Common use of BENEFICIAL OWNERSHIP DISCLOSURE FORM Clause in Contracts

BENEFICIAL OWNERSHIP DISCLOSURE FORM. INSTRUCTIONS TO TENDERERS: DELETE THIS BOX ONCE YOU HAVE COMPLETED THE FORM This Beneficial Ownership Disclosure Form (“Form”) is to be completed by the successful tenderer. In case of joint venture, the tenderer must submit a separate Form for each member. The beneficial ownership information to be submitted in this Form shall be current as of the date of its submission. For the purposes of this Form, a Beneficial Owner of a Tenderer is any natural person who ultimately owns or controls the Tenderer by meeting one or more of the following conditions: • Directly or indirectly holding 25% or more of the shares. • Directly or in directly holding 25% or more of the voting rights. • Directly or indirectly having the right to appoint a majority of the board of directors or equivalent governing body of the Tenderer. Tender Reference No.: [insert identification no] Name of the Assignment: [insert name of the assignment] to: [insert complete name of Procuring Entity] In response to your notification of award dated [insert date of notification of award] to furnish additional information on beneficial ownership: [select one option as applicable and delete the options that are not applicable]

BENEFICIAL OWNERSHIP DISCLOSURE FORM. INSTRUCTIONS TO TENDERERS: DELETE THIS BOX ONCE YOU HAVE COMPLETED THE FORM This Beneficial Ownership Disclosure Form (“Form”) is to be completed by the successful tenderer. In case of joint venture, the tenderer must submit a separate Form for each member. The beneficial ownership information to informationto be submitted in this Form shall be current as of the date of its submission. For the purposes of this Form, a Beneficial Owner of a Tenderer is any natural person who ultimately owns or controls the Tenderer by meeting one or more of the following conditions: • Directly or indirectly holding 25% or more of the shares. • Directly or in directly holding 25% or more of the voting rights. • Directly or indirectly having the right to appoint a majority of the board of directors or equivalent governing body of the Tenderer. Tender Reference No.: [insert identification no] Name of the Assignment: [insert name of the assignment] to: [insert complete name of Procuring Entity] In response to your notification of award dated [insert date of notification of award] to furnish additional information on beneficial ownership: [select one option as applicable and delete the options theoptions that are not applicable]

BENEFICIAL OWNERSHIP DISCLOSURE FORM. INSTRUCTIONS TO TENDERERS: DELETE THIS BOX ONCE YOU HAVE COMPLETED THE FORM This Beneficial Beneficial Ownership Disclosure Form (“Form”) is to be completed by the successful tenderer. In case of joint venture, the tenderer must submit a separate Form for each member. The beneficial beneficial ownership information to be submitted in this Form shall be current as of the date of its submission. For the purposes of this Form, a Beneficial Beneficial Owner of a Tenderer is any natural person who ultimately owns or controls the Tenderer by meeting one or more of the following conditions: • Directly or indirectly holding 25% or more of the shares. • Directly or in directly holding 25% or more of the voting rights. • Directly or indirectly having the right to appoint a majority of the board of directors or equivalent governing body of the Tenderer. Tender Reference No.: [insert identification identification no] Name of the Assignment: [insert name of the assignment] to: [insert complete name of Procuring Entity] In response to your notification notification of award dated [insert date of notification notification of award] to furnish additional information on beneficial beneficial ownership: [select one option as applicable and delete the options that are not applicable]