Fit Expression of Interest Project Application Form: For Official Use Only

FIT EXPRESSION OF INTEREST
PROJECT APPLICATION FORM

For official use only
Project reference number
Date of submission of application
Date of receipt of application
Application form complete?
Date of FiT Committee review
Decision of FiT Committee
Yes
No
Approve
Reject
Request more
info
Date of response to applicant
Instructions to applicants:
Please complete the FiT Expression of Interest Project Application Form in full. Where
information requested is not relevant or not available, please indicate such or provide relevant
alternative information.
Project Applicant Contact Information
Full legal name of applicant
Mailing address
Physical address if different from
mailing address
Telephone number
Fax number
Email address
Website
Primary contact person
Project Applicant Organization Details
Type of legal entity (e.g. private limited
company)
Date of incorporation/registration
Incorporation/registration certificate
number
Income tax registration (PIN) certificate
number
Value added tax (VAT) registration
certificate number
Authorized share capital
Applicant ownership, management or

shareholder structure
Names and nationalities of key
shareholders or managers
Description of main or related business
activities
Description of experience with
renewable energy projects
Proposed Project Location
Please enclose with your FiT Project Application Form a 1:50,000 topographical, Google
Earth or other map of the project site in electronic and or print form clearly identifying the
intended project boundaries, the preliminary locations of the main project infrastructure (if
known), the proposed grid connection point and the proposed power line routing.
Site name
Geographical coordinates of project site
boundaries
Site elevation above sea level
Nearest urban centre
Location/Division
County
Distance to nearest access road
Distance to proposed grid connection
point
Legal status/classification of the land at
the project site
Current ownership of the land at the
project site
If the project applicant does not
currently have access to the land rights,
please provide a brief description of how
the applicant intends to acquire such
Description of the Proposed Project
Technology type (please tick one)
Wind
Hydro
Solar
Geothermal
a
Project name
Brief summary of energy resource
assessment results (e.g. wind speeds,
river flow, solar irradiation level,
feedstock availability, etc)
Planned installed capacity (MW)
10
Biomass
(grown)
Biomass
(waste)
Biogas
Anticipated annual electricity generation

(MWh)
Description of any preliminary
environmental or social considerations
to be addressed
Preliminary Project Economics and Financing
Estimated project development costs to
reach financial closure
Projected project CAPEX
Expected debt/equity ratio
Source(s) of equity financing
Source(s) of debt financing
Evidence of the availability of adequate
development and equity funds or
description in which the required
financing will be obtained
Overview of any local benefits that are
expected to derive from the project
Information on Project Applicant Partners
Please provide, where known, the name(s) of the consultants, technical experts, advisors,
equipment suppliers, contractors and other partners with whom the applicant is working or
intends to work to develop the proposed project. In each case, please provide a brief
description of the partner(s) capabilities
Feasibility study consultant(s)
Other project technical expert(s)
Legal advisor(s)
Financial advisor(s)
Anticipated equipment supplier(s)
Engineering, procurement and
construction contractor(s)
Project Development and Implementation Plan

Please provide an outline of the proposed project development and implementation plan with
anticipated dates of relevant milestones from the date of EOI approval by the Ministry of
Energy.
Full feasibility study
Land acquisition
Environmental Impact Assessment
Licence
Grid connection study
11
Other consents and approvals

Financial closure
Construction
Commissioning
Further Information
The Applicant will be required to attach a prefeasibility study or energy resource assessment
report. Please provide any further information that may be relevant for the assessment of your
EOI application such as , any initial approvals secured by the project applicant, land rights
agreements, etc.
Project Applicant Signature

Please sign this FiT Project Application Form to confirm that the information provided herein
is accurate and to acknowledge that the project applicant has read and understood the
Feed-in-Tariff Policy, the Feed-in-Tariff Guidelines and other relevant policies, laws and
regulations for electricity generation
Name of representative of the applicant
Title of representative
Signature
Date and place
12

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FIT EXPRESSION OF INTEREST

PROJECT APPLICATION FORM

Date of response to applicant

Applicant ownership, management or

Anticipated annual electricity generation

Project Development and Implementation Plan

Other consents and approvals

Project Applicant Signature

Date and place

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