:

Recognizing the importance of implementing the Inter-Agency Task Force for the
Management of Emerging Infectious Diseases’ (IATF-EID) Health and Safety Protocols and
contact tracing for tourism enterprises, we at the GRAND PAVILLION HOTEL (MBKK
HOTEL) located at JL DE GUZMAN COR FRIANEZA ST. POBLACION, MANGALDAN,
PANGASINAN hereby express our intent to apply for the Department of Tourism’s (DOT)
Safety Seal Certification issued by virtue of the DOLE-DOH-DILG-DOT-DTI Joint
Memorandum Circular (JMC) No. 21-01, Series of 2021 or the “Implementing Guidelines of
the Safety Seal Certification Program”.

We believe that the issuance of a Safety Seal Certification, which ensures compliance with
the DOT’s Minimum Public Health Standards (MPHS), together with the use of the
StaySafe.ph application adopted by the IATF-EID as the official digital contact tracing
application of the government (IATF Resolution No. 87 S. 2020) will contribute in rebuilding
the trust and confidence of the travelers to restart tourism.

By being a part of this initiative, we pledge to strictly implement the health and safety
guidelines set by the DOT and other relevant government agencies to protect the welfare of
both the tourism workforce and the travelers.

In this regard, we request for an assessment of our enterprise’s compliance with the DOT
requirements for the issuance of a Safety Seal Certification. Attached is a duly accomplished
form for your reference.

Thank you.

Sincerely,

Gladys Aborquez Fabia

Admin | Grand Pavillion Hotel
 APPLICATION FORM
SAFETY SEAL CERTIFICATION PROGRAM

Name of Tourism Enterprise: GRAND PAVILLION HOTEL (MBKK HOTEL)

Type of Tourism Enterprise:
Kindly check one box
`
✔ Accommodation Establishment
(Hotels, Resorts, Apartment Hotels, and other
Accredited Accommodation Establishments)
Travel and Tour Services

Meetings, Incentives, Conferences & Events

(MICE) Venues/Facilities
Restaurants inside Hotels/Resorts
Full Name of Focal Person: LYDIA NABUA DE VERA
Designation: HOTEL MANAGER
JL DE GUZMAN COR FRIANEZA ST. POBLACION,
Office Address: MANGALDAN, PANGASINAN
grandpavillionhotel
Email Address: @gmail.com Contact Number: 09658718067
DOT-RO1-RES- OCTOBER
DOT Accreditation No.: 00573-2021 Validity: 31, 2023
https://www.staysafe.ph/g/logbook/a06b1a86-1917-
StaySafe.ph Location Code 4490-a4a7-c9417d122af5

Note: Please attach an image of your StaySafe.ph QR code or Location code and/or any
other proof of the use of the application upon sending this form via email.

Gladys Aborquez
Fabia November 3,
Submitted by: Admin Date of Application: 2021