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ESSAR’ Expression of Interest for inCcatel| OLN cIE Reg. No. State District Category Misc. Essar Oil Ltd. ESSAR’ IMPORTANT 1.This form is available free of cost at any of our offices or can be downloaded from our website: www.essar.com. 2.Essar Oil has not appointed any agents or business associates for allotting petrol pumps, you are requested to deal with the Company directly. ESSAR” TT Te ier: err oer ee Pees 1.1 Name and edidress of applicant District Pin code State 1.2 Address for communication 13 Contact Nos. Residence with (STD) code Office wth (STD) code Mobile Emil id (Please provide name and contact nos. of «person tobe contacted in your absence) 1.4 Contact person name Residence with (STD) code Office with (STD) code Mobile OCCUPATION / BUS! sro r 2.4 Current occupations (individual) 2.2 Current source of income (Findividuat 23 Current business (fim) 24 Name of the first existing) 28 Type cf firm Proprietorship ©) Partnership, C1 Public Lid, © Private Lt, 268 Turnover of the company 2.7 No.of employes employed ESSAR’ 28 —Willthis proposal be your primary / ‘additonal source of income? Primary source Additional source 2.9 Experience in any other retail sales {Give details of products traded. FMCG, pharma, plastics, textiles et.) ‘Source of supply {Name of manutacturers) How long have you been in this business? ‘Annual turnover (Rs.) 34 jous experience in ppotroloum industry? Ves Ne (ifyes, ploase atach separate cheat to provide more details with 3.2 Any family members involved in the petroleum business? Yee No {lf yes, please attach a separate sheet 5 5 te provide more details) 3.3 if dealing in retail petroleum business please provide following information (of your dealership {8} Name of the company ) Name of the dealership & addrass 6} Operating since 4) Sales volume per annum (Produetwise) Ms. 80. 4.1 Land availabe for development ave aN {ityes, plesse provide the following details) A) Sito Location address ‘Survey no. / Gut no. ofthe plot Plot / Property address Village Taluka District State National Highway No. State Highway No. Major District Road No. City Rosd No. ESSAR’ 8) Site dimensions : Size of site [Length and Width (Murs) Frontage of site (Mirs) Length of plot along the road ‘Tota and area (Sar. Mirs.) Site plan (Please attach a sketch of the plot showing dimensions of the plot and also that of the road ‘on which the plot i situated) Please attach photographs of land / surrounding area ©) Site within / outside city limits Distance from nearest city /town OEIC ns 5.1 Distance of nearest Km stone from the plot (Mirs) 5.2 Location of the Km stone Same side of the plot or Opp. side of the plot And LHS with respect to plot or) RHS with respect to plot 5.3 Description on the Km stone 6. Nearest road junction Pea 6.1 Name of the land owner Whats your relationship withthe owner? 6.2 Areal documents relating to the property clear? OYes No (Actach copies ofall documents) 63 Are you willing to give the land / property on long term lease to Essar = OYes CINo 64 Status of land Agricultural TINon agricutural (agricultural, indicate time to convert for non agricultural use) 65 _Isthe plot property currently vacant? : Dyes No (ifn, indicate time required 10 get the sit fully vacated) Des! OONo 66 Is power connection readily a (itn, indicate time required {0 get the power connection) ESSAR’ 67 Is there any electrical wire passing over your site Dyes CINo if yes D High Tension (HT) OlLow Tension (LT) 62 ls water connection available reedily?: Yes No {ifno, indicate ime required to get the wator supply) 69 Are motorable approach roads to yur landiproperty existing? Des CONo (Wfno, what isthe plan for development) 70 AK Tor Se Ag 7.1 What activites exist adjacent to your plot (300 meters on either side and ‘also on opposite side) Please describe brietly 7.2. Areany now roads / highways / fty-overs/ by-pass diversions coming ‘up near your land / property? Dyes: No If yes, please describe 0 Es) Se 8.1 Estimated potential of sale from proposed site Ms (Petrof)__KL-per month (1KL = 1000 tres) HSD (Diese) KL per month Lubricants lies per month 8.2 Whatis your expectation of earning per month from the dealership? (Make a rough calculation of your earnings using industry margins and prices and forthe services you propose to offer) Soles of MS /HSD/ Lubes Servicing of vehicles Seling tyres, tubes, batteries Spare tyres Medicines Food joint Dhaba Consumer goods Communication canto (STD/8D / Internet) Fertizers / Pesticides Any other (Please list dotalls product-wisa) ea 92 9 24 List existing potrotoum retail outlets in the vicinity (within 10 Kms radius of your site as per Annexure I) It the proposed sit is located on highway, please give details of retail outlets within 25 Kms on either sido of the proposed location (as por Annexure ) Which of these products if any, ‘would you be intrested to 1D _LPG (Cylinders) CO Kerosene in the adjoining market? 1D Furnace oi! DToleune (Prease provide details 1G Naphtha 12 Solvents 8 per Annexure I) ‘Are any more outlets being sotup Inthe vicinity (within 5 Kes radius)? IF yes, please indicate the company's name ioc Oech Hct “The data provided on this page willbe kept strictly confidential Light Diesel oil (LD0) 1D Benzene OP ORL others MO 10.4 102 103 104 ‘Assets owned (By applicant) Assets owned / Housing property ete, (Gy individuairmsy partners) Name of partners (U pacnershio} ‘Addross ofeach portnar ‘cach constitution copy partnership deed Ratio of partnership ‘Alocable surplus funds from current business ESSAR’ 10.5 Income Tax returns last two years} : Attach relevant documents 10.6 Name of your banks 107 Branch 108 Address 109 Account type 10.10. Account number 10.11. Are you a resident Indian? Dyes No Ino, give details OMe 11.1. Indicate amount you are willing to invest in the rota outlet business: C1 Rs. 5 0.25 lakhs CARs. 25 10 60 lakhs 1 Re. 50 to 100 lke 1 More than Rs. 100 ake 11.2 Soureas of fund Own funds Loan Re. Own % Loan {Please mention allthe documents you willbe attaching with the completed form) 1 4 2. 5 3. 6. Terms and Conditions 1. The dota asked for in this form is purely to evaluate your ‘Expression Of Interest (EON for puting up retail outlet for Esser Oi 2 Submission ofthis form does not gurantee award of dealership. 3. Forms not complete in all respects may be rejected. | agree with the above terms and conditions. Signature [Name of the Applicant: Date Poms xi mae sso sta Bn | wianlilalula 4s posodoid ou jo AnuInin oun uy siopno wero4 ous yo sei

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