REF. No. Country Project Value  Participation Leadership Start date  End date For EIB use only  (€) % Y/N (mm/yyyy) (mm/yyyy) 3 (a)  3 (b) 3 (c) 1 2 3 4 5 6 7 8 TOTAL 0 0 0 MINIMUM REFERENCES REQUIRED 2 1 2 PASS QUALIFICATION? NO Submitted for criteria (Y/N) 2 Years before last  year Year before last  year Last year Current year For EIB use only  < specify year > < specify > < specify > < specify > EUR EUR EUR EUR Total permanent staff for the relevant fields  2 Years before last  year Year before last  year Last year Current year For EIB use only  < specify > < specify > < specify > < specify > EUR EUR EUR EUR Annual turnover Reference code: Contract title: Technical Assistance to Ukrainian Railways to support the implementation of the Ukraine Railway Modernisation Project AA-000799-002 <Lot number & lot title, if applicable> N/A Nationality <Country in which the legal  entity is registered> Leader Member 1 Member 2 Name(s) of legal entity or entities submitting the application  (as  per point 1 of the TSF) e-mail (alternative contact) Name Organisation Full physical Address Telephone e-mail (main contact) CONTACT PERSON  (as per point 2 of the TSF) The information provided below must be fully in line with the tender submission form (TSF). In case of discrepancy, the information and data of the application will prevail.  to be submitted in excel format only with the electronic verison of the technical offer (see section 7 of the ITT) ECONOMIC AND FINANCIAL CAPACITY  (as per point 3 of the TSF) PROFESSIONAL CAPACITY  (as per point 4 of the TSF) TECHNICAL CAPACITY  (as per point 6 of the TSF) TENDER SUBMISSION FORM DATASHEET 