![](media/image1.wmf)**[Fact Sheet]{.smallcaps}**

[**Project Finance - Eligibility Of Costs**]{.smallcaps}

Eligibility of costs for Ex-Im Bank\'s support of limited recourse
project finance (\"Project Finance\") transactions generally tracks the
overall criteria developed and used for other Ex-Im Bank programs.
However, eligibility guidelines for Project Finance cases require
further explanation since the coverage requested under these cases
brings into focus cost categories and eligibility issues that are only
occasionally seen in other Ex-Im Bank programs.

The following explains the various Ex-Im Bank cost eligibility
guidelines as they pertain to Project Finance cases. The criteria
underlying these guidelines are based on assessments of whether the
respective cost categories satisfy the two objectives of 1) consistency
with Ex-Im Bank\'s policies, and 2) the flexibility required to
appropriately support Project Finance cases. Ex-Im Bank\'s Engineering
and Environment Division, with input from the Project Finance Division,
determines the eligibility of the various costs associated with a
specific project. Actual [support]{.underline} determination is always
subject to the receipt of proper supporting documentation (invoices,
Supplier\'s Certificates, etc.) by Ex-Im Bank\'s Credit Administration
Division during the disbursement stage of the transaction.

In order to determine the support available for a given transaction, the
total project cost *must* first be broken down according to major items
in a form acceptable to Ex-Im Bank. *An example of an acceptable Project
Cost Breakdown is provided as Attachment \"A\".* Before Ex-Im Bank will
consider an application for a final commitment, the Project Sponsors
must submit a U.S. Acquisition List satisfactory to Ex-Im Bank setting
forth the U.S. and eligible foreign costs of all the U.S. items of the
particular project. *An example of a U.S. Acquisition List is provided
as Attachment \"B\".*

There are seven major guidelines used to determine the eligibility of
costs associated with various elements of Project Finance transactions:

-   [Foreign Content]{.smallcaps}

-   [Reach-Back]{.smallcaps}

-   [Related Parties]{.smallcaps}

-   [Capital Cost]{.smallcaps}

-   [Contingencies]{.smallcaps}

-   [Local Cost]{.smallcaps}

-   [Progress Payments]{.smallcaps}

    The guidelines and the manner in which they are applied are
    explained as follows:

    EBD-P-03 May 2001

    **I - [Foreign Content Guidelines]{.smallcaps}**

    Foreign Content guidelines for Project Finance transactions follow
    an "aggregate\" approach. To be eligible for support, goods and
    ***s***ervices in a U.S. supply contract must be shipped from the
    United States to a foreign buyer.

    Ex-Im Bank will finance either 85 percent of the net Contract Price
    , or 100 percent of its U.S. Content (U.S. Contract Price less
    Eligible Foreign Content), whichever is less. The amount eligible
    for Ex-Im support will be aggregated on a contract by contract

    **[II - \"Reach-Back \" Guidelines]{.smallcaps}**

    Shipments of goods and services that occurred prior to the
    submission of a final commitment request to Ex-Im Bank may be
    eligible for Ex-Im Bank financing provided the shipments occurred
    within one of the following allowable time frames:

    1\. On or after the date Ex-Im Bank issued the original Letter of
    Interest for the transaction;

    2\. On or after the date Ex-Im Bank received the initial request for
    Preliminary Commitment for the transaction;

    3\. Up to 12 months prior to the date Ex-Im Bank received the final
    commitment application or insurance application for the transaction.
    The maximum reachback period is the earliest of the three above
    dates.

    Where required by the OECD Arrangement, repayment terms would be
    shortened to accommodate a long reachback.

    **[III - Related Parties Cost Guidelines]{.smallcaps}**

    Most Project Finance transactions contain elements of costs for
    services or products provided by a U.S. supplier which also has
    ownership in the project. Ex-Im Bank provides support for such costs
    as long as there is evidence that the sale in question was
    negotiated and administered on an \"arms-length\" basis. When
    parties to a contract are related to one another, Ex-Im Bank will
    presume that the contract is not arms-length.

    In determining cost eligibility of a related party\'s contract, the
    sponsor or supplier may first be asked to provide evidence that the
    contract was negotiated on an arm\'s-length basis. It can usually be
    assumed that if the percentage of ownership between a supplier and
    buyer is not a controlling one, a negotiated sale may be
    arms-length. However, *when the ownership percentage is close to or
    greater than 50 percent, Ex-Im Bank\'s Engineering and Environment
    Division will review each cost element of a contract to determine
    which can be considered arms-length for purposes of Ex-Im Bank
    support.* Factors taken into account in the Ex-Im Bank determination
    include whether or not offers from other suppliers were solicited
    (thereby introducing competition), whether separate divisions of the
    company negotiated the contract on an independent basis, and whether
    the costs involved reflect market prices.

    *Fees including \"development fees\" charged by a sponsor having
    ownership in a project are not considered eligible for Ex-Im Bank
    support*. In certain instances, however, if a cost breakdown of such
    a fee shows that it covers the cost of certain project related
    services subcontracted to a U.S. company, the Engineering and
    Environment Division will review the costs to determine their
    eligibility for inclusion in the Ex-Im Bank supported portion of the
    project. For example, the cost reflecting an actual invoiced amount
    for engineering services subcontracted to a U.S. company and
    undertaken within the Reach-Back period, represents an element of a
    fee which may be eligible for Ex-Im Bank support.

    Engineering services undertaken directly by a sponsor may also be
    considered eligible when factors including competitive pricing
    elements and inter-company contractual controls of the service costs
    are evident. While certain bona fide sponsor incurred costs (such as
    the salaries paid for the undertaking of required project services)
    may be eligible for support, actual fees associated with
    [any]{.underline} related party\'s contract are not eligible for
    Ex-Im Bank support.

    **[IV - Capital Cost Guidelines]{.smallcaps}**

    This straightforward guideline reflects the fundamental policy that
    Ex-Im Bank will limit its support of Project Finance transactions
    (as it does for all project related transactions) to only those
    items deemed to be \"capital cost\" in nature. This means that
    pre-development costs incurred at the project definition stage, as
    well as costs incurred after the project is operational, such as
    operations & maintenance (O&M) activities, will not be considered
    eligible for Ex-Im Bank financial support. Working capital costs are
    also considered ineligible for support. Only those capital cost
    items, such as equipment and services covered under an engineer,
    procure and construct contract (EPC), legal, financial and
    engineering services associated with the undertaking of the project,
    and items such as training and insurance during construction will be
    considered eligible for Ex-Im Bank support. Refer to the Sample
    Acquisition List, Attachment B, for examples of eligible capital
    cost items.

    The costs of all pre-construction activity must be itemized so that
    Ex-Im Bank can establish whether they constitute a capital cost
    eligible for Ex-Im Bank support. Specific costs incurred in the
    project development stage may be considered eligible if Ex-Im Bank
    determines that a) they were incurred on an arms-length basis, b)
    fall within the established Reach-Back period, and c) relate to
    final design, construction and related activities such as
    acquisition of permits or finalization of financial support.
    Investments made by sponsors to cover preliminary studies regarding
    the viability or feasibility of a project, especially related to
    decisions of sponsor participation, are not considered capital in
    nature.[^1] (Usually such costs will have been incurred well before
    the established Reach-Back date.) Similarly, post-completion
    operating expenses should be met with project revenue, and will not
    be considered eligible for support.

    **[V - Contingency Cost Guidelines]{.smallcaps}**

    Generally, amounts for contingencies associated with EPC contracts
    or major supply contracts which do not exceed 10 percent of the
    total contract price, will not be questioned by Ex-Im Bank at the
    application stage and thus will be considered eligible. However,
    prior to any Ex-Im Bank disbursement, these amounts will be reviewed
    by the Engineering and Environment Division to ascertain whether
    they are technically appropriate and necessary to successfully
    complete the project. Also, input from the Lender\'s Independent
    Engineer will be used in the determination. Contingency related
    items must also be fully described and are subject to the other
    eligibility criteria described in this paper. In no case will
    disbursements be made for an unused contingency.

    Only those contingencies associated with eligible project supply
    contracts will be considered for financial support by Ex-Im Bank.
    The appropriateness of the request, and the nature of the project
    and related project risks will always be the principal factors by
    which Ex-Im Bank will determine the eligibility at the application
    stage of a contract contingency allowance.

    *Ex-Im Bank considers \"Owner\'s Contingencies\" as an element of
    the equity portion of a project, and hence ineligible for financial
    support.* Contingencies associated with related party contracts will
    be reviewed on a case-by-case basis to determine eligibility.

    **[VI - Local Cost Guidelines]{.smallcaps}**

    Ex-Im Bank will generally support eligible local costs to an amount
    of up to 15 percent of the U.S. Contract Price associated with the
    project. This support is in addition to the normal support of 85
    percent of the U.S. Contract Price. To be eligible for Ex-Im Bank
    support, the local costs must represent goods and services produced
    and procured within the host country ***and*** must be included in
    the Export Certificate.

    **[VII - Contract Progress Payment Guidelines]{.smallcaps}**

    Progress payments (and construction \"milestone payments\") made
    under the terms of an EPC or other supply contract, are generally
    eligible for Ex-Im Bank support to the extent that the supplier can
    certify that the accrued costs for actual work performed under the
    contract, including expenses for any subcontracted equipment, are at
    least equal to the value of the respective progress payment. A
    certification that the value of the progress payment does not exceed
    the costs incurred by the supplier to date must accompany any
    request for a progress payment disbursement. Similarly,
    disbursements for initial down payments will only be made once the
    supplier can certify to Ex-Im Bank that actual expenses associated
    with the work performed are equal to the value of the requested
    disbursement. The Lender\'s Independent Engineer may be required to
    confirm the level of work performed. Ex-Im Bank disbursements may
    not serve as general working capital for the supplier.

    In cases where the requested progress payments exceed 60 percent of
    the value of the export before it is shipped, the Engineering and
    Environment Division will advise the Credit Administration Division
    as to whether any further disbursements should be made until such
    time as the product is actually delivered. The Engineering and
    Environment Division will review the payment terms of the major
    project supply contracts, especially the EPC contract, and will
    advise the U.S. supplier if it appears that the progress payment
    schedule conflicts with Ex-Im Bank requirements, as described above.

    .

    **[More Information]{.smallcaps}**

    **Headquarters**

    Internet [http://www.exim.gov](http://www.exim.gov/)

    U.S. Toll Free Number (800) 565-EXIM

    Worldwide Number (202) 565-3946

    Project Finance (202) 565-3690 Fax (202) 565-3695

    TDD (202) 565-3377

    E-Mail <structuredfinance@exim.gov>

    [bdd@exim.gov]{.underline}

    Order User's Guide (800) 565-EXIM, ext. 3912

    Seminars (800) 565-EXIM, ext. 3912

    **Regional Offices**

    Northeast - New York (212) 809-2650 Fax (212) 809-2646

    Mid-Atlantic - Washington, DC (202) 565-3940 Fax (202) 565-3932

    Southeast - Miami (305) 526-7436 Fax (305) 526-7435

    Midwest - Chicago (312) 353-8081 Fax (312) 353-8098

    Southwest - Houston (281) 721-0465 Fax (281) 679-0156

    West - Long Beach (562) 980-4580 Fax (562) 980-4590

    *Satellite -* San Francisco, CA (415) 705-2285 Fax (415) 705-1156

    *Satellite -* Orange County, CA (949) 660-1688 ext. 150 Fax (949)
    660-8039

    Attachments

    **EXPORT-IMPORT BANK OF THE UNITED STATES**

    **EXPORTER\'S CERTIFICATE For Use With An EXPORT CREDIT INSURANCE
    POLICY**

    Policyholders/Assignees must keep this document and submit it with
    Claims

    Name and Address of Policyholder: Name and Address of Supplier if
    different from Policyholder:

    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
    Taxpayer ID No.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Congressional
    District:\_\_\_\_\_\_\_\_\_

    Policy No.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
    Supplier\'s Dun & Bradstreet No.
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

    (to be completed by policyholder, also see B3)

    Indicate (not required) if owned by a woman, or an ethnic minority,
    describe\_\_\_\_\_\_\_\_\_\_\_\_

    Upon representation that the Export-Import Bank of the United States
    (\"Eximbank\") has issued an export credit insurance policy to the
    policyholder (may also be the supplier) identified above and, in
    consideration of the payment, acceptance or negotiation of an
    irrevocable letter of credit in support of an export, the financing
    of an export or the receipt of funding as a result of assigning the
    proceeds of the policy **we, the supplier, hereby certify** to
    Eximbank and, if we are not the policyholder, to the policyholder as
    follows **(check one)**:

    The supplier is **not the policyholder** and is either the
    beneficiary of a letter of credit, or the recipient of a funding
    under a direct buyer credit loan, or the recipient of the buyer\'s
    payment under a reimbursement loan, or the financing or factoring of
    a receivable under a Financial Institution Supplier Credit Policy.

    The supplier must complete and certify to parts **A and B** only.

    The supplier is **not the policyholder** and **not a beneficiary**
    or recipient as described above.

    The supplier must complete and certify to part **B** only.

    The supplier is a Medium Term Single-Buyer Policyholder and is
    **assigning** the proceeds of the policy to a financial institution.

    The supplier must complete and certify to parts **A, B and C.**

    **A**

    **1**. a. We are **not the policyholder** and the policyholder has
    **(check one)**:

    informed us of an irrevocable letter of credit with Identification
    No.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ and we
    have presented, or shall present, documents which are in compliance
    with the terms and conditions of such irrevocable letter of credit;
    or,

    to our belief, established an obligation of the foreign buyer named
    below to make repayment of funds on a specified term in support

    of an export for which we will receive payment or have received
    payment on (date); or,

    to our belief, provided a financing facility to the foreign buyer
    named below in support of the export which has been made on a
    documentary collection, sight payment basis, the proceeds of which
    will be paid to us.

    **OR**

    b\. We **are the supplier and policyholder** and have:

    assigned the proceeds of the referenced policy, and in return for
    this assignment will receive payment or have received payment on

    (date).

    **2**. To the best of our knowledge and belief, the products were
    **shipped from the U.S.**

    **3**. To the best of our knowledge and belief the products are
    **for use only in** countries in accordance with Ex-Im Bank's
    [Country Limitation]{.underline} [Schedule]{.underline} in effect on
    the date of shipment. See Ex-Im Bank's Internet Website
    \<[www.exim.gov](http://www.exim.gov/)\> Country and Fee
    Information.

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-   The undersigned declares that it **is not** currently, nor has it
    been within the preceding three years:

    a\) debarred, suspended or declared ineligible from participating in
    any Federal transaction; or,

    b\) formally proposed for debarment, with a final determina­tion
    still pending; or,

    c\) voluntarily excluded from participation in a Federal
    transaction; or,

    d\) indicted, convicted or had a civil judge­ment rendered against it
    for any of the offenses listed in the Regulations governing
    Debarment and Suspension (Governmentwide Nonprocurement Debarment
    and Suspension Regulations; Common Rule).

    **5.** The undersigned certifies that it is **not delinquent** on
    any amounts due and owing to the U.S. Government or its agencies or
    instrumentalities as of the date of execution of this certification.

    **B**

    **1**. The above referenced irrevocable letter of credit or the
    buyer\'s obligation to pay the policyholder is in support of an
    export transaction described as follows:

    a\) Name and address of
    buyer\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

    b\) Description and quantity of
    product(s)/service(s)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ c)
    The product(s) are: New, Used. If used, attach Used Equipment
    Questionnaire form EIB-92-63.

    d\) Place of
    Shipment\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ e)
    Date of
    Shipment\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ f)
    Contract Price to Buyer:

    \(i\) Products/Services \$\_\_\_\_\_\_\_\_\_\_

    \(ii\) Less discounts or similar allowances \$\_\_\_\_\_\_\_\_\_\_

    \(iii\) Plus total insurance, freight or other

    delivery charges included in the transaction \$\_\_\_\_\_\_\_\_\_\_

    Subtotal: \$

    POLICYHOLDER NOTE: minimum 15% cash payment required for repayment
    **terms of 1 year or more**.

    SUPPLIER who is not a policyholder: may enter N/A in (iv) and (v) if
    cash payment and financed portion are not known.

    \(iv\) Less cash payment \$\_\_\_\_\_\_\_\_\_\_

    \(v\) Total final net delivered financed portion \$

    **2**. *Discounts and Allowances*. We have not granted or paid,
    agreed to grant or pay, offered to grant or pay, caused to be
    granted or paid, or arranged for, directly or indirectly, any
    discount, allowance, rebate, commission, fee or other payment,
    entered into any barter, buyback, countertrade or offset agreement
    or other similar agreement in connection with the sale of, or for
    obtaining the contract to sell, the products/services described
    above, **[except]{.underline}**:

    a\) the discounts and allowances to the buyer, if any, stated above;
    or,

    b\) the regular remuneration of our regular full-time directors,
    officers and employees; or,

    c\) regular commissions or fees, if any, to our regular sales agent
    or representative in the country of the buyer; or,

    d\) other payments, as follow:

    [Payee or Intended Payee]{.underline} [Address]{.underline}
    [Amount]{.underline}

    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
    \$\_\_\_\_\_\_\_\_\_\_\_\_\_\_

    (If **None**, then the word \"none\" must be inserted in order for
    this certificate to be considered complete. If any payee is named, a
    statement must be attached showing the reason for payment and method
    of calculation.)

    **3**. The materials and labor comprising the products/services
    above

    \- which were originated or manufactured by us were originated or
    manufactured in the U.S. **or**,

    \- if not originated or manufactured by us, were acquired from
    sources in the U.S., **and**

    \- to the best of our knowledge and belief, the value of the
    products/services, consisting of direct material, direct labor and
    indirect costs which can be reasonably attributed to the production
    of the product, and **excluding price markup**, is as below:

    NOTE: If the supplier is not the policyholder, policyholder should
    inform supplier and indicate if repayment term is: 360 days or less,
    or 1 year or more.

    a\) for products with a repayment period of **360 days or less**:
    for **each product** at least **50%** of U.S. origin;

    for products with a repayment period of **1 year or more**: the
    **aggregate value** of **all products** at least **85%** of U.S.
    origin;

    b\) for **services**: exclusively by U.S. personnel (either in the
    U.S. or on-site);

    c\) for the sale of **raw materials** or **commodities**:
    exclusively of U.S. origin and

    \- that **no value** has been **added** to the product by us **after
    export** from the U.S.

    **4**. With respect to products/services which, to the best of our
    knowledge,

    a\) could be used for **military** purposes;

    b\) could be **components** of a product or equipment which could be
    used for military purposes;

    c\) could be used to **manufacture** products or equipment which
    could be used for military purposes;

    d\) are listed on the **U.S. Munitions List** (part 121 of Title 22
    of the Code of Federal Regulations); or,

    e\) are purchased by military or defense **organizations**,

    we have received the **written approval** of Eximbank for such sale
    of the products.

    **5**. The products do not consist of technology, fuel, equipment,
    materials or goods and services to be used in the construction,
    alteration, operation or maintenance of **nuclear** power,
    enrichment, reprocessing, research or heavy water production
    facilities.

    **C**

    **1**. The products/services in the export transaction described
    above were sold for U.S. dollars on terms which required that we
    receive from the buyer, or we provide financing to the buyer for, a
    cash payment on or before delivery to the buyer at least equal to
    such amount as may be specified in the **Transaction Endorsement or
    Declarations** to the policy, and the **financed portion** of the
    transaction, as described in the policy, approved under the
    **Transaction Endorsement or Declarations**, or of a shipment made
    thereunder, was evidenced by a valid and legally enforceable
    **note**, as defined in the policy.

    **2.** No dispute exists between us and the buyer, with respect to
    any loss, that has not already been finally determined to be a valid
    and legally enforceable indebtedness of the buyer, its legal
    representatives, or successors in interest, or has not already been
    otherwise settled to the satisfaction of the Insurer.

    **3**. We have not contracted with, shipped to, or failed to cancel
    further transit to the buyer after knowledge of that buyer\'s
    **insolvency**, as defined in the policy, or financial difficulty.

    **4**. We agree to notify Eximbank in writing of the buyer\'s
    **insolvency**, as defined in the policy, financial difficulty, or
    the occurrence of any event likely to cause a **loss**, as defined
    in the policy, within 10 calendar days of learning thereof.

    **5**. We agree to hold Eximbank harmless from any loss:

    a\) arising from the failure of ourselves or our agents to fulfill
    our or their contractual duties to the buyer with respect to the
    sale of the products/services, if such failure of performance shall
    have relieved the buyer of its duty, in whole or part, to pay the
    **note** when due, and,

    b\) arising from the unwillingness of the buyer to accept the
    products/services, and,

    c\) due to any dispute that arises between us and the buyer, with
    respect to any **loss**, that is not finally determined to be a
    valid and legally enforceable indebtedness of the buyer, its legal
    representatives, or successors in interest, or is not otherwise
    settled to the satisfaction of the Insurer, and,

    d\) that was insurable under the American Institute of Marine
    Underwriters\' War Risk and Strikes, Riots and Civil Commotion
    Clauses current on the date of shipment.

    \*\*\*\*\*\*\*\*\*\*

    With knowledge that Eximbank will rely on the certifications and
    representations made in this certificate, we agree to be liable for
    any damages (including, without limitation, **reimbursement to
    Eximbank** of any claim payment under the export credit insurance
    policy) suffered by Eximbank\'s reliance on such certifications and
    representations. We further understand that this certification is
    subject to the penalties for fraud provided in Article 18 U.S.C.,
    Section 1001.

    By:
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

    Print Name:
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

    *(Authorized Representative of the Supplier)*

    Title:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

    Date:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

    **If the supplier can not make any or all of the required
    certifications as they are presented here, Ex-Im Bank must be
    contacted to request written permission to delete or alter the
    certification, without which the insurance policy may not be
    valid.**

    On this\_\_\_\_\_\_ day of\_\_\_\_\_\_, \_\_\_\_\_, before me
    personally
    appeared\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_,
    to me known, who first being duly sworn by me, did depose and say
    that he/she is
    the\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_of
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

    *Title Supplier*

    described herein and who executed the foregoing instrument; and that
    he/she has full authority to complete and execute the said
    instrument in the name of, and on behalf of, the said supplier.

    Notary Public

    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

[^1]: 0 ^0^ 1 If the pre-project services were financed under the Ex-Im
    Bank Engineering Multiplier Program, then these services may be
    rolled into the capital cost of the project, in keeping with the
    special feature of that Program