AVIATION

ENGINEERS ACCEPTANCE FORM

An electronic copy of this form shall be completed and submitted to the Field Aviation Supervisor or
the Field Aviation Superintendent for ExxonMobil Aviation approval before any engineer is assigned to
operate any helicopter on contract to ExxonMobil and Affiliate companies in Nigeria.
The minimum qualification requirements and levels of experience as set out in the Aviation Operations
Guide, (AOG) and the Helicopter Logistics Support Agreement must be complied with.
Following a review by ExxonMobil Aviation, the form will be returned to the Contractor indicating
ExxonMobil Aviations approval, non-approval or provisional approval of the engineer to operate on
the contract. A signed hard copy will also be sent to the Contractor in respect of approved candidates.
Only engineers with ExxonMobil approval may be employed on the contract.
DETAILS OF ENGINEERING PERSONNEL
Name
Date of Birth

Nationality

Estimated date of arrival on site

A & C or Avionics

DETAILS OF LICENCE
Licensed/ or Non Licensed
Type/License
Number
No Yes (Specify)
YET TO BE ISSUED

Country of
issue

Year of initial issue

2014

QUALIFICATION
(Emphasis should be on helicopter types to be operated on contract)
Formal Training and Field experience
NIL
Appropriate Ratings
NIL
Approved Factory courses attended
NIL
Refresher training attended

NIL

WORKING EXPERIENCE
Total time on Helicopter (Yr)
Total time in Field operations (Yr)
Supervisory Role (Number of yrs)

NA
NA
NA

I certify that the above details are

correct and a security background
check has been completed on the
candidate.

Chief Engineer

Date

EXXONMOBIL COMMENTS:
The Engineer is:

APPROVED

EM Field Aviation
Superintendent or Supervisor
(Name and Date)

Femi

NOT APPROVED

PROVISIONALLY
APPROVED

EM FURTHER COMMENTS ON PROVISIONAL APPROVAL OR CONDITIONS OF APPROVAL

Electronic Version 001

March 06