[complete Section 8 where applicable]

That I/we confirm that I/we have been advised in writing by the City
that it relies exclusively on the Letter of Assurance of
“Professional Design" and Commitment for "Field Review" prepared
by (insert name of engineer or architect)
in reviewing the drawings, specifications and plans submitted with
the application for a building permit.

That I/we understand that the Project includes all electrical,
plumbing, mechanical, gas and other works necessary to complete the
contemplated construction.

That I/we have read and understood the “Port Coquitlam Building and
Plumbing Bylaw, 1991, No. 2568".

That I/we am/are authorized to give these representation, warranties,
assurances and indemnities to the City.

That I/we confirm that I/we have been advised by the City that I/we
Should seek independent legal advice before Signing this release.

Witness's Name (print) Owner's Name (print)

By:
Witness's Signature Owner or Owner's Appointed Agent
Signature

Address (print)

Occupation. Title of Agent (if applicable)

AEfix Seal below

Address (print)

The Corporate Seal of was
hereunto affixed in the
presence of:

Authorized Officer

Authorized Officer

ITEM