Form of Request to participate in tender

This form is to be filled–in and sent to the following e-mail address: COM-302@shtokman.ru in the original .doc format and scanned
in the pdf. format

To: SHTOKMAN DEVELOPMENT AG

3, Malaya Pirogovskaya street, Moscow, 119435
Russian Federation

Subject of tender: the right to conclude contract №COM-0960-302 for supply of flower arrangements
and bouquets of natural flowers for Shtokman Development AG, Switzerland, Moscow Branch

Announcement: #CFT/ COM-0960-302

Request to participate in tender

Dear Sirs,
Having reviewed your company Announcement Ref. No. CFT/ COM-0960-302 about the tender and
its general conditions posted on your company web-site www.shtokman.ru, [specify the name of the
company] expresses its readiness to consider its participation in this tender.
We acknowledge and agree that the above-mentioned tender shall be held exclusively in
accordance with the rules and regulations established by your company, and shall not create any
obligation for your company in respect of any and all tenderers. Your company may at any time call back
the above-mentioned tender, or change its conditions, or at any stage refuse participation to any entities,
or refuse to award a contract to any tenderer without incurring any legal consequences or liability
whatsoever. Providing explanation of reasons of any of the above-listed actions shall be the decision of
your company, yet in no way an obligation.
We also enclose the completed Prospective Tenderer Information Sheet, we guarantee that
information contained therein is correct, and we acknowledge that your company is entitled to acquire
information about our company using all legally permitted methods.

Prospective Tenderer Information Sheet

№ Name Tenderer’s information
1 Name and legal status of the tenderer, date of
registration.
2 Legal address
3 Postal address
4 Actual address
5 Name of the person, appointed (elected) to be the
sole executive body of the tenderer, or of the person
who may act without a power of attorney on behalf of
the tenderer
6 Telephones, Fax (with area prefix)
7 E-mail, web-site
8 Individual Identification Number/ Reason for tax
registration (INN/KPP)
9 Bank information (Name and address of the bank,
account number, telephones, further bank details)
10 Parent companies (list names and legal status, or
personal names of any parents who’s share in the
charter capital is more than 10%)
11 Affiliates of tenderer (names and postal addresses)
12 Certificate of register entry in the Integrated State
Register of Legal Entities or Individual Entrepreneurs
(date, number, issuing authority)
13 Name of the responsible person of the tenderer with
indication of the job title and contact telephone and
fax.
14 E-mail address of the responsible person *
*This e-mail will be included into the distribution list for information associated with tender (clarifications to Tender documentation,
change to the dates of tender, etc).

_____________________
(Signature, seal)
_____________________________________________
(Name and job title of the undersigned)