WORK PERMIT

WORK PERMIT NO:______________

DATE FILED:____________________

This is to authorize the Tenant _______________________________________________, whose

Employees or contractor’s personnel names are listed below to undertake construction and/or
other works:

SCOPE OF WORKS:____________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
(Ex. Aircon/ Carpentry/ Electrical/ Plumbing/ Sanding/ Spray Painting/ Water proofing/ Hot Works/ Delivery & Pull-out)
DURING MALL HOURS: No works with harsh/ Foul odor; No delivery and pull-out bulky/ construction materials; No loud noise;
Follow SM House Rules and Guidelines

PERMIT IS VALID:

FROM TO
DATE :
TIME :
REMARKS:_____________________________________________________________________

SERVICES NEEDED:
Security Posting

Janitorial Deployment

NAME OF PERSONNEL (Attach another sheet for additional names)

1. 11.
2. 12.
3. 13.
4. 14.
5. 15.
6. 16.
7. 17.
8. 18.
9. 19.
10. 20.

**NOTE: ADDITIONAL PERSONNEL, PLEASE SEE ATTACHED FILE.

__________________________________
Name/Designation/Signature
(TENANT/CONTRACTOR AUTHORIZED SIGNATORY)

_______________ _________________ ____________________________

CRS EMB Department Mall Admin Authorized Signatory

Cc: 1-ADMIN.COPY 2-TENANT 3-CRS 4-EMB

SCMC-OPC-MOPS-CF-0004
Version no: 01
Effectivity Date: July 30, 2015