FORM A-1

(SEE RULE-3)

To,

The ELECTRICAL INSPECTOR (LIFT MUMBAI)

I.E. & L. DEPARTMENT
RATIONING OFFICE COMPOUND
CHEMBUR, MUMBAI-400 071

LIFT AT :- ________________________________________________

________________________________________________

Dear Sir,

We declare that we undertook & completed all the contract of installation of lifts
for which permission was granted in the Mumbai Lift Act 1939, prior to 6 Months from
the date of the declaration. We also declare that all the completed lifts installation have
been duly inspected by the inspector of the lifts and defects pointed out by them has
been duly.

At present our lifts is/are under erection as per permission.

Thanking you,