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Checklist for Export Control

Request No. / P.O. No.:

Minimax Offer No.


and/or Ref. No.:

Minimax Fire Solutions International GmbH


Industriestr. 10/12
Vendor:
23840 Bad Oldesloe
Germany

PRISMECS GmBH
Buyer / Country:
TRPP BIRR GEB 188N
(detailed address)
ZENTRALSTRASSE 40, 5242 BIRR, SWITZERLAND

EPC Contractor /
Country: SAME AS BUYER
(detailed address)

Consignee /
Country of Destination: SAME AS BUYER
(detailed address)

Enduser (Owner) / GE, SWITZERLAND


Country of Destination: TRPP BIRR GEB 188N
(detailed address) ZENTRALSTRASSE 40, 5242 BIRR, SWITZERLAND

Project: (purpose of
POWER GENERATION
use):

Is the Buyer / EPC Contractor / Consignee / Enduser acting in the field


of nuclear, biological and chemical weapons-or in the Missile Yes No
Technology?
Is the Buyer / EPC Contractor / Consignee / Enduser acting in the
Yes No
Military Field?
Is the Buyer / EPC Contractor / Consignee / Enduser acting in the
Yes No
Nuclear Field?

Place, Date Signature / Company Stamp

687620081.doc, Stand: 28.03.2012, Seite 1/1

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