Republic of the Philippines

DEPARTMENT OF AGRICULTURE
Regional Field office No. 12
Carpenter Hill, Koronadal City

Date: ________________________

CERTIFICATE OF SITE INSPECTION

This is to CERTIFY _______ _(name of representative)_________________of
___________________(name and address of firm/office)________________________
Had conducted the site inspection for ____(name and address of
project)____________
This certification is being issued for whatever purpose it may serve him best.
Issued this _______ day of _________, 2023.

Certified:

______________________
DA-RFO XII Engineer

REPUBLIC OF THE PHILIPPINES

___________________________)S.S
SUBSCRIBE TO AND SWORN TO before me this _____ day of _____ , 2023.
Affiant exhibiting to me his/her Residence Certificate number No. _____ issued on ____
at ________________.

NOTARY PUBLIC
Doc No. _____
Page No. _____
Book No. _____
Series of 202___