EIB 95-9 Letter of Interest Application

OMB# 3048-0009

Expires 12/31/2009

LETTER OF INTEREST APPLICATION

Please type. Processing of applications may be delayed if the requested information is not provided.

1.

Applicant. The applicant may be any responsible individual, financial institution or non-financial enterprise.

Check if applicant has been assisted by a city or state export agency and provide the name of the agency:

Applicant name: _______________________________________________

Duns #:

_____________________

Contact person: _______________________________________________

Phone #:

____________________

Position title: _________________________________________________

Fax #:

______________________

Street Address: City: ___________________________________________

State/Province: ______________________________ Postal Code: _________

Country:

_____________________

2.

Exporter. The “exporter” is the company which contracts with the buyer for the sale of the U.S. goods and services.

Check if the exporter is also the applicant. If not, complete the information below.

Exporter name: ________________________________________________

Duns #: ________________________

Street address: ________________________________________________

Phone #: _______________________

City: _______________________________ State: _______________

Postal code: ____________________

Taxpayer ID #: ____________ Is the exporter a minority-owned business? Yes No. A woman-owned business? Yes No

3. Supplier. The “supplier” is the U.S. company which manufactures the goods and/or performs the services to be exported.

Check if the supplier is also the exporter.

Check if the supplier is not determined. If neither applies, attach the same

information for the primary supplier as requested above for the exporter. Information on additional suppliers is not required

for an LI.

4. Borrower. The “borrower” is the company which agrees to repay the Ex-Im Bank direct or guaranteed loan. Complete

the information below. Check the box for “public sector” if the borrower is at least 50% directly or indirectly owned by a

government. Check the box for “private sector” if the borrower is less than 50% owned by a government.

Contact person: ________________________________________________

Fax #: __________________________

Borrower name: ________________________________________________

Duns #: ________________________

Street address: ___________________________________ City: _____________

public sector 

private sector

State/Province: __________________________________ Postal Code: _______________ Country: _____________

5. Buyer and End-user. The “buyer” is the company which contracts with the exporter for the purchase of the U.S. goods

and services. The “end-user” is the foreign company which utilizes the U.S. goods and services in its business.

Check if

the borrower, buyer, and end-user are not the same entity. If box is checked, attach the same information for the buyer and

the end-user as requested above for the borrower.

6. Export Items. The “export items” are the goods and services to be exported from the U.S.

6a. Large Aircraft.

Check if the export items include aircraft which, in a passenger configuration, contain more

than 70 seats. If box is checked, complete Attachment A.

6b. Military.

Check if the buyer is associated in any way with the military, if any export items are to be

used by the military, or if any export items are defense articles or have a military application.

6c. Limited Recourse Project Finance.

Check if you want a Letter of Interest issued by the Project Finance

Division. If box is checked, complete Attachment D.

6d. Description of Export Items. Briefly describe the principal goods and services, including the type, quantity,

model numberand capacity (if applicable), and SIC Code. For an aircraft transaction, include a description of the

engines.

EIB Form 95-9

01/07

Taxpayer ID #: ____________ Is the applicant a minority-owned business? Yes No. A woman-owned business? Yes No

OMB# 3048-0009

Expires 12/31/2009

Letter of Interest Application

6e. Utilization of Export Items. Briefly describe the principal business activity of the end-user. If the export items are to be

used in a project, also provide the name, location, purpose, and scope of the project.

____________________________________________________________________________________________________

7. Financing Type Requested. Check applicable box(es). You may request both a direct loan and a guarantee. If both financing

options are acceptable to Ex-Im Bank, they will be indicated in the LI as options. Refer to Attachment A if the transaction involves

the export of new large aircraft.

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Direct Loans

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Comprehensive Guarantee

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Political Risk Guarantee

8. Contract Price. The “contract price” is the amount to be shown in the supplier’s invoice related to goods to be exported from the

U.S. and services to be performed by U.S. companies. If there is more than one supplier, the contract price is the sum of the

suppliers’ invoice amounts. The “eligible foreign content” is the portion of the contract price representing components to be purchased by

the supplier outside the U.S. and incorporated in the U.S. into the items to be exported. Costs to be incurred in the end-user’s country are

not considered eligible foreign content. Note that the eligible foreign content, if any, is part of the contract price.

8a. Contract Price: $ ______________ (including eligible foreign content)

8b. Eligible Foreign Content: $ ________________

9. Foreign Competition.

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Check if, to the best of your knowledge, there is at least one entity offering non-U.S. goods and/or

services indirect competition for this specific export sale.

10. Other U.S. Government Agencies.

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Check if an application for support of this export contract or related project has been filed

with the Agency for International Development, Maritime Administration, Overseas Private Investment Corporation or Trade

DevelopmentAgency.

11. Environmental Effects. If 85% of the contract price exceeds $10,000,000, complete Attachment B. Attachment B is not

required foraircraft transactions.

12. Tied Aid Capital Projects Fund. If you want Ex-Im Bank to preclude or counter a tied aid offer, complete Attachment C.

13. Certifications. The undersigned certifies that the facts stated and the representations made in this application and any attachments to

this application are true, to the best of the applicant’s knowledge and belief after due diligence, and that the applicant has not omitted any

material facts.

The undersigned further certifies that it is not currently, nor has it been within the preceding three years: 1) debarred, suspended or

declared ineligible from participating in any Federal program; 2) formally proposed for debarment, with a final determination still

pending; 3) voluntarily excluded from participation in a Federal transaction; or 4) indicted, convicted or had a civil judgment rendered

against it for any of the offenses listed in the Regulations Governing Debarment and Suspension (Governmentwide Nonprocurement

Debarment and Suspension Regulations: Common Rule), 53 fed. Reg. 19204 (1988). The undersigned is not listed on any of the

publicly available debarment lists of the following international financial institutions: World Bank Group, African Development Bank,

Asian Development Bank, European Bank for Reconstruction and Development and the Inter-American Development Bank.

In addition, the undersigned certifies that neither the undersigned nor anyone acting on its behalf, such as agents, has engaged, or will

engage, in any activity in connection with this transaction that is a violation of the Foreign Corrupt Practices Act of 1977, 15 U.S.C.

78dd-1, et seq. (which provides for civil and criminal penalties against companies and individuals who directly or indirectly make or

facilitate corrupt payments to foreign officials to obtain or keep business).

Further, neither the undersigned nor anyone acting on its behalf in connection with this transaction is currently under charge or have been,

within the past 5 years, convicted in any court or been subject to national administrative measures of any country for bribery of foreign

public officials

.

Applicant (company) name: ________________________________________________________________________________________

Name and title of authorized officer: __________________________________________________________________________________

Signature of authorized officer: _____________________________________________________ Date: _________________________

Payment, payable to the Export-Import Bank of the U.S., must accompany application; please indicate:

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Visa

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Mastercard

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Check

Account #:

Expiration Date:

Signature:

Ex-Im Bank would be pleased to assist you in applying for financial support. If you have any questions, please contact the Business Development Division

(Telephone: 202-565-3946 or Fax: 202-565-3931). For information concerning financing of large aircraft and ancillary equipment, please contact the Aircraft

Finance Division (Telephone: 202-565-3550 or Fax: 202-565-3558).

Taxpayer Identifying Numbers: Ex-Im Bank intends to use the taxpayer identifying numbers furnished on this application for purposes of collecting and reporting on any claims arising out of such

persons’ or business entities’ relationships with the U.S. government.

EIB 95-9

01/07

OMB# 3048-0009

Expires 12/31/2009

Letter of Interest Application

N

OTICES

The applicant is hereby notified that information requested by this application is done so under authority of the Export-Import

Bank Act of 1945, as amended (12 U.S.C. 635 et seq.); provision of this information is mandatory and failure to provide the

requested information may result in Ex-Im Bank being unable to issue the Letter of Interest. Ex-Im Bank may not require the

information and applicants are not required to provide information requested in this application unless a currently valid OMB

control number is displayed on this form (see upper right of each page).

Public Burden Statement: Public burden reporting for this collection of information is estimated to average 20 minutes per

response, including time required for searching existing data sources, gathering the necessary data, providing the information

required, and reviewing the final collection. Send comments on the accuracy of this estimate of the burden and

recommendations for reducing it to: Office of Management and Budget, Paperwork Reduction Project (#3048-0004),

Washington, D.C. 20503.

EIB 95-9

01/07

OMB# 3048-0009

Expires 12/31/2009

Letter of Interest Application

A

TTACHMENT

A: Large Aircraft Transactions

1. Financing Type Requested. Three financing options are available for new large aircraft transactions under the Large

Aircraft Sector Understanding (LASU), contained in the OECD Arrangement. Check the option(s) you are requesting.

For used large aircraft transactions, complete No. 7 of the Letter of Interest Application.

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Option 1: An Ex-Im Bank guarantee for up to 85% of the contract price.

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Option 2: An Ex-Im Bank guarantee for 42.5% of the contract price coupled with an Ex-Im Bank direct loan at

the applicable LASU interest rate for 42.5% of the contract price. The Ex-Im Bank direct loan is repaid during the

later maturities.

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Option 3:

An Ex-Im Bank guarantee for 22.5% of the contract price coupled with an Ex-Im Bank direct loan at

the applicable LASU interest rate for 62.5% of the contract price. The Ex-Im Bank guaranteed loan and direct loan

are repaid on a paripassu basis.

2. Spare Parts Financing. Indicate in No. 6d. of the Letter of Interest Application if any spare parts or spare engines

are included in the export sale. Provide the requested information on these items.

3. Transaction Information. Include with your application a background summary on the airline, the reason for the

purchase, proposed routes, and delivery dates. This information replaces the information requested in No. 6e. of the

Letterof Interest Application.

4. Contract Price. If credit memoranda information is available, deduct all airframe and engine credit memoranda, if

any, from the aircraft price when calculating the contract price to be entered in No. 8a. of the Letter of Interest

Application.

If you have questions about this attachment, please contact the Aircraft Finance

Division at 202-565-3550.

EIB 95-9

01/07

OMB# 3048-0009

Expires 12/31/2009

Letter of Interest Application

A

TTACHMENT

B: Ex-Im Bank Environmental Screening Document

Limited Recourse Project Financing and Long-Term Programs Only

Ex-Im Bank will screen project finance and long-term transactions into three categories, as defined in Ex-Im Bank’s

Environmental Procedures. The information you provide will help Ex-Im Bank to determine the proper category for your

application. This information is crucial to the appropriate and timely review of your application. Check the boxes that apply to

your application

.

1.

Project Identification. ~

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Check if the goods and/or services described in your application are destined for an identified project.

If checked, identify the project: _________________________________________________________________________

If not checked, explain: ________________________________________________________________________________

2.

Project Location. Is the project located in or sufficiently near to have perceptible environmental effects in any of the

following areas?

Check all that apply.

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Tropical Forest

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Nationally designated seashore areas

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Nationally designated wetlands or protected wild lands

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Habitat of endangered species

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National parks

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Large scale resettlement

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Nationally designated refuges

(How many persons?

)

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Coral reefs or mangrove swamps

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Properties on the World Heritage List

Project Sector or Industry

.

Which classification describes the project for which the exports are destined? Check all that

apply.

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Airport construction

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Nuclear power plant

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Consulting services

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Chemical plant

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Oil & gas field development

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Hospitals and medical equipment

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Forestry

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Petrochemical plant or refinery

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Pre-project services (feasibility &

environmental studies)

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Geothermal Power

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Pharmaceutical project

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Railway signaling

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Hydropower plant

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Pulp & paper plant

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Telecommunications or satellites

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Iron & steel plant

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Smelter

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Transportation carriers (aircraft)

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Large infrastructure project

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Thermal power plant locomotives, boats)

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Large-scale water reservoir

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Waste management

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Other (describe)

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Mining & mineral processing plant

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Air traffic control systems or

navigational aids

Name of Applicant ________________________________________________________

Date __________________________

If you have questions about this attachment, please contact the Engineering and Environment Division at 202-565-3570.

EIB 95-9

01/07

OMB# 3048-0009

Expires 12/31/2009

Letter of Interest Application

A

TTACHMENT

C: Tied Aid Capital Projects Fund

1.

Check if you are requesting appropriate Ex-Im Bank support to preclude or counter foreign tied aid offers.

2.

Check if one or more foreign governments are offering, or planning to offer, unusually long repayment periods,

unusually low interest rates, and/or mixed grant-credit financing for the specific contract for which Ex-Im Bank

support is sought. Attach available documentary evidence of a foreign tied aid credit offer. If such evidence is not

available, specify your reasons for suspecting foreign tied aid.

3.

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Check if you authorize Ex-Im Bank to ask the OECD Secretariat to issue a confidential “no aid” common line

request to OECD member governments. Acceptance of this request would preclude future foreign and U.S. aid

financing for the project.

4.

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Check if you believe that loss of this contract will jeopardize follow-on sales opportunities for similar sales in the

same market. Provide the type and estimated value of potential follow-on sales.

5.

Provide the following information, if known, for each foreign government’s tied aid offer.

Foreign Offer #1

Foreign Offer #2

Donor government

_____________________________

_______________________________

Foreign exporters supported

_____________________________

_______________________________

Total offer amount

_____________________________

_______________________________

Currency of offer

_____________________________

_______________________________

Credit portion amount

_____________________________

_______________________________

Credit portion interest rate

_____________________________

_______________________________

Credit portion grace period

_____________________________

_______________________________

Credit portion repayment period Grant portion, if any

_____________________________

_______________________________

If you have questions about this attachment, please contact the Credit Applications and Processing Unit at 202-565-3800.

EIB 95-9

01/07

OMB# 3048-0009

Expires 12/31/2009

Letter of Interest Application

A

TTACHMENT

D: Project Finance Transactions, Executive Summary

Ex-Im Bank’s analysis of potential limited recourse project finance transactions differs from routine export trade finance

transactions. Therefore, we require additional information from applicants for a Project Finance Letter of Interest. Please provide

the information outlined below to the best of your ability. It is highly recommended that you provide as much information as

possible at this stage of the application process.

1. Project Name: _____________________________________________________________________________________

2. Type of Project: ____________________________________________________________________________________

3. Project Location: ___________________________________________________________________________________

4. Project Description: __________________________________________________________________________________

______________________________________________________________________________________________________

______________________________________________________________________________________________________

5. Project Participants:

a. Sponsors: ____________________________________________________________________________________

_______________________________________________________________________________________________

b. EPC Contractor: ______________________________________________________________________________

_______________________________________________________________________________________________

c. Project Input Supplier(s): ______________________________________________________________________

_______________________________________________________________________________________________

d. Off-taker(s):__________________________________________________________________________________

_______________________________________________________________________________________________

6. Estimated Debt to Equity Ratio:

____________________________________________________________________

7. Other Potential Financing Sources:

____________________________________________________________________

8. Is this an international tender?

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Yes

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No Bid due date: _______________________________________________

9. Estimated Project Timeline: (e.g. financial close, construction start date, etc.)

______________________________________________________________________________________________________

10.

Project Status: (e.g. signed EPC contract, status of offtake contract, etc.)

______________________________________________________________________________________________________

11. Other Relevant Factors:

___________________________________________________________

If you have questions about this attachment, please contact Business Development Divisionat 202-565-3946.

EIB 95-9

01/07