ERC/PET/LIC-1(1)

THE ENERGY ACT, 2006

APPLICATION FORM FOR A PETROLEUM BUSINESS LICENCE (EXCEPT LPG)

(This application form is FREE and ERC does NOT charge any Licence fees)
(A separate application form must be completed in respect of each separate business
establishment)

1. Name of business/applicant ____________________________________

2. Details of applicant:

a) Income Tax Personal Identification Number(s)__________________

b) Postal address ______________________________________

c) Email Address : ___________________________________

d) Location of business premises:

Plot No ___________ Building Name _________________________

Street/Market _______________________________________

Town/District _________________________________________

3. Give full details of proprietors or partners owning business or directors/shareholders of the

company, as the case may be.

Name Nationality (Where applicable

No. of shares held)
_________ ________________ __________________

___________ ________________ ___________________

___________ __________________ ___________________

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(Any additional information should be submitted on a separate sheet of paper.)

4. Give full details of directors of the company.

Name Nationality Passport/ ID No.

_____________ ____ _________________ _________________
_____________ ____ __________________ ________________
(any additional information should be submitted on a separate sheet of paper.)

5. Full description of the business (es) for which the licence is required

_______________________________________________________________

6. (a) Indicate the number and date of issue of any licence previously held under the Act.

_______________________________________________________________

(b) Indicate the period for which the licence is being applied (maximum is one year from the
date of issue).

_______________________________________________________________

7. State if you are or any of your partners/directors is an undischarged bankrupt. (If so indicate
the names.)

_______________________________________________________________

8. (a) Has any previous application for a licence been rejected under the Act? (If so, give details)

____________________________________________________________

(b) Has any previous licence been cancelled under the Act?

____________________________________________________________
9. (a) A criteria to be met for new application and for renewal of a licence is attached at the back
of the application form.

(b) Certified copies (by advocate / commissioner of oaths) of documents as per criteria
specified above should be submitted together with the licence application.

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 ERC/PET/LIC-1(1)

10. CONDITIONS FOR IMPORTING AND MARKETING PETROLEUM PRODUCTS IN KENYA

a) THE ENERGY ACT 2006 AND ANY OTHER SUBSIDIARY REGULATION

b) REFINED PRODUCTS OFF TAKE AGREEMENT

Companies importing petroleum products for the Kenyan market are required to purchase
such quantities of refined petroleum products from the Kenya Petroleum
Refineries Ltd (KPRL) as the minister may prescribe for such an importer having regard to
market share and also undertake their imports through the Open Tender System (OTS).
Refer to Legal Notice No.24, Kenya Gazette Supplement No. 26 of 10th April 2012.

c) MINIMUM OPERATIONAL STOCKS

Companies importing petroleum products for marketing in Kenya are required to maintain
minimum operational stocks as per Legal Notice Number 44 dated 10th April 2008

d) SUBMISSION OF SALES DATA

Companies marketing petroleum products in Kenya are required to submit monthly sales
data. Refer to Legal Notice No. 31 of 18th March, 2002 and any revision/amendment
thereof

DECLARATION

i. I/We have read and understood the relevant sections of the Energy Act, No. 12 of
2006 and the related petroleum rules and regulations, and agree to abide with them.

ii. I/We hereby certify that the information given above is to my/our knowledge
true and accurate.

iii. I/We understand that it is an offence to give false information in an application for a
licence.

iv. I/We understand that it is a serious offence to divert into the Kenyan market petroleum
products destined for export.

v. I/We understand that any person or company found diverting export petroleum
products to the Kenyan market, either directly or indirectly will have the their licence
cancelled.

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 ERC/PET/LIC-1(1)

vi. I/We understand to conduct an honest petroleum business and shall ensure that
my/our Company will not promote the diversion of export petroleum products into the
Kenyan market either directly or indirectly.

vii. I hereby confirm that our Company/Business shall abide by the above terms and
conditions with regard to importation and marketing of petroleum products in Kenya. I
also understand that the trade licence issued for importation of petroleum for the
Kenyan market is subject to these conditions.

Name of Company: ____________________________________________

Name and ID of
Person signing __________________________________________
The Declaration:

Designation and telephone No.:_____________________________________

Signature & Stamp: ______________________________________________

Date: _________________________________________________________

Email address: _________________________________________________

FOR OFFICIAL USE ONLY

1. Date application received:

2. Date of meeting of Petroleum Licencing Committee:

3. Decision of Petroleum Licencing Committee.

Members present: Signature

1.

2.

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3.

4.
4. If application is deferred or rejected, date of letter advising applicant accordingly

5. Date of review of application

Decision of Committee

Members present: Signature

1.

2.

3.

4.

6. License details

No. ___________ Date issued__________ Expiry date_________________

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 ERC/PET/LIC-1(1)

THE ENERGY ACT, 2006

QUESTIONNAIRE TO BE FILLED BY NEW APPLICANTS FOR A

PETROLEUM BUSINESS LICENCE

1. Name of applicant: _________________________________________

3. Nature of business (Sole Trader, Partnership, Private Company or Public

Company):__________________________________________________

4. Certificate of Incorporation/Registration Number and date: ___________

Country of Incorporation: ______________________________________

Physical address:

Postal address: ____________________________________________

Telephone/ fax: __________________________________________

Email address:

5. Give particulars of proprietors or partners or directors/shareholders of

Company as may be the case.

Name Nationality Shares (if applicable)

____________ __________ ____________
____________ __________ ____________
____________ __________ ____________
____________ __________ ____________

6. Give details on equity capital including other sources of financing ______

_______________________________________________________________

7. Indicate bank references ______________________________________

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8. Type of business required to be licensed (tick as appropriate):

(i) Refining.
(ii) Importation.
(iii) Exportation.
(iv) Wholesale.
(v) Storage.
(vi) Transportation.
(vii) Specify any other __________________________________

9. Indicate if you

(a) Own storage facilities (If so, give details including location and
capacity)____________________________________________

(b) Have hospitality/rental arrangement (If so, give details including copies of any
agreements) ____________________________

10. Do you intend to market your product locally? ___________________

If Yes,

(a) Give the number and locations of Retails Outlets

_____________________________________________

(b) Give the number and locations of Distribution Depots including their
capacities _____________________________________________________

(c) If neither (a) nor (b) is applicable, explain __________________________

__________________________________________________________________

(d) Give details on how you propose to maintain the approved quality of your
product ________________________________________________________

11. (a) Give details of measures you have taken/you propose to take to ensure that the
product you handle does not endanger life or pollute the environment
____________________________________________________________

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(b) Any additional information that the applicant wishes to give

____________________________________________________________

(If space provided above is not adequate use plain paper where applicable and attach to this
questionnaire)

Name of Company: _______________________________________________

Name and ID of
Person signing __________________________________________
The Declaration:

Designation and telephone No.:______________________________________

Signature & Stamp: _______________________________________________

Date: ______________________________________________________

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 ERC/PET/LIC-1(1)

LICENCE EVALUATION CRITERIA FOR NEW PETROLEUM BUSINESSES (EXCEPT LPG)

Criteria REF IMP EXP STO WH PL

Application form Yes Yes Yes Yes Yes Yes

Detailed Questionnaire Yes Yes Yes Yes Yes Yes
Certified copy of Memo and Articles of association Yes Yes Yes Yes Yes Yes
Certified copy of Certificate of Incorporation/Business registration Yes Yes Yes Yes Yes Yes
Certified copy of PIN certificate Yes Yes Yes Yes Yes Yes
Certified copy of VAT registration certificate Yes Yes Yes Yes Yes Yes
Copy of a valid tax compliance certificate Yes Yes yes yes yes yes
Certified copies of Identification documents for directors (ID/passport page 1 and 5) Yes Yes yes yes yes yes
Work permits for non-citizens / Entry permit class H Yes Yes yes yes yes yes
Certified copy of Lease agreement/Tittle Deed Yes Yes Yes Yes Yes Yes
Confirmation of application for membership to a National Oil Spill Group Yes Yes Yes
Confirmation from KPRL of a signed refined products off take Agreement Yes
Confirmation from MOE of signed OTS agreement for refined products Yes
Proof of ownership of at least 3 operational petrol stations in Kenya or a petroleum depot Yes
Environmental Impact Assessment Licence (if new) Yes Yes Yes
Copy of annual Environmental Audit acknowledgement letter from NEMA (Existing) Yes Yes Yes
Confirmation from KEBS that the facility complies with the Kenya Standard Yes Yes
Certified copy of certificate of compliance with Physical Planning Act, 1996 Yes Yes Yes
Certified copy of clearance certificate from chief fire officer/Fire Certificate Yes Yes Yes
Detailed approved drawing by local government drawn to scale Yes Yes Yes
Certified copy of certificate of registration of workplace by DOSHS Yes Yes Yes

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LICENCE EVALUATION CRITERIA FOR RENEWAL OF PETROLEUM BUSINESSES (EXCEPT LPG)

Criteria REF IMP EXP STO WH PL

Application form Yes Yes Yes Yes Yes Yes
Copy of the previous petroleum licence Yes Yes Yes Yes Yes Yes
Copy of a valid tax compliance certificate Yes Yes Yes Yes Yes Yes
Letter from KPRL confirming compliance with the refined products off take agreement Yes
Proof of ownership of at least 3 operational petrol stations in Kenya or a petroleum depot Yes
Confirmation of active membership of a National Oil Spill Group Yes
At least 4 copies of purchases invoices as proof of previous licence utilization Yes Yes
At least 4 copies of sales invoices as proof of previous licence utilization Yes Yes
Copy of annual Environmental Audit acknowledgement letter from NEMA Yes Yes Yes
Certified copy of clearance certificate from chief fire officer/Fire Certificate Yes Yes Yes
Certified copy of certificate of registration of workplace by DOSHS Yes Yes Yes

KEY

REF Refining IMP Import EXP Export STO Storage WH - Wholesale PL Pipeline Transport

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