Green Fleet Consultancy Services Application form This application form is for organisations wishing to receive Fleet Consultancy and support from the Energy Saving Trust funded by the Department for Transport. In receiving these services, the organisation will automatically be enrolled as a member of the Motorvate Network which provides a forum and framework to enable organisations to engage in the development and promotion of best practice fleet advice and measures that will reduce carbon emissions from business transport. The Green Fleet Consultancy services available from Energy Saving Trust within the Motorvate Scheme aim to: Quantify the CO2 emissions and costs resulting from fleet and staff business travel; Highlight priority areas within a fleet operation and provide practical recommendations to improve fleet efficiency reduce carbon emissions and achieve cost savings. Applicant information Organisation Name Organisation Address Main Contact Position Telephone Mobile E-mail Line Manager / Secondary Contact Position Telephone Mobile E-mail Where did you hear about this programme? Energy Saving Trust – October 2014 page 1 of 5 Vehicle fleet information To ensure that you get comprehensive advice, we will need data about your fleet, for example fuel card reports and/or business mileage claims and relevant documents such as company car policies and a live fleet list. The data and policy requirements will be discussed with you by your allocated Fleet Consultant. It is very important that you provide us with the best information that you can as this will enable us to provide an accurate carbon footprint and possible cost and carbon savings. Vehicle Numbers Total Average Annual Mileage Company cars (owned and/or leased) Cash opt-out (where a fixed monthly allowance is provided in lieu of a company car) Pool cars Grey Fleet Light commercial vehicles (< 3.5t GVW) Mini Buses HGVs (> 3.5t GVW) Other Fleet total Objectives Please summarise what you would like to achieve for your fleet and/or specify areas you would like to focus on (for example, grey fleet) Energy Saving Trust – October 2014 page 2 of 5 Conditions of state aid It is your responsibility to ensure that you have not received more than this or you may be required to repay any excess. Forms of State Aid may include grants, loans, guarantees or other forms of assistance from central or local government, a regional development agency or a devolved administration of a Business Link. Not all grants are classified as De Minimis. If you are not sure whether any assistance that you have received is De Minimis aid, please contact the body from which the assistance was received for confirmation. The provision of free consultancy under the Motorvate Scheme falls under European ‘state aid’ rules. These rules only apply to ‘undertakings’ (broadly speaking, organisations that carry on some form of commercial activity) – that is, sole traders, partnerships running a business and companies running a business. The European Commission’s State Aid rules allow organisations to receive up to €200,000 of De Minimis state aid over any three financial years (or €100,000 for organisations in the road transport sector). It is estimated that the maximum value of the Fleet Consultancy that your organisation will receive is €5,000. Therefore you will be eligible to receive Energy Saving Trust Fleet Consultancy unless you have currently received between €195,000 and €200,000 of State Aid in the last three financial years (or between €95,000 and €100,000 for organisations in the road transport sector). By signing the declaration overleaf, you are stating that by receiving €12,500 of free consultancy, you will not exceed your State Aid limit. If your organisation is not classed as an ‘undertaking’ (because it does not carry out any commercial activity), the above condition does not apply, and you do not need to check how much State Aid you have received. Examples of organisations which are not usually classified as undertakings are local authorities, NHS trusts and housing associations. Please tick one of the following: Our organisation is not an ‘undertaking’. Our organisation is an ‘undertaking’ but has not received more than €200,000 of De Minimis state aid within the last three financial years “Undertakings” are provided this service under the European Commission's De Minimis Regulation (EC) No. 1998/2006 of 15 December 2006 on the application of articles 87 and 88 of the Treaty to De Minimis aid, OJ2006L379/5. Energy Saving Trust – October 2014 page 3 of 5 Terms and conditions 1. Eligibility Membership of the Motorvate Scheme is open to organisations based in England; Members must either operate a fleet of sub 3.5 tonne vehicles or provide fleet services to organisations. Energy Saving Trust reserves the right to limit the Fleet Consultancy services available to members. 2. The Motorvate logos All members are entitled to use the Motorvate logo in accordance with the guidelines supplied. 3. Termination 3.1. Either party may terminate Organisation’s membership of the Scheme at any time (including Energy Saving Trust ceasing to provide the Scheme) by giving the other party not less than 30 days written notice at any time. 3.2. Energy Saving Trust is entitled to terminate your membership of the Scheme immediately by giving written notice if: 3.2.1. Any information that you provided to Energy Saving Trust in your application or subsequently (or that was provided on your behalf) is found to be untrue, inaccurate or incomplete in any material respect; 3.2.2. You commit a material breach of any of these Terms; 3.2.3. You or any person employed by you has offered or given or agreed to give any person any improper gift or commission or consideration of any kind in relation to the Scheme or any of Energy Saving Trust 's other programmes; 3.2.4. You become insolvent or in Energy Saving Trust’s reasonable opinion are likely to become insolvent; or 3.2.5. You cease or threaten to cease to carry on business. 4. Consequences of termination 4.1. At the date of termination or expiry of Membership: 4.1.1. any licence to use the Logos shall immediately cease; 4.1.2. You will immediately cease to claim to be or hold yourself out as a Member; 4.1.3. You will immediately withdraw and destroy any materials or literature in whatever format bearing the Logos which are either in your possession or under your control, or at Energy Saving Trust’s request, deliver up such materials to Energy Saving Trust. For the avoidance of doubt, nothing in this clause will prevent you from retaining copies of and making use of any reports (or similar documentation) provided to you by Energy Saving Trust under the Scheme. 5. Nature of advice While every effort is made to ensure that advice provided to you is accurate and relevant, it is your responsibility to assess whether recommended actions are appropriate for your organisation and to determine the steps that you will take to implement the advice. Energy Saving Trust will not be liable to you for any indirect loss or damage you may suffer as a result of receiving or implementing the advice. 6. Liability Neither party will be liable to the other for any indirect, special, incidental or consequential damages, or loss of profits or loss of business (whether direct or indirect) arising out of this agreement. Energy Saving Trust – October 2014 page 4 of 5 7. Use of information We or UK Government departments may wish to use information relating to the Transport Advice programme to carry out research or statistical analysis, to assess the effectiveness of the programme, to shape future policy and to publish information about the programme and related research. Aggregated or non-attributable information may be used for these purposes. We will never publish any of the attributable fleet or organisational data you have supplied in relation to the programme without your consent. 8. Expectations on Client Organisation In providing these services we ask the organisation to commit to: Provide the as much accurate data and information as they can to allow for the analysis of the clients fleet to be completed in a timely manner, Supply feedback on the service they received to enable Energy Saving Trust to review and improve the service they provide. 9. Declaration I hereby confirm that the organisation will comply with the conditions set out above with respect to Fleet Consultancy services and apply to become a member of the Energy Saving Trust Motorvate Scheme. For and on behalf of the organisation Name Position Date Please tick the box on the right to confirm acceptance of these terms: As a member of Motorvate, you will receive transport communications from Energy Saving Trust by email. We will not share your details with any third parties. If you would prefer NOT to receive information from other business departments within Energy Saving Trust (about reducing energy costs), please tick this box Please return your completed application form to: Email: Email your appointed Energy Saving Trust Fleet Consultant or email transportadvice@est.org.uk Post: Transport Advice, Energy Saving Trust Ltd, 21 Dartmouth Street, London, SW1H 9BP Energy Saving Trust – October 2014 page 5 of 5