ESOS Lead Assessor Enquiry Form

ESOS ENQUIRY FORM

EPSILON CONSULTANTS (IOM) LIMITED

ESOS LEAD ASSESSOR ENQUIRY FORM NAME OF UNDERTAKING

BRIEF DESCRIPTION OF THE MAIN ACTIVITY UNDERTAKEN

PRINCIPAL ADDRESS

Address line 1

Address line 2

Town or City

Country

Post code

CONTACT NAME

First Name

Last Name

CONTACT EMAIL

Ex. myname@example.com

CONTACT PHONE

Area code

Number

ESOS LEAD ASSESSOR ENQUIRY FORM

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IS THE UNDERTAKING ISO 50001 ACCREDITED ☐ YES ☐ NO ☐ UNCERTAIN ☐ IN PROGRESS IS THE UNDERTAKING ISO 14001 ACCREDITED? ☐ ☐ ☐ ☐

YES NO UNCERTAIN IN PROGRESS

IS THE UNDERTAKING ISO 14064 ACCREDITED? ☐ ☐ ☐ ☐

YES NO UNCERTAIN IN PROGRESS

IS THE UNDERTAKING ISO 9001 ACCREDITED? ☐ ☐ ☐ ☐

YES NO UNCERTAIN IN PROGRESS

IS THE UNDERTAKING PARTY TO THE EU EMISSIONS TRADING SCHEME? ☐ ☐ ☐ ☐

YES NO UNCERTAIN IN PROGRESS

OTHER QUALITY / ENVIRONMENTAL / EMISSIONS / ENERGY MANAGEMENT SCHEMES? ☐ ☐ ☐ ☐

YES NO UNCERTAIN IN PROGRESS

IF YES, PLEASE SPECIFY THE STANDARD OR SCHEME

SJSJSJSJS HAVE ANY ENERGY AUDITS BEEN CARRIED OUT IN THE PREVIOUS 5 YEARS? ☐ ☐ ☐ ☐

YES NO UNCERTAIN IN PROGRESS

IF YES, PLEASE SPECIFY WHETHER CARRIED OUT IN-HOUSE OR OUTSOURCED ☐ IN-HOUSE ☐ OUTSOURCED ☐ UNCERTAIN IF YES, PLEASE STATE WHETHER THE RECOMMENDATIONS WERE IMPLEMENTED ☐ ☐ ☐ ☐

NONE PARTIALLY IN FULL UNCERTAIN

IS THERE A POST WITH RESPONSIBILITY FOR ENERGY MANAGEMENT? ☐ YES ☐ NO ☐ UNCERTAIN ESOS LEAD ASSESSOR ENQUIRY FORM

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IF YES, PLEASE STATE THE JOB TITLE

ENERGY MANAGER NAME

ENERGY MANAGER PHONE NUMBER

ENERGY MANAGER EMAIL

Ex. myname@example.com

PLEASE STATE THE TOTAL NUMBER OF UK SITES

PLEASE STATE WHETHER ANY SITE BENEFITS FROM THE FEED-IN-TARIFF ☐ YES ☐ NO ☐ UNCERTAIN PLEASE STATE WHETHER ANY SITE BENEFITS FROM THE RENEWABLE HEAT INCENTIVE ☐ YES ☐ NO ☐ UNCERTAIN PLEASE STATE WHETHER ANY SITE BENEFITS FROM COGENERATION OR TRIGENERATION ☐ YES ☐ NO ☐ UNCERTAIN

ESOS LEAD ASSESSOR ENQUIRY FORM

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ONLY COMPLETE THIS PAGE IF UNCERTAIN WHETHER YOU QUALIFY FOR ESOS. IS THE UNDERTAKING PART OF A CORPORATE GROUP? ☐ YES ☐ NO ☐ UNCERTAIN STATUS OF UNDERTAKING ☐ ☐ ☐ ☐ ☐ ☐ ☐

PRIVATE LIMITED COMPANY PUBLIC LIMITED COMPANY PARTNERSHIP TRUST UNINCORPORATED ASSOCIATION NOT-FOR-PROFIT-BODY (WHERE ENGAGED IN A TRADE OR BUSINESS) OTHER *

* IF OTHER PLEASE SPECIFY

ACCOUNTING YEAR (FROM / TO)

NUMBER OF EMPLOYEES IN 2014 ACCOUNTING YEAR

NUMBER OF EMPLOYEES IN 2013 ACCOUNTING YEAR

NUMBER OF EMPLOYEES IN 2012 ACCOUNTING YEAR

ANNUAL TURNOVER IN 2014 ACCOUNTING YEAR (EUROS)

ANNUAL TURNOVER IN 2013 ACCOUNTING YEAR (EUROS)

ANNUAL TURNOVER IN 2012 ACCOUNTING YEAR (EUROS)

BALANCE SHEET IN 2014 ACCOUNTING YEAR (EUROS)

BALANCE SHEET IN 2013 ACCOUNTING YEAR (EUROS)

BALANCE SHEET IN 2012 ACCOUNTING YEAR (EUROS)

ESOS LEAD ASSESSOR ENQUIRY FORM

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