Republic of the Philippines

Department of the Interior and Local Government

Bureau of Fire Protection
Regional Office 6
Antique Provincial Office
Tobias Fornier Fire Station
T. A. Fornier St., San Jose de Buenavista, Antique
(036) 540-7175 / 0915-324-8833
sanjose_fire@yahoo.com.ph)

ORDER OF PAYMENT
OPS No. BFP- Date:
NAME OF ESTABLISHMENT/PROJECT:
LOCATION:
Owner/Name of Representative:
FIRE SAFETY CLEARANCE APPLYING FOR:
nFire Safety Evaluation Clearance (FSEC)
nFire Safety Inspection Certificate (FSIC)
nOthers:

APPLICABLE FEES (Fill-up)

NATURE OF PAYMENT ACCOUNT BASIS OF TOTAL

CODE COMPUTATION
Fire Code Construction Tax (0.1% of the verified estimated value of the buildings or 628 – BFP - 01
structures to be erected)
Fire Code Realty Tax (0.01% of the assessed value of the buildings or structures) 628 – BFP - 02
Fire Code Premium Tax (2% of the gross sales of companies, persons or agents 628 – BFP - 03
licensed to sell insurances)
Fire Code Sales Tax (2% of gross sales of companies, persons or agents selling 628 – BFP - 04
firefighting appliances or devices)
Fire Code Proceeds Tax (2% of the service fees received from insurance adjustment 628 – BFP - 05
companies)
Fire Safety Inspection Fee (15% of all fees charged by the local government or by the 628 – BFP - 06
other government agencies concerned) but in no case shall be lower than Five
Hundred Pesos (Php 500.00).
Storage Clearance ( Refer to schedule of fees) 628 – BFP - 07
 Calcium carbide
 Pyroxylin
 Matches
 Nitrate etc.
 Shredded combustible
 Tar, resin etc.
 Flammable liquids having flashpoints of 6.67 degree centigrade
 Flammable liquids having flashpoints of above -6.67 degree centigrade
 Liquids having flashpoints of 22.8 degree centigrade and below 93.3
degree centigrade
 Combustible liquids with flashpoint greater the 93.3 degree centigrade
 LPG for bulk storage
 LPG other bulk storage
 Flammable gases
Conveyance Clearance (Refer to schedule of fees) 628 – BFP - 08
Installation Clearance (Refer to schedule of fees provided) 628 – BFP - 09
Fire Code Administrative Fines 628 – BFP - 10
Other Clearance Fee 628 – BFP - 11
 Fire Works Display
 Fumigation/Fogging
 Fire Drill
 Hotworks
 Fire Incident Clearance
 Certified true copy of FSIC/FSEC/other clearances
 Electrical Installation 5 KVA or less
 FSEC Filing Fee
TOTAL AMOUNT OF FIRE CODE FEES
TOTAL AMOUNT (IN WORDS):

Breakdown:
Twenty percent (20 %) LGU share to be remitted to BFP Account Amount :
Eighty percent (80 %) BFP share – BFP Account No. D2531 Amount :
Official Receipt No. : _________________ Payment Date:
Amount Paid :

Name and Signature of Fire Code Fee Assessor

PAALALA: “MAHIGPIT NA IPINAGBABAWAL NG PAMUNUAN NG BUREAU OF FIRE PROTECTION SA MGA KAWANI NITO ANG
MAGBENTA O MAGREKOMENDA NG ANUMANG BRAND NG FIRE EXTINGUISHER”
“FIRE SAFETY IS OUR MAIN CONCERN”

BFP-QSF-FSED-030 Rev. 01 (02.22.19)Page 1 of 2

 Republic of the Philippines
Department of the Interior and Local Government
Bureau of Fire Protection
Regional Office 6
Antique Provincial Office
Tobias Fornier Fire Station
T. A. Fornier St., San Jose de Buenavista, Antique
(036) 540-7175 / 0915-324-8833
sanjose_fire@yahoo.com.ph)

BFP-QSF-FSED-030 Rev. 01 (02.22.19)Page 2 of 2