ORACLE CDH Supplier Request / Maintenance Form A form W-8 (Foreign Vendors) or form W-9 (US-based Vendors) must be provided. Noble Energy Contact Noble Energy Supplier Contact Noble Energy Email: Telephone Number: Business Unit: Need Purchase Site: ¥ ot N Ts this a One-time Payment? ¥ oF N: Ifyes: Can vendor be inactivated after payment?: ‘Anticipated Annual Spend Third Party Information ‘Vendor/Suppiee Company Name (English: Hebrew Name (if Applicable) ‘Address Line 1: 520) eS State: City Zip Code: Country: BUNTON Tax ID # or VAT fe ‘Vendor Contact Name: ‘Vendor Contact Phone Number: -240 222 291108 Vendor Contact Email; evans 00s8q-=1) rom israel Local Vendor: Y ooNO@) Witiolding Tax ¥ of (Org Type Code: Book Keeping Cert: ¥ or N: ‘Sham Reporting: Yor N: Expiry Date! Payables WHT Code: Tax Office # WHT Rpt Group: ‘Occupation Description: Types of Goods or Services to be Provided: © Goods (Not Services) © Rentals © Service Select Type Below) Type of Services: 1 Operational Services 1 Non-OperationalComy C Cleaning Tank Bottoms Accounting Consulting or Services OF Drilling Rigs Agent Engineering Design and Consultation 1 Attomey or Legal Services Fabrication Services Audit Consulting or Services Flight Services (Rotary or Fixed Wing) Customs Broker or Freight Forwarder 1 Geological / Geophysical Services 1 Financial Institution or Bank Offshore Installation Services / Work 1 Gov't Relations Consultant / Lobbying Services (Oil Field Services (Downhole) 1 IIR Services or Job Agency Oil Field Services (Not Downhole) } Immigration Consultant or Visa Processor J. Onshore Construction Services / Work 1 IT Serviees, Software or Hardware Professional Consultation (No Physical Labor) } Join Venture Partner / Farm-in-Partner C. Seismic Processing / Data Acquisition Services } Licensing Consultant / EHS Intermediary OF Survey / Related Services 1 Security / Guard Force Service Provider (Trucking Services Social Investment Recipient (Donations or Gifts) Vessel Charters OD Tax Authority Waste Disposal Services OF Tax Consulting Service Other:ORACLE CDH Supplier Request / Maintenance Form Third Party Banking Information Bank Name: ©?" ABA / Routing Number (US vendors) SWIFT Code (foreign vendors): IBAN Code (foreign vendors): 25 “Account Number: 725% Service Currency: A000 Payment Method (Electronic, Wire): DDINTIOAITSAOI Related Party Disclosure Is the third party a relative or close friend of an employee, director, or officer of Noble Energy? Y or N: “© Ifyes, who is the relationship with (Name): Ifyes, describe the relationship: Is there anything special that should be reviewed by legal/Compliance regarding this relationship? ¥ or N: A form W-8 (Foreign Vendors) or form W-9 (US-based Vendors) must be provided. Requestor Information Note: Completion of this information request form does not guarantee that this supplier/vendor will be setup and available for use. Various compliance checks may be required depending on the type of services the vendor performs. Requestor's Name: Request Date: