ANNEX B.

2- SWORN STATEMENT OF THE BUSINESS PARTNER (LEGAL ENTITY)

The information provided in this document is required for achieve with the requirements established according to Law No. 19,913
law that created the Financial Analysis Unit (UAF), which establishes that the natural persons and legal entities indicated are obliged
to report suspicious transactions that they notice in the exercise of their activities, modified by Law No. 20. 119, which gives greater
powers to the Financial Analysis Unit . Likewise, in accordance with Law No. 20,393, which establishes the criminal liability of legal
persons in the crimes of money laundering , financing of terrorism and bribery and its amendments and regulatory norms; Law No.
18,314 that determines terrorist conduct and sets its penalties, modifications, extensions and regulatory, Law No. 21,121 that
incorporates as crimes base of the washed of assets, the illicit of appropriation improper and unfair administration, Law No. 21,132,
Law No. 21,240, and all other applicable internal and external regulations on the matter in Chile and that could be incorporated later,
in accordance with what is required by the regulations and laws current.

Business Partner is understood as customers, partners, suppliers, subcontractors or any company that has or intends to have a
contractual relationship with COSAPI SA AGENCY IN CHILE
With the signature of this document, I declare that the information contained is complete and correct of agreement with my better
knowledge. The answers provided by the Business Partner will be treated with absolute reserve .
I. CONTACT DETAILS OF THE PARTNER OF BUSINESS :

Denomination or social reason: RUT:

Address:

Main activity:

Registration in the Commercial Registry:

Contact person: Email: Phone:

SHAREHOLDERS, DIRECTORS, MANAGERS AND LEGAL REPRESENTATIVES

(*) That have more than 25% of the social capital, contribution or participation of the legal entity.
Type of document:
Shareholder participated Identity Card or RUT Document No. Nationality
s* (%)

Note to the Business Partner : If you need additional space to complete the questions, you can attach pages indicating the title of the section and
the number of the question.

If the company has a Board of Directors, please complete:

Post Identity Starting date
directors Nationality
card in office

President

Director

Director

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 Director

Director
Place the 5 most relevant positions

Post Identity Starting date

Management Plan Nationality
card in office

General manager

Financial Manager

Post Identity Starting date

Legal representative Nationality
card in office

Official who will sign documents with COSAPI SA AGENCY IN CHILE

II. BACKGROUND

ASK Y NO
Indicates if any Shareholder, director, legal representative, general manager, main executives or the E
legal entity itself has been sentenced or is(are) part of an investigation for the crimes of criminal
activities, whether criminal or administrative, for crimes of falsehood or against the property, or for
crimes of bribery, embezzlement of public funds, influence peddling, illicit association, incompatible
negotiation, money laundering, illicit drug trafficking, terrorism, financing of terrorism, fraud and
illegal exactions, corruption, kidnapping, promotion of prostitution , human trafficking, illegal arms
trafficking, migrant smuggling, tax crimes, smuggling, fraud, extortion, robbery, customs crimes or
any other:

If your answer is affirmative, specify:

Status
Name Crime Year
(sentenced / investigated)

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III. SWORN STATEMENT OF PERSON EXPOSED POLITICALLY
The People exposed Politically (PEP) are the of nationality Chilean either foreign that play either have played functions public featured in a country, up to it less
a year of finalized the exercise of the same . HE include in this category to the President of the Republic, senators, deputies and mayors, Ministers of the
Supreme Court and Courts of Appeals, Ministers of State, undersecretaries, mayors, governors, regional ministerial secretaries, ambassadors, bosses superiors
of Service, so much centralized as decentralized, and he executive his lower immediate that must subrogate to each of they, Commanders in Boss of the Forces
armed, director General of carabinieri, managing Director of Research, and he officiates he superior that must subrogate each of them, National Prosecutor of
the Public Ministry and regional prosecutors, Comptroller General of the Republic, Directors of the Central Bank of Chili, counselors of the Advice of Defending
of the State, ministers of the Court Constitutional, ministers of the Court of the Free Competence, Regular and alternate members of the Public Procurement
Tribunal, Counselors of the Senior Public Management Council, Directors and main executives of public companies, as defined by Law No. 18,045, Directors of
corporations appointed by the State or its agencies, Members of the party directives politicians.

By the persons mentioned in section I; I declare that the company I represent:

ASK Y NO
Have you fulfilled, in the last 1 year: i) public functions in a public body or ii) prominent E
functions in an international organization? o Have you been a direct collaborator of the
highest authority in said institutions?

In the event that the existence of a PEP is declared, please complete the following information for each of them:

Full name:

Identity card:

Position in the company:

Position in the public institution:

Institution:

Period of exercise in the position:

Full name:

Identity card:

Position in the company:

Position in the public institution:

Institution:

Period of exercise in the position:

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IV. SWORN STATEMENT OF CONFLICT OF INTEREST

I hereby declare that the company I represent:

Y NO
Has a relationship up to the fourth degree of consanguinity and/or second degree of E
affinity with a COSAPI shareholder, director, executive director, manager, legal
representative or worker.

For these purposes, the aforementioned persons are in a situation of Conflict of Interest, when they have a family
relationship:
 Until second degree of consanguinity: spouse either cohabitant, parents, children, grandparents, siblings and grandchildren .
 Up to second degree of affinity: In-laws, son-in-law, daughter-in-law and brother in law.
 Up to the fourth degree of consanguinity: spouse or partner, parents, children, grandparents, siblings,
grandchildren, great-grandparents, great-grandchildren, uncles, nephews, and cousins.

If the existence of a Conflict of Interest is declared, please complete the following information for each of them:

Name of person in a situation of Conflict of

Interest:
Position held at the client:

Name of Cosapi executive or worker:

Position held at Cosapi:

Description of the situation that

generates the Conflict of Interest:

Name of person in a situation of Conflict of

Interest:
Position held at the client:

Name of Cosapi executive or worker:

Position held at Cosapi:

Description of the situation that

generates the Conflict of Interest:

These situations must be duly declared for Cosapi to take the appropriate and appropriate measures.

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V. ETHICS AND COMPLIANCE
(SGAS: Anti-Bribery Management System, SPLA/FT: Money Laundering and Terrorist Financing Prevention System, SPD: Crime Prevention System)

i. About the Prevention System Crimes:

YES NO Description
A. The entity has a Crime Prevention System and/or Anti-
Bribery Management System
The entity has a compliance function or area that
B. monitors and supervises the operation of the Crime
Prevention Systems.

The entity has a procedure and/or guidelines for risk

C. identification, evaluation and mitigation.

The entity has internal controls for the

prevention, detection or correction of risks.
The entity has internal controls for prevention,
detection either correction that enable them to
face facilitation payments, contributions to
campaigns policies, gifts, auspices, trips, etc
The entity has a periodic dissemination and training
D. plan for the crime prevention model.

The entity has an internal audit person or area.

E.

The entity has guidelines and/or mechanisms that

recognize and promote the communication of ethical
F or illegal misconduct or potential crimes (complaints
channel ) .
The entity has guidelines and/or procedures to manage
G.
and/or interact with public officials.
The entity has procedures, policies or controls for the
H. treatment of conflicts of interest.

The entity has procedures or policies on gifts,

I
hospitality and presents.
The entity has procedures or policies on donations.
J

The entity has sufficient policies and/or procedures to

ensure an adequate practice for the knowledge of
k Business Partners (Due Diligence).

The entity has some other document related to Ethics

L
or Anti-Corruption.

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ii. On the Prevention of Money Laundering and Financing of Terrorism:
YES NO Description
The entity is considered as a Subject Obliged to inform
A.
the Financial Analysis Unit in matters of washed of
assets and of financing of the terrorism or to the
financial intelligence agency of your country.
If your answer is affirmative, answer: If the answer was "NO" please go to section iii.

YES NO Description
The entity has a ML/FT Prevention Manual ( Attach )

The entity has a Code of Ethics and Good Practices for the
Prevention of ML/FT ( Attach ).
The entity has a Compliance Officer registered with the
UAF in accordance with art. 3 of Law No. 19,913.
The Entity has guidelines and/or procedures to prevent or
detect suspicious transactions, as well as SAR, ROE and
NEGATIVE ROE records.
The Entity carries out a review of its business partners to
verify if they are included in International Lists of persons
linked to ML/FT activities.

The Entity has implemented a training program in

accordance with the provisions of the current standard.
The Entity has established policies and procedures for due
diligence in the knowledge of clients, directors and
workers, and business partners.
The entity has ever been investigated, prosecuted or
sanctioned for non-compliance with the regulations on
ML/FT Prevention.

In case of not complying with any of the indicated aspects, I declare that I have been aware of the regulatory
requirement and, if applicable, I promise to regularize it in the shortest possible time.

iii. About Anti-Corruption Management and Anti-bribery:

YES NO Description
A. The entity has a Code of Ethics ( Attach ).
The entity has an Ethics and/or Anti-Bribery, Anti-
B. Corruption and/or Crime Prevention Policy ( Attach ).

The entity periodically disseminates the

C.
aforementioned documents. Indicate the period.
The entity provides periodic training on ethics, anti-
D. corruption and/or anti-bribery issues. Indicate the
period.

ATTACH THE DOCUMENTS THAT SUPPORT THE PROCEDURES AND GUIDELINES INDICATED IN THIS
DOCUMENT.

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I declare that:

1. The information contained in this Affidavit is true and in the event of detecting fraud and falsity in it or the omission of
requested information, I will be subject to the administrative sanctions established in the current legislation on the matter,
without prejudice to personal responsibility and / or penalty that corresponds to me for such infraction or the rescission of
the contract.

As a sign of agreement, I affirm and ratify everything stated in this affidavit:

Full name:

Identity Card / CE No.:

Post:

SIGNATURE
Representative

Legal Date: / /

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