Supple’s Conflict of interest Certification Statement Please complete the following questionnaire as it relates to your relationship with Minctree. if you answer “Yes" to 2 question, please descrive with comments the potential conflet of interest, A “Yes! answer does not necessariy constitute a conflict of interest. However, without complete disclosure, fair and reasonable assessment of whether the Supplier is an appropriate ‘business partner of Mindtree cannot be made, ‘Supplier Name: MCI GeTS India Pt. id Certification Statements ‘Query ‘Yes, with comments No Ts any director oF key personnel of the Supplier organization or an NO Immediate family member or extended famiy member of such persons (eg, spoute, chil, sibling, parent, niece, nephew, oF In- Jaw) employed by Mindtree , acting as 2 consultant, or have 2 fnancal interest n Mindtree? Has the Supplier, officers, dvecors or any immediate family NO rember or extended family member given or offered any gifts | {otherthan promationalitems or an occasional meal) or more than Incidental hospitality to any Mindtree personnel within the last2 months? Tg anyone inthe Supplier company Greely or Indrecly connected NO ‘to Mindtree in a way which may influence the procurement order, in the Supplier's favar eg. arelatwe who Isa Mindtree employee? Ts the Susplier or any of ts directors or officers a significant NO shareholder in Mindtree? Ts the Supplier a sole Supplier to Mindtresin any product or service NO ‘category? Has Mindtree terminated any of the Supplier contracts with NO Mingtree in past 3 years due to Supplier's breach? Is the Supplier under any legal, statutory or contractual restriction NO ‘which prohibits Supplier from working with Mindtree? Tas the Supplier mluanced the decision mating is any manner NO other than based on the qualties and pricing of his goods and Has the Supplier offered any gifts or gratuities of any Kind to any NO person connected to Mindtree procurement or In Mindtree 10 secure the order/potentil order? Does any relative oF frend of the Supplier work with Mindtree NO procurement function or the use funetion ofthe goods or services? Declaration | declare on behalf of the above named Supplier including is drectors and key personnel that all the above facts are true tothe best of my knowledge and are based on the verifications mace. If at anytime We suspect that a present or future acts or events may create @ conflict with provision of goods or services to Mindtree, | We shall immediately and fuly inform Mindtres about the potential or actual conflict of interest, | promise to abide by 'Mindtree who may accordingly advise me/us on the future course of ction, which shall be final and binding, rng submitting the form: Vijaya] Ain Date19-09-2018,