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APPENDICES TO ANNEX II

Appendix 1 — EASA Form 157

Commission Implementing Regulation (EU) 2020/469

CERTIFICATE FOR SERVICE PROVIDER

EUROPEAN UNION

COMPETENT AUTHORITY

SERVICE PROVIDER CERTIFICATE

[CERTIFICATE NUMBER/ISSUE No]

Pursuant to Implementing Regulation (EU) 2017/373 and subject to the conditions specified below, the [competent authority] hereby certifies

[NAME OF THE SERVICE PROVIDER]

[ADDRESS OF THE SERVICE PROVIDER]

as a service provider with the privileges, as listed in the attached service provision conditions.

CONDITIONS:

This certificate is issued subject to the conditions and the scope of providing services and functions as listed in the attached service provision conditions.

This certificate is valid whilst the certified service provider remains in compliance with Implementing Regulation (EU) 2017/373 and the other applicable regulations and, when relevant, with the procedures in the service provider's documentation.

Subject to compliance with the foregoing conditions, this certificate shall remain valid unless the certificate has been surrendered, limited, suspended or revoked.

Date of issue:

Signed:

[Competent authority]

EASA Form 157 Issue 1 — Page 1/4

SERVICE PROVIDER

CERTIFICATE

SERVICE PROVISION CONDITIONS

Attachment to service provider's certificate:

[CERTIFICATE NUMBER/ISSUE No]

[NAME OF THE SERVICE PROVIDER]

has obtained the privileges to provide the following scope of services/functions:

(Delete lines as appropriate)

Services/Functions

Type of Service/Function

Scope of Service/Function

Limitations27

Air traffic services (ATS)28

Air traffic control (ATC)

Area control service

Approach control service

Aerodrome control service

Flight information service (FIS)

Aerodrome flight information service (AFIS)

En-route flight information service
(En-route FIS)

Advisory service

n/a

Air traffic flow management (ATFM)

ATFM

Provision of the local ATFM

Airspace management (ASM)

ASM

Provision of the local ASM (tactical/ASM Level 3) service

Conditions29

Services/Functions

Type of Service/Function

Scope of Service/Function

Limitations1

Air traffic services (ATS) for flight test2,30

Air traffic control (ATC)

Area control service

Approach control service

Aerodrome control service

Flight information service (FIS)

Aerodrome flight information service (AFIS)

En-route flight information service
(En-route FIS)

Advisory service

n/a

Conditions3

Services/Functions

Type of Service/Function

Scope of Service/Function

Limitations31

Communication, navigation or surveillance services (CNS)

Communications (C)

Aeronautical mobile service (air-ground communication)

Aeronautical fixed service (ground-ground communications)

Aeronautical mobile satellite service (AMSS)

Navigation (N)

Provision of NDB signal in space

Provision of VOR signal in space

Provision of DME signal in space

Provision of ILS signal in space

Provision of MLS signal in space

Provision of GNSS signal in space

Surveillance (S)

Provision of data from primary surveillance (PS)

Provision of data from secondary surveillance (SS)

Provision of automatic dependent surveillance (ADS) Data

Conditions32

Services/Functions

Type of Service/Function

Scope of Service/Function

Limitations1

Aeronautical information services (AIS)

Aeronautical information products (including distribution

services)

Aeronautical information publication (AIP)

Aeronautical information circular (AIC)

NOTAM

AIP data set

Obstacle data sets

Aerodrome mapping data sets

Instrument flight procedure data

sets

Preflight information services

n/a

Conditions2

Services/Functions

Type of Service/Function

Scope of Service/Function

Limitations1

Data services (DAT)

Type 1

Provision of Type 1DAT authorises the supply of aeronautical databases in the following formats:

[list of the generic data formats]

Provision of Type 1 DAT does not authorise the supply of aeronautical databases directly to end-users/ aircraft operators.

Type 2

Provision of Type 2 DAT authorises the supply of aeronautical databases to end-users/aircraft operators for the following airborne application/ equipment, for which compatibility has been demonstrated:

[Manufacturer] Certified Application/ Equipment model [XXX], Part No [YYY]

Conditions2

Services/Functions

Type of Service/Function

Scope of Service/Function

Limitations33

Meteorological services (MET)

MET

Meteorological watch office

Aerodrome meteorological offices

Aeronautical meteorological stations

VAAC

WAFC

TCAC

Conditions34

Services/Functions

Type of Service/Function

Scope of Service/Function

Limitations1

Flight procedure design (FPD)

Design, documentation and validation of flight procedures3

n/a

Conditions2

Services/Functions

Type of Service/Function

Scope of Service/Function

Limitations1

ATM network functions

Design of ERN

n/a

Scarce resources

Radio frequency

Transponder code

ATFM

Provision of the central ATFM

Conditions2

Date of issue:

Signed: [Competent authority]

For the Member State/EASA

EASA Form 157 Issue 1 — Page 4/4