Document on FOSS-Disclosure Disclosure of Free Software and Open-Source-Software (FOSS) in App [NAME OF THE SUPPLIER ADDRESS ADDRESS] SUPPLIER NUMBER CREATION DATE [Please check one of the following boxes] □ Application for approval regarding the use of FOSS for the specific product or □ Statement of full compliance regarding the use of FOSS under an existing approval for the specific product or □ Statement that no FOSS components are used 1. Purpose of the Form, Process The statement on the disclosure of FOSS comprises of this document and its attached FOSS Disclosure Bill of Material (hereinafter referred to as “Items List”) (Annex 1). 1.1 Application for Approval Regarding the Use of Free Software/Open-Source-Software Components of free software and open-source-software (“FOSS-Components”) may only be used with Daimler’s (hereinafter referred to as “DAI”) explicit prior consent. Subject of the approval is the use of any FOSS-Component for an application for mobile devices to be created (“App”, hereinafter also referred to as “Product”), that has been acquired under a license for free software/open-source-software (“FOSS-License”). By submission of this duly completed document including the Items List (Annex 1) regarding the disclosure of FOSS (“FOSS-D”), the supplier applies to Daimler for the approval to use those particular FOSS-Components listed in this FOSS-D that have been acquired under the FOSS-Licenses described herein for the use in the Product described herein (“Product”). Daimler will inform the supplier explicitly in writing about the decision regarding the proposed use of the FOSS-Components. This decision may be a rejection, an approval or an approval with certain limitations or statutory requirements. Also a full rejection of the applied use of FOSS-Components is without prejudice to the supplier’s obligation in particular towards the fulfillment of all existing contractual obligations towards Daimler. The Items List (Annex 1) contains for informational purposes (unbinding) only, a list of FOSS- Licenses frequently approved by Daimler (including particular combinations) and frequently non- approved FOSS-Licenses. The current version of this FOSS-License list is also available under [add address for download of the current FOSS-License list]. From the content of the FOSS- License list no entitlement or claim for an approval of a FOSS-Component or FOSS-License by Daimler may be derived. 1.2 Statement of Unreserved Compliance with the Granted Approval With every delivery of the Product the supplier will by submission of this duly completed FOSS- D confirm without restriction or limitation that the Product fully complies with Daimler’s approval FOSS Disclosure Doc for Apps_2013-12-11_engl.docx Page 1 of 6