Energy Saver Nomination

ACP (company)	EC Focus Pty Ltd
ABN/ACN	79166767424
Contact name	Mourace Ding
Contact email	savings@energyconservation.com.au
Contact phone	02 9660 9997
RESA accreditation #	GHGR02013A/1

Corporation/entity name	{corporationentityName}
ABN/ACN	{abnacn}
Email	{signatoryEmail}
Phone number	{phoneNumber}

3.1         Implementation site(s)

 

Address

{implementationAddress42}

3.2         Energy saving activities implemented at the site(s)

Description

LED Lighting upgrade

3.3         Past activities implemented at the site(s)

Have you or, to the best of your knowledge, has any other person, previously nominated an energy saver for this activity or activities at this site(s)?		Yes ☐ No ☒
If yes, please provide a reason for the new nomination form

I, on behalf of the original energy saver, nominate the Accredited Certificate Provider as the energy saver in respect of the activity or activities at the implementation sites listed above.

For the purpose of creating energy savings certificates in the ESS, this nomination entitles the Accredited Certificate Provider to create and own all energy savings in respect of each of the above activities at the implementation sites listed above, once they have been completed and energy savings have commenced.

This nomination takes effect from [date this nomination form is signed, or such later date as is specified] and remains in force until the earlier of [end date] and the date this nomination is revoked by the original energy saver.

I hereby declare that:

• I am authorised to execute this nomination form on the original energy saver’s behalf.
• I have received the contact details of the Accredited Certificate Provider.
• Except as set out above, I have not previously nominated an energy saver under the NSW Energy Savings Scheme (ESS) in respect of the activity or activities at the implementation sites listed above and neither, to the best of my knowledge, has any other person.
• The original energy saver agrees to provide information regarding the above activities and provide reasonable access to the implementation sites to a representative of the ESS or a member of the ESS Audit Services Panel, upon request.
• The date recorded below is the date when I signed this form.
• The information provided in this nomination form is accurate and is not misleading by inclusion or omission.
•  I am aware that this nomination form contains information that may be provided to the Scheme Administrator and that there are penalties for providing false or misleading information to the Scheme Administrator.

Note: Section 158 of the Electricity Supply Act 1995 imposes a maximum penalty of $11,000 and/or six (6) months imprisonment for knowingly providing false or misleading information to the Scheme Administrator.

Signed by the original energy saver’s authorised signatory