Complete this document to become an endorsed Intermediary for the Victorian Residential Efficiency Scorecard program.

An Intermediary can be a business, local council or not-for-profit organisation that employs, or has a similar type of relationship with Accredited Scorecard Assessors.

The Intermediary Agreement outlines the relationship between the Department and the Intermediary. All Intermediaries must sign the Intermediary Agreement to become endorsed. A signed Intermediary Agreement may be submitted with this document. Endorsement provides access branding materials and allows Intermediaries to provide insurance coverage for Scorecard Assessors.

Section One: Contact detailsName of Intermediary

(name of business, local council or not-for-profit organisation)Address

Website

Contact person Name

Position

Phone number

Email address

Alternative contact details(if available)

Description of your organistaion (what you do or sell)Are you: Not-for-profit / Commercial business (please circle)

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Section Two: Scorecard Assessor AssociationsPlease provide details of any assessors that are currently proposed to have an association with this Intermediary.

The Intermediary must take necessary action to ensure an engaged Assessor’s compliance with the Assessor’s insurance requirements set out in clause 13 of the Assessor Agreement, this includes:

Public liability insurance covering the Intermediary, any Engaged Assessor and its agents for any death, injury, damage or loss to other persons arising from the carrying out of Scorecard Ratings. The Intermediary must maintain such insurance current for the duration of this Agreement and for an amount of not less than ten (10) million dollars for any single occurrence.

Professional indemnity insurance covering the Intermediary and any Engaged Assessor for breaches of professional duty (whether owed in contract or otherwise) in carrying out Scorecard Ratings. The Intermediary must maintain such insurance current for the duration of this Agreement and six (6) years thereafter, and for an amount of not less than two (2) million dollars for any single occurrence.

Name of Assessor Is this assessorcurrently Accredited /applying for accreditation/is likely to apply in future?

Will this assessor be covered by the Intermediary’s insurance*?

Accredited/ applying/ future applicationAccredited/ applying/ future applicationAccredited/ applying/ future applicationAccredited/ applying/ future application

Note that it is the Intermediary’s responsibility to ensure that the Department is informed of any changes to this information.

*If yes, you will need to provide evidence of insurance to the required value.

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Section Three: Conflict of InterestConflict of Interest means a situation where the Intermediary’s actions may be at odds with another role, or where there are circumstances which mean that:

(a) the Intermediary is not capable of exercising objective and impartial judgement when making recommendations on the basis of Scorecard Material; or

(b) a reasonable person, with full knowledge of all relevant facts and circumstances, would conclude that there is a real risk that the Intermediary would not be capable of exercising objective and impartial judgment when making recommendations on the basis of Scorecard Material.

Notification of a Conflict of Interest

When a Conflict of Interest arises, or appears likely to arise, the Intermediary must:

(a) inform the Department as soon as is practicable after becoming aware that the Conflict of Interest has arisen, or appears likely to arise;

(b) make full disclosure of all relevant information relating to the conflict, including, but not limited to, the Intermediary’s strategy for managing the relevant Conflict of Interest; and

(c) take such steps as the Department requires to resolve or otherwise deal with the Conflict of Interest.

Obligation to keep informed and prevent Conflicts of Interest

The Intermediary must, at all times use its best endeavours to:

(a) keep themselves informed of any potential Conflicts of Interest; and

(b) take necessary steps to prevent and mitigate the effects of any Conflicts of Interest.

The Intermediary acknowledges that there is a potential Conflict of Interest in respect of the recommendation of particular house upgrade solutions where the Intermediary or an Engaged Assessor is an agent of a supplier of such a house upgrade solutions.

The Intermediary must disclose to all customers such Conflicts of Interest prior to commencing the energy assessment services utilising the Scorecard Tool.

List all current or potential conflicts of interest*(eg name of associated business and product line likely to be promoted)

Strategy for managing conflict of interest

*If you are not sure if there is a conflict of interest, please outline any potential conflict.

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Section Four: Marketing Material

The Scorecard Brand Guidelines provide the requirements when using the Victorian Government and Scorecard logos. Use of these logos require becoming either an Accredited Assessor or Endorsed Intermediary. Outside of these arrangements these logos should not be used.

All promotional materials with the Scorecard branding must be approved by the Department. Please see the Brand Guidelines for more information.

To assist in timely processing of Scorecard branded material please indicate the marketing material likely to be developed.

Type of marketing material (eg website text, email bulletin, flyer distribution)

Estimated date material will be provided to the Department for approval

Section Five: Signature

I declare that all information contained in this document and any attachments are true and correct.

Signed for and on behalf of [ insert name of Intermediary ]

Name (print)

Position

Signature and date _______________________ _

_______/ ________/ ________

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