„AUTOROBOT-STREFA” Sp. z o.o.

ul. Leona Wyczółkowskiego 29, 44-109 Gliwice PL NIP/PL 6342266684, KRS NR 0000156775 Sąd Rejonowy w Gliwicach X Wydz. Gosp. Krajowego Rejestru Sądowego Wysokość Kapitału Zakładowego: 6.760.739,73 PLN tel.: +48 (0) 32 775 33 90/95 fax.: +48 (0) 32 775 33 86

ANNEX 4

Statement of the Participant “Steel Design – across technology and art” concerning

the assignment (transfer) of the proprietary

rights to the Competition Entry upon the Organizer without any

PERSONAL CODE OF THE PARTICIPANT

……………………………

I hereby transfer, without any remuneration, in favor of “Autorobot-Strefa”, a limited

liability company, with head office at 29 Wyczółkowskiego Street (zip code: 44-109)

in Gliwice, entered in the Polish Court Register of Companies and Enterprises kept at the

District Court in Gliwice – Department X of Economic Registration – under No: 0000156775,

Tax Identification Number (NIP): 6342266684, REGON (the National Register of Economic

Units): 273831324, with the initial capital of PLN 6.760.739,73,

and

“ Autorobot 2”, a limited liability company, with head office at 29 Wyczółkowskiego Street

(zip code: 44-109) in Gliwice, entered in the Polish Court Register of Companies

and Enterprises kept at the District Court in Gliwice – Department X of Economic

Registration – under No: 0000496283, Tax Identification Number (NIP): 9691609210,

REGON 243465096, with the initial capital of PLN 50.000,000,

hereunder, jointly referred to as: “the Organizer”.

all copyrights, proprietary and personal rights to the work or works comprising the

Competition Entry, as far as timely and territoriality unlimited introduction to commercial

circulation, dissemination, use and management of the work and works concerning the

Competition Entry, both in the territory of Poland and abroad, in the following fields of use:

a. Introduction to economic turnover (including the sale, publication and

dissemination,

b. Recording, copying – by any technique- including digital and photosensitive,

computer or magnetic, printing, video- by any possible means,

c. Public performance, display on any open and close events, including

exhibitions, fairs, training courses, also by means of the internet or on the

internet pages,

d. Broadcasting, re-editing,

„AUTOROBOT-STREFA” Sp. z o.o.

ul. Leona Wyczółkowskiego 29, 44-109 Gliwice PL NIP/PL 6342266684, KRS NR 0000156775 Sąd Rejonowy w Gliwicach X Wydz. Gosp. Krajowego Rejestru Sądowego Wysokość Kapitału Zakładowego: 6.760.739,73 PLN tel.: +48 (0) 32 775 33 90/95 fax.: +48 (0) 32 775 33 86

e. Public release in the manner securing unlimited access at the place and time,

f. Insertion to the computer memory,

g. Other manners of dissemination,

h. Lending, hire, lease, free of charge use,

i. Making use in the construction of models and their patterns and their

dissemination,

j. Use for furniture production and sale,

k. Use, upon the application of the utility model or industrial model to the Polish

Patency Office, as well as to other such offices in Europe, or transfer

of the copyrights to the model.

___________________________________

(date and legible signature of the Participant)