APPENDIX 36
END USE CUM END USER CERTIFICATE IN CASE OF EXPORT OF SCOMET ITEMS
(TO BE SUBMITTED ON THE LETTERHEAD OF THE END USER)
I /We (name of the end user)______________________________________________________________________ Certify that we are importing (name of the SCOMET item)_______________________________________________ From (name and address of the exporter)____________________________________________________________ Against our purchase order No________________ date__________ as capital equipment/ Component / raw material / other use (specify)_____________________________________________________________________________ For the manufacture of (end product)____________________________which will be used for (state specific use)*____________________________________________________________.
(* if more than one use then enclose self certified list )
I/we further certify that the items detailed in the referenced purchase order will not be used for any purpose other than the purpose (s) stated above and that such use shall not be changed nor the items modified or replicated without the prior consent of the Government of India. And further, if required, post installation verification shall be allowed.
The end-user shall not himself, or through another, cause the items, or replicas, or derivatives thereof to be retransferred / sold without the knowledge / consent of the Government of India, to any party within (name of the country)___________________________________/ or outside it.
I/We also certify that the above items imported by us shall not be used for any purpose that relates to the development of Weapons of Mass Destruction.
I/we also certify that all the facts contained in this certificate are true and correct to the best of my knowledge and belief and that I/we do not know of any additional facts that are inconsistent with this certificate.
Place:
Date: | _______________________________
Signature of end-user / authorised signatory
of the end-user with stamp and seal
Name:____________________________
Designation:_______________________
Address & e-mail:___________________ |
CERTIFICATION ON BEHALF OF THE RECEPIENT STATE
(For Schedule 3 Chemicals of CWC, viz . Category 1 C of SCOMET list)
(To be filled for transfers of Schedule 3 Chemicals to states not party to the Convention)
It is hereby certified that the transferred Chemical referred to above will be used only for purposes not prohibited / disallowed under the Chemical Weapons Convention and shall not be transferred to any other person or re-exported from the recipient country.
| Name of the chemical (IUPAC nomenclature) | Quantity |
| | |
Signature:__________________________
Name:_____________________________
Position:____________________________
Organisation / State:_________________
Address:____________________________