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Green Deal Provider Authorisation - Application for the ‘non-domestic’ Green Deal Provider status
Applicants should note:
The information you supply in this application will be used to determine eligibility to become a Green Deal
Provider with ‘non-domestic’ status. Green Deal Providers, including those with ‘non-domestic’ status, may
register with the Crown Commercial Service (CCS), the ECO Brokerage platform administrators, for access to the
auctions and to trade. For further information on ECO Brokerage, including the rules, other eligibility
requirements and evidence required by CCS to gain access, please visit https://www.gov.uk/energy-companies-
obligation-brokerage.
As a ‘non-domestic’ Green Deal Provider you will not be able to write Green Deal plans that require consumer
credit permissions. If you wish to write Green Deal plans you must contact the Financial Conduct Authority (FCA)
to obtain the requisite consumer credit permissions. You will also need to apply on separate forms to the Green
Deal Oversight and Registration Body to operate as a ‘domestic’ Green Deal Provider:
http://gdorb.decc.gov.uk/providers/become-a-provider. For further information please visit http://www.fca.org.uk
or call the FCA contact centre on: 0845 606 9966.
Before submitting this application please ensure copies of the following documentation are provided:
Your Organisation’s Complaints Handling Procedure
Your Organisation’s Queries Handling Procedure
Your Organisation’s Data Protection and Information Security Policy/Procedure
Your Organisation’s Health and Safety Policy/Procedure
Note: The Green Deal Oversight and Registration Body (GD ORB) will not be able to process application forms
that do not have the above documents attached.
Prior to completing this application, Applicants are advised to refer to the following, which should be read in
conjunction with Part 1, Chapter 1 of the Energy Act 2011, the Green Deal Framework Regulations (Disclosure,
Acknowledgement, Redress, etc.) Regulations 2012 and the Green Deal Code of Practice (GD CoP):
Guidance for Applicants
Becoming an Active Green Deal Provider Guidance
Please visit: http://gdorb.decc.gov.uk/providers/green-deal-provider-guidance for details.
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Green Deal Provider Authorisation - Application for ‘non-domestic’ Provider Status
This application should be completed by:
(a) a Company Director, where the applicant organisation is a registered company, or
(b) a person with the appropriate authority, for all other kinds of applicant organisations.
The GD ORB may contact applicants for further information to supplement their application. Completed
applications must be submitted electronically via email to: [email protected]. Electronic
signatures are acceptable.
Any queries regarding this application should be directed to the GD ORB helpdesk via
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1. APPLICATION AND ADMINISTRATION DETAILS
1.1 CORPORATE INFORMATION
Please provide current details in the table below.
Applicant Organisation Name (Registered Company Name if applicable)
Click here to enter text.
Company Registration Number (if applicable)
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Nature of Applicant Organisation’s Legal Structure (e.g. Company Limited Liability Partnership)
Click here to enter text.
Registered Address line 1: Click here to enter text.
Registered Address line 2: Click here to enter text.
Registered Address line 3: Click here to enter text.
City / Town: Click here to enter text.
Postcode: Click here to enter text.
Country (England / Scotland / Wales): Click here to enter text.
Principal Trading Address line 1 (If different from registered address):
Click here to enter text.
Principal Trading Address line 2: Click here to enter text.
Principal Trading Address line 3: Click here to enter text.
City / Town: Click here to enter text.
Postcode: Click here to enter text.
Country (England / Scotland / Wales): Click here to enter text.
Telephone Number: Click here to enter text.
Email: Click here to enter text.
Website: Click here to enter text.
Parent Registered Name and Number (If applicable):
Click here to enter text.
Parent Entity Trading Name (If applicable and different to above):
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Name(s) of all the Applicant Organisation’s Click here to enter text.
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Green Deal Provider Authorisation - Application for ‘non-domestic’ Provider Status
Registered Company Directors:
Operational Contact for Green Deal Provider Authorisation Process (Name, Contact number and Email) :
Click here to enter text.
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Green Deal Provider Authorisation - Application for ‘non-domestic’ Provider Status
1.2 APPLICANT DETAILS
Applicant Name: Click here to enter text.
Applicant Reference Number: Click here to enter text.
Point of Contact for Green Deal Provider Authorisation Process:
Note: Details of the application will only be disclosed to the nominated point of contact.
Name: Click here to enter text.
Contact number: Click here to enter text.
Email: Click here to enter text.
Please provide a Profile for the Applicant Organisation (MAX 300 WORDS). Please include:
the applicant organisation’s name;
Director/s relevant skills, history and
experience;
which sector(s) the applicant
organisation currently operates in;
whether the applicant organisation has
previously been involved in the CERT
or CESP schemes;
if the applicant organisation is an
authorised GD Installer/Assessor
whether it plans to install all measures
itself; and
which town or city the applicant
organisation principally operates in.
Click here to enter text.
1.3 OPERATIONAL REGIONS
Please indicate your organisations planned geographical coverage in which you intend to become operational in,
if authorised.
National or:
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Green Deal Provider Authorisation - Application for ‘non-domestic’ Provider Status
England
Wales
Scotland
2. PREVIOUS APPLICATIONS
2.1 PREVIOUS APPLICATIONS
Has your business, any director, manager or shareholder applied for Green Deal Provider authorisation
previously? Please tick as appropriate:
No
Yes (please provide details below)
NAME OF ORGANISATION / INDIVIDUAL THAT PREVIOUSLY APPLIED
DATE(S) OF PREVIOUS APPLICATION(S)
PREVIOUS APPLICATION NUMBER(S) (GDPA)
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3. ASSOCIATED APPLICANTS
Is your organisation commercially connected in any way to any other authorised Green Deal Provider(s), other
applicant(s) or to organisations whose applications for authorisation as a Green Deal Provider were refused?
Please tick as appropriate:
Yes No
If yes, please provide the organisation name(s), GDPA reference number(s) and brief details of commercial
relationship (200 word max):
Click here to enter text.
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Green Deal Provider Authorisation - Application for ‘non-domestic’ Provider Status
4. IS THE APPLICANT ORGANISATION ACCREDITED OR AUTHORISED UNDER ANY OF THE FOLLOWING SCHEMES?
Please tick all that apply and provide relevant membership numbers.
SCHEME MEMBERSHIP NUMBER
British Standards Institution (BSI) Click here to enter text.
The Microgeneration Certification Scheme (MCS) Click here to enter text.
Trustmark Click here to enter text.
ISO Accreditation (please list all that apply) Click here to enter text.
Competent Persons Scheme Click here to enter text.
Construction Licensing Executive (CLE Scotland) Click here to enter text.
Gas Safe Click here to enter text.
Fenestration Self-Assessment Scheme (FENSA) Click here to enter text.
Solid Wall Insulation Guarantee Agency (SWIGA) Click here to enter text.
The Contractor’s Health and Safety Assessment Scheme
(CHAS)
Click here to enter text.
Cavity Wall Insulation Self Certification Scheme Click here to enter text.
NICEIC Click here to enter text.
Renewable Energy Consumer Code (RECC) Click here to enter text.
Other (Please list all relevant schemes and corresponding membership numbers)
Click here to enter text.
5. IS THE APPLICANT ORGANISATION A MEMBER OF ANY OF THE FOLLOWING PROFESSIONAL OR TRADE BODIES?
Please tick all that apply and provide relevant membership number.
PROFESSIONAL/TRADE BODY MEMBERSHIP NUMBER
Royal Institution of Chartered Surveyors Click here to enter text.
Royal Institute of British Architects Click here to enter text.
Building and Engineering Services Association (formally HVCA)
Click here to enter text.
National Insulation Association Click here to enter text.
Electrical Contractors Association Click here to enter text.
Energy Institute Click here to enter text.
Other (Please list all relevant bodies and corresponding
membership numbers)
Click here to enter text.
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6. DO ANY SENIOR MEMBERS OF STAFF, DIRECTORS OR THE ORGANISATION HAVE UNSPENT CRIMINICAL CONVICTION(S) OR CIVIL COURT JUDGEMENT(S) AGAINST THEM IN THE LAST FIVE YEARS?
Yes No
Please note: The GD ORB will conduct a credit check as part of the verification process.
If yes, please provide the following information:
YEAR ISSUE OUTCOME BRIEF SUMMARY OF PREVENTATIVE MEASURE
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enter text.
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7. HAVE ANY DIRECTORS FILED FOR BANKRUPTCY OR INSOLVENCY WITHIN THE PAST FIVE YEARS?
Yes No Ongoing
If yes, please provide the following information:
BUSINESS TRADING NAME
COMPANY HOUSE NO.
BANKRUPTCY/INSOLVENCY? PLEASE INCLUDE INFORMATION ON CUSTOMER IMPACT E.G DETAILS OF ANY MONEY LEFT OWING.
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Green Deal Provider Authorisation - Application for ‘non-domestic’ Provider Status
8. CREDIT PROVISION
8.1 HAS THE APPLICANT ORGANISATION CARRIED OUT ANY TYPES OF
BUSINESS THAT ARE REGULATED UNDER THE CONSUMER CREDIT ACT
1974 IN THE PAST?
Yes No Ongoing
If yes, what types of regulated business has your organisation carried out?
Click here to enter text.
8.2 HAS YOUR ORGANISATION EVER BEEN INVESTIGATED BY THE
FINANCIAL CONDUCT AUTHORITY (FCA) OR OFFICE OF FAIR TRADING
IN RELATION TO THE PROVISION OF CREDIT?
Yes No Ongoing
If yes, was your organisation found to be in breach of their standards?
Yes No Ongoing
If yes, please provide the following information:
DATES OF INVESTIGATION BREACH OUTCOME
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8.3 HAS THE APPLICANT ORGANISATION EVER BEEN SUBJECT TO
SANCTIONS IN RELATION TO THE PROVISION OF CREDIT?
Yes No Ongoing
If yes, please provide the following information:
DATES OF INVESTIGATION SANCTION OUTCOME
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Green Deal Provider Authorisation - Application for ‘non-domestic’ Provider Status
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8.4 HAS THE APPLICANT ORGANISATION EVER BEEN INVESTIGATED FOR
BREACHING ANY OTHER CODES?
Yes No Ongoing
If yes, please provide the following information:
DATES OF INVESTIGATION CODE BREACH OUTCOME
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text.
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text.
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text.
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9. MARKETING AND SALES
9.1 HAS THE APPLICANT ORGANISATION EVER BEEN INVESTIGATED FOR A BREACH OF CONSUMER PROTECTION LEGISLATION IN RELATION TO MARKETING AND SELLING PROCEDURES?
Yes No (Ongoing no findings have yet been made)
If yes, was the organisation found to be in breach?
Yes No
If yes, please provide the following information:
DATES OF INVESTIGATION
BREACH (E.G. UNSUBSTANTIATED MARKETING CLAIMS)
OUTCOME
BRIEF SUMMARY OF PREVENTATIVE MEASURE (E.G. MODIFIED SALES SCRIPTS, MONITORED SALES STAFF CONDUCT)
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text.
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text.
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Green Deal Provider Authorisation - Application for ‘non-domestic’ Provider Status
text. text.
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9.2 HAS THE APPLICANT ORGANISATION’S ADVERTISING OR MARKETING EVER BEEN INVESTIGATED BY THE ADVERTISING STANDARDS AUTHORITY?
Yes No Ongoing
If yes, was the organisation found to be in breach of their standards?
Yes No Ongoing
If yes, please provide the following information:
DATES OF INVESTIGATION
REFERENCE NUMBER
CIRCUMSTANCE (E.G. MISREPRESENTATIONS OR UNPROVEN CLAIMS ON WEBSITE)
BRIEF SUMMARY OF OUTCOME (E.G. WEBSITE CONTENT AMENDED OR EVIDENCE PROVIDED TO SUBSTANTIATE CLAIM)
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text.
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9.3 WHICH OF THE FOLLOWING STRATEGIES WILL BE THE PRIMARY
METHODS EMPLOYED FOR MARKETING AND SELLING THE ECO OR
NON-DOMESTIC GREEN DEAL PLANS?
(Please select all that apply and rate in order of importance, 1 being the most important).
Print media (e.g. newspaper adverts)
TV Advertising Regional National
Radio advertising Regional National
Leaflet/flyer distribution
Industry exhibits
Local events (e.g. local trade fairs)
Estate Agents
Housing Associations
Website/s
Search Engine Optimisation or equivalent
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Green Deal Provider Authorisation - Application for ‘non-domestic’ Provider Status
Direct selling (e.g. door knocking)
Cold calling by Click here to enter text. This is an internal staff member external provider (tick one).
Lead Generators
Other Click here to enter text.
The above marketing materials will be produced by: Click here to enter text. This is an internal staff member
external provider (tick one).
9.4 PLEASE PROVIDE A SUMMARY OF THE INFORMATION THE APPLICANT
ORGANISATION WILL PROVIDE IN ITS SALES MATERIAL AND HOW IT
WILL COMPLY WITH THE GREEN DEAL CODE OF PRACTICE (COP)
Click here to enter text.
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Green Deal Provider Authorisation - Application for ‘non-domestic’ Provider Status
9.5 HOW THE APPLICANT ORGANISATION PLANS TO ENSURE THAT
MARKETING AND SALES ARE CARRIED OUT IN ACCORDANCE WITH ALL
APPLICABLE CONSUMER PROTECTION LEGISLATION, THE ASA CODES
AND THE GD COP.
Click here to enter text.
9.6 PLEASE PROVIDE THE DETAILS OF THE INDIVIDUAL WHO WILL BE
RESPONSIBLE FOR ENSURING THE MARKETING MATERIAL IS
COMPLIANT WITH RELEVANT LEGISLATION:
Click here to enter text.
9.7 PLEASE PROVIDE THE FOLLOWING INFORMATION ABOUT
MARKETING/SALES STAFF TRAINING ON RELEVANT LEGISLATION:
Training will be provided: face to face online
Frequency of training inductions available: Choose an item. Days Choose an item. Months Choose an item. Years
Frequency of refresher courses: Choose an item. Days Choose an item. Months Choose an item. Years
Person responsible for training: Click here to enter job title.
This is an Choose an item.
Marketing and Sales topics that will be covered in the compliance training: Click here to enter text.
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Green Deal Provider Authorisation - Application for ‘non-domestic’ Provider Status
9.8 ALONGSIDE SALES STAFF TRAINING, HOW WILL THE APPLICANT
ORGANISATION ENSURE STAFF REMAIN COMPLIANT WITH ABOVE
LEGISLATION?
Staff handbook/guidance documents on legislative requirements and compliance
Managerial sign-off of marketing material
Cold calls will be recorded/monitored
Randomised staff assessments/tests
Other:
9.9 IF THE APPLICANT ORGANISATION IS USING LEAD GENERATORS, COLD
CALLING AND/OR OTHER DIRECT SELLING TECHNIQUES, PLEASE
PROVIDE DETAILS ON HOW IT WILL ENSURE THEY COMPLY WITH THE
GD COP.
Click here to enter text.
9.10 WILL SALES STAFF MEMBERS RECEIVE INCENTIVES (FINANCIAL OR
OTHERWISE) FOR SALES GENERATED?
Financial Other Click here to enter text.
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Green Deal Provider Authorisation - Application for ‘non-domestic’ Provider Status
Click here to enter text.
10. AGREEMENTS
GREEN DEAL CODE OF PRACTICE, GREEN DEAL ARRANGEMENTS AGREEMENT, OMBUDSMAN AND EPC REGISTER
Please tick all four boxes to confirm that you have read, understood and agree to do the following, if authorised.
Green Deal Providers must:
Comply with the Green Deal Code of Practice (GD CoP)
Participate in the Green Deal Ombudsman and Investigation Service
Enter into and comply with the Green Deal Arrangements Agreement (GDAA)
Obtain access to EPC register
Unless you confirm your understanding and agree to adhere to the above if authorised, your application will not
be processed.
To make you aware, Applicant Organisation names will be shared with the Green Deal Ombudsman in order to
expedite the registration process.
11. SUPPLY CHAIN MANAGEMENT
Please set out the applicant organisation’s policy and practices in relation to its dealings with the supply chain, of
particular interest are negotiating practices, prompt payment and communication.
Click here to enter text.
11.1 WILL THE APPLICANT ORGANISATION HAVE A SELECTION CRITERIA FOR
CHOOSING A SUPPLIER? MAX 200 WORDS.
Please summarise key considerations (e.g. previous experience, references, competitive pricing, accreditations,
financial position, health and safety policies, products and services offered etc.)
Click here to enter text.
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Green Deal Provider Authorisation - Application for ‘non-domestic’ Provider Status
11.2 WHAT WILL BE THE APPLICANT ORGANISATION’S PRIMARY FORM OF
COMMUNICATION WITH SUPPLIERS?
Email Phone Other Click here to enter text.
11.2.1 PLEASE PROVIDE THE DETAILS OF THE INDIVIDUAL RESPONSIBLE FOR MANAGING GD SUPPLIER RELATIONS:
Click here to enter job title.
11.3 WHAT WILL BE THE APPLICANT ORGANISATION’S NEGOTIATION
PRACTICES AFTER A SUPPLIER IS SELECTED? (E.G. REGARDING PRICE,
TERMS AND CONDITIONS – INCLUDING PAYMENT TERMS)
Click here to enter text.
11.4 HOW WILL THE APPLICANT ORGANISATION ENSURE SUPPLIER
SATISFACTION?
In person meetings, frequency Click here to enter text.
Feedback surveys
Follow up contact (phone call/email/letter)
Contract Terms and Conditions
Other Click here to enter text.
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Green Deal Provider Authorisation - Application for ‘non-domestic’ Provider Status
11.5 WHAT WILL BE THE APPLICANT ORGANISATION’S PROCESS FOR
HANDLING SUPPLIER CONCERNS AND/OR FEEDBACK?
Click here to enter text.
11.6 WILL THE APPLICANT ORGANISATION BE A SIGNATORY TO THE PROMPT
PAYMENT CODE?
Yes No
If no, what will be the standard payment timescale: Choose an item. Days Choose an item. Months Choose an item. Years
11.7 WHAT IS THE APPLICANT ORGANISATION’S INTERNAL PROCEDURE
FROM RECEIVING AN INVOICE THROUGH TO PAYMENT?
Please include relevant job titles, internal checks and timescales.
Click here to enter text.
11.8 DOES THE APPLICANT ORGANISATION HAVE A SYSTEM IN PLACE TO
MAINTAIN QUOTES RECORDS AND INVOICES?
Please provide a brief summary.
Click here to enter text.
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Green Deal Provider Authorisation - Application for ‘non-domestic’ Provider Status
11.9 PLEASE PROVIDE DETAILS OF TRAINING THE APPLICANT
ORGANISATION WILL BE OFFERING TO ITS STAFF IN RELATION TO THE
GREEN DEAL TO MAKE SURE THEY ARE COMPLIANT TO GREEN DEAL
STANDARDS:
Click here to enter text.
11.10 PLEASE PROVIDE THE FOLLOWING INFORMATION ABOUT SUPPLY
CHAIN STAFF TRAINING ON RELEVANT LEGISLATION:
Training will be provided: Face to face Online
Frequency of training refresher courses: Choose an item. Days Choose an item. Months Choose an item.
Years
Person responsible for training: Click here to enter job title.
Green Deal topic list for compliance training.
Click here to enter text.
11.11WILL YOU PROVIDE THE ABOVE TRAINING TO SUPPLIERS?
Yes No
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Green Deal Provider Authorisation - Application for ‘non-domestic’ Provider Status
11.12 HOW WILL THE APPLICANT ORGANISATION KEEP STAFF/SUPPLIERS
UP TO DATE ON GREEN DEAL/ECO POLICY DEVELOPMENTS?
Training
Staff newsletter
Website update
Staff Meeting
Other Click here to enter text.
11.13 HOW WILL THE APPLICANT ORGANISATION ENSURE SUPPLY CHAIN
STAFF COMPLY WITH RELEVANT LEGISLATION, THE GD COP AND
COMPANY POLICIES?
Handbook/guidance documents
Internal auditing/monitoring of supplier conduct, frequency Click here to enter text.
External auditing, frequency Click here to enter text.
Accreditation scheme: Click here to enter text.
Contract Terms and Conditions
Other: Click here to enter text.
11.14 IF NON-COMPLIANCE IS DETECTED, WHAT STEPS WILL BE TAKEN?
Click here to enter text.
11.15 THE PERSON RESPONSIBLE FOR COMPLIANCE IS:
Click here to enter job title.
12. CUSTOMER SERVICES AND COMPLAINTS HANDLING
Please provide a summary of the number of customer complaints made in relation to the applicant organisation in the last three years. Where possible please provide numbers and an indication of customer base, breaking this down into the different categories of complaint and indicating in relation to each category how many complaints have been resolved.
(Click here to enter text. ) Total number of Green Deal related complaints over last three years, of
which:
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Green Deal Provider Authorisation - Application for ‘non-domestic’ Provider Status
(Click here to enter text. ) Related to off-premises selling (sales activities that take place away from
the applicant organisation’s premises); and
(Click here to enter text. ) Related to ongoing customer service and contact where the applicant
organisation has a long relationship with a customer.
12.1 PLEASE CONFIRM THAT THE APPLICANT ORGANISATION’S SPECIFIC
COMPLAINTS HANDLING PROCEDURE IS INCLUDED IN THIS
APPLICATION.
Procedure documentation is included
This should be a step-by-step guide for staff, including how complaints are received and responded to,
timescales, methods of communication, monitoring arrangements, escalation and resolution procedures. (Please
see GD CoP 4.17-4.25)
12.2 HOW MANY OF THESE CUSTOMER COMPLAINTS HAVE BEEN
REFERRED TO THE OMBUDSMAN SERVICES IN THE LAST THREE
YEARS?
Choose an item. Complaints
Please provide the complaint and outcome for each of these referrals (please ensure examples adhere to
relevant data protection policies):
DATE COMPLAINT CATEGORY BRIEF SUMMARY OF OUTCOME/PREVENTATIVE MEASURE
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enter text.
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enter text.
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enter text.
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If you are a new company with no complaints data, do any Directors have any experience of complaints
handling? Click here to enter text.
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Green Deal Provider Authorisation - Application for ‘non-domestic’ Provider Status
12.3 WHAT IS THE APPLICANT ORGANISATION’S PROCESS FOR HANDLING
GENERAL CUSTOMER QUERIES (NOT INCLUDING COMPLAINTS)?
Please include timescales, job titles, methods of communication, monitoring arrangements, escalation and
resolution procedures:
Click here to enter text.
12.4 HOW WILL CUSTOMERS BE ABLE TO SUBMIT ENQUIRIES?
Telephone number
Email address
Website form
Social Media site
Other Click here to enter text.
13. DATA PROTECTION AND INFORMATION SECURITY
How does the applicant organisation plan to ensure that its Green Deal related activities meet its data protection obligations, including how Green Deal information is kept securely and maintained to appropriate standards? Please provide evidence of relevant policies and procedures.
13.1 PERSON RESPONSIBLE FOR DATA PROTECTION AND INFORMATION
SECURITY:
Click here to enter job title.
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13.2 HOW WILL THE APPLICANT ORGANISATION ENSURE THE DATA
PROTECTION AND INFORMATION SECURITY POLICIES ARE ADHERED
TO?
Click here to enter text.
13.3 HOW WILL STAFF RECEIVE TRAINING ON DATA PROTECTION AND
INFORMATION SECURITY?
Training will be provided: Face to face Online
Frequency of training courses: Choose an item. Days Choose an item. Months Choose an item. Years
13.4 HOW WILL STAFF BE UPDATED ON NEW INFORMATION REGARDING
COMPLIANCE WITH THE DATA PROTECTION ACT 1998?
Training
Staff newsletter
Website update
Staff meeting
Other Click here to enter text.
13.5 HOW OFTEN WILL THE DATA PROTECTION AND INFORMATION
SECURITY POLICIES BE REVIEWED AND UPDATED?
Choose an item. Days Choose an item. Months Choose an item. Years
13.6 IF NON-COMPLIANCE IS DETECTED, WHAT STEPS WILL BE TAKEN?
Click here to enter text.
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13.7 IS THE APPLICANT ORGANISATION CURRENTLY REGISTERED WITH THE
INFORMATION COMMISSIONERS OFFICE (ICO)?
Yes: ICO Registration Number Click here to enter text.
No
Registration Pending: ICO Reference Number Click here to enter text.
14. HEALTH AND SAFETY
How will the applicant organisation ensure that Green Deal related processes comply with health and safety legislation? Please provide evidence of Health and Safety policies and procedures.
14.1 PERSON RESPONSIBLE FOR HEALTH AND SAFETY:
Click here to enter job title.
14.2 HOW WILL THE APPLICANT ORGANISATION ENSURE HEALTH AND
SAFETY POLICIES ARE ADHERED TO?
Click here to enter text.
14.3 HOW WILL STAFF RECEIVE TRAINING ON HEALTH AND SAFETY?
Training will be provided: Face to face Online
Frequency of training courses: Choose an item. Days Choose an item. Months Choose an item. Years
14.4 HOW WILL STAFF BE UPDATED ON NEW INFORMATION REGARDING
HEALTH AND SAFETY POLICIES?
Training
Staff newsletter
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Website update
Staff meeting
Other Click here to enter text.
14.5 HOW OFTEN WILL THE HEALTH AND SAFETY POLICIES BE REVIEWED
AND UPDATED?
Choose an item. Days Choose an item. Months Choose an item. Years
14.6 IF NON-COMPLIANCE IS DETECTED, WHAT STEPS WILL BE TAKEN?
Click here to enter text.
15. REFERENCE
Please provide contact details for two references from previous business associates, organisations you have
purchased goods and services from, or you have supplied goods and services to.
REFEREE 1:
Referee Company Name:Click here to enter text.
Referee Telephone Number: Click here to enter text.
Referee Email Address: Click here to enter text.
How Long Have You Been Associated With This Reference?:
Click here to enter text.
Referee Relationship: Click here to enter text.
REFEREE 2:
Referee Company Name:Click here to enter text.
Referee Telephone Number: Click here to enter text.
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Referee Email Address: Click here to enter text.
How Long Have You Been Associated With This Reference?:
Click here to enter text.
Referee Relationship: Click here to enter text.
16. DECLARATION
I declare that the information I have provided in this form, and in all supporting documentation, is true and
accurate and I have not knowingly presented information in a misleading manner.
I can provide evidence to corroborate all the information recorded, or will be able to identify parties that can do
so.
I confirm that I am authorised to act on behalf of the Applicant Organisation and that I have completed this form in that capacity.
Signature*:
* Please sign or insert your electronic signature.
Print Name: Click here to enter text.
Role in Applicant Organisation: Click here to enter text.
Date (dd/mm/yyyy): Click here to enter text.
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