Document No.

AO7-001-220608-01
Declaration Form Effectivity

Paid Pop-up Revision No. 1

Page No. 1

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1. MERCHANT INFORMATION
Name of company: Personal Business Website/Social Media Accounts:

Contact Oliver C. Cruz Mobile:

Person # 1 09274139413
Email:
[email protected]
Contact Diana C. Cruz Mobile:
Person # 2 09171199899
Email:
[email protected]
Note: Please attach to this form the IDs of contact persons.

2. ABOUT THE POP-UP

Type of business (check what applies):
[/ ] Food and beverage
[ ] Non-food
[ ] Others. Please specify the products/services that your business offers:
Note: Please attach the photos of your kiosk and products to this form. Kindly send photos of the
front, back, and sides of your kiosk.

2.1. Location
Proposed location(s):
1. Back of ECJ Building
2.
3.
Space requirement in sqm (to be used for the computation of rental charges):PHP 750/4sqm/day

2.2. Work Schedule

Date Start Time End Time
Ingress January 29, 2024 8:00 am 5:00 pm
Activity Proper January 29, 2024 8:00 am 5:00 pm
Egress January 29, 2024 8:00 am 5:00 pm
2.3. Equipment (Please properly indicate the electrical requirement for the assessment of electrical
charges)
No Item/Description Brand Quantity Watts
Electric Fan Asahi 1 55w

TO BE ACCOMPLISHED BY IA ELECTRICIAN

This is to certify that i have reviewed and approved the electrical requirement of the pop-up activity

____________________________ _________________
Name of Electrician Date
2.4. People
Name of overall director or manager to be present on-site:
1. Oliver C. Cruz
 Document No. AO7-001-220608-01
Declaration Form Effectivity

Paid Pop-up Revision No. 1

Page No. 2

2. Diana C. Cruz
List of other staff to be present on-site:
1. Ana Luisa Mandi
2. Marilyn Simbol Paraiso
3. Melecio De Vera

3. PREFERRED MODE OF PAYMENT (At least 3 days before your schedule)

[ ] Paymaya
[ ] Landbank (over-the-counter cash deposit)
[ /] Walk-in at IA Office

The Intramuros Administration shall accept full payment of the necessary fees through the available payment
platforms within and no later than 24 hours upon issuance of the IA order of payment. Unless justified, non-
payment within the said period will mean cancellation of the reservation.

WAIVER OF LIABILITY

The undersigned hereby acknowledge and agree that they understand the nature of the pop-up activity; that
the person/s stated above is/are qualified, in good health, and in proper physical condition to work therein; that
there are certain inherent risks and dangers associated with the ingress/egress/pop-up activity proper; and that,
except as expressly set forth herein, they, knowingly and voluntarily, accept, and assume responsibility for, each
of these risks and dangers, and all other risks and dangers that could arise out of, or occur during,
ingress/egress/pop-up activity proper.
Further, the undersigned and the organization/entity it represents, as well as all the person/s stated above
hereby RELEASE, WAIVE, DISCHARGE, AND AGREE NOT TO SUE THE INTRAMUROS ADMINISTRATION
and its member institutions, or any subdivision thereof, and each of them, their officers and employees, (for
brevity the “Administration”), any and all liability, claims, demands, actions and causes of action whatsoever
arising out of or related to any loss or damage, personal injury, accident or illness (including death), and/or
property loss, however, caused, arising from, or in any way related to, involvement of the person/s above during
ingress/egress/pop-up activity proper, that may be sustained by me and the person/s stated above, or to any
property belonging to me, while doing a transaction with the Administration.
In signing this form, I acknowledge and represent that I HAVE READ THE FOREGOING WAIVER OF
LIABILITY, UNDERSTAND IT AND SIGN IT VOLUNTARILY as my own free act and deed; no oral
representations, statements, or inducements, apart from the foregoing written agreements have been made; and
I EXECUTE THIS RELEASE FOR FULL, ADEQUATE AND COMPLETE CONSIDERATION FULLY INTENDING
TO BE BOUND BY SAME.

Oliver C. Cruz January 29, 2024

______________________________________________________ __________________________
PRINTED NAME AND SIGNATURE DATE

Other Terms

1. RENTAL FEE - The rental fee is SEVEN HUNDRED FIFTY PESOS per 4 square meters per 8-hour day
(PHP750.00/4sqm/day), exclusive of actual utility consumption and other fees to be computed by the Business
Management Division (BMD), if applicable.

2. For areas/locations without electrical provision, the client is required to provide their own generator set at their
own expense, should they need a power supply.

3. The rate of electricity consumption is Php 15.00/kwh.

4. CHANGE OF SCHEDULE OR LOCATION AND/OR POSTPONEMENT - In case of transfer of schedule or

location and/or postponement, the client is required to submit a signed letter personally or through email. The letter
must be submitted not later than five (5) days before the actual date of the pop-up activity with complete details
such as the reason for rescheduling and new date of the pop-up, etc.
 Document No. AO7-001-220608-01
Declaration Form Effectivity

Paid Pop-up Revision No. 1

Page No. 3

5. CANCELLATION - In case of cancellation or non-usage of the area for any reason whatsoever, the client is
required to notify the agency in writing to be submitted personally or through email not later than five (5) days
before the date of the pop-up..

6. REFUND - For a full refund of rental fees, cancellation must be made not less than five (5) days prior to the pop-
up activity date. 50% refund - if cancellation is made less than five (5) days prior to the pop-up activity date. No
refund will be given if cancellation is made within 24 hours prior to the pop-up activity date.

7. The client is allowed to enter the premises subject to the presentation of this ACCOMPLISHED AND
APPROVED form signed by IA..

8. COOKING IS STRICTLY PROHIBITED ON THE PREMISES. Only food warming is allowed. Usage of huge
LPGs, flammable goods, combustible articles, or any other articles which may expose the Subject Property to fire
is prohibited.

9. Use of drone cameras and/or fireworks is subject to the approval of IA and subject to the presentation of separate
permits issued by the government agencies concerned. Application is through the IA-Urban Planning and
Community Development Division. Copies of the permits shall be emailed to the Business Management Division
at ([email protected]) one (1) day before the scheduled pop-up otherwise the use of fireworks and/or
drone cameras shall not be allowed.

10. Clients shall be held responsible for any damage caused by the client, its employees, agents, merchants,
concessionaires, and representatives, to the facilities of the Intramuros Administration as well as the protection of
the general public. Nailing and mounting of props or any materials to the walls and ceilings are not allowed. For
the protection of the general public, it is also prohibited to obstruct doorways, staircases, corridors, emergency
exits, and similar passages.

11. Clients shall properly observe cleanliness on the premises and be responsible for keeping the place clean and free
of equipment, furniture, and props after the pop-up activity. Clients shall provide sufficient garbage bags for waste
materials and food wastes for disposal.

12. Clients should be properly dressed and at no instance will they be allowed to work in kamiseta, shorts, slippers, or
other similar forms of improper attire. They should at all times wear their IDs and uniforms during the function.

13. Clients should at all times be courteous and cooperative in dealing with the maintenance crew of the Intramuros
Administration who are assigned to the leased premises.

14. Washing of dishes and utensils will only be allowed in the designated area/s.

15. Bringing in pets is allowed as long as they are on a leash and subject to IA guidelines.

16. The Intramuros Administration will not be held liable for the unavailability of the premises because of fortuitous
or manmade pop-up activity beyond the control of the Intramuros Administration.

17. In case of brownout, the client shall provide their own generator at their own expense for all areas. Only minimal
lighting and houselights will be provided by IA.

18. Engaging in any illegal activity such as but not limited to any form of gambling, drug use and/or sale, etc, is
prohibited in the premises and will be dealt with in accordance with the law.

19. The client shall strictly follow all health and safety protocols issued by the government to avoid the spread and
contamination of Covid-19.

20. Any client found violating the foregoing guidelines will be banned by the Intramuros Administration.

I agree:
 Document No. AO7-001-220608-01
Declaration Form Effectivity

Paid Pop-up Revision No. 1

Page No. 4

January 29 , 2024
Oliver C. Cruz
________________________________________ ______________________
PRINTED NAME AND SIGNATURE DATE

-------------------------------------------------------------------
TO BE ACCOMPLISHED BY IA

ASSESSMENT OF FEES

PARTICULARS UNIT COST TOTAL

Space rental PHP 750.00/ 4 sqm X DAYS PHP

Electricity PHP 15.00 X KWH X HRS X PHP

DAYS

Water

Others

TOTAL PHP

PROOF OF PAYMENT

Date of Payment

Official Receipt Number

INTRAMUROS ADMINISTRATION

APPROVED / DISAPPROVED

_____________________________________
RODA V. MENDOZA
Chief, Business Management Division DATE