=== dc2021-09-0029-pages-21.ppm === fy Department of Energy Annex B-2 Oil Industry Manegement Bureau (O1MB) July 2021 COMPANY PROFILE NOTICE TO ENGAGE IN THE DOWNSTREAM OIE INDUSTRY BUSINESS - HAULING SERVICES Prepared By: Approved By: {Posinon and Signature over Pruned Name? {Pasition and Signature over Printed Name} imine ne Type of Ownership: ( _) Single Praprietorship { ) Partnership (_) Corporation "add ro § as necessary Description of ue Organizational Surucnise: (adach Organizadonal Structure and indicate number of staff’ employees} TL BUSINESS PLAN History of operations and invesiments ii the Plulippines Expansion Propraie’s Product Source: thoth fucal and abroad} —~ Location where the product will be sourced List of Buyers ’ Market Area (scope or area coverage where the products will be marketed or distributed) Business Address Page L of 2 === dc2021-09-0029-pages-22.ppm === es. - Department of Energy Annex B-2 Oil Industry Managemen! Bureau {OTMB) July 2021 COMPANY PROFILE NOTICE TO ENGAGE IN THE DOWNSTREAM OIL INDUSTRY BUSINESS - HAULING SERVICES Company Name / Address: Contact Details (email and tel #): Prepared By. Approved By: (Position and Signature over Printed Name IU, DISTRIBUTION FACILITY ATES Position and Signature overt Printed Nainc} 5 Land Transportation Office Registration Bureau of Fire Protection Conveyance Permit Dey ent of Scienee and Technology Capacity Calibration Certificate fin KL erthi istrati um € cate Reet Me | Official Receipt No. Issued Date Valid Until } asus Dae | Valid Until Valid Until Vehicle Type (i.¢.tonk truck! lorry trailer} Maritime Transport Mantme Indusiry Authority Philippine Ports Author Acctedivation Name of Vessel Product Regisuation Certificate No Safer Certificate Na. } test Bate Vatid Until Issued Date Valid Und DC Page 2 of 2 === dc2021-09-0029-pages-23.ppm === om “_ Annex C July 2021 Notice to Engage in the Downstream Oil Industry Business — Lubes Products Date OIL INDUSTRY MANAGEMENT BUREAU DEPARTMENT OF ENERGY 3*4 Floor, PNOC Building 5 Energy Center, Rizal Drive, Fort Bonifacio, Taguig City Attention: Director Dear Sir/Madam In compliance with the Department Circular No. , we wish to inform you of this notice to engage in the lubes business with the following details below: A. Company Details (Applicant) Business Name Address Telephone Number Email Address Lube Business Activity (Blender, Marketer or Own User) Wwe B. Supporting Documentary Requirements Please refer to the attached documents in compliance with Annexes C-f and C-2. Very truly yours, Name, designation & signature of applicant or authorized representative Reminder/ [nstructions: t. Submit this application form with complete documentary attachments to OIMB for the issuance of the required acknowledgment before the start of commercial operation; Pay the application fee based on the Order of Payment if submission of application is complete; and Issuance of acknowledgement shall de not later than seven (7) working days from receipt of application. wy Page | of 2 Annex C Notice to Engage in the Downstream Oil Industry Business — Lubes Products === dc2021-09-0029-pages-24.ppm === ACKNOWLEDGMENT REPUBLIC OF THE PHILIPPINES ) CITY/MUNICIPALTY OF )S.5 BEFORE ME, a Notary Public for and in the City/Municipality of ,this day of 20__, personally appeared presenting his/her identification, to wit: Competent Evidence of | Date & Place of Issue Identity known to me and to me known to be the same person who executed and voiuntarily signed the foregoing application, which he/she acknowledged before me as his/her own free and voluntary act and deed, and with full authority to sign in that capacity. This application consisting of (__) original copy/ies submitted to OIMB with complete attachment, duly signed by the applicant. IN WITNESS WHEREOF, | have hereto set my hand on the day, year and place above the written. NOTARY PUBLIC Doc No. Page No. Book No. Series of 20 Page 2 of 2 Annex C Notice to Engage in the Downstream Oil Industry Business — Lubes Products === dc2021-09-0029-pages-25.ppm === on oe Deparaneat of Energy Annex C-1 Oil Industry Management Bureau (OIMB} July 2021 CHECKLIST OF REQUIREMENTS NOTICE TO ENGAGE IN THE DOWNSTREAM OL INDUSTRY BUSINESS - LUBES PRODUCTS Company Name ' Address: Contact Details {email and tei #}: Prepared By- Approved By: (Position and Signature over Printed Name) {Position and Signature over Printed Name) 1 Application Form ~ Annex C CSC > Checks of Requtemenes “ANDERE —] 2, Company Profile Form = Annex C2 DF] 7 anached Supporing Documents _ 4.1. Executive briefer of operation, 4.2. Business Registration for the applied business activity from the Securties and Exchange Commission or Deparanent of Trade and Indusuy fiwhiche 2.3. Securities and Exchange Commission Articles of Incorporacion (if 4.4. Business/Mayor's Permut for the applied business activity from the concemed city or municipalicy, 4.6. BIR Registration for the Applied Business Activity. 4.7. Additional supporting documents ff the production plant ang storage facility arc constructed by the applicant 4.7.1. Site, plant and storge facitin: layout plan with sofficient descnption and supported by blueprint copy with legend: 72 Fat wevenion and Tesponse manna ty ver is applicable); 4.7.3. Lubes onshore (Sand) spsll prevennon and response manual: 4.7.4. Lubes offshore (water) spill preveation and response nianual, 4.7.5. Occupancy Permit for the production plant and storage facility fram the City or Municipality, 4.7.6. Fire Safery Inspection Certificate for the production plant aad storage facility from the Bureau of Fire Protecuon: 4.7.7. Environmental Compliance Certificate of the site, office building, storge and blending facility from the Depasunent of Environment 4.8, Auditionz] Sapporting Documents if the Production Plant and Storage are leased by thre Applicant Pg 4.8.1. Lease Agreement!Contract with lhe owner of the site, office building, plant and storage facility, 4.8.2, Site, plant and storge facility layout plan with sufficient description and supported by blueprint copy with legend: 4.8.3. Lubes offshore (water) spill prevention and response manual: 4,8.6. Occupancy Permit for the production plant and storage facility froin the City or Municipality, 4.8.7. Fire Safety Inspection Cernficate for the production plant and storage fociliny fromm the Bureau of Fire Protection: 4.8.8. Environmental Compliance Cemificate of the site, office building. storge and blending facility from the Deparnneni of Environment 4.9. Company Secretary’s Cestificate for Antborized Representative and Signatory, and 4.10. Proof of Payment af Application Fee. Reminderf Instructions: 1, Submil one (1) Certified True Copy of all tbe required supporting documenis: Page t of 2 === dc2021-09-0029-pages-26.ppm === ~~ Department of Energy Annex C-2 Oil Industry Management Bureau (OFMB) July 202! COMPANY PROFILE NOTICE TO ENGAGE IN THE DOWNSTREAM OIL INDUSTRY BUSINESS - LUBES PRODUCTS Company Name ; Address: Comact Details temail and tel 21: Prepared By: Approved By: (Posinon ard Signature over Pruued Name? L COMPANY BACKGROUND Company Name: Business Address: Landline: PresidenvCEO- Position and Signature over Printed Name) £-mail Address: Type of Ownership: il. BUSINESS PLAN 1. Bescnption: a. Propased Actin ies related to dubes business Name of suppher/s Location where the product will be sourced ‘imported 1. Production Plant Regional “ Location or Address Capacity in Thousand Liters (KL) "add row 5 as necessary Regional/Location or Address Product's 10 be stored Philippine Peso Number of Manpower Requirement Blending Facility Storave Tanks Warehouse Other Ancillary Facilities Operational Cost = Note: Please anached detailed fact sheet of the individual details of investment and the required manpower, The information in dis matix is a requirement for the preparation of the DO! investment data sheet in the Philippine Enersy Plan and the subsequent endorsement fo the BOI, Pave lof 1 === dc2021-09-0029-pages-27.ppm === Annex D July 2021 Notice to Import for Sale or Own Use — Liquid Petroleam Products Date OIL INDUSTRY MANAGEMENT BUREAU DEPARTMENT OF ENERGY 3" Floor, PNOC Building 5 Energy Center, Rizal Drive, Fort Bonifacio, Taguig City Attention: Director Dear Sir/Madam In compliance with the Department Circular No. , please be informed of this notice to import with details as follows: A. Company Details (Applicant) Company Name/ Business Name Address Contact Number Email Address FYNr B. Details of Shipment Purpose (For Sale or Own Use) Type of Product Description (if applicable) Quantity Unit Percent Tolerance Name of Supplier Source Loadport 0. Estimated Loading Date From To 11. Estimated Arrival Date From To 12. Discharge Port Region Province Municipality Address 13. Vessel Name SO PNAARYN- C. Estimated Price 1. FOB ($/KL or $/CBM) 2. Insurance cost ($/KL or $/CBM) 3. Freight cost ($/KL or $/CBM) Page | of 2 Annex D Notice to Import for Sate or Own Use ~ Liquid Petroleum Products === dc2021-09-0029-pages-28.ppm === D. Attached Documentary Requirements 1. Certified true copy of the Proforma Invoice; 2. Certified True Copy of Certificate of Quality; 3. EMB/DENR clearance pursuant to RA 6969, otherwise known as “Toxic Substances, Hazardous and Nuclear Wastes Control Act of 1990” in accordance with the Basel Convention, if importing the following products: a. Aviation Gas b. Slop/used water, sludges and similar petroleum products/by-products 4, Material Safety Data Sheet (MSDS) indicating the petroleum weight percentage content, if importing petroleum-based solvents. Very truly yours, Name, designation & signature of applicant or authorized representative Reminders/ Instructions: I, Submit this application form with complete documentary attachments 1o OIMB before date of arrival; 2. Pay the application fee based on the Order of Payinent if submission of application is complete; and 3. Issuance of acknowledgement shall be not later than seven (7} working days from receipt of application. Page 2 of 2 Annex D Notice to Import for Sale or Own Use — Liquid Petroleum Products === dc2021-09-0029-pages-29.ppm === , Annex E July 2021 Notice to Import for Sample Testing — Liquid Petroleum Products and Bioethanol OIL INDUSTRY MANAGEMENT BUREAU DEPARTMENT OF ENERGY 3° Floor, PNOC Building 5 Energy Center, Rizal Drive, Fort Bonifacio, Taguig City Attention: Director Dear Sir/Madam In compliance with the Department Circular No. to import with details as follows: A. Company Details (Applicant) Business Name Address Telephone Number Email Address feNne B. Details of Shipment Type of Product Quantity of cargo (in KL) Supplier Loadport Estimated Date of Loading (ETL) Estimated Date of Arrival (ETA) Disport Name of Transporter SrNAWE WH C. Estimated Price 1. FOB ($/KL or $/CBM) 2. Insurance cost ($/KL or $/CBM) 3. Freight cost ($/KL or $/CBM) Date , please be informed of this notice Page 1 of 2 Annex E Notice to Import for Sample Testing — Liquid Petroleum Products and Bioethanol === dc2021-09-0029-pages-30.ppm === om, ae D. Attached Documentary Requirements — Certified true copy of the Proforma Invoice; 2. Certified True Copy of Certificate of Quality; 3. Material Safety Data Sheet (MSDS) indicating the petroleum weight percentage content, if importing petroleum-based solvents; and 4. Airway Bill/Bill of Lading. Very truly yours, Name, designation & signature of applicant or authorized representative Reminders/ Instructions: 1. Submit this application form with complete documentary attachments to OIMB before date of arrival; 2. Pay the application fee based on the Order of Payment if submission of application is complete; and 3. Issuance of acknowledgement shall be not later than seven (7) working days from receipt of apptication. Page 2 of 2 Annex E Notice to Import for Sample Testing — Liquid Petroleum Products and Bioethanol === dc2021-09-0029-pages-31.ppm === on; Annex F July 2021 Notice to Import for Sale or Own Use — Lubes Products OIL INDUSTRY MANAGEMENT BUREAU DEPARTMENT OF ENERGY 3" Floor, PNOC Building 5 Energy Center, Rizal Drive, Fort Bonifacio, Taguig City Attention: Director Dear Sir/Madam In compliance with the Department Circular No. notifying our application for importation as follows: A. Company Details (Applicant) Business Name Address Telephone Number Email Address Lube Business Activity (Blender, Marketer or Own User) YRwWNo B. Details of Shipment roy Purpose (For Sale or Own Use) 2. Type of Product (Base Oil or Lubricating Product) Name of Product Packaging per product Quantity of cargo a. Lube oils in liters b. Greases in kilograms c. Other lubricating products 6. Supplier 7. Loadport 8. Estimated Loading Date (ELD) 9. Estimated Arrival Date (EAD) 10. Discharge Port 11. Vessel Name 12. Voyage Number Vey C. Estimated Price 1. Estimated Price per Unit ($/li, $/kg) 2. Pricing Term (CFR, FOB, etc.) Date , please be informed that we are Page I of 2 Annex F Notice to Import for Sale or Own Use - Lubes Products === dc2021-09-0029-pages-32.ppm === rot as, D. Attached Documentary Requirements 1. Proforma Invoice or Commercial Invoice; 2. Product brochure/ builetin; and 3. Material Safety Data Sheet (MSDS). Very truly yours, Name, designation & signature of applicant or authorized representative Reminders/ Instructions: 1. Submit this application form with complete documentary attachments to OIMB before date of arrival; 2. Pay the application fee based on the Order of Payment if submission of application is complete; and 3. Issuance of acknowledgement shall be not later than seven (7) working days from receipt of application. Page 2 of 2 Annex F Natice to Import for Sale or Own Use — Lubes Products === dc2021-09-0029-pages-33.ppm === a Department of Energy Annex MR-A [SUMM-EPP) Onl Industry Management Bureau (OIMB} July 2021 REFINER, IMPORTER, BULK DISTRIBUTOR, BUNKER TRADER OR OWN USER MONTHLY REPORT ON FINISHED PETROLEUM PRODUCTS SUPPLY AND DEMAND SUMMARY Company Name ‘ Address: Contact Details (email and te} #): Covered Mouth: Prepared By; Approved By: Deadline of Submission: (Position and Signature over Printed Name) (Positon and Signature Not taler than the 2h calendar day of the succeeding month over Printed Name! _ Tr COdCSCSCSCi‘iRNSNNNN “NN WITHDRAWAL BEGINNING : ; REFINERY ; ; INVENTORY {MPORTS DOMESTICLOCAL PRODUCTION | TOTAL AVAILABLE EXPORT DOMESTICLOCAL ; TOTAL ENDING INVENTORY PETROLEUM PRODUCTS (KL) | (On Hand or In- Country ; PURCHASE L _ SALES OWN USE ; Endine Inventory i {Actual Quannty in ‘Actual tiny in (Net Refinery Ourpat Per SUPPLY {Actual Quantity in (Acmual Sales in ANNEX CONSUMPTION WITHDRAWAL 5 ie ANNEX MR-C} ‘ Quantity it fo oduct in ANNEX MR- (A+B+C+D) ANNEX MR-D) (F+G+H) ANNEX MR-B- previous) month} ANNEX MR-E) SASOLINE__————SS TS [Gasoline unblended wath biofuel | [Gasoline blended with biofuel] DES CSCC [Diesel anblended with biofel___|________ [Diesel biended with biofuel | [0 A INAPHTHATOPS |i [ASPHALTSBITUMEN |} ] HYDRO SOLVENT]. _] MIXED XYLENE PROPYLENE} _._}—4 POLUENE SSS Cd es Co ee Zz BENZENE PETCOKE [CME ETHANOL -_ Te OTHER, PRODUCTS ipls. specify) eee Page {of 1 === dc2021-09-0029-pages-34.ppm === tn Department of Energy Oil industry Management Bureau (OMB) Company Name / Address: Prepared By «Position and Signature over Printed Name) Depot Location Fintshed Petrolewn Product City ! Municipality a : Diesel blended with biofuel AVIATION GAS ml5/2|sleStselslelzlelelale Fee S dee eerie Z ta 2105/5 (5 ZII9 al m BElglale Alot RIelel3 a alglela : sz baal m Zz ULPHUR, Le | Le [LT DIESEL pt } aes po | TY -—_ Annen MR-B July 2021 IMPORTER, REFINER, BULK DISTRIBUTOR, BUNKER TRADER OR OW’ USER MONTHLY REPORT ON CRUDE OfL AND FINISHED PETROLEUM PRODUCTS ENDING INVENTORY Approved By: Deadline of Submission: {Position and Signature over Printed Name} Not later than the 20th calendar day of the succeeding month ON HAND OR IN- COUNTRY ladividval Funshed ENDING INVENTORY Product Ave. Daily { (Basis for MIR Compliance) Demand for the past six nonths| EN TRANSIT INVENTORY TOTAL AVAILABLE (Already loaded within the covered month) INVENTORY Storage Capacity’ Vol (KL) Vol {KL Total Days Supply (By OUINE | sole wablended with biofvel soline blended with biofuel Diesel unbiended with biofuel po OTHER PRODUCTS Ips. specify) Page | of 2 === dc2021-09-0029-pages-35.ppm === on Department of Esergy Annex MR-B Oil Indussy Management Bureau (OIMB) July 2021 IMPORTER, REFINER, BULK DISTRIBUTOR, BUNKER TRADER OR OWN USER MONTHLY REPORT ON CRUDE OIL AND FINISHED PETROLEUM PRODUCTS ENDING INVENTORY Company Nane i Address: Contact Details (email and tel #): Covered Month: Prepared By: Approved By: Deadline of Submission: {Position and Sienature aver Prted Name} {Position and Signature over Printed Name) Nat larer than the 20th calendar day of the succeeding month City Municipality : ; _ ON HAND OR IN. COUNTRY IN TRANSIT INVENTORY TOTAL AVAILABLE Depot Location Weighted Ave. of Individual Finished ENDING INVENTORY (Already loaded within the covered month) INVENTORY Crude Type Storage Capacity Product Daily Demand {Basis for MIR Comphance} Vol (KL) for the past six months Vol (KL) Days Supply Vol (KL) Day's Supply Vol (KL) Total Days ETL ETA Vessel {B) (Bia) (c) {D} PT | Ld Reminder/Iestruction: i 3 3 . Covered Inventory - refers to the following inventory as of end of the month on 2 pes depot. per location, and per product basis’ (2) On hand or {n- coumry stocks and (b) import in-cansit volume already loaded within the covered penod: . Average Daily Demand - refers to the average daily sades Jor the past six (6) months in thousand lners pes calendar day (KLLCD), and . Days Supply - refers 10 the equivalent number of days of in-country ending inventory and/or in transit inventory divided by the average daily demand. Page 2 of 2 === dc2021-09-0029-pages-36.ppm === vai Department of Energy Annex MRC Oil Industry Manarement Bureau | OIMtB} Jaly 2021 IMPORTER, REFINER, BUNKER TRADER OR OWN USER MONTHLY REPORT GN FINISHED PETROLEUM PRODUCTS IMPORTS Company Name Address: Contact Details | == (SS SS AO rc on EEE el ec eS eee ee pT TAVTORBOWET-AL [EE Eee ell eee a Re eS (0X0) |S SS SQ eee EeeaeaeScweg' po EEE ETA TATION Ga EEE Oe eT eeeeeseeeSeeeoeeoee ew ee NS Rs eS (£7.02 1057.02 ©) SG SO DO po OO EEO eee een PHALTS'BTUMEN [Ee Tjmr mew, cc EEE po DRO SOLVENT pee MIXED XYLENE nee OO eee pe SE ERE, PROPYLENE eee eee ee,,»sssssss ai eee ee EO p00 ee COUTOLTENE EEE EES Esse SE eS pe ENE eee ee eee Tee ee PETC, 8660S st ee (310) 18) (CO Pe ee OTHER PRODUCTS (pis. specify) Ee SE a ee RE Reminder/Instruction: This report shall have the followine attachments: i. Certified tue copy of Bill of Lading; and 2. Cenified true copy’ of Commercial Invoice. Page fof | === dc2021-09-0029-pages-38.ppm === ons, Depertment of Enerey Annex MR-E Oii Industry Management Bureau (CIMB} July 2021 IMPORTER, REFINER, BULK DISTRIBUTOR, BUNKER TRADER OR OWN USER MONTHLY REPORT ON DOMESTIC/LOCAL fURCHASE OF FINISHED PETROLEUM PRODUCTS FROM IMPORTER, REFINER OR BULK DISTRIBUTOR j Gommaes Name satis Nasne # Address: Contact Details (email and tel } Commer Demistemmianeet | Soe oveted Month: Prepared ee Approved ee Leg of Submission: (Position and Signature over Printed Name) (Pasition and Sienature over Prinied Name} Not tater than tbe 21h Ta day of the succeeding month Buyer Depot Location Supplier Depot Location GASOLINE (KL) DIESEL {KL} Blended with Biofuel Unblended with Biofuel Blended with | Unblended with Biofuel Biofuel above | 97 RON} 95 > RON u RON above | 97 RON] 63 RON a RON 0.005%} 0.3% | 0.005%] 0.3% 97 RON] win. 9TRON| min. amin. Sulfue | Sulfur | Sulfur | Sulfur OWN So1oatly] pioeunue,> (iN) ANTSOUIN (ion (V-Lat /OUMALAY 410 Tan IN) SLNIA TOS FOUGAL ci SLIVUGSY (1m) LVINOAAL 2 YELLIN Ajroadg “Std Ee 2. & =. = — = “ dauAoL Ayyjedrumpy Remunder'Lnstruction: This repon shai} have the following attachment: i. Certified owe copy of Commercial firvoice. Page Lofl === dc2021-09-0029-pages-39.ppm === Departuent of Energy Annex MR-F (SUMM-CO} Oil Industry Management Bureau (OMB) July 2021 REFINER MONTHLY REPORT ON CRUDE OIL SUPPLY AND DEMAND SUMMARY Contact Details (email and tel #1: Covered Meath: Prepared By Approved By: Deadtine af Submission {Position and Signanire over Printed Name) (Position and Signanure over Printed Name) Not later then the 20th calendar day of the succeeding month a. SS PSS ; OS oS SURES» EY ASRS“ CROSS OO —SC=CSPPLYCO™~“‘S*S*S*S™S™”””TTC*dCSC‘(‘CNSNNNNY_____ WITHDRAWAL Fo s—isiS Depot Lecatan Bexinning inventory Crude Oil layport Refining Input Export TOTAL Crade Type {On Hand or fn- Country | Actual Quaotity in Annex| Total Crude Oi! Supply {| (Actual Quantity in *P Ending Inventory (Actual Quantizy in WITHDRAWAL Ending Lnventory in ANNEX Annex MR-[) ‘Annex MR-H) MR-8- previous month) Page 1 of } === dc2021-09-0029-pages-40.ppm === a Department of Energy Oil Industry Management Bureau (OMB) REFINER MONTHLY REPORT ON CRUDE OIL IMPORTS Company Name ’ Address: Contact Details femail and tet #): Prepared By. Approved By: (Position and Signature over Printed Name! (Position and Signamre over Printed Name} SHIPMENT PARTICULARS OIMB TRACKING CODE DETAILS AS STATED PX APPLIED IMPORT NOTICE . Estimaied Price per unit Crude Type (USS: KL) (a9ulAosg £ GiqedovenyA) arg Dupe] aleg pean ie) 2 3 3 = = 2 E = =. = s o = — a "ON F771 BIO DOTIEANSU] $so'y wwDd3¢) Annex MR-G July 2021 Covered Manth: Deadline of Submission: Not later than the 20th calendar day of the succeeding month DETAILS AS SEEN IN SUBMITTED POST-IMPORTATION DOCUMENTS. ACTUAL PRICE (US$: KL) Aanune > (2MMAOIY 7 Aunpedtstunyyy) ag fupreT aig jRALMy ON] S9gOANt] julvawiio > Reroinderinstruction: This report shoil bave the following attachnenu: 1. Certified true copy of Bill of Lading: 2. Certified true copy of Commercial Invoice; and 3, Copy of fully processed BOC Singie Administrative Document or SAD. Page | of 1