ESP®ecially FOR YOUR PT6A – REGISTRATION FORM CUSTOMER / OPERATOR
Company Name:* *Indicates required fields, if applicable
AGENT / MANAGEMENT COMPANY Company Name:* Street Address:* Street Address:* City:* City:* Region/Province/State:* Region/Province/State:* Postal/ZIP Code:* Postal/ZIP Code:* Country:* Country:* Principal Contact:* Principal Contact:* Title: Title: Phone:* Fax: Phone:* Email:* Fax: Email:* USA Customers only*: ☐Employer / Federal Tax ID Number:
or ☐ IRS Number: AIRCRAFT AND ENGINE INFORMATION Aircraft Model:* Aircraft Tail No.:* Aircraft Serial No.:* Aircraft Delivery date:* Engine Model:* Build Specification: Engine TBO: Engine Serial No. (#1):* Engine TSN:* Engine CSN:* Engine Serial No. (#2): Engine TSN: Engine CSN: Engine Delivery Date:* Engine(s) purchased from:* ☐Aircraft OEM ☐Pratt & Whitney Canada (P&WC) ☐Other (company name): Forecast utilization: Hours/Year: Mandatory: Export Control And Average Cycles/Hour: Is the aircraft destined for, or being operated by or on behalf of a (para)military end user?* ☐Yes ☐No
In which country will the aircraft be physically based?* EAGLE SERVICETM PLAN (ESP®) PROGRAM – ESP®ecially FOR YOUR PT6 ☒ P&WC is including a special offer on your new PT6A engine(s): First 400 hours* of ESP® Gold Lite maintenance program at no
charge à Our PT6 ESP® Specialist will come back to you with your ESP® contract for signature (*Up to 400 hours Total Time Since New or two years from date of aircraft delivery, whichever occurs first, for engines enrolling when new) Contract holder:* ☐Customer/Operator ☐Agent/Management Company
ESP® Program agreement to be addressed to:* ☐Customer/Operator ☐Agent/Management Company
To benefit from this offer, please complete the ESP® Contact Information Form (see Annex A) Other parties:* ☐Registered Aircraft Owner ☐“Aircraft Interest Holder” (company name):
☐I decline this offer
Full address:* Phone:* Fax: Email:* Contact:* OIL ANALYSIS TECHNOLOGY TRIAL ☒ Your new PT6A engine(s) have been enrolled in P&WC’s Oil Analysis Technology Trial at no charge à Sampling Kits Shipping
Recipient: ☐Customer/Operator ☐Agent/Management company ☐FBO (company name):
See Legal Terms and Conditions on next page
☐I decline this offer
WARRANTY Would you like to register your engine warranty now? ☐Yes à Please provide a proof of delivery. (Aircraft proof of delivery from aircraft manufacturer or dealer, or copy of logbook. New engines warranty will be registered based on your aircraft/engine delivery date.) ☐No CREDIT If you are planning on regularly making purchases from P&WC, for an annual value of US$25,000 or more, you can apply for a credit. Filling out the credit application form in advance will ensure that no delays are incurred, should you require logistic (spare parts) support. Would you like to fill out your credit application form now? ☐Yes à Please complete the form in Annex B. ☐No TECHNICAL PUBLICATIONS Revision service from date of new aircraft delivery is provided free of charge for a period of two years, and at a nominal fee thereafter providing access to Service Bulletins, Spare Parts Bulletins and Service Information Letters. Please register now at https://customer.pwc.ca to obtain your user name and password. To benefit from this service, please complete the Publications Technical Data Agreement (see Annex C) I, the undersigned, hereby declare that all the information provided herein is to the best of my knowledge true, complete and correct and agree it can be communicated within Pratt & Whitney Canada. Signature:* _________________________ Date:* _________________________ NOTE: AFTER FILLING OUT AND SIGNING THIS FORM AND ITS RELEVANT ANNEXES PLEASE SCAN IT AND SEND IT BY EMAIL TO ESPeciallyPT6@pwc.ca 1 of 5 ESP®ecially FOR YOUR PT6A – REGISTRATION FORM FURTHER INSTRUCTIONS OIL ANALYSIS TECHNOLOGY TRIAL By submitting the oil samples, the participant donates the oil samples to Pratt & Whitney Canada Corp. ("P&WC") for P&WC's use and agrees that any use of the samples, and the use and publication of the results of any analysis of the samples will be within the sole direction and authority of P&WC. P&WC oil analysis technology trial is still in development. if you elect to receive the results, such reports will be provided by P&WC on an as is basis and for information purposes only, without any representation or warranty whatsoever, express or by implied, including any warranties as to the information's quality, accuracy or non/ infringement, adequacy, sufficiency and/or freedom from any defect of any kind. The reports do not replace or supersede any existing maintenance activities or schedules as outlined in the appropriate engine maintenance manual or any instructions for continued airworthiness. Because the technology is still in development, P&WC is not able to provide any maintenance recommendations nor should the reports or results be interpreted as such indicator of an engine issue. P&WC shall have no liability for any errors in or omissions resulting from the reports or the results and P&WC shall assume no responsibility, warranty or liability expressed or implied arising from the reports or the results. In no event shall P&WC be liable for economic loss, indirect, incidental, consequential or special damages, whether in contract, tort or under any other legal theory. The parties agree this agreement shall be interpreted and enforced under Quebec law. The parties have agreed that this agreement be in English (Les parties ont convenu que les présentes soient rédigées en anglais). CUSTOMER PORTAL ACCOUNT To help us provide you with the P&WC services you need, we encourage you to create your E/ Portal account. Please refer to:
https://customer.pwc.ca
PUBLICATIONS To each new aircraft operator, we supply a free online Maintenance Collection consisting of the following: 1.
2.
3.
4.
5.
6.
7.
Engine Maintenance Manual,
Engine Illustrated Parts Catalog,
Engine Service Bulletins,
Spare Parts Bulletins and
Service Information Letters,
Engine Diagnostic Tool – Spotlight (available online only for PW100, PW200 and PW300 models),
Ground Base Software – DPHM (available online only for selected models)
Revision service from date of aircraft delivery is also provided free of charge for a period of two years, and at a nominal fee thereafter. For additional information regarding Technical Publications please visit the following P&WC Web: http://www.pwc.ca/en/service/ support/
technical/ publications. ADDITIONAL SERVICES RENTALS & EXCHANGES ENGINES (LEASECO) With our engine pool, we offer a wide range of services to satisfy your requirements. For information on Engine Rentals please refer to: http://www.pwc.ca/en/service/ support/engine/ rentals. For information on Engine Exchanges please refer to: http://www.pwc.ca/en/service/
support/engine-­exchanges. TECHNICAL TRAINING If engine maintenance is being performed by employees of your company, and you require technical training, a course schedule and registration can be found at: http://www.flightsafety.com/fs_prattwhitneycanada.php. REPAIR AND OVERHAUL (O/H) SUPPORT AND PAY-­BY-­THE-­HOUR PROGRAM ESP® An engine repair and overhaul capabilities booklet is included in the initial email. For information on ESP® please refer to: http://www.pwc.ca/en/service-­support/general-­aviation-­pay-­by-­the-­hour. DIAGNOSTICS, PROGNOSTICS AND HEALTH MANAGEMENT (DPHM) SERVICE The DPHM Service comprises of the software and hardware needed to perform flight line maintenance activities and diagnostic tasks. For further information on these services, please refer to: http://www.pwc.ca/en/service-­support/advanced-­diagnostics. Have you already been contacted by a Field Support Representative? ☐ Yes ☐No
“I need additional information on”: ☐ Entry into Service Package
☐ Line Maintenance Tooling
☐ Technical Training
☐ Publications
☐ Rental & Exchanges Engines (Leaseco)
☐ Repair and Overhaul Support
Your local Field Representative will contact you. ☐ Initial Parts Provisioning
☐ “Pay-­by-­the-­hour” programs
☐ DPHM Service
2 of 5 ESP®ecially FOR YOUR PT6A – REGISTRATION FORM ANNEX A – ESP® CONTACT INFORMATION FORM When the ESP® contract is in effect, it will be important for P&WC to know whom in your organization to contact in the event of issues regarding monthly hours reporting, payments, rate adjustments, or engine condition trend monitoring. A. ESP® PROGRAM MONTHLY REPORT SUBMISSION Company Name: Contact Name: ☐Mr. ☐Ms. Country: Phone: Fax: Email: B. ESP® PROGRAM MONTHLY PAYMENTS Same as: ☐A. If different, please fill in below. Company Name: Contact Name: ☐Mr. ☐Ms. Country: Phone: Fax: Email: C. ESP® PROGRAM ANNUAL RATE ADJUSTMENT Same as: ☐A. ☐B. If different, please fill in below. Company Name: Contact Name: ☐Mr. ☐Ms. Country: Phone: Fax: Email: D. ENGINE CONDITION TREND MONITORING DATA TRANSMISSION Same as: ☐A. ☐B. ☐C. If different, please fill in below. Company Name: Contact Name: ☐Mr. ☐Ms. Country: Phone: Fax: Email: 3 of 5 ESP®ecially FOR YOUR PT6A – REGISTRATION FORM ANNEX B -­ CREDIT APPLICATION *Indicates required fields, if applicable COMPANY INFORMATION Company name:* Same as in General Information? ☐Yes ☐No Year of company’s establishment:* Federal ID No.:* No. of Employees:* D&B Number: Is the company publicly traded?* ☐ Yes, stock symbol: ☐ No Is the company a subsidiary of one or more companies?* ☐ Yes ☐No IF YES, Parent Company information: Legal name: Address: Email: IF NO, Owners information: Contact name: Telephone: Fax: Owner Name: Owner Name: Owner Name: Ownership%: Ownership%: Ownership%: Names of Principals (with titles):* Accounts Payable contact person:* Email:* Telephone:* Fax: Canadian GST/HST/PST number: U.S. Federal I.D. number: PRINCIPAL BANK REFERENCE Legal name:* Contact name:* Address:* Telephone:* Email:* Fax: PRINCIPAL TRADE REFERENCES Legal name:* Address:* Contact name:* Email:* Telephone:* Legal name:* Address:* Fax: Contact name:* Email:* Telephone:* Legal name:* Fax: Contact name:* Address:* Telephone:* Email:* Fax: ADDITIONAL INFORMATION Do you have an account with other UTC/P&WC affiliates?* ☐ Yes ☐ No IF YES, UTC/P&WC Organization: Contact name: Telephone: Email: Fax: Do you have an active ESP or FMP coverage?* ☐ Yes ☐ No IF YES, Plan Type: ☐ Silver Lite ☐ Silver ☐ Gold Lite ☐ Gold ☐ Platinum ☐ FMP Agreement Number: No. of P&WC engines owned: Registered engines (ESN and Engine Model): Additional Engine Models (not registered): Expected yearly purchases: $USD: What other info, business plan, etc., can you provide? Credit limit requested: $USD: You must also submit audited financial statements for the last two years. If your application is approved, you agree to pay all invoices within 30 days from the date of invoice. You agree to pay all late payment charges of 1.5% per month on any overdue invoice. P&WC reserves the right to review and/or revoke any approved credit limit on overdue accounts without notice. I, the undersigned, hereby declare that all the information provided herein is to the best of my knowledge true, complete and correct and agree it can be communicated within Pratt & Whitney Canada. Signature: _________________________ Date: _________________________ 4 of 5 ESP®ecially FOR YOUR PT6A – REGISTRATION FORM ANNEX C -­ TECHNICAL DATA AGREEMENT Subject to the following terms and conditions, Pratt & Whitney Canada Corp., 1000 Marie-­Victorin, Longueuil, Québec, Canada, J4G 1A1 (“P&WC”) and Customer Full Legal Name (Company Name): _________________________ Customer No.: _________________________ Customer Address: _________________________ enter into this agreement ("Agreement"), effective as of the date of last execution hereof ("Effective Date"), regarding the furnishing to Customer, from time to time, of P&WC technical documents and data, which may include but is not limited to, technical manuals, service bulletins, technical publications, parts catalogues, drawings, specifications, reports, approvals, technical instructions, tooling drawings, ground support equipment information and training materials, and all information and data therein or derived therefrom (collectively defined as "Technical Documents and Data") for the support and/or service of parts and products produced by or for P&WC (defined herein as “P&WC Products”). 1. Restrictions on Use of Information and Data All information and data contained in or derived from Technical Documents and Data is proprietary to, and remains the property of P&WC. P&WC licenses Customer to use such information and data for the sole and limited purpose of using, maintaining, inspecting, servicing and repairing P&WC Products as specifically directed in Technical Documents and Data. Customer agrees: (i) to receive such information and data in confidence;; (ii) to preserve and protect the confidentiality of such information and data using no less than reasonable care;; (iii) not to disclose such information and data, in whole or in part, to any third party;; (iv) to use such information and data only for the purpose directed in Technical Documents and Data;; and (v) not to use such information and data, in whole or in part, for any other purpose, including but not limited to: (a) designing, creating, developing, reproducing, manufacturing or deriving any design, part, product, material, process, modification, configuration change or repair;; (b) seeking FAA or other governmental or regulatory approval or acceptance for any of the foregoing;; or (c) any other commercial activity not expressly authorized by P&WC. Nothing in this Agreement conveys, grants, or obligates P&WC to convey or grant, a license to any patent, trademark or other P&WC right. Customer shall not, in whole or in part: (i) modify, copy, translate into any language, reproduce or make derivative works of Technical Documents and Data;; or (ii) reverse engineer, reverse compile, reverse assemble or otherwise translate into any human or machine-­readable form any Technical Documents and Data. 2. No Assignment or Amendment This Agreement may not be assigned, in whole or in part, by Customer without the prior written consent of P&WC. The Agreement may only be amended in a writing signed by both parties. 3. Termination The obligations of Customer defined in Paragraphs 1 and 2 of this Agreement shall survive any termination of this Agreement. 4. Miscellaneous Should any provision of this Agreement be held unenforceable or in conflict with the law of any relevant jurisdiction, the validity of the remaining provisions shall be unaffected by such holding. This Agreement and the performance thereof shall be governed and construed using the laws applicable in the Province of Ontario, Canada, excluding conflict or choice of law rules. The parties have agreed that this Agreement shall be drawn up in English. IN WITNESS WHEREOF, the parties hereto have caused this instrument or its facsimile to be executed on their behalf by their duly authorized officers. PRATT & WHITNEY CANADA CORP. CUSTOMER Signature: _______________________ Signature:* _________________________ Print Name: Jean-­François Arcand Print Name:* _________________________ Title: Manager, Publications Title:* _________________________ Date: Mar 20, 2013 Date:* _________________________ 5 of 5