REVISED

KUWAIT OIL COMPANY (KSC)

(Register of Commerce No. 21835)

ATTACHMENT NO. 6
-to-
FORM OF TENDER
-for-
ENVIRONMENT REHABILITATION PROGRAM UNDER UN LEGISLATION FOR
INDEMNIFICATION
SOUTH KUWAIT EXCAVATION, TRANSPORTATION AND REMEDIATION
(SKETR) PROJECT
DECLARATION OF COMMISSIONS ( ZONE-1)

In accordance with the provisions of Articles 2 and 3 of Law No. 25/1996 relating to
declaration of commissions in connection with State Contracts, we submit the following
details relevant to this Contract:

Third Party (e.g. agent/ broker/ middleman)

Full name of third party
Role of third party in connection with this Contract and tender
Occupation of third party
Home of record of third party
Kuwait address of third party
Kuwait address for serving notices on third party
Value/ percentage of commission
Whether commission made direct/indirect
Method of payment of commission
Type of commission (money, benefits, or in kind)
Place where commission made
Name of recipient

* A separate form is to be used for each transaction/commission/third party.

In case bidding as single entity:

Signed and Stamped

:

Name :
SL 3
Designation :

For and on behalf

: of

Date :

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 REVISED

In case bidding as joint venture/consortium (JV/Consortium):

Lead JV/Consortium member

Signed and Stamped

:

Name :
SL 3
Designation :

For and on behalf

: of

Date :

Other JV/Consortium member

Signed and Stamped

:

Name :

Designation : SL 3

For and on behalf

: of

Date :

Note : Bidder shall strike out whichever is not applicable.

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