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Industrial Scientific Oldham SAS

Rue Orfila Z.I. Est B.P. 20417 62027 ARRAS Cedex FRANCE Tl. : 33 3 21.60.80.80 Fax : 33 3.21.60.80.00 Website : www.oldhamgas.com

Industrial Scientific Corporation End-Use Certification


This end-use certificate must be completed, signed, dated, and returned to Industrial Scientific Corporation via either email to CustomerService@oldhamgas.com or fax to 33 3 21 60 80 03 prior to shipment of your order. Please complete page #1, initial page #2 ,initial #3 and return all pages. This is to certify that the goods imported or exported from Industrial Scientific Corporation- as ordered to ISC under Distributor P.O. #______________________________________ -will be destined for the following end-use application. (Examples: to monitor CO2 in a beer production facility. Or, to monitor CO in a steel production facility.) I certify that this product will be utilized to: __________________________________________________________________________________________________ __________________________________________________________________________________________________. Further, the goods will not be destined for the end-uses listed below and on the next page, as dictated by United States export control law and European Union and/or EU Member State export control law (if applicable). (Please print clearly) Company Name of ultimate destination End User: _________________________________________________ Company Address:___________________________________________________________________________ (No PO Box Address) Company Telephone No.: Company Website: Signature: ______________________________________________________ ______________________________________________________ ______________________________________________________

Printed Name and Title of Signatory: _____________________________________________________ Date of signature:

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A. Will not be imported, re-exported or transferred to be used in the design, development, production, stockpiling, or use of chemical or biological weapons and their precursors. B. Will not be imported, re-exported or transferred to be used in the design, development, production, stockpiling, or use of missiles, rocket systems or unmanned air vehicles of any range or payload. Rocket systems include, but are not limited to, ballistic missile systems, space launch vehicles, and sounding rockets. Unmanned air vehicles include, but are not limited to, cruise missile systems, target drones and reconnaissance drones. C. Product and/or replicas (Replicas refers to items produced abroad on physical examination of the item originally exported, matching it in all critical design and performance parameters) thereof will not be used (either directly or indirectly) in sensitive nuclear end-uses, as follows: 1.Nuclear explosive activities: Nuclear explosive activities, including research on or development, design, manufacture, construction, testing or maintenance of any nuclear explosive device, or components or subsystems of such a device.

End Use Certificate - Page 1 of 3: Rev 11-9-11)

O U R

M I S S I O N

Design - Manufacture - Sell: Highest quality products for the preservation of life and property Provide: Best customer service.

Industrial Scientific Oldham SAS


Rue Orfila Z.I. Est B.P. 20417 62027 ARRAS Cedex FRANCE Tl. : 33 3 21.60.80.80 Fax : 33 3.21.60.80.00 Website : www.oldhamgas.com

2. Un-safeguarded nuclear activities: Activities including research on or development, design, manufacture construction, operation, or maintenance of any nuclear reactor, critical facility, facility for the fabrication of nuclear fuel, facility for the conversion of nuclear material from one chemical form to another, or agency separate storage installation, where there is no obligation to accept International Atomic Energy(IAEA) safeguards at the relevant facility or installation when it contains any source or special fissionable material (regardless of whether or not it contains such material at the time of export), or where any such obligation is not met. 3. Safeguarded and un-safeguarded nuclear activities: Safeguarded and un-safeguarded nuclear fuel cycle activities, including research on or development, design, manufacture, construction, operation or maintenance of any of the following facilities, or components for such facilities: for the chemical processing of irradiated special nuclear or source material, facilities for the production of heavy water facilities for the separation of isotopes of source and special nuclear material; or for the fabrication of nuclear reactor fuel containing plutonium. D. Will not be imported, re-exported or transferred to be used in the design, development, production, construction, support, or maintenance of a maritime nuclear propulsion project; including any machinery, devices, components or equipment specifically developed or designed for use in such plants or facilities. E. Will not be imported, re-exported or transferred for use in crime control and detection commodities and end-uses.

F. Will not be imported, re-exported or transferred to destinations embargoed by the U.S. government (unless deminus provisions apply). The current list of embargoed countries is available at: www.bis.doc.gov and www.treas.gov/ofac. G. Will not be re-exported or transferred to entities listed on U.S. government denial lists: U.S. Department of Commerce Denied Persons List and General Order #3 to EAR Part 736, (www.bis.doc.gov ), Treasury Department Specially Designated Nationals and Block Persons Lists (www.treas.gov/ofac), State Department Debarment List and State Department Parties of Proliferation Concern (www.pmddtc.state.gov). Will not be imported, re-exported or transferred for use by the end-users listed on the Entity List, Supplement No. 4, Part 744 of the EAR without approval from the U.S. Department of Commerce or the Industrial Scientific Corporation International Dept. This list is available at www.bis.doc.gov. Will not be imported, re-exported or transferred for use by persons on the Unverified List as published by the US Department of Commerce Bureau of Industry and Security. This list is available at www.bis.doc.gov. Written Authorization will be obtained from the Bureau of Industry and Security prior to re-exporting or transferring the items or technology, unless they would be eligible for export from the United States to the new country of destination under NLR.

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K. Will not be used, sold, resold, delivered or transferred, directly or indirectly, contrary to U.S. export regulations. L. Will not be imported, re-exported or transferred for use by persons who commit, threaten to commit or support terrorism. The term terrorism means an activity that: a. Involves a violent act or an act dangerous to human life, property, or infrastructure; and b. Appears to be intended: 1. to intimidate or coerce a civilian population; 2. to influence the policy of a government by intimidation or coercion; or 3. to affect the conduct of a government by mass destruction, assassination, kidnapping or hostage taking.

PAGE #2 Initials of signatory_______________


(End Use Certificate - Page 2 of 3: Rev 11-9-11) O U R M I S S I O N

Design - Manufacture - Sell: Highest quality products for the preservation of life and property Provide: Best customer service.

Industrial Scientific Oldham SAS


Rue Orfila Z.I. Est B.P. 20417 62027 ARRAS Cedex FRANCE Tl. : 33 3 21.60.80.80 Fax : 33 3.21.60.80.00 Website : www.oldhamgas.com

If the goods are to be exported from or imported into the customs territory of the European Union, the following additional end-use certifications shall apply: M. Will not be used in connection with the development, production, handling, operation, maintenance, storage, detection, identification or dissemination of chemical, biological or nuclear weapons or other nuclear explosive devices or the development, production, maintenance or storage of missiles capable of delivering such weapons. N. Will not be imported, re-exported or transferred for a military end-use to destinations subject to an arms embargo decided by a common position or joint action adopted by the Council of the European Union or a decision of the Organisation for Security and Cooperation in Europe (OSCE) or an arms embargo imposed by a binding resolution of the Security Council of the United Nations. Will not be used as parts or components of military items listed in the national military list of the applicable EU Member State that have been exported from the territory of the applicable EU Member State without authorization or in violation of an authorization. Will not be used, sold, resold, delivered or transferred, directly or indirectly, contrary to European Union and applicable EU Member State export regulations.

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PAGE #3 Initials of signatory_______________

(End Use Certificate - Page 3 of 3: Rev 11-9-11) O U R M I S S I O N

Design - Manufacture - Sell: Highest quality products for the preservation of life and property Provide: Best customer service.

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