Access application for the transportation of natural gas in the transmission system of the Republic of Latvia. On 201 No. /Place of preparation/

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Martha Pitts
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1 1 Access application for the transportation of natural gas in the transmission system of the Republic of Latvia Annex 1 to the Regulations of use of Natural Gas transmission system of the Joint-Stock Company Latvijas Gāze On 201 No. /Place of preparation/ Addressee: Applicant: Joint-Stock Company Latvijas Gāze (hereinafter referred to as the Storage Facility operator) Operational section Gas transport, Stigu Street 14, Riga, LV-1021, Latvia. Registration No.: Legal address: On the basis of the information regarding free capacity of transmission capacity published on the website of the Joint-Stock Company Latvijas Gāze as the transmission system operator (hereinafter referred to as PSO), pursuant to the Regulations of Use of Natural Gas transmission system of the Joint-Stock Company Latvijas Gāze (hereinafter referred to as the Regulations) and the Standard contract, we, undersigned, hereby certify that (hereinafter referred to as the Applicant) would like to purchase natural gas transmission system services in the transmission system of the Joint-Stock Company Latvijas Gāze at such a volume: accumulate and storage of natural gas complying in terms of quality to Latvian National Standard LVS 459:2014 Combustible gases. Gas properties, parameters, quality assessment. in Inčukalns Underground Gas Storage Facility of the Joint-Stock Company Latvijas Gāze (hereinafter referred to as the Storage Facility) and delivery therefrom at the following volume and within the following time limits: Item Month 1 January Nominated volume of accumulation m 3 (20 C; Pa) Transportation route Entry point Exit point

2 2 February 3 March 4 April 5 May 6 June 7 July 8 August 9 September 10 October 11 November 12 December TOTAL We hereby certify that, if our application will be accepted, the Applicant will conclude a contract regarding use of the transmission system services (hereinafter referred to as the Contract) 1

3 2 within the time limit set by the Regulations and make payment for the use of the transmission system services within the time limit, according to the procedure and at the volume set by the Contract. We undertake to submit to PSO of the Republic of Latvia the schedule of natural gas transportation volume by months and in distribution by days coordinated with PSO of the Republic of Lithuania and PSO of the Republic of Estonia. We agree that, taking into consideration technical capabilities of transmission system or Latvia, PSO shall be entitled to change nominated accumulation volume by months, as well as our submitted natural gas transportation schedule. Information on the Applicant s responsible person to be providing negotiations with PSO regarding all matters related to this access application, including conclusion of the contract:. (name, surname, position, contacts (phone, , fax)) Information on whether the Applicant can/cannot be considered a company related to the Joint-Stock Company Latvijas Gāze within the meaning of the Law on Enterprise Income Tax. Information on whether the Applicant is/is not registered in a state, with which the Republic of Latvia has concluded a Convention on the elimination of double taxation and tax evasion. Upon signing of this access application the Applicant certifies that the Applicant s access application shall be in force up to 201 and that PSO may assign to the Applicant the capacities of the transmission system specified in this access application at any time, to propose update of the capacities of the transmission system specified in this access application and/or periods of use of the transmission system services, as well as to refuse access to the free capacity of the transmission system in cases specified in the Regulations. Annexes: 1 Current certification issued by the Lursoft database of companies on the Applicant or an extract from the Register of Enterprises of the state of residence of the

4 Applicant or equal registers pursuant to the regulations of the state, where the Applicant was established; 2 A copy of decision adopted by the Register of Enterprises confirming the representation rights of the executive institution of the applicant or a procuration or corresponding authorization confirming the rights of the representative of the applicant to submit the access application; 3 A certification issued by a tax authority of a competent state confirming that the applicant has no tax debts in Latvia and its state of residence, including debts of compulsory State social insurance contributions exceeding in total 150 euro in each state issued not earlier than 20 days prior to the day of submission of the access application); 4 A certification issued by the Register of Enterprises of the Republic of Latvia or the Register of Enterprises of the state of residence of the applicant or equal registers not earlier than 20 days prior to the day of submission of the access application confirming that no 2

5 3 insolvency proceedings of the applicant have been declared, no economic activity thereof has been suspended or discontinued, no legal proceedings have been initiated regarding the bankruptcy of the applicant, and it may not be determined that the applicant would be liquidated before the expiry of the foreseeable deadline of the execution of contract; 5 A copy of value added tax (hereinafter referred to as VAT) payer s certificate, certified according to the procedure provided by regulatory enactments. If the Applicant shall be registered as a VAT payer in several Member States of the European Union, a copy of registration certificate must be attached for the VAT payer s registration number, which the Applicant has planned to use for transactions related to natural gas transportation services. (Documents issued by institutions of the state of residence of an applicant, which is not registered by the Commercial Register of the Republic of Latvia, shall be submitted by the applicant accompanied by a translation into the official language certified according to the procedure provided by the Cabinet of Ministers or by notary public.) (Signature and position of the representative (-s) of the Applicant) 3

ACCESS APPLICATION. On 201 No. /Place of preparation/ Applicant:

ACCESS APPLICATION. On 201 No. /Place of preparation/ Applicant: 1 1 ACCESS APPLICATION Annex 2 to the Regulations of use of Inčukalns Underground Gas Storage Facility of the Joint-Stock Company Latvijas Gāze On 201 No. /Place of preparation/ Addressee: Applicant: Joint-Stock