This application with statements and supplementary documents consists of consecutively numbered pages.

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Abigail Palmer
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1 1 / 7 The Economic s contact person: Correspondence address: Telephone:... Fax.: APPLICATION LETTER FOR ADMISSION TO BARGAINING WITH ANNOUNCEMENT concerning: flue gas duct system for EDF Polska S.A. at Rybnik Plant carried out as bargaining with announcement pursuant to Rules of Preparing and Conducting Contract Award Procedures Based on EU Directive by Companies of EDF Group in Poland valid from , the Rules ) The Contracting Entity: EDF Polska S.A. with its seat in Warszawa, ul. Złota 59 Poland With reference to tender notice published in the Official Journal of the European Union 2014/S of 28/02/2014 (the Contract Notice ), we hereby apply for our company/consortium* being admitted for participation in bargaining with announcement and we hereby submit documents and statements required in the Contract Notice. We hereby accept participation conditions specified in Contract Notice. We hereby have become acquainted and fully accept the rules of the procurement included in the Rules and Contract Notice as well as we recognize them as binding in addition we agree that any possible disputes connected with the Proceedings pursuant to the Rules shall be adjudicated by the arbitration court in accordance with the provisions thereof. This application with statements and supplementary documents consists of consecutively numbered pages. Information provided on page to of the application constitute our business secret within the meaning of the Art. 11 section 4 of the Act of April 16, 1993 on counteracting unfair competition (Journal of Law No. 47 item 211). The authorized persons from our company/consortium* to contact The Contracting Entity s Representative are: [name, phone, ]. In order to confirm that we have fulfilled the conditions specified in the Tender Notice, we are attaching hereto the following documents: 1. General Presentation of Economic s* 2. A statement of compliance with the conditions laid down in Article 9 sec. 3 of the Rules; 3. A statement of the Economic, confirming that: - the Economic, and any of its dominant entities within the meaning of the Accountancy Act dated 29 September 1994 are not and/or are not becoming bankrupt or insolvent, going into liquidation, having a receiving or administration order made against them, compounding with their creditors, or carrying on business under a receiver, trustee or manager for the benefit of their creditors, or any act done or event occurring which (under any applicable laws) has a similar effect to any of these acts or events; and 1

2 2 / 7 - the Economic shall satisfy in due time their payment obligations; - the Economic is not in arrears with payment of taxes, or that they obtained an exemption, deferral or payment in instalments of overdue payments or suspension in whole of the execution of the decision of the competent authority; - against the Economic no judicial decision was issued concerning a ban on application for contract award based on regulations concerning collective entities liability for acts prohibited under penalty; - the Economic is not in arrears with payment of health and social security insurance contributions, or that they obtained an exemption, deferral or payment in instalments of overdue payments, or suspension in whole of the execution of the decision of the competent authority; - the Economic have not been convicted for anything related to their professional integrity and behavior; - the Economic have not committed a serious professional misdeed; - the Economic are not in conflict of interest with the objectives of the Contracting Entity. 4. Recent extract from the commercial register, if separate regulations require registration or the respective foreign documents*; 5. Financial statements or relevant parts of the financial statements for the last 3 (three) business years*; 6. Statement of the bank or savings and loan institution*; 7. Paid-in insurance policy or other respective document*; 8. A table with the list of projects performed properly, in the scope and time frame; 9. Copies of the valid (i) EN ISO9001, (ii) ISO14001 and (iii) OHSAS 18001, or (alternatively) MASE, or (alternatively) VCA - or equivalent certificates*; 10. A table with number of accidents at work and average number of employees separately for each of the last three calendar years; 11. A statement of a third party on granting for the Economic s use all the necessary resources**; 12. A power of attorney*. [Please make sure that all statements and documents were submitted, as required in the Contract Notice.] *) Amend / delete as appropriate **) To be submitted only by the Economic s who rely on resources of other entities under Article 9 item 7 of the Rules 2

3 3 / 7 Enclosure no. 1 GENERAL PRESENTATION OF ECONOMIC OPERATORS* announcement pursuant with the Rules concerning Supply, construction, assembly, commissioning and start-up of a here is to present the following: 1. A General Presentation of the Economic s (for all members if consortium) 2. Economic s main contacts for commercial and technical issues (name, telephone number, mail, address) *) This additional information will not be used to the prequalification evaluation and is not mandatory at this stage of the tender, however would be appreciated 3

4 4 / 7 Enclosure no. 2 STATEMENT ON FULFILMENT OF REQUIREMENTS OF ART. 9 SEC. 3 OF THE RULES* announcement pursuant with the Rules concerning Supply, construction, assembly, commissioning and start-up of a, we hereby certify that we fulfil the requirements for participation in the proceedings under art. 9 sec. 3 of the Rules, relating to: 1. Holding a permission to perform specific work activities or actions, if laws are required by their possession, 2. Having knowledge and experience, 3. Having appropriate technical capacity and personnel capable of performing the contract, 4. Economic and financial situation, 5. Requirements concerning work safety and hygiene in business activity, 6. Reliability and correctness of performance of contracts so far entrusted to the economic operators by any of EDF Group companies in Poland and around the world *) for Economic s jointly applying for the award of the contract, the statement can be filed jointly by the members of the consortium 4

5 5 / 7 Enclosure no. 3 STATEMENT ON NO GROUNDS FOR EXCLUSION UNDER ART. 30 SEC. 1b OF RULES* announcement pursuant with the Rules concerning Supply, construction, assembly, commissioning and start-up of a, we hereby certify that as an Economic * we are not subject to the exclusion from the proceedings under art. 30 sec. 1b of the Rules and other conditions stipulated in the Contract Notice, since: 1. We and any of our dominant entities within the meaning of the Accountancy Act dated 29 September 1994 are not and/or are not becoming bankrupt or insolvent, going into liquidation, having a receiving or administration order made against us, compounding with his creditors, or carrying on business under a receiver, trustee or manager for the benefit of his creditors, or any act done or event occurring which (under any applicable laws) has a similar effect to any of these acts or events; 2. We shall satisfy our payment obligations; 3. We are not in arrears with payment of taxes, or that we obtained an exemption, deferral or payment in instalments of overdue payments or suspension in whole of the execution of the decision of the competent authority. 4. We have not judicial decision was issued concerning a ban on application for contract award based on regulations concerning collective entities liability for acts prohibited under penalty; 5. We are not in arrears with payment of health and social security insurance contributions, or we have obtained an exemption, deferral or payment in instalments of overdue payments, or suspension in whole of the execution of the decision of the competent authority; 6. We have not been convicted for anything related to our professional integrity and behavior; 7. We have not committed a serious professional misdeed; 8. We are not in conflict of interest with the objectives of the Contracting Entity. 9. All documents submitted throughout the tendering process must be regarded as compatible with the original *) to be filed in by each member of the consortium 5

6 6 / 7 Enclosure no. 4 Experience lists announcement pursuant with the Rules concerning Supply, construction, assembly, commissioning and start-up of a here is to certify that: We have necessary knowledge and experience as specified in the Contract Notice to perform the contract: We have performed (as a general contractor or a contractor, or a member of a consortium performing the role of a general contractor or a contractor) over the past 8 years before the deadline for filing applications for participation in the proceedings, at least 2 projects in power generating industry according to European norms and standards (or equivalent), comprising civil works, flue gas ducts prefabrication and assembly piping, structural steel works, electrical installations, and DCS systems with a total value of minimum 7,000, EURO (say: seven million EUR) each. In order to justify the compliance to the above conditions we hereby present the following information: 6

7 page 7 / 7 Table : The list of works performed properly, in the scope and time frame defined above. Project name Start date End date Owner name and contact details Type of industry the works have been performed for Project location Main contractor s name (if the Economic has worked as a subcontractor of a main contractor) Scope of works, description of the scope of works in a short summary 10 lines max Price of the work the Economic was responsible for List of activities subcontracted by the Economic submitting the application Project X Project Y Project Z

INSTRUCTIONS TO ECONOMIC OPERATORS APPLYING FOR ADMISSION TO CONTRACT AWARD PROCEDURE IN A FORM OF BARGAINING WITH ANNOUNCEMENT CONCERNING:

1 OF 24 INSTRUCTIONS TO ECONOMIC OPERATORS APPLYING FOR ADMISSION TO CONTRACT AWARD PROCEDURE IN A FORM OF BARGAINING WITH ANNOUNCEMENT CONCERNING: Design and construction of balance of plant for two gas-fired