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    Authorization For CMR

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    Sam Lovendino
    1. Joseph Alain Azagra designates Samuel Lovendino as the official representative for Eco Cycen Corporation (Goa Breeder Farm) for filing the Compliance Monitoring Report in accordance with DENR regulations. 2. The affidavit confirms that all information in the Compliance Monitoring Report dated March 30, 2021 for Eco Cycen Corporation (Goa Breeder Farm) is accurate and complete. 3. Joseph Alain Azagra accepts responsibility for any penalties that may arise from misrepresentations or failure to provide material information in the Compliance Monitoring Report.

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    Authorization For CMR

    Uploaded by

    Sam Lovendino
    2K views1 page
    1. Joseph Alain Azagra designates Samuel Lovendino as the official representative for Eco Cycen Corporation (Goa Breeder Farm) for filing the Compliance Monitoring Report in accordance with DENR regulations. 2. The affidavit confirms that all information in the Compliance Monitoring Report dated March 30, 2021 for Eco Cycen Corporation (Goa Breeder Farm) is accurate and complete. 3. Joseph Alain Azagra accepts responsibility for any penalties that may arise from misrepresentations or failure to provide material information in the Compliance Monitoring Report.

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    Authorization for CMR

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    1. Joseph Alain Azagra designates Samuel Lovendino as the official representative for Eco Cycen Corporation (Goa Breeder Farm) for filing the Compliance Monitoring Report in accordance with DENR regulations. 2. The affidavit confirms that all information in the Compliance Monitoring Report dated March 30, 2021 for Eco Cycen Corporation (Goa Breeder Farm) is accurate and complete. 3. Joseph Alain Azagra accepts responsibility for any penalties that may arise from misrepresentations or failure to provide material information in the Compliance Monitoring Report.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    2K views1 page

    Authorization For CMR

    Uploaded by

    Sam Lovendino
    1. Joseph Alain Azagra designates Samuel Lovendino as the official representative for Eco Cycen Corporation (Goa Breeder Farm) for filing the Compliance Monitoring Report in accordance with DENR regulations. 2. The affidavit confirms that all information in the Compliance Monitoring Report dated March 30, 2021 for Eco Cycen Corporation (Goa Breeder Farm) is accurate and complete. 3. Joseph Alain Azagra accepts responsibility for any penalties that may arise from misrepresentations or failure to provide material information in the Compliance Monitoring Report.

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    © All Rights Reserved
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    AFFIDAVIT OF DESIGNATED REPRESENTATIVE OF

    THE PROPONENT

    I, ____Joseph Alain Azagra __, hereby designate ___Samuel Lovendino____, as my official


    representative on ___Eco Cycen Corporation (Goa Breeder Farm)____ with respect to the filing of
    Compliance Monitoring Report (CMR) in accordance with Section 19 (a) of the Revised Procedural Manual
    for DENR Administrative Order No. 30, Series of 2003 and to confirm THAT:

    1. All the information and commitments in this Compliance Monitoring Report (CMR) dated
    March 30, 2021 for the Eco Cycen Corporation (Goa Breeder Farm)_____ with ECC
    Ref. No. ______________ECC-OL-RO5-2019-0210__________________ are accurate and
    complete to the best of our knowledge and documents available on file;

    2. No DENR-EMB personnel was directly involved in the preparation of this Compliance


    Monitoring Report (CMR); and

    3. I hereby bind myself to answer any penalty that may be imposed arising from any
    misrepresentation or failure to state material information in this CMR REPORT;

    This designation will remain in effect until revoked by written notice.

    IN WITNESS WHEREOF, I hereby set my hand this _____ day of ________________ at


    _____________________________________.

    Engr. Joseph Alain Azagra_____


    NAME OF PROPONENT HEAD
    Operation Manager/Managing Head
    Eco Cycen Corporation

    CONFORME:

    Samuel Lovendino
    Name of Representative
    1002-5372-7874

    SUBSCRIBED AND SWORN to before me this _____ day of _____________________, Affiant


    exhibited to me his/her respective official identifying documents as stated above which are competent
    evidence of identity.

    Doc. No._______
    Page No._______
    Book No._______
    Series of _______

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