CLEAN GROWTH INFRASTRUCTURE ROYALTY PROGRAM2019 REQUEST FOR APPLICATION – RESPONSE FORM

Instructions:

Please complete this document and submit as part of your application.

Required attachments to Sections 8, 10 and 11 should be appended to the completed document.

A person authorized to sign on behalf of the Applicant must complete and sign Section 2.

Please include the original completed and signed page 1 with the hard copy of the application.

SECTION 1: GENERAL INFORMATION

Project Name[response here, 50 characters max]

ApplicantApplicant Legal Name [response here]Business Associate ID [response here]

Partner Applicant #1 (if applicable)Partner Applicant Legal Name [response here, or n/a]Business Associate ID [response here, or n/a]

Partner Applicant #2 (if applicable)Partner Applicant Legal Name [response here, or n/a]Business Associate ID [response here, or n/a]

SECTION 2: APPLICANT AUTHORIZATIONThe enclosed application is submitted in response to the above-referenced RFA, including any addenda. Through submission of this application we agree to all of the terms and conditions of the RFA and agree that any inconsistent provisions in our proposal will be as if not written and do not exist. We have carefully read and examined this entire RFA (including sample Agreements, templates and all attachments), and have conducted such other investigations as were prudent and reasonable in preparing the application. We agree to be bound by statements and representations made in our application.Authorized Contact Name [response here]Authorized Contact Title [response here]Authorized Contact Signature [signature here]

CGIRP 2019 RFA Response Page 1 of 15

SECTION 3: CONTACT INFORMATION

ApplicantContact Name [response here]Contact Title [response here]Contact Phone Number [response here]Contact Email [response here]Physical Address [response here]Mailing Address [response here]

Partner Applicant #1 (if applicable)Contact Name [response here, or n/a]Contact Title [response here, or n/a]Contact Phone Number [response here, or n/a]Contact Email [response here, or n/a]Physical Address [response here, or n/a]Mailing Address [response here, or n/a]

Partner Applicant #2 (if applicable)Contact Name [response here, or n/a]Contact Title [response here, or n/a]Contact Phone Number [response here, or n/a]Contact Email [response here, or n/a]Physical Address [response here, or n/a]Mailing Address [response here, or n/a]

CGIRP 2019 RFA Response Form Page 2 of 15

SECTION 4: SURVEY QUESTIONSHow did you find out about the Clean Growth Infrastructure Royalty Program? (check all that apply)☐ Ministry Website ☐ Industry Organization ☐ Past Applicant (IRCP/CIRCP)☐ Ministry Email Notification ☐ Media Bulletin ☐ Word of Mouth☐ Other (please specify):Has this project been applied for under a previous Infrastructure Royalty Credit Program (IRCP) or Clean Infrastructure Royalty Credit Program (CIRCP) Request for Application?☐ Yes please specify

program and year☐ No

[response here or n/a]

Does the Applicant (corporately) provide voluntary disclosure of emissions?☐ Yes - please explain:☐ No [response here or n/a]

Does this project support any BC liquefied natural gas (LNG) projects?☐ Yes - please explain:☐ No [response here or n/a]

CGIRP 2019 RFA Response Form Page 3 of 15

SECTION 5: APPLICATION DETAILSApplication Type: (select 1 only)☐ Growth Project ☐ Sustainability ProjectProject Type: (select 1 only)Growth Project:☐ Road Infrastructure☐ Pipeline Infrastructure☐ Value-add Infrastructure

Sustainability Project:☐ Emissions Reductions Infrastructure☐ Electrification Infrastructure

If Road Infrastructure Project, complete the following section:Road Type:☐ Oil and Gas Road☐ Forest Services Road☐ Mining Access Road

Road Construction:☐ New☐ Upgrade

Total Project Length (km): [enter km here or n/a]If Pipeline Infrastructure Project, complete the following section:Type:☐ Pipeline☐ Facility☐ Associated installations

Fluid Type:☐ Sweet Natural Gas☐ Sour Natural Gas

☐ Oil☐ Water

Pipeline Authorization:☐ BC OGC Authorized☐ NEB Authorized

[If OGC/NEB Authorized, note file number(s) here, or n/a]

H2S Content: [% here or n/a]Total Project Length (km): [enter km here or n/a]Pipeline Diameter: [enter diameter here or n/a]If Value-add Infrastructure Project, complete the following section:Type:☐ Supports BC natural gas related products☐ Encourages development of value-add midstream plants for export productsIf Electrification Infrastructure Project, complete the following section:Type:☐ Greenfield electrification of oil and gas equipment and/or facilities and associated infrastructure☐ Retrofitting equipment and/or facilities for electrificationIf Emissions Reductions Infrastructure Project, complete the following section:Type:☐ Vented☐ Combustion

CGIRP 2019 RFA Response Form Page 4 of 15

SECTION 6: PROJECT SUMMARYPlease provide a general summary/overview of your project scope of work (2 pages maximum) , including (as applicable):

Location/route of project area description number of construction components/segments type of equipment/technology currently used associated facilities why the Applicant intends to build the project

[response here or n/a]

CGIRP 2019 RFA Response Form Page 5 of 15

SECTION 7: PROJECT DESCRIPTIONPlease describe Step 1 of your project (1 page max), including (as applicable):

Detailed scope of work Start/end locations amount, make and model of all equipment/instrumentation to be installed current GHG emissions profile and emissions reductions expected due to project

[response here or n/a]

Please describe Step 2 of your project (1 page max, if required for Growth Project only)

[response here or n/a]

Please describe Step 3 of your project (1 page max, if required for Growth Project only)

[response here or n/a]

CGIRP 2019 RFA Response Form Page 6 of 15

SECTION 8: DRILLING AND PRODUCTION PERFORMANCE (Growth Project only)1. Please attach the completed Drilling and Production Table to this application.

2. Please provide details of the drilling and production performance expected below (2 pages max), in terms of: : location area formation/zone production rates and reservoir plays seismic information available timing and number of new wells to be drilled and produced as a result of the project over the

next 5 years plan for market access for oil and gas produced by this project

[response here or n/a]

CGIRP 2019 RFA Response Form Page 7 of 15

SECTION 9: SCHEDULEPlease provide project milestone dates below. Note:

Construction Start Date can not be earlier than the RFA Closing Time Construction Completion Date can not be later than December 31, 2022 (ie max 3 year

completion date) Design Activities include:

o Planningo Engineeringo Applicationso Surveying/Mappingo Land acquisitiono Regulatory approvalo Off-site pre-fabrication activities

Construction Activities include:o Mobilizationo On-site construction/fabricationo Equipment purchase/installation/retrofit/replacement/conversiono Testingo Commissioning and Start-upo Clean-upo Demobilizationo Final permitting and reporting

Activities/costs occurring before the Design Start Date or after the Construction Completion Date will not be considered eligible costs.

Sustainability Projects must be completed within 1 stepDesign(Step 1)

Start Date [enter date in YYYY-MM-DD format]Completion Date [enter date in YYYY-MM-DD format]

Construction(Step 1)

Start Date [enter date in YYYY-MM-DD format]Completion Date [enter date in YYYY-MM-DD format]

Design(Step 2, if applicable)

Start Date [enter date in YYYY-MM-DD format, or n/a]Completion Date [enter date in YYYY-MM-DD format, or n/a]

Construction(Step 2, if applicable)

Start Date [enter date in YYYY-MM-DD format, or n/a]Completion Date [enter date in YYYY-MM-DD format, or n/a]

Design(Step 3, if applicable)

Start Date [enter date in YYYY-MM-DD format, or n/a]Completion Date [enter date in YYYY-MM-DD format, or n/a]

Construction(Step 3, if applicable)

Start Date [enter date in YYYY-MM-DD format, or n/a]Completion Date [enter date in YYYY-MM-DD format, or n/a]

CGIRP 2019 RFA Response Form Page 8 of 15

SECTION 10: ESTIMATED COST & ROYALTY DEDUCTIONPlease attach the following documents to this application:

Estimated Cost Table (use template provided) Detailed Cost Breakdown Table

Has this project received any additional provincial funding?☐ Yes - please explain:☐ No [indicate funding source and total amount received or n/a]

SECTION 11: EVALUATION QUESTIONSPlease select and complete one of the following two tables based on your project category (ie Growth or Sustainability.

CGIRP 2019 RFA Response Form Page 9 of 15

COMPLETE THIS TABLE IF GROWTH PROJECTCompany Business Case (Growth)Does this project stimulate any additional oil and gas activity in the surrounding area?☐ Yes - please explain:☐ No [response here or n/a]

Does this project open up unexplored or under-produced areas?☐ Yes - please explain:☐ No [response here or n/a]

Does this project make use of emerging technologies?☐ Yes - please explain:☐ No [response here or n/a]

Does completion of this project help create operational efficiencies for the company?☐ Yes - please explain:☐ No [response here or n/a]

Does the Applicant anticipate any risks to implementation of this project? Eg. budget, schedule, insurance, regulatory, stakeholders, etc.☐ Yes - please explain:☐ No [response here or n/a]

Does the Applicant have a plan to manage project risks?☐ Yes - please explain:☐ No [response here or n/a]

Provincial Economic Impact (Growth)Do multiple companies benefit from this project upon completion? Eg. Shared use of roads, pipelines, etc.☐ Yes - please explain:☐ No [response here or n/a]

Does this project increase the competitiveness of BC resources?☐ Yes - please explain:☐ No [response here or n/a]

Does this project use BC energy sources?☐ Yes - please explain:☐ No [response here or n/a]

Does this project create other products/uses for BC natural gas?☐ Yes - please explain:☐ No [response here or n/a]

Are there midstream or downstream benefits associated with this project?☐ Yes - please explain:☐ No [response here or n/a]

Does this project support BC LNG?☐ Yes - please explain:☐ No [response here or n/a]

Local Economic Benefit (Growth)Does the project support community/regional initiatives or the regional land resource management plan (LRMP)?☐ Yes - please explain:☐ No [response here or n/a]

CGIRP 2019 RFA Response Form Page 10 of 15

COMPLETE THIS TABLE IF GROWTH PROJECTDoes this project create local jobs?☐ Yes - please explain:☐ No [response here or n/a]

Does this project improve public safety or provide alternative emergency access for residents?☐ Yes - please explain:☐ No [response here or n/a]

Does this project improve existing local infrastructure?☐ Yes - please explain:☐ No [response here or n/a]

Are there any short-term benefits to the community/region associated with this project? (training, supplier contracts, accommodation demand, etc.)☐ Yes - please explain:☐ No [response here or n/a]

Are there any long-term benefits to the community/region associated with this project? (permanent housing, permanent jobs, new infrastructure, new local industry base, increased tax base, etc.)☐ Yes - please explain:☐ No [response here or n/a]

Does this project benefit any other regional industries (eg. forestry, farming, tourism, manufacturing, etc.)☐ Yes - please explain:☐ No [response here or n/a]

Emissions Reductions (Growth)Does this project utilize technology or techniques that minimize emissions intensity?☐ Yes - please explain:☐ No [response here or n/a]

Cumulative Environmental Effect (Growth)Does this project impact sensitive environments or ecosystems?

a) Water (wetlands, lakes, headwater)b) Forests (old growth forests, buffer areas)c) Caribou (birthing grounds, feeding areas, migrating corridors)

☐ Yes - please explain:☐ No [response here or n/a]

Does this project result in improved techniques for water resource or land use management?☐ Yes - please explain:☐ No [response here or n/a]

Does this project conserve or reduce fresh water usage?☐ Yes - please explain:☐ No [response here or n/a]

Does this project support alternative disposal options, responsible disposal of water, or improve management of produced water?☐ Yes - please explain:☐ No [response here or n/a]

Does the project result in (or have) shared infrastructure that reduces overall land use impacts?☐ Yes - please explain:☐ No [response here or n/a]

CGIRP 2019 RFA Response Form Page 11 of 15

COMPLETE THIS TABLE IF GROWTH PROJECTDoes this project consolidate the industry footprint of pipelines corridors, roads, infrastructure locations, pads, etc.?☐ Yes - please explain:☐ No [response here or n/a]

Does this project cause a new disturbance to the environment (air, land, water)? Eg. increased fragmentation of land☐ Yes - please explain:☐ No [response here or n/a]

Does this project improve air quality?☐ Yes - please explain:☐ No [response here or n/a]

Social Impact (Growth)Has Applicant included involvement of indigenous peoples on this project?☐ Yes - please explain:☐ No [response here or n/a]

Does this project benefit local indigenous peoples?☐ Yes - please explain:☐ No [response here or n/a]

Does or will this project employ indigenous peoples?☐ Yes - please explain:☐ No [response here or n/a]

Does this project benefit any specific group or organization (outside of industry)?☐ Yes - please explain:☐ No [response here or n/a]

Does this project provide new or improved access to developed or back country recreational resources?☐ Yes - please explain:☐ No [response here or n/a]

Does this project reduce truck traffic? (frequency, volume, etc.)☐ Yes - please explain:☐ No [response here or n/a]

Does this project reduce noise?☐ Yes - please explain:☐ No [response here or n/a]

Does this project improve public safety or provide alternative emergency access for residents?☐ Yes - please explain:☐ No [response here or n/a]

CGIRP 2019 RFA Response Form Page 12 of 15

COMPLETE THIS TABLE IF SUSTAINABILITY PROJECTCompany Business Case (Sustainability)Does this project make use of emerging technologies?☐ Yes - please explain:☐ No [response here or n/a]

Does completion of this project help create operational efficiencies for the company?☐ Yes - please explain:☐ No [response here or n/a]

Does the Applicant anticipate any risks to implementation of this project? Eg. budget, schedule, insurance, regulatory, stakeholders, etc.☐ Yes - please explain:☐ No [response here or n/a]

Does the Applicant have a plan to manage project risks?☐ Yes - please explain:☐ No [response here or n/a]

Provincial Economic Impact (Sustainability)Does this project create other products/uses for BC natural gas?☐ Yes - please explain:☐ No [response here or n/a]

Is there midstream or downstream benefits associated with this project?☐ Yes - please explain:☐ No [response here or n/a]

Local Economic Benefit (Sustainability)Does the project support community/regional initiatives or the regional land resource management plan (LRMP)?☐ Yes - please explain:☐ No [response here or n/a]

Does this project create local jobs?☐ Yes - please explain:☐ No [response here or n/a]

Does this project improve existing local infrastructure?☐ Yes - please explain:☐ No [response here or n/a]

Are there any short-term benefits to the community/region associated with this project? (training, supplier contracts, accommodation demand, etc.)☐ Yes - please explain:☐ No [response here or n/a]

Are there any long-term benefits to the community/region associated with this project? (permanent housing, permanent jobs, new infrastructure, new local industry base, increased tax base, etc.)☐ Yes - please explain:☐ No [response here or n/a]

Does this project benefit any other regional industries (eg. forestry, farming, tourism, manufacturing, etc.)☐ Yes - please explain:☐ No [response here or n/a]

Emissions Reductions (Sustainability)Does this project use clean BC electricity?

CGIRP 2019 RFA Response Form Page 13 of 15

COMPLETE THIS TABLE IF SUSTAINABILITY PROJECT☐ Yes - please indicate

what specific components of the project are electrified:

☐ No

[response here or n/a]

Does this project reduce greenhouse gas (GHG) emissions?If yes, please also attach a copy of the estimated GHG emissions reduction calculations to this application – see RFA Appendix C for further information.☐ Yes – please indicate

reduction in emissions associated with this project:

☐ No

[enter total amount here, in tonne CO2e]

Cumulative Environmental Effect (Sustainability)Does this project impact sensitive environments or ecosystems?

a) Water (wetlands, lakes, headwater)b) Forests (old growth forests, buffer areas)c) Caribou (birthing grounds, feeding areas, migrating corridors)

☐ Yes - please explain:☐ No [response here or n/a]

Does this project result in improved techniques for water resource or land use management?☐ Yes - please explain:☐ No [response here or n/a]

Does this project conserve or reduce fresh water usage?☐ Yes - please explain:☐ No [response here or n/a]

Does this project support alternative disposal options, responsible disposal of water, or improve management of produced water?☐ Yes - please explain:☐ No [response here or n/a]

Does this project improve air quality?☐ Yes - please explain:☐ No [response here or n/a]

Social Impact (Sustainability)Has Applicant included involvement of indigenous peoples on this project?☐ Yes - please explain:☐ No [response here or n/a]

Does this project benefit local indigenous peoples?☐ Yes - please explain:☐ No [response here or n/a]

Does or will this project employ indigenous peoples?☐ Yes - please explain:☐ No [response here or n/a]

Does this project benefit any specific group or organization (outside of industry)?

CGIRP 2019 RFA Response Form Page 14 of 15

COMPLETE THIS TABLE IF SUSTAINABILITY PROJECT☐ Yes - please explain:☐ No [response here or n/a]

Does this project provide new or improved access to developed or back country recreational resources?☐ Yes - please explain:☐ No [response here or n/a]

Does this project reduce truck traffic? (frequency, volume, etc.)☐ Yes - please explain:☐ No [response here or n/a]

Does this project reduce noise?☐ Yes - please explain:☐ No [response here or n/a]

Does this project improve public safety or provide alternative emergency access for residents?☐ Yes - please explain:☐ No [response here or n/a]

CGIRP 2019 RFA Response Form Page 15 of 15