Certificate of structural adequacy

2.0 - Site details
Venue name
Venue address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please attach drawings of all structural details (if required) as a separate document

Cancelof
Details of any structures at the venue for which you are not responsible

4.0 - Declaration
I hereby certify that the structures and installations (as described below) at the undermentioned site have been inspected by me. I certify the structures and installations to be safe, that it/they is/are structurally adequate for their intended use and that it/they comply with the manufacturer’s installation/erection specifications.

First NameLast Name
Date

DayMonthYear
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2.0 - Site details