Statement and strategic partner identification checklist (booking 12 08 14)
1. STRATEGIC PARTNER STATEMENT
The undersigned hereby acknowledges, represents and warrants that (i) the following warranties, (ii) answers in Strategic Partner Identification
Checklist, and (iii) all information disclosed to Booking.com is true, accurate, complete, correct and not misleading on the date hereof and throughout
the term of the relationship between the Strategic Partner and Booking.com:
(a) he/she is fully and duly authorized and empowered to sign, execute and deliver this statement and to represent and act for and on behalf of
the Strategic Partner;
(b) he/she has full (or at least sufficient) knowledge, insight and understanding (and to the extent required title, power and authority to conduct a
full due diligence investigation) about and/or in respect of (the (ultimate) ownership, management and control in respect of) the Strategic
Partner;
(c) to the extent required, he/she conducted and satisfactorily completed a full (due diligence/audit) investigation in respect of the Strategic
Partner, its management and (direct and ultimate beneficial) ownership;
(d) the Strategic Partner and its management/directors and (direct and ultimate (beneficial)) owners (and their management/directors) are not in
any way connected to, part of, involved in or related to or under the control, management or ownership of:
(i) terrorists or terrorist organizations;
(ii) organizations that fund, assist or otherwise support (with whatever means (cash and kind)) terrorists and/or terrorist organizations;
(iii) parties / persons guilty of trade violations;
(iv) parties / persons subject to (US/UN/EU/UK/Dutch) (a) trade embargo, or (b) financial, economic and trade sanctions, and
(v) parties / persons guilty of money laundering, bribery, fraud or corruption;
(e) the completed Strategic Partner Identification Checklist (attached as Appendix A) is true, accurate, complete, correct and not misleading.
The undersigned shall immediately notify Booking.com in respect of any change of control, ownership, membership, management or any other
change pursuant to which any trade restrictions/embargo or financial, economic and trade sanctions as (from time to time) issued by US, UN and EU
authorities shall become relevant or applicable or appropriate to comply and follow up with.
SIGNED FOR ACKNOWLEDGEMENT, AGREEMENT, CONFIRMATION AND ACCEPTANCE:
______________________________x
Name:
Place:
Date:
Name Strategic Partner:
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STRATEGIC PARTNER IDENTIFICATION CHECKLIST 3/2
APPENDIX A – STRATEGIC PARTNER ("Partner") IDENTIFICATION CHECKLIST
QUESTION YES/NO (√) ANSWER / EXPLANATION/
1. Strategic Partner name: what is the statutory name and trade name of the
Partner
2. Ownership: Which company, enterprise, organization and/or naturalperson is
(are) the direct and ultimate (beneficial) ow ner/shareholder of the Partner1
(i.e.
"(ultimate) owner of the owner") (the "Owners")1
3. Government: Is the Partner ow ned by, under the controlor management of:
- Your government
- a governmental official2 YES □ NO □
YES □ NO □
4. RestrictedParty: Do any of the follow ing qualify as, related to or identified as a
Restricted Party3
:
- Partner
- management/director(s) of the Partner
- (direct/ultimate (beneficial) ow ner(s) of the Partner
- Management/director(s) of the Ow ners
YES □ NO □
YES □ NO □
YES □ NO □
YES □ NO □
5. Governmental officials: Are there any government officials in, connected or
related to:
- the Partner (as ow ners, management or in other relevant positions)
- the persons, entities, corporations owning or controlling the Partner. YES □ NO □
YES □ NO □
Further comments/remarks Partner:
1 Give full name (including surname, family/mother name, given names and aliases) of person and/or statutory name and trade name of shareholder.
2 "Government official" means (i) an officer or employee of any government or any department, agency, or instrumentality of a government, (ii) an individual acting in an officialcapacity for or on behalf of a
government agency, department, instrumentality or of a public international organization, or (iii) any officer or employee of a company ow ned or controlled by your government.
3 "Restricted party" means persons, bodies, enterprises, corporations or organizations w hich are (a) a member of the Government (e.g. senior officials, political party or organization) and (i) their related
family members, or (ii) their related entities (companies, corporations, enterprises, businesses, foundations) or bodies associated w ith them, or (b) identified or appointed as restricted party or (special)
designated party under or pursuant to any US/UN/EU/UK/Dutch) trade embargo, or financial, economic and trade sanctions.