for insurance of a credit extended in relation with investment of Czech legal persons
abroad against the risk of non-payment of the credit
GIC type If
I. Applicant (Insured/Policyholder)
V. Description of project
Brief characteristics of investment intention (intention, current development, prediction, products and services to be generated)
Other sources: (please specify)
Is there a permit from authorities of the host state for establishment of this investment?
The company which is subject of investing is:
Will there be participation of the host state in the company?
Declaration of applicant for insurance
I declare herewith that I am acquainted with General Insurance Conditions "If" and confirm that data entered in this form are truthful, complete and no important data known as on day of submission of this application for insurance have been omitted or withheld.
I obligate myself to inform the insurer without delay on other circumstances and changes related to the requested insurance which could occur after the submission of this application.
I agree to reimburse EGAP for expenses connected with assessment of insurance risk made on the basis of this application even if there was no concluded insurance promise contract or insurance contract; reimbursement will be in the extent of internal price directive of EGAP.
Please attach to the filled-in application:
- business plan of the investment or a feasibility study
- further documentation to assessment of the investment according to the list of EGAP
- extract from the company register of the investor and of foreign company where the investment is to be directed
- questionnaire for assessment of environmental impact of the investment and the declaration of the Investor (Attachment No. 1).
This questionnaire and this declaration are inseparable parts of this application
- Declaration of the Investor on compliance on compliance with legal provisions against bribery in international trade. (Attachment No. 2)