Pilot Projects Pro-forma for Applicants
1.0
Name of Applicant/Pilot Lead
First Name
Last Name
Address of Applicant/Pilot Lead
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
2.0
Name of Building/Project
Address of Building/Project
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
3.0
Is this Building part of a larger portfolio which you would like to submit for Pilot Testing?
Yes
No
4.0
Owner of Project (if differentfrom 1.0)
5.0
Please confirm that you have the owner’s agreement and support to participate in the Pilot Project Programme
I confirm
6.0
Size:
GIA
blanks
sqm
NIA
blank
sqm
7.0
Sector(s) – please tick predominant use
Homes
Office
Schools
Healthcare
Sports + leisure
Retail
Culture + entertainment
Science + technology
Higher education
Hotel
Commercial residential
Storage + distribution
Data centres
Other (please state)
8.0
New build or existing
New build
Existing (subject to refurbishment)
Existing (in operation)
If existing, please state if the building has heritage status i.e. Grade I, II, II*, local listing, conservation area.
9.0
Stage of Project:
Design
Under construction / refurbishment
At / near practical completion
Recently in operation (less that one year)
More than 75% occupied, in operation for one year or more
10.0
Please confirm that you/owner will be liable for the Pilot Testing fee of £2,500 (+ VAT)
I confirm
If you would like to participate but cannot pay this fee, please could you indicate what discount you would need(up to 100%), and why.
Name for the invoice (if different from 1.0 or 4.0).
First Name
Last Name
Address for the invoice (if different from 1.0 or 4.0).
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
11.0
Is the building / project already seeking or has it achieved certification under NABERS, Passivhaus, BREEAM or other low energy or low carbon schemes? If so, please state which.
12.0
Is the building:
Owner-occupied
Occupied by a single tenant
Occupied by several tenants
13.0
Other relevant comments:
14.0
Data Sharing Requirements: No data or results derived from the Pilot Testing will be made public in an identifiable manner, unless specifically agreed with the Pilot Lead, however it will be used on an anonymised basis to inform Version 1 of the Standard. All participants will be expected to share their experiences with other participants in their cohort on a Chatham House rules basis – they will be reportable but not attributable. Validated project or building data may be submitted to the BECD to record progress towards achieving Net Zero Carbon for the built environment sector and to inform future versions of the Standard. Please confirm that you will accept the requirements to share data as set out above.
*
I confirm
Signature
On behalf of:
Date
-
Month
-
Day
Year
Date
SUBMIT
SUBMIT
Should be Empty: