(Date)

CERTIFICATION/WAIVER

This is to certify that we cannot accommodate the testing of the following construction

materials submitted by
(Name of Supplier/Contractor)

for the

(Name of Project)

Materials / Samples Required Test/s

due to the following reason/s:

Voluminous samples received are currently being tested in the laboratory.

Test reports needed could not be obtained on time.

Lack of chemicals/supplies needed to perform the tests required.

Lack of capability to undertake the test/s specified above.

This certification is being issued to

(Supplier/Contractor)
which authorize them to avail the services of DPWH Accredited Private Testing
Laboratories
pursuant to Department Order No. 203, Series of 2003

(Head of Office)