Description of the investment project
I. Basic data
1. Name of the investment project, its capacity (extent) and location.
2. Value of the investment/principal of the investment 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 investment project.
6. Expected date of start and completion of the investment project.
7. Is the contract on the investment project for which you request the insurance a part of a project realized by other subject?
8. Has the environmental review (environmental impact assessment) been made of the investment project?
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 investment project?
10. Is there releasing of information on the investment project under way in the country of final destination or will it be in the future (newspapers, radio, TV, posters, internet, etc.)?
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 investment 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 INVESTOR
I declare herewith that:
- 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,
- I have not distorted or withheld anything having influence on the environment review of the investment,
- 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.
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