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Attachments to application for conclusion of an insurance contract

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Attachment No.1:
Schedule of invoicing of deliveries and repayment of the supplier credit financed by a bank
(in currency of the Export Contract):
Document evidencing the origination of receivable/s:
Invoicing of deliveries*   Repayment of receivable/s
Date Amount
of principal 		Amount
of interest 		  Date Amount
of principal 		Amount
of interest
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
*state the amount lowered by the value of paid advance payment
Attachment No.2
Declaration of Exporter on share in the value of export
Exporter:
Commercial name:
Company Identification No.:
with seat:
represented by:
declares,
that the share of goods and services of Czech origin in the total value of export1), which is subject to insurance of export credit risks,      at least % from the value of the export which isCZK and
accepts obligation
  • to inform the Export Guarantee and Insurance Corporation (hereinafter "export insurance company") on decrease in the share of goods and services of Czech origin in the total value of the export which has been stated in this declaration in case this decrease would be more than 5 % and to explain reasons for this change,
  • in case the share of goods and services of Czech origin in the total value of the export falls under 50%, to ask the export insurance company for a subsequent approval of the exception,
  • reimburse the export insurance company for damages by an amount equal to the indemnification paid as a result of non-fulfilment of mentioned criteria in case the Exporter has given untruthful data in the above-mentioned declaration or if it has been discovered later that in realization of the Export Contract the above-mentioned share was by more than 5 % lower than the share assumed by the insurance contract.
This declaration is an inseparable part of the application for insurance from ,
submitted 
(Applicant for insurance)
Signature:   .......................................................................................
Full name, signature and position of the person authorized to act on behalf of the Exporter:

Date:
1) the share of the export is calculated according to instruction for calculation of the share of goods and services of Czech origin in the total value of the export which is a part of this Declaration
Instruction for calculation of the share of goods and services of Czech origin in the total value of the export
  1. The share of goods and services of Czech origin has to represent at least 50 % of the value of the export unless stated otherwise below.
  2. Goods and service, which are subject of the export are considered as goods and services of Czech origin if following conditions are fulfilled:
    1. Export Contract has been negotiated by the exporter who is a legal person with seat or a natural person with permanent residence on the territory of the Czech Republic or a foreign company who is controlled by a legal person having its registered seat on the territory of the Czech Republic and participating - directly or indirectly - in the basic capital of the foreign company by more than 50 %, or controlling the majority of voting rights related to the participation in the basic capital of the foreign company, or can appoint a majority of members of the Board of Directors, Supervisory Board or other similar managing body of the foreign company,
    2. goods and services, which are subject of the export are invoiced by the Exporter (defined according to letter a) to a foreign buyer (importer),
    3. a sub-delivery for the export is considered to be Czech if it has been delivered and invoiced to the Exporter by a sub-supplier who is a legal person with seat or a natural person with permanent residence on the territory of the Czech Republic (hereinafter Czech sub-supplier),
    4. sub-deliveries (components, parts, material and such), bought by the Exporter or his Czech sub-supplier from abroad, are considered to be Czech ones only in case the Exporter or his Czech sub-supplier added value to these sub-deliveries in production (it cannot be pure re-export of goods in an unchanged state and the Exporter cannot be a mere trader whose share in the export is made by trade margin only); the Exporter and/or his Czech sub-supplier have to be able to prove (way of proving - e.g. comparison of payment for a sub-delivery with calculation of the final price of product in which the sub-delivery is included),
    5. a sub-delivery from abroad which is a part of the Export Contract and for which EGAP obtained reinsurance from a foreign credit insurance company, has the same character for calculation of the share as Czech sub-deliveries even if it does not comply with criteria under letter d),
    6. in case of insurance of an export credit and if the credit is financed from several sources, the sub-delivery from abroad which is a part of the Export Contract and which is financed without Czech state export support (i.e. without insurance by EGAP or without financing/refinancing by CEB, it has the same character as the Czech sub-delivery for purposes of the calculation even if it does not comply with criteria under letter d),
    7. in case of insurance of a bank guarantee and when the foreign sub-delivery is covered by a counter guarantee, it has the same character as the Czech sub-delivery for purposes of the calculation even if it does not comply with criteria under letter d).
  3. Sub-deliveries bought by the Exporter or his Czech sub-supplier from abroad which do not comply with conditions mentioned under par. 2, are considered for purposes of the calculation of the share of goods and services as foreign sub-deliveries.
  4. Provisions on foreign sub-deliveries according to par. 2 letters d) through g) do not apply on sub-deliveries whichthe Exporter has bought from sub-suppliers in the country of final destination of the export. Such sub-deliveries represent local costs ; extent of insurance with state support for them is restricted by international rules.
Attachment no.3
Questionnaire for environmental review of the export project
Description of the export project
I. Basic data
1. Name of the export project, its capacity (extent) and location.
2. Value (i.e. principal) of the export credit.
3. Possibility of cumulation with other projects.
4. Rationale for the necessity of the project and its localization, containing a summary of considered variants (including also the zero variant) and main reasons (from the point of view of environment, economic aspects, etc.) for their selection and/or refusal.
5. Description of technical and technological solution of the export project.
6. Expected date of start of realization of the export and of its completion.
7. Is the export contract for which you request the insurance of export credit risks a part of a project realized by other subject?
8. Has the environmental review (environmental impact assessment) been made of the export or project the export is a part of?
9. Are there significant non-governmental organizations (NGOs), civic associations, etc., in the country of destination from the aspect of the project, which could have been expected to be interested in dialogue in respect of the environmental review of the project?
10. Is there releasing of information on project under way in the country of final destination or will it be in the future (newspapers, radio, TV, posters, internet…)?
II. Input data
1. Soil (e.g. category, type, class, protection, extent of land requirement).
2. Water (e.g. water source, water consumption).
3. Other raw material and energy sources (e.g. type, source, consumption).
4. Demands for transport and other infrastructure (e.g. need for related constructions).
III. Output data
1. Air (e.g. a summary of sources of pollution, type and extent of emitted pollutants, ways and efficiency of absorption of polluting substances).
2. Sewage water (e.g. a summary of sources of sewage water, quantity of sewage and place of its releasing, released pollutant, sewage water treatment plants and their efficiency).
3. Wastes (e.g. a summary of sources of wastes, classification and quantity of wastes, ways of treating the wastes).
4. Others (e.g. noise and vibrations, radiation, smell and other outputs - a summary of sources, quantity of emissions, ways of their reduction).
5. Additional data (e.g. significant landscape forming and area changes).
IV. Data on present environmental conditions in the area where the export project shall be realized
1. Listing of most important environmental characteristics of the area involved (e.g. the present way of utilization of the locality and its closest surroundings, type of vegetation overlay, specially protected areas, areas of historical, cultural or archaeological importance, densely populated areas, areas strained beyond limits of sustainable burden, old environmental strains and burdens, extreme conditions in the area involved).
2. Characteristics of the present state of environment in the area involved (e.g. air and climate, water, soil, rock environment and natural resources, fauna and flora, ecosystems, landscape, population, material property, cultural monuments).
3. Overall assessment of the present quality of environment in the area involved from the point of view of its sustainable burdening.
STATUTORY DECLARATION OF THE EXPORTER
I declare herewith that:
  1. Facts given in this Questionnaire, during negotiations and in written correspondence related to it have been stated to the best of my knowledge and conscience and that they are true,
  2. I have not distorted or withheld anything having influence on the environment review,
  3. I take note and agree with possibility of reduction or refusal of the indemnification payment in case the insurance loss occurs as a result of breach of conditions arising from the environmental review.
Place and date:
Commercial name and seat of the Exporter:
Signature of the person authorized to act on behalf of the Exporter:  ..........................................................
Name and position:
ILLUSTRATIVE LIST
OF CATEGORY "A" PROJECTS

This list is not exhaustive and contains examples of the types of new and major expansion projects that may be classified as Category A (if production is extended by more than 25 %).

  1. Crude oil refineries (excluding undertakings manufacturing only lubricants from crude oil) and installations for the gasification and liquefaction of 500 tonnes or more of coal or bituminous shale per day.
  2. Thermal power stations and other combustion installations with a heat output of 300 megawatts1) or more and nuclear power stations and other nuclear reactors, including the dismantling or decommissioning of such power stations or reactors (except research installations for the production and conversion of fissionable and fertile materials, whose maximum power does not exceed 1 kilowatt continuous thermal load).
  3. Installations designed for the production, or enrichment of nuclear fuels, the reprocessing, storage or final disposal of irradiated nuclear fuels, or for the storage, disposal or processing of radioactive waste.
  4. Integrated works for the initial smelting of cast-iron and steel; installations for the production of non-ferrous crude metals from ore, concentrates or secondary raw materials by metallurgical, chemical or electrolytic processes.
  5. Installations for the extraction of asbestos and for the processing and transformation of asbestos and products containing asbestos: for asbestos-cement products, with an annual production of more than 20 000 tonnes finished product; for friction material, with an annual production of more than 50 tonnes finished product; and for other asbestos utilisation of more than 200 tonnes per year.
  6. Integrated chemical installations, i.e. those installations for the manufacture on an industrial scale of substances using chemical conversion processes, in which several units are juxtaposed and are functionally linked to one another and which are for the production of: basic organic chemicals; basic inorganic chemicals; phosphorous-, nitrogen- or potassium-based fertilizers (simple or compound fertilizers); basic plant health products and of biocides; basic pharmaceutical products using a chemical or biological process; explosives.
  7. Construction of motorways, express roads and lines for long-distance railway traffic and of airports with a basic runway length of 2 100 metres or more; construction of a new road of four or more lanes, or realignment and/or widening of an existing road so as to provide four or more lanes, where such new road, or realigned and/or widened section of road would be 10 km or more in a continuous length.
  8. Pipelines, terminals, and associated facilities for the large-scale transport of gas, oil, and chemicals.
  9. Sea ports and also inland waterways and ports for inland-waterway traffic which permit the passage of vessels of over 1 350 tonnes; trading ports, piers for loading and unloading connected to land and outside ports (excluding ferry piers) which can take vessels of over 1 350 tonnes.
  10. Waste-processing and disposal installations for the incineration, chemical treatment or landfill of hazardous, toxic or dangerous wastes.
  11. Large2) dams and other impoundments designed for the holding back or permanent storage of water.
  12. Groundwater abstraction activities or artificial groundwater recharge schemes in cases where the annual volume of water to be abstracted or recharged amounts to 10 million cubic metres or more.
  13. Industrial plants for the (a) production of pulp from timber or similar fibrous materials; (b) production of paper and board with a production capacity exceeding 200 air-dried metric tonnes per day.
  14. Peat extraction, quarries and open-cast mining, and processing of metal ores or coal.
  15. Extraction of petroleum and natural gas for commercial purposes.
  16. Installations for storage of petroleum, petrochemical, or chemical products with a capacity of 200 000 tonnes or more.
  17. Large-scale logging.
  18. Municipal waste water treatment plants with a capacity exceeding 150 000 population equivalent.
  19. Municipal solid waste-processing and disposal facilities.
  20. Large-scale tourism and retail development.
  21. Construction of overhead electrical power lines.
  22. Large-scale land reclamation.
  23. Large-scale primary agriculture/silviculture involving intensification or conversion of natural habitats.
  24. Plants for the tanning of hides and skins where the treatment capacity exceeds 12 tons of finished products per day.
  25. Installations for the intensive rearing of poultry or pigs with more than: 40 000 places for poultry; 2 000 places for production pigs (over 30 kg); or 750 places for sows.
  26. Projects which are planned to be carried out in sensitive locations or are likely to have a perceptible impact on such locations, even if the project category does not appear in the above list. Such sensitive locations include National Parks and other protected areas identified by national or international law, and other sensitive locations of international, national or regional importance, such as wetlands, forests with high biodiversity value, areas of archaeological or cultural significance, and areas of importance for indigenous peoples or other vulnerable groups.
1) The Working Party on Export Credits and Credit Guarantees agrees that the terms "a heat output of 300 megawatts" shall be interpreted as "usually equivalent to a gross electrical output of 140 MWe for steam and single cycle gas turbines power stations".
2) As per the definition of the International Commission on Large Dams (ICOLD). ICOLD defines a large dam as a dam with a height of 15 m or more from the foundation. Dams that are between 5 and 15m high and have a reservoir volume of more than 3 million m3 are also classified as large dams.
Attachment No.4
Declaration of the Exporter on compliance with legal provisions against bribery in international trade.

Insurance of export credit risks with state support cannot be given to exports which were negotiated by way of bribery in international trade in the sense of the § 160 and subsequent of the Criminal Code. For these purposes, I declare on behalf of our company and on behalf of persons representing our company that there has been and there will be no breach of rules against bribery in international trade 1). In this relation I further declare that persons acting on behalf of our company or representing our company were not charged by the criminal offence of bribery and they had not been convicted of such criminal offence in last 5 years. Furthermore, I declare that that our company has not been mentioned in the publicly accessible debarment list of the World Bank Group.

I accept that the insurer has the right to verify truthfulness of the above-mentioned declaration and obligate myself to submit all information and documentation the insurer may request in this regard.

I am aware of my obligation according to Art. XIII letter j) of the GIC Cf to reimburse the insurer for material damage incurred by indemnification to a beneficiary in case I, or a person acting for me or on my behalf should breach norms and practices of international law binding for the Czech Republic.1)

Commercial name of the Exporter and Seat:
Name and position:
Place and date:
Signature of a person authorized to act on behalf of the Exporter:   ...........................................................
1) Communication of the Ministry of Foreign Affairs No. 25/2000 Coll. of international treaties) on acceptance of Convention on Combating Bribery of Foreign Public Officials in International Business Transactions (part 13/2000 of the Collection of international treaties circulated on March 29, 2000).
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