Application form Call for the promotion of renewable sources for electricity production and / or heat through facilitation

to small and medium enterprises, according to the DM 3 37/2000, Art. 5. Recipient firm Title: Legal status: Tax Code: Registration record companies: N ° REA: Registered office Address (street / square / ... and number): ZIP: City: Province: Phone: Fax: E-mail: Project Title: Type of Technology (1): a) PHOTOVOLTAIC SYSTEM b) WIND POWER PLANT c) solar ther mal plant d) A THERMAL PLANT BIOMASS Estimate cost (2) ⠬ Contribution required (3) ⠬ Installed power / gross area kW / m² Location of site development of the project Address (street / square / ... and number): ZIP: City: Province: Phone: Fax: E-mail: Classification zone membership (4): Area 87 Area 87 3.a 3.c IBA Signature of legal representative recipient (1) Place an "x" in the cell of interest, (2) this value must match the value of "PC" Annex 7a) or 7b) - Statement of Assurance viability, (3) the value specifi ed must match the value of I shown in Annex 7a) or 7b) - Statement of Assurance viability, (4) For the only companies that have ticked a) "Photovoltaic" section of Project / Type technology, place an "x" in the cell of interest. The recipient is claiming benefits against the project in this application and a

ttach the following documents (in duplicate), prepared according to the diagrams in the text. ATTACHMENTS: 1) Certificate of registration with the Chamber of Co mmerce, issued recently, which shows: a) the Company's regular registration in the Register of Companies; b) the local unit, located in the region, in which it intends to carry out the project, c) a statement that in the last five years has been sent to the Company statement of bankruptcy, compulsory administration, entered into an arrangement or administr ation d) the composition of the boards in charge. 2) Declaration of Legal Representative, together with legible photocopy of ident ity document (Annex 2) 3) Technical annexes: Preliminary draft (drawn up in accordance with Art. 7 - How to submit an applica tion, paragraphs 7.3.1 and 7.9.1 of the Notice) Technical A1 or B1 or C1 or D1 ( compiled on the type chosen technology Section Project / Technology Types of thi s form); table containing the eligible cost items. 4) DVD or CD Rom containing the file referred to in paragraph 3); 5) If the project is implemented in municipalities where both types are "not Are a 87 Area 87.3c-3c" declaration by the municipal authority certifying the owners hip of the place of execution of the intervention areas indicated on also availa ble on the basis of the following the path "Technica l / Ob List depressed areas. 2. FOR APPLICATIONS TO INVESTMENTS costs over ⠬ 100,000.00 MUST 'BE ATTACHED ALSO T HE FOLLOWING DOCUMENTATION: 6) Last official budget approved, full of the notes and minutes of meeting and a certified copy of any resolution to increase the ca pital authorized, pursuant to the Civil Code, the date of application or (for partnerships, not required to draw up a budget official): - Financial Statements in accordance with the Fourth EC Directive, signed on eac h page by the Legal Representative, and its last full financial year to 31/12 of the year preceding the application. - Statement by the Legal Representative of the diagram of corporate financial accounting records (Annex 6). 7a) - 7b) State ment of Assurance viability (Attachments 7a) - 7b)) prepared taking into account in calculating the first parameter, the percentage of 50% or 55% or 60% capital subsidy (cf. . Section 4.1 Section 4-Notice of the accounts), if it has been ti cked a) "Photovoltaic" the present form, Section Project / Technology Types, 30% capital subsidy in the case have been barred boxes b) "wind farm, c)" solar the rmal "or)" Thermal Plant to Biomass "section of this module Project / Technology Types NB In the case of consortia or consortium company proposing that does not meet t he standards of reliability, you can verify the parameters only on financial inf ormation of each of the consortium members, dividing between them the cost of th e project because of their share consortium.€In this case, where n is the numbe r of associates, will be presented the "n +1" signing statements to legal repres entatives of the applicant and each associate, provided that the possibility of capital increase reserved for only proposing the application . 8) Only if the required contribution exceeds 154,937 Euro: a) Certificate chambe r with the word mafia. Meaning: b) Copy of certificate request submitted by the proposer to mafia Prefecture of competence as specified in Article 10 of Presidential Decree June 3 1998 No 252 and photocopy of the Chamber of Commerce with "mafia words" delivered to the Pre fecture and attached to this request: a copy of the request must bear the stamp of the Prefecture and the date of receipt. The certificate must be submitted by mafia Prefecture same MCC SpA, Research and Innovation Services, Via Piemonte 51 .00187 - Rome. NB In the case of consortia or consortium company proposing, that the request sh

ould also be made by associates who have a share of the consortium funding or ca pital exceeding 10% and by the consortium on behalf of which the consortium or t he consortium operates exclusively in against PA. The form must be completed in its entirety and together with all the required documents Date (dd / mm / yy): The beneficiary company (The Legal Representative)