INSTRUCTION FOR FORM A OF THE APPLICATION FOR PROVISION OF THE REGASIFICATION SERVICE

Transcription

1 INSTRUCTION FOR FORM A OF THE APPLICATION FOR PROVISION OF THE REGASIFICATION SERVICE 1. Number of the application for provision of the regasification service, hereinafter the Application to be filled out by Polskie LNG S.A., hereinafter Operator. 2. Date of the Application submission to Operator to be filled out by Operator. 3. Please check this field, if you apply for provision of the new regasification service. 4. Please check this field, if modification of an earlier Application is required and indicate the date of such modification in the next field. 5. Please check this field, if you submit the Application to modify the existing regasification agreement (modification of the terms, extension, etc.) and fill out its number and date in the next fields. Information about the Applicant 6. Please provide full legal name of the entity submitting Application, hereinafter referred to as the Applicant. 7. Please provide the registry number confirming the legal entity (e.g. KRS court registration number) or the legal capacity of the Applicant or the number of Business Activity Register of the Applicant. 8. Please provide the REGON number (statistical number) of the Applicant. 9. Please provide the NIP number (tax identification number) of the Applicant. 10. Please provide the address of the registered office of the Applicant in the following fields. 11. Please check this field, if the correspondence address of the Applicant is different than the address of the registered office, and provide the details in the following fields. 12. Please provide the answer by filling out yes or no. In case of a positive answer, next to the yes word please provide the license number and than indicate, which of the licenses indicated in items of the Application the Applicant holds. In case of a negative answer (no) e.g. when LNG re-gasified by Operator is not used by the Applicant to carry out an activity requiring a license, please fill out the addition yes word in item Please check, if the agreement on provision of the transmission service with Transmission System Operator, hereinafter TSO, was/will be entered into by the Applicant or an entity authorized to act on his behalf. If the entity authorized to act on behalf of the Applicant is checked, please provide information about this entity: the full legal name of such the entity, the registry number confirming the legal entity (e.g. KRS) or the legal capacity or the number of Business Activity Register of the Applicant; the REGON number, the NIP number, the registered office address, the correspondence address. Then please fill out the following fields, with the provision, that in case when the field description refers to the Applicant and in the entering (for the agreement entered into or applied for) agreement with TSO the entity authorized to act on behalf of the Applicant, the Applicant is understood as this entity If the Applicant entered into an the agreement on provision of the transmission service with TSO ( The agreement with TSO ) please answer yes. When yes is provided, please do also: check the type of the Agreement entered into with TSO by selecting one of the following: the unconditional Agreement with TSO, the conditional Agreement with TSO the continuous service the intermittent service provide the date of the Agreement with TSO provide the starting date of provision of the transmission service provide the ending date of provision of the transmission service provide the following details included in the Agreement with TSO

2 the reserved transmission capacity (conventional capacity) at the entry item to the transmission system in Świnoujście, the minimal amounts of gaseous fuel that must be provided at the entry item to the transmission system in Świnoujście If the Applicant applied to TSO an application for provision of the transmission service please provide a yes answer. When yes is provided by the Applicant, please do also: provide the date of submission to TSO an application for provision of the transmission services check the type of the proposed Agreement with TSO by selecting from the following: the unconditional Agreement with TSO, the conditional Agreement with TSO provide the proposed starting date of provision of the transmission service provide the proposed ending date of provision of the transmission service provide the following proposed provisions of the Agreement with TSO: the reserved transmission capacity (conventional capacity) at the entry item to the transmission system in Świnoujście, the minimal amounts of gaseous fuel that must be provided at the entry item to the transmission system in Świnoujście If the Applicants plans to submit to TSO the application for provision of the transmission service, please provide a yes answer. When yes is provided, please do also: provide the proposes date of submitting to TSO the application for provision of the transmission service, check the type of the proposed Agreement with TSO by selecting one of the following: the unconditional Agreement with TSO, the conditional Agreement with TSO provide the proposed starting date of provision of the transmission service provide the proposed ending date of provision of the transmission service provide the following proposed details of the Agreement with TSO: the reserved transmission capacity (conventional capacity) at the entry item to the transmission system in Świnoujście, the minimal amounts of gaseous fuel that must be provided at the entry item to the transmission system in Świnoujście. 14. Please provide information about the obligation to posses by the Applicant the storage capacity or the exemption from such the obligation, among the following: The Applicant posses at his disposal the storage capacity in the territory of the Republic of Poland please check a yes or no answer the decision has been issued concerning the dismissal of the Applicant from the obligation to maintain mandatory reserves of natural gas in case such the decision has been issued, please check yes, providing basic information about the decision: the issue date with information if it is legally valid, other the Applicant s crucial rights and obligations emerging from this decision. 15. Please provide the preferred form of the financial security among the following possibilities: a. Cash deposit on a bank account indicated by Operator ; paid back, at the end of provision of the regasification service, together with bank interests at a fixed rate for that account during the deposit, reduces by the costs of running the account and bank transfer costs,

3 b. Irrevocable and unconditional bank or insurance guarantee, issued by financial institutions that hold financial rating no smaller than A or the equivalent to Moody Agency, Standard and Poors Agency or Fitch Agency and approved by Operator, c. Other irrevocable, unconditional financial security form, approved by Operator. The selection of the preferred form of security results in the need to submit a statement about the preferred form of financial security in accordance with this item and according to the formula included in Form D. The security amount will be determined by Operator prior to entering into an agreement with the Applicant in accordance with the provisions of the Terminal Instruction in case of long-term or short-term agreements in the amount equal to the average monthly value of the financial obligations of the Applicant to Operator resulting from the provided regasification service specified on the basis of the regasification agreement or an annual port entry log and assigned contractual capacities, and in the case of a framework agreement, in the amount equivalent to the price of the spot type regasification service of one load of 150 thous. m 3 with the fixed conventional capacity during 30 days. Details of an entity authorised for contacts 16. to 22. Please provide the first name, surname and other required details of a proxy authorized by the Applicant for the regular contacts with Operator regarding the submitted Application. Details concerning the proposed regasification service (RS) 23. Please provide the proposed starting date of provision of the regasification service by Operator. 24. Please provide the proposed ending date of provision of the regasification service by Operator. 25. Please check the type of the agreement for provision of the regasification service that the Applicant intends to enter, among the following: a framework agreement for spot type service only spot for a fixed period up to 1 year short-term for spot type service only for a fixed period 1 year of longer, long-term this item should be checked in case when the agreement referred to in item 25.3 is intended to be entered into and with additional possibility to purchase the spot type service within such the agreement. Delivery details In items (with exemption of item 28 and item 31) for the long-term agreements entered into for the fixed period, please provide information regarding each gas year of the regasification agreement in force, and for short-term agreements information regarding the whole period of the regasification agreement in force. 26. Please provide the proposed conventional regasification capacity (the terminal capacity amounting to 200 thous. m3/h is at the disposal). 27. Please provide the proposed the average regasification capacity. 28. Please provide the proposed total number of deliveries of liquefied natural gas, hereinafter LNG, to the terminal in thous. m3 and MJ/BTU/Mtoe. 29. Please provide the proposed number of LNG deliveries to the terminal in thous. m3 and MJ/BTU/Mtoe: for long-term agreements entered into for a fixed period, please provide information regarding each gas year of the regasification agreement in force, indicating the gas year and amounts in thous. m3 and MJ/BTU/Mtoe during that year; for short-term agreements information regarding the whole period of the regasification agreement in force. 30. Please provide the proposed number of LNG tankers arrivals: during the period of RS agreement: the item should be filled out in case of selecting the long-term agreement from item 25.3 or an agreement from item 25.2.

4 31. Please provide the proposed tankers entry log by filling out Form B. 32. Please provide the technical parameters of the tankers by which LNG will be delivered to the terminal (such as: the tankers length, width, depth and capacity in line with item ). 33. Please provide the following LNG quality parameters: The LNG source of origin The LNG loading port: The LNG chemical composition (please fill out Form C)

5 The demand for additional services 34. Please provide what additional services the Applicant requests the need for, among the following: a. provision of the service of LNG transhipment to road tankers, in case of selecting this service, please specify the proposed LNG amount that is to be transhipped to the road tankers. b. adaptation of the quality parameters of re-gasified gaseous fuel to the requirements of Transmission Network Code in the reduction of the Wobbe index by adding nitrogen. The power change 35. If applicable, please provide the demand of the Applicant for additional regasification powere in every year in m3/h. and in kwh/h (this field to be filled out by the Applicant in case of submitting the application for the modification of agreement on provision of the regasification service). Other crucial information Please check this field, in case of existence of other crucial, according to the Applicant, information that my influence on the accomplishment of provision of the regasification service. Such information should be attached in a separate attachment. Attached documents 37. Please check this field in case when the Applicant attached to the Application the required current extract from Business Activity Register or extract from the appropriate registry confirming the legal personality or the legal capacity. 38. Please check this field in case when the Applicant attached to the Application the required document of the NIP tax identification number granting. 39. Please check this field in case when the Applicant attached to the Application the required document of the REGON statistical number granting. 40. Please check this field in case when the Applicant attached to the Application the documents confirming the rights of entities signing the forms to represent and to incur liabilities on behalf of the Applicant and which rights do not derive from KRS or the extract from Business Activity Register. 41. Please check the appropriate field in case when the agreement with TSO was entered into or is submitted for entering into, in accordance with item 13. In such the case, please provide to the Application the agreement or the extract of the agreement entered into with TSO/the statement or the extract from the statement in the area resulting from item 13 (in case of a copy of the document - confirmed as a true copy by a notary public, legal adviser or solicitor and in case of the extract - a confirmed as a true copy by a notary). 42. Please check the appropriate field in case when the Applicant entered the agreement on provision of LNG. In such the case please attach to the Application the agreement or the extract from the agreement on provision of LNG: the name of the contractor, number and timetable of LNG loadings, duration and the conditions of the agreement termination; the LNG transportation rules (if the transport is performed under a separate agreement, please provide this information as the extract from the separate agreement on the LNG transportation). In case of submitting a copy of the document, the copy must be confirmed as a true copy by a notary public, legal adviser or solicitor, and in case of the extract - a confirmed as a true copy by a notary). 43. Please provide other documents attached to the Application (e.g. other crucial information influencing the accomplishment of provision of the regasification agreement as referred to in

6 item 35 of the Application).Form A must be signed by persons authorised to represent the entity.

7 INSTRUCTION FOR FORM B OF THE APPLICATION FOR PROVISION OF THE REGASIFICATION SERVICE The following information is provided at the top of the form: The name of the Applicant: Please enter the full legal name of the entity submitting the Application (the same as in item 6 of Form A). The number of the Application for provision of the regasification agreement to be filled out by the Operator. The proposed log of LNG tankers arrivals to the terminal will constitute the basis for specifying the framework log of arrivals in the agreement on provision of the regasification service. Description of columns of the table: Table Tankers port entry log 1. Row number 2. Please enter the subsequent gas years of provision of the transmission service. 3. Please enter the size of a single LNG delivery in m Please enter the energy amount of a single LNG delivery in MJ/BTU/Mtoe. 5. Please enter the proposed date of the LNG tanker entry to the terminal broken down by each month. The proposed LNG tankers entry log much define the arrivals of tankers: a. In each month of every gas year for the long-term, fixed period agreements b. For the total duration of the regasification service provision agreement for short-term agreements. Form B must be signed by persons authorised to represent the entity.

8 INSTRUCTION FOR FORM C OF THE APPLICATION FOR PROVISION OF THE REGASIFICATION SERVICE The following information is provided at the top of the form: - The name of the Applicant: Please enter the full legal name of the entity submitting the Application (the same as in item 6 of Form A). - The number of the Application for provision of the regasification agreement to be filled out by the Operator. Description of columns of the table: 1. Row number 2. The LNG component 3. Please enter the individual amounts of individual chemical components in LNG. In case when the Applicant brings LNG from various sources, the table should be completed for each source with a clear indication of the source. Form C must be signed by persons authorised to represent the entity.

9 INSTRUCTION FOR FORM D OF THE APPLICATION FOR PROVISION OF THE REGASIFICATION SERVICE The following information is provided at the top of the form: The name of the Applicant: Please enter the full legal name of the entity submitting the Application (the same as in item 6 of Form A). The number of the Application for provision of the regasification agreement to be filled out by the Operator. Statement on the preferred form of financial security must be submitted with the content included in Form D. In the statement, please enter: in the first empty field: the name of the Applicant: please enter the full legal name of the entity submitting the Application (the same as in item 6 of Form A). in the second empty field: the selected preferred form of the financial security proposed by the Applicant in item 15 of Form A among the forms listed in item 15 of the Instruction for Form A of the Application. Form D must be signed by persons authorised to represent the entity.