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VII.. Inspector Information: <br />The inspections documented in the attached Inspection and Maintenance Checklists were <br />conducted by the following inspector(s): <br />Inspector Name and Title Inspector's Employer and Address <br />VIII. Certification: <br />I hereby certify, under penalty of perjury, that the information presented in this report and <br />attachments is true and complete: <br />Signature of Property Owner or Other Responsible Party Date <br />Type or Print Name <br />Company Name <br />Address <br />Phone number: Email: <br />Page 4 of 13 <br />ATTY/AGR/2019.203/515 CLEVELAND - STMMA EXHIBIT C <br />REV: 07-25-19 DZ <br />