Affidavit of Change of Engineer/Architect

Project: Crystal Clear, Inc.

Permit No: 2 3 0 8 0 0 0 1 9 Job Address: Basement 1, Ayala Mall Bay, Parañaque

Owner’s Information:
Name: Clear Clear, Inc.
Address: Blk. 1 Lot 18 Amor St., TDS Trails, Brgy. Sto. Cristo, San Jose, Bulacan
Phone Number: 09190057860

Current Engineer/Architect of Record Information:

Name: Ryan Rhay P. Vicerra License Number: PRL NO. 176
Address: 279 Pastor St., Tondo, Manila
New Engineer/Architect of Record Information: Name:
ENGR. Jesse H. Jumonong Issued License Number:
0001068 Expiration Date: January 3, 2023
Address: Makati City
T.I.N.: 302-715-497-000

Thorough inspection performed by Engineer/Architect of record ( ) Yes, Dates ( ) No.

I agree to hold the project

and relieve them from any responsibility and liability for the completion of resulting from substituting the design
professional. I furthermore assume responsibilities and corrections, if required for work performed under the permit for
which I am requesting substitution of the design professional. In the event that there have been a change of
ownership of the property/company, the new owner assume the responsibility for notifying the previous owner of his/
or her intent to substitute the design professional. I am also certifying that I understand and full comply with the
required standards, requirements and codes regarding authorizing the re-use of plans from one professional to
another.

ENGR. Jesse H. Jumonong June C. Ramos

Architect/Engineer of Record New Owner:
Date: 09/08/2023 Date: 09/08/2023

SUBSCRIBED AND SWORN TO before me this 6th day of September 2023 at City of Manila,
Philippines, affiant personally known to me. affiant exhibiting to me his UMID ID with no.: 0111-
6415191-7 as competent proof of his identity.
Signature of Notary Public

(seal)