CERTIFICATE OF EXAMINATION AND TEST OF LIFTING GEARS,

LIFTING APPLIANCES & LIFTING EQUIPMENTS

Certificate No: BLC/C2 Job No: ASC-20N-0658
CLIENT & ADDRESS: EVAN LIM-PENTA CONSTRUCTION CO LLC, DUBAI, UNITED ARAB EMIRATES
TYPE OF INSPECTION & TEST PERFORMED: PERIODIC SURVEY REQUESTED BY: MR. VISHNU
LOCATION: BUSINESS BAY,PR NO:-1298, DUBAI, UNITED ARAB REFERENCE & REGULATION: BS EN 474-4:2006+A2:2012
EMIRATES
INSPECTION STATUS
DATE OF PREVIOUS INSPECTION: 30/09/2019 ASC TEST EQUIPMENT NO: ASC/EQ/01,02,15
DATE OF INSPECTION & TEST: 31/03/2020 ASC TEST PROCEDURE NO: ASC/ITP/N/16
NEXT INSPECTION AND TEST : 30/09/2020* MAKER OF SUPPLIER OF EQUIPMENT: BOSCARO
VALIDITY: 6 MONTHS PREVIOUS INSPECTION DONE BY: GENUINE SAFETY CONSULTANTS
INSPECTOR'S NAME: JAYAKRISHNAN TK AUTHORIZED NAME:
INSPECTOR'S SIGNATURE: AUTHORIZED SIGNATURE:

DESCRIPTION SAFE WORKING

ID/NO QTY REMARKS
(make/name, model, date of manufacture, type, dimensions, others) LOAD

BLOCK LIFTING CAGE

RECTANGULAR SHAPED BLOCK LIFTING CAGE
WITH 4 NOS OF LIFTING PAD EYE AT THE TOP
2.0 T SATISFACTORY AT THE
190075 1 TIME OF INSPECTION.
DIMENSIONS(LXWXH): 140 CMX 130 CM X 150 CM
PAD EYE THICNESS:4 NOS X 20 mm THICKNESS 1) Regular
GENERAL CONDITION: SATISFACTORY Maintenance
shall be conduc
to maintain the
structure

*This Certificate becomes invalid, if any alteration/major repair/ modification made on the equipment. Electronic signature and stamp are not allowed.
THIS IS TO CERTIFY THAT the undersigned competent representative did attend to examine this equipment/machine to assure that it is in safe working condition.
Examination indicates that the said equipment has no indigenous defects and it is in safe working condition at the time of inspection.
The said equipment was found Satisfactory for further use, provided there is continuous maintenance applied and only qualified operators employed.
This certificate will be valid for 06 Months from date of inspection
This certificate is granted subject to the condition that is understood and agreed that nothing herein contained shall be deemed to relieve any designer, manufacturer, seller,
supplier, Repairer or operator of any warranty, express or implied, and admiral safety consultant’s liability shall be limited to the acts or omissions of its employees, agents
and Subcontractors. under no circumstances whatsoever shall Admiral Safety Consultants nor their Engineer be liable for any injury or damage to any person or occurring
by reason of negligent operation or any defect in material, machinery, equipment or other items other than such defects ascertainable by normally accepted standards and
only those items actually inspected by Admiral Safety Consultant and which are covered only by this certificate. Any person not a party to the contract pursuant to which
this document is delivered may not assert claim against Admiral Safety Consultants for any liability arising out of errors or omissions which may be contained in said document and in
connection with any activities for which it may provide. This Certificate shall not be reproduced except in full without the approval of Admiral Safety Consultants and the receiving client.

ADMIRAL SAFETY CONSULTANTS, TRADE LICENCE NO. 741090, AL GARHOUD, P.O.BOX 125218, DUBAI -UAE, TEL: 04-2899389, FAX: 04-2840557

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