Your ref : [Insert Building Permit Application Number]

Date : [Insert Date]

[Name of submitting Company or Letterhead]

[Company address]
[Company contact details including phone, facsimile and email]

TO: Dubai Municipality Building Department

Dear Sirs

Green Building Declaration

By means of submitting this letter to Dubai Municipality, I/we hereby commit [insert company
name] to meeting the full requirements of the Dubai Green Building Regulations. This commitment
without exception applies to the permit application and building design, working practices during
construction and the specification of the final building.
Should any specification, feature, fitting, structural element or building service not comply with the
Green building Regulations, I/we accept that a building completion will not be issued until full
evidence of compliance is demonstrated to Dubai Municipality.
It is understood that failure to comply with the regulations may also result in a fine or other penalty.
The Municipality will have the final decision on all matters.

Yours sincerely,
[Insert signature of authorised personnel]

[Company Stamp required]