[complete Section 8 where applicable]

8. That I/we confirm that I/we have been advised in writing by the City
that it relies exclusively on the Letter o£ 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.

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

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

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

12. 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)
P

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

Address (print) : | Date

yp Occupation Title of Agent (if applicable)

A£Efix Seal below

Address (print)

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

Authorized Officer

Authorized Officer
ITEM | PAGE