Document No.: [Unique ID]
Date of Issue: [Date]
Client Name: [Formal Name]
Project Description: [Project Name]
Project Location: [Address]
Total Contract Amount: [$Value]
Start Date: [Date]
Estimated Completion Date: [Date]
Date of Claim Submission: [Date]
Detailed Description of the Issue:

Supporting Evidence Provided:

☐ Photos
☐ Videos

I hereby request the execution of the guarantee as outlined in this certificate.

Client’s Signature: ____________________________

Date: ___________________