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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