1  SUBMITTED by (i.e. the identity of the Tenderer)  2  CONTACT PERSON (for this tender)  Name(s) of legal entity or entities making this application  Nationality $^{1}$  Leader $^{2}$  Member  Etc … Name  Organisation  Complete Address  Telephone  Fax  e-mail  e-mail (alternative) Financial data $^{5}$  Year n-2  < specify > €  Year n-1  < specify > €  Year n $^{6}$  < specify > €  Year n+1  < specify > €  Annual turnover $^{7}$, excluding this  contract  Please complete the following table of financial data 4 based on your annual accounts and your latest  projections. If annual accounts are not yet available for this year or last year, please provide your latest  estimates, clearly identifying estimated figures in italics. Figures in all columns must be on the same basis to  allow a direct, year-on-year comparison to be made (or, if the basis has changed, an explanation of the change  must be provided as a footnote to the table). Any clarification or explanation which is judged necessary may  also be provided. In case of applicant being a public body, equivalent information should be provided.  3  ECONOMIC AND FINANCIAL CAPACITY $^{3}$  $^{1}$ Country in which the legal entity is registered  2 Add / delete additional lines for consortium members as appropriate.  Note  that a sub-contractor is not considered to be a  consortium member for the purposes of this application form. Subsequently, the data of the subcontractor must not appear in the  data related to the economic, financial and professional capacity. If this application is being submitted by an individual legal entity,  the name of that legal entity should be entered as 'Leader' and all other lines should be deleted.  Any change in the identity of  the Leader and/or any consortium members between the deadline for receipt of tenders indicated in the Instructions to  tenderers and the award of the contract is not permitted without the prior written consent of the Contracting Authority.  Infringement of this rule will lead to the exclusion of the tenderer from this tender procedure. $^{3}$ Please see item 5 –  Selection criteria , point 1)  Economic and financial capacity of the tenderer , of the Instructions to tenderers.  Note  that the data included in the table will have to be proven by means of documentary evidence by the tenderer that will be  awarded the contract. Natural persons have to prove their capacity in accordance with the selection criteria and by the appropriate  means.  $^{4}$ If this application is being submitted by a consortium, the data in the table must be the sum of the data in the corresponding  tables in the Declarations provided by the consortium members – see point 7 of this submission form (Declaration to be provided  by each member of the consortium).  $^{5}$ If the accounts of the legal entity(ies) are in a currency other than EUR and EUR equivalents are not included in the entity’s  financial statements, the financial data to be provided in the table will be converted into EUR using the average InforEuro exchange  rate for the respective financial year. In this case, the tenderer will indicate, in an endnote to the table, the start and end date of  the financial year(s) and the exchange rate used for conversion. InforEuro monthly rates are available at the following website:  http://ec.europa.eu/budget/inforeuro/index.cfm?Language=en $^{6}$  Year n  = last year for which accounts have been closed for the tenderer (in case of a consortium, this will be the last year for  which accounts have been closed for all members). Please remember to include in the table  the actual year  ( e.g. “ 2009”) for which  data is provided.  $^{7}$ The gross inflow of economic benefits (cash, receivables, other assets) arising from the ordinary operating activities of the  enterprise (such as sales of goods, sales of services, interest, royalties, and dividends) during the year. 