Národná diaľničná spoločnosť, a.s., Mlynské Nivy 45, 821 09 Bratislava

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 +421 2

 3511 1

111.

Zapísaný v obchodnom registriOkresného súdu Bratislava I,Oddiel Sa, Vložka č. 3518/B

IČO35 919 001

DIČ2021937775

IČ DPHSK2021937775 1/3

Contract on the use of specified road sectionsunder the Postpaid Toll Regime

entered into in accordance with Act No. 25/2007 Coll. on Electronic Toll Collection for the use of specified sections of roads and on amending andsupplementing certain acts as amended (hereinafter referred to as “Act on Electronic Toll Collection”) between Národná diaľničná spoločnosť,a.s., Mlynské Nivy 45, 821 09 Bratislava, Slovak Republic, recorded in the Business Register of District Court Bratislava I, section Sa, insert no.3518/B, Company ID No. 35 919 001, Tax ID No. 202 193 7775 (hereinafter referred to as the "Toll Collection Administrator”), represented by aperson empowered/authorised in this matter by the Toll Collection Administrator, and the Vehicle Operator, as specified below.

(hereinafter referred to as the “Contract”)

Contract is concluded for the Vehicle Operator

Vehicle Operator number:

Toll account number:

Contract number:

A. Vehicle Operator (Natural person – Entrepreneur)

Name and surname/Businessname:

Tax ID No.:

Company ID No. (*):

Place of business – St. & No.:

City:

Postcode:

VAT ID No.:

Country:

Record in commercial register orother similar register:

(*) or another, similar identifier identifying the natural person – entrepreneur

B. Person signing the Contract

Name and surname:

Date of birth:

Address – St. & No.:

City:

Postcode:

Nationality:

Country:

ID card No. or passport No.:

C. Subject of the Contract

Through this Contract the Toll Collection Administrator commits, after entering into the Contract on the Provision of the On­Board Unit, to enablethe Vehicle Operator to use the Specified Road Sections in accordance with Act on Electronic Toll Collection and the Vehicle Operator commits topay Toll for the use of the Specified Road Sections. In accordance with the General Business Terms and Conditions of the Toll CollectionAdministrator and the General Business Terms and Conditions of the System Operator the On­Board Unit has to be installed in the vehicle byfixed installation.

I declare that all the data is complete and accurate and at the same time by attaching my signature I grant my consent to the Toll CollectionAdministrator and/or persons authorised by it for electronic storage of my data for the purpose of processing, use and handling of claims. I agreewith all the indivisible parts of this Contract, namely with Annex 1 "List of Registered Vehicles", Annex 2 "General Business Terms and Conditionsof the Toll Collection Administrator" and the List of Fees. This Contract is produced in two copies; one copy is intended for the Vehicle Operatorand the other one for the Toll Collection Administrator.

D. Invoice data

E. Security for the Toll Payment Liability

Bank name:

Account number:

Billing period: Invoice maturity:

BIC/SWIFT:

Name of the issuing bank:

Date of the Bank Guaranteeprovision:

Type of security:

Bank Guarantee number:

Amount of the Bank Guarantee:

Bank Guarantee validity:

Národná diaľničná spoločnosť, a.s., Mlynské Nivy 45, 821 09 Bratislava

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lekt

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kého v

ýberu

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a m

ôžete

 zís

kať 

na in

tern

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vom

 port

áli 

ww

w.e

myt

o.s

k ale

bo p

rost

redníc

tvom

 zákazníc

kej lin

ky n

a tel. č

ísle

 +421 2

 3511 1

111.

Zapísaný v obchodnom registriOkresného súdu Bratislava I,Oddiel Sa, Vložka č. 3518/B

IČO35 919 001

DIČ2021937775

IČ DPHSK2021937775 2/3

F. Contact person in charge of billing:

Name and surname:

E­mail:

Signature of the authorised personof the Toll Collection Administrator:

Place, date:

Signature of the Vehicle Operatoror its authorised representative(the corporate seal, if appropriate):

Place, date:

Národná diaľničná spoločnosť, a.s., Mlynské Nivy 45, 821 09 Bratislava

Váže

ný 

Pre

vádzk

ova

teľ 

vozi

dla

, in

form

áci

e týk

ajú

ce s

a e

lekt

ronic

kého v

ýberu

 mýt

a m

ôžete

 zís

kať 

na in

tern

eto

vom

 port

áli 

ww

w.e

myt

o.s

k ale

bo p

rost

redníc

tvom

 zákazníc

kej lin

ky n

a tel. č

ísle

 +421 2

 3511 1

111.

Zapísaný v obchodnom registriOkresného súdu Bratislava I,Oddiel Sa, Vložka č. 3518/B

IČO35 919 001

DIČ2021937775

IČ DPHSK2021937775 3/3

Annex 1 to the Contract on the Use of Specified Road Sections under the Postpaid TollRegime no.

List of registered vehicles and parameters of the initial setting of the On­Board Unit

License plate number:

Country of vehicle registration:

Vehicle category:

Minimum number of vehicle axles:

Emission class:

Maximum permissible vehicle mass:

Maximum permissible combination mass:

Coated glass or other modification:

Estimated number of km per day:

Fleet card number:

Date of expiration of the fleet card validity:

License plate number:

Country of vehicle registration:

Vehicle category:

Minimum number of vehicle axles:

Emission class:

Maximum permissible vehicle mass:

Maximum permissible combination mass:

Coated glass or other modification:

Estimated number of km per day:

Fleet card number:

Date of expiration of the fleet card validity:

License plate number:

Country of vehicle registration:

Vehicle category:

Minimum number of vehicle axles:

Emission class:

Maximum permissible vehicle mass:

Maximum permissible combination mass:

Coated glass or other modification:

Estimated number of km per day:

Fleet card number:

Date of expiration of the fleet card validity:

License plate number:

Country of vehicle registration:

Vehicle category:

Minimum number of vehicle axles:

Emission class:

Maximum permissible vehicle mass:

Maximum permissible combination mass:

Coated glass or other modification:

Estimated number of km per day:

Fleet card number:

Date of expiration of the fleet card validity:

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con corriere

ritiro (gratuito) Avviso importante! Tutte le indicazioni della guida alla compilazione sono senza garanzia. Vi preghiamo di osservare anche le Condizioni generali di contratto del gestore dei pedaggi che troveretealla pagina www.dkv-euroservice.com. Vi preghiamo di inviarci i documenti di registrazione in originale compresa la vostra firma e un timbro della ditta a: DKV EURO SERVICE GmbH + Co. KGMaut SK Balcke-Dürr-Allee 3 D-40882 Ratingen o alla rispettiva unit¨ di distribuzione. Non inviate la documentazione direttamente al gestore dei pedaggi slovacco SkyToll, poiché altrimenti non potrete essere registrati come clienti DKV.

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