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Application for ICIC the Israeli Credit Insurance Company shipment and services insurance We are interested in insurance and would like you to inform us the conditions under which you are willing to insure us against losses that could be caused in connection with the shipments and services covered as defined in the policy. Declaration Company details: Company name Company registration number Address Contact person Position Email Phone Fax Nature of business::   Mother/subsidiary/associated companies (if applicable, please provide the company names and the relationship):   Legal structure (Limited company, partnership, private company, etc.) Management CEO CFO Export department Treasurer/Accountant Has the company insured export shipments in the past or is it insuring current shipments? Yes No Sales portfolio The following are details of the company’s exports of shipments and services (hereinafter: “sales volume”) in the past three years and the company’s bad debts from sales transactions, due to bankruptcy or non-payment in those years (in $ terms). Year Anticipated 2008 2007 2006 2005 Exports Bad debts For insured companies that have exports: Please detail below your sale volume by country in the past year (either fiscal or calendar) and the anticipated sales for the insurance period. (Please not the average credit period for each country. Please include all the anticipated sales, except transactions that will be paid in cash, in advance, or backed by an irrevocable documentary letter of credit in countries with an A or B rating (in the table of countries relayed to you). Country Annual sales Anticipated sales to be insured during the insurance period Proposed credit terms Guarantees (if such exist) The following are the debts that were not paid on time (as of the date of this application). Country Buyer’s name Amount of arrears Duration of arrears Reason for non-payment The following are details of our estimate of the real losses that could be caused to the company as a result of the above debts:   Buyers The following are the details of the number of customers the company has, categorized according to the maximum exposure for the company. Exposure in US$ No. of customers Exposure in US$ No. of customers Until $5,000 $50,000 - $100,000 $5,000 - $20,000 $500,000 - $100,000 $20,000 - $50,000 Over $500,000 We customarily do/do not investigate the financial status of the buyers and/or service orders with whom we do business.(If yes, describe how you conduct the investigation and which information sources you use and how frequently this information is updated).   Marketing channels: Does the company sell via subsidiaries; does the company sell via agents, distributors, forward warehouses and/or on consignment. Does the company sell via a mother company, associated companies and/or branches? If so, please indicate this in the table below: Company name Country Nature of relationship * Exports No. of customers * In this column please indicate whether the company is a subsidiary, otherwise associated company, branch, agent, distributor, forward warehouse, and whether sales are on consignment. Customer sample for examination: Please provide the following details concerning your principal (3-6 customers) or as agreed at the meeting: Full registered company name Complete address Telephone number' Company registration No. or Dun’s No. Maximum exposure from customer Number of days of credit Anticipated total annual sales Customer’s arrears history Declarations We, the undersigned, hereby declare that the answers provided are correct and truthful and we have not concealed any essential detail concerning this insurance. We are unaware of any circumstances concerning the buyer or any specific contract that could negatively affect your decision to insure the proposed risks, in all or in part. We know that these answers will serve as a foundation for the policy and will be an inseparable part thereof and their truthfulness shall constitute a prerequisite for the company’s responsibility. We promise to notify the company of any fundamental change in the status of any of our buyers. We promise to notify you in writing of any change of over 10% in the above estimates, immediately after we learn of it. We hereby denote ourselves as the beneficiary of the policy. * If the applicant is a company, cooperative or partnership, the people usually authorized to sign obligations on behalf of the company, cooperative   or partnership, as relevant, must sign this declaration.   Telephone number for questions: 972-3-7962440 Fax number: 972-3-7962485.

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