CSA Group GHG CleanStart® Registry

APPLICATION FORM

CSA Group’sGHG CleanStart® Registry complements the International Organization for Standardization’s (ISO) 14064 series of standards relating to greenhouse gas measurement and reporting. More specifically, it provides transparency to publicly reporting a variety of GHG inventoriesand related assertions and claims.

Before completing this application, you must review the ISO 14064-1 and ISO 14064-3 Standards in order to be familiar with the requirements and terminology. Conformance with these standards is integral to this service.

CSA Group’s GHG CleanStart® Registry is a credible and transparent service that allows you to:

  • publicly showcase your carbon management efforts and gain recognition for your achievements;
  • develop and document commitments, actions, results and recognitions associated with GHG emissions;
  • register GHG inventories and related assertions and claims in an open, transparent way, consistent with the principles of the ISO 14064 series of standards; and,
  • prepare your organization for the CSA Registered Carbon Neutral™Program.

Effective December 1, 2014, the following documents must be submitted to meet theCSA Group GHG CleanStart® Registry reporting requirements:

  • an ISO 14064-1 conformant GHG Report;
  • an ISO 14064-3 conformant 3rdparty Verification Statement OR 1stparty self-declaration statement;
  • a completed CSA Group GHG CleanStart® Registry Application Form; and
  • theCSA Group GHG CleanStart® Registry Application and Listing Fee of $745 (plus applicable taxes).

You may also include other supporting documentation such as a Letter of Intent.

As part of the application process for the CSA Group GHG CleanStart® Registry, we require that you complete all sections of this Application Form and provide all applicable supporting documents. Please note that you must re-apply for each distinct GHG inventory and pay the associated fees.

New and/or updated reports may be required if there is a change to any of the information as previously submitted, including changes in organizational management, structure or operations. Additional fees may apply.

1.Submission Information

Application submission date:
(yyyy-mm-dd) / (yyyy-mm-dd)
What is the boundary scope of your GHG inventory?
(Select one type only) / Organizational Operations
Event or Conference
Building
What is the start date of the GHG Inventory? / (yyyy-mm-dd)
What is the end date of the GHG Inventory? / (yyyy-mm-dd)
Is the GHG Inventory 3rd party verified or a 1st party self-declaration? / 3rd party verified
1st party self-declaration

2.Applicant Information

Main Business Contact for Applicant

The main business contact is the’responsible party’ and as per 14064-1 is the person or persons responsible for the provision of the GHG assertion and the supporting GHG information.

Name of Applicant:
Applicant Website:
Applicant Contact Name(s):
Position or Title:
Address:
City:
Province / State:
Postal Code / Zip Code:
Country:
Telephone No.:
Fax No.:
E-mail Address:
Primary Technical Contact for Applicant [ Not applicable ]
The primary technical contact is usually the person responsible for preparing your GHG Report.
Name of Technical ContactOrganization:
Technical Contact Organization Website:
Technical Contact Representative Name(s):
Position or Title:
Address:
City:
Province / State:
Postal Code / Zip Code:
Country:
Telephone No.:
Fax No.:
E-mail Address:
Designation of Authorized Agent Information [ Not applicable ]
This section is to be completed only if the Applicant appoints an Authorized Agent to instruct and interact with CSA Group on behalf of the Applicant. Both the Applicant and Authorized Agent must sign the Application Form and the Designation of Authorized Agent Form.
Name of Authorized Agent Organization:
Agent Organization Website:
Agent Organization Contact Name(s):
Position or Title:
Address:
City:
Province / State:
Postal Code / Zip Code:
Country:
Telephone No.:
Fax No.:
E-mail Address:
Verifier Information [ Not applicable]
An ISO 14064-3 conformant 3rd party Verification Statement OR 1st party self-declaration statement must be provided. If a 1st party self-declaration is provided, then it must be provided by a person whose independence can be demonstrated by the freedom from responsibility for the development of GHG data and information.
Name of Verifier Organization:
Verifier Organization Accreditation ID No.:
(if applicable)
Verifier Organization Accredited by:
(if applicable)
Verifier Organization Website:
Verifier(s) Contact Name(s):
Verifier(s) Certification or ID No(s).:
(if applicable)
Position or Title:
Address:
City:
Province / State:
Postal Code / Zip Code:
Country:
Telephone No.:
Fax No.:
E-mail Address:

3.Billing Contact and Address

Please provide the contact information and billing address for this application. Please note that the invoice for the requested actions will be sent to this address. Payment details and associated fees can be found in the PAYMENT DETAILS section of this application form

Name of Organization:
Contact Name:
Street Address
City:
Province / State:
Postal Code / Zip Code:
Country:
Telephone No.:
E-mail Address:

4.PUBLIC POSTING OF INFORMATION AND PRIVACY STATEMENT

The information provided on this Application Form is used for administration and internal purposes only and will not be posted in full. However, some of the contact information, such as the Applicant’s, Authorized Agent’s, and Verifier’s names and website addresses will form part of the public Registry listing.

Be aware that supporting reports submitted to the Registry may be posted on the Registry and may contain contact information and other details that will be accessible for public viewing. In completing and signing this Application Form, the Applicant warrants that it:

(i)has the authority to disclose the information and has obtained all appropriate consents, including, where applicable, with respect to the disclosure of personal information; and

(ii)agrees to be bound by all the terms set out in this Application Form.

Note:To review the CSA Group Privacy Policy, please visit .

5.DECLARATION

I have read and understand the documents contained in the Application Form, including, without limitation, the Terms of Use (found in Annex A, below),and I expressly agree to the terms set out therein. I warrant by my signature below that I have authority to bind the Applicant.

Signatures / CSA Group / Applicant / Authorized Agent
(if applicable)
Name of Organization: / Canadian Standards Association, operating as CSA Group
Name of authorized signatory: / Michael Leering
Title of authorized signatory: / Program Manager,
Environment and Climate Change
Signature:
Date:
(yyyy-mm-dd)

6.SUBMISSION

Submit the attached completed Application Form, including all required documents by e-mail .

Upon receiving the Application Documents, CSA Group will send a confirmation of receipt to the Applicant or Agent along with an invoice for the Application Fee (including applicable taxes) and a Payment Remittance Form. The Application Fee is charged for each submission of the Application Documents.

CSA Group will perform the internal administration and assessment of the Application Form and supporting documents for completeness against the CSA Group GHG CleanStart® Registry requirements.

  • In case any deficiencies are noted by CSA Group, the Applicant or Authorized Agent will be requested to address them. An additional fee may be incurred if the Applicant or Authorized Agent takes longer than six (6) months to respond to any noted deficiencies.
  • If there are no deficiencies or all deficiencies have been resolved, CSA Group will issue a successful Letter of Participation and will list the documentation on the CSA Group GHG CleanStart® Registry.

Results of the review will be sent by email to the Applicant or Authorized Agent.

The listing on the CSA Group GHG CleanStart® Registry is always subject to acceptance by CSA Group.

APPLICATION DOCUMENTS SUBMISSION CHECKLIST
Did you remember to include the following documents for your submission to CSA Group?
Signed Application Form
Signed Designation of Authorized Agent Form
(Attach if applicable) / included / not applicable
GHG Report
Verification Statement
or
Self Declaration
PAYMENT DETAILS
5.1.1Fees

Effective December 1, 2014, the CSA Group GHG CleanStart® Registry Application and Listing Fee is $745 CAD (plus applicable taxes).

5.1.2General

An invoice and a Payment Remittance Form will be provided to the Applicant for the Application and Listing Fee. All fees must be paid in full before the successful Applicant is:

a)Listed on the Registry, and

b)Provided a Letter of Participation.

5.1.3Payment Method

Payments to CSA Group can be made using either of the two (2) methods listed below. Payments will not be processed without thecompleted Payment Remittance Form.

i)Credit Card

Credit card payments are to be submitted by completing the Payment Remittance Form and faxing it to the secure fax number (416) 401-6773.

ii)Cheque

Cheques are to be made payable to “CSA Group” and mailed with the completed Payment Remittance Form to the following address:

CSA Group
Accounts Receivable, 178 Rexdale Boulevard
Toronto, Ontario M9W 1R3 CANADA

All fees are:

a)to be paid in Canadian dollars;

b)non-refundable, and

c)subject to local taxes where applicable.

.

Annex A
TERMS OF USE
(the “Agreement”)

  1. Interpretation and Construction

For the purpose of this Agreement, unless the context otherwise requires, terms have the meaning set out below. All capitalized terms not defined herein shall have the meaning given to them in the Application Form and the Standards.

“Applicant” means the organization applying for registration of its GHG inventories and related assertions and claims in an open, transparent way, consistent with the principles of the ISO 14064 series of standards.

“Application Form” means the form which the Applicant must complete and submit in order to apply for listing on the Registry, and includes this Agreement.

“Authorized Agent” means the organization appointed by the Applicant as its sole and exclusive agent to act on the Applicant’s behalf in connection with all matters relating to Registry.

“Registry” means the CSA Group GHG CleanStart® Registry.

“Standards” means CAN/CSA-ISO 14064-1:06 (ISO 14064-1:2006) Greenhouse gases – Part 1: Specification with guidance at the organization level for quantification and reporting of greenhouse gas emissions and removals (also referred to as “ISO 14064-1”); and CAN/CSA-ISO 14064-3:06 (ISO 14064-3:2006) Greenhouse gases – Part 3: Specification with guidance for the validation and verification of greenhouse gas assertions (also referred to as “ISO 14064-3”), as either may be amended or supplemented from time to time.

  1. Services

Subject to the terms of this Agreement, the Applicant has applied to Canadian Standards Association, operating as CSA Group (“CSA Group”) for, and CSA Group agrees to provide, such services as set out in the Application Form, and as otherwise agreed to in writing between the Applicant and CSA Group in relation to the listing of information on the Registry (the “Services”).

  1. Fees

The Applicant shall pay such fees for the Services as set out in the Application Form. Fees are subject to change from time to time at CSA Group’s discretion. Fees are non-refundable.

  1. Applicant Obligations

4.1General

The Applicant will:

a)use this Registry in a manner that is consistent with the following: the Registry is intended to reflect Applicants’ conformance with the Standards and provide transparency in reporting a variety of GHG inventories and related assertions and claims. Without limitation to the foregoing, the Registry is intended to allow organizations to publicly account for and register GHG emission inventories as quantified and reported in accordance with ISO 14064:1; and verified by a third party in accordance with ISO 14064:3 or as self-declared by Applicants; and

b)promptly update CSA Group if there is any change to information as previously submitted to CSA Group and/or change in the management, organizational structure or operations of the Applicant. The Applicant will provide supporting documentation as reasonably required by CSA Group and pay any fees associated with updating information as listed on the Registry.

4.2Representations and Warranties

The Applicant represents and warrants that:

a)all information provided to CSA Group is complete and accurate and conforms to the requirements (as applicable) of the Standards;

b)the Applicant is authorized to disclose all information as provided, including any personally identifiable information about individuals;

c)without limiting the generality of the foregoing, the provision of information to CSA Group by the Applicant and the listing of such information on the Registry does not infringe the intellectual property rights (including the moral rights) of any third party; and

d)none of the information provided to CSA Group is subject to export controls and regulations.

4.3Acknowledgements

The Applicant acknowledges and agrees as follows:

a)compliance with all terms as set out in this Agreement and elsewhere in the Application Form (together, the “Terms”) is a condition being listed on the Registry. In the event of conflict between provisions in this Agreement and those appearing elsewhere in the Application Form or on the Registry webpages, those as contained in this Agreement will prevail;

b)CSA Group is not responsible for the contents of any information provided by or on behalf of the Applicant to CSA Group in connection with the Services, and the Applicant bears sole responsibility for the accuracy, completeness and currency of such information and ensuring conformance with the applicable Standards and compliance with applicable laws. In no way is CSA Group responsible for verifying or confirming such conformance or compliance, even if the Applicant’s application is accepted by CSA Group, information submitted by the Applicant is listed on the Registry, or CSA Group conducts an audit pursuant to Section 9.1 of this Agreement. The Applicant further bears sole responsibility for the use of or reliance on such information by the Applicant, CSA Group or any third party during the term of this Agreement and thereafter;

c)CSA Group will provide all Services in accordance with CSA Group’s usual practices and procedures, as may be amended or supplemented from time to time;

d)at minimum, the following submitted information will be accessible on the public portion of the Registry: (i) the names, contact information and website domain of the Applicant and/or Authorized Agent, and Verifier(as applicable), (ii) the GHG Report; and (iii) the Verification Statement;

e)CSA Group may reject any information as submitted if, in CSA Group’s sole discretion, it fails to meet the requirements for listing on the Registry, and CSA Group may remove information as listed on the Registry at any time if, in CSA Group’s sole discretion, the Applicant has failed to meet any of its obligations as set out in the Terms;

f)CSA Group may use information received from Applicants on an aggregate, non-identifiable basis for research purposes;

g)in order to document the Services, CSA Group may retain all information as submitted by Applicants and will not be obligated to return same upon any circumstances. This Subsection will survive termination of this Agreement;

h)CSA Group will use reasonable commercial efforts to ensure that the Registry website is accessible to the Applicant and to third parties as required, however access to the internet is not always reliable and the Registry website may not be available at all times;

i)CSA Group makes reasonable efforts to ensure the prompt listing and/or removal of information from the Registry; however such updates may be subject to time delays depending on internet, systems, and/or staff availability or for other reasons; and

j)the Registry was created for the limited purpose of publicly registering information relating a variety of GHG inventories and related assertions and claims. The Applicant is participating in the Registry for the purpose of public registration of such information, and that CSA Group undertakes no activities whatsoever in relation to facilitating the trading of offsets and related contracts and products, and does not constitute an exchange, a clearinghouse, a dealer, an advisor, a trader or any other form of market participant relating to such transactions. CSA Group has no commercial interest in the delivery, transfer or use of offsets except indirectly in connection with the provision of services such as listing and removing information concerning same on or from its registries.

  1. Intellectual Property

5.1References to CSA Group

During the term of this Agreement, and while the Applicant’s information is listed on the Registry, CSA Group will permit the Applicant’s non-exclusive use of references to CSA Group and the Registry (the “CSA Group Trademarks”) in accordance with the license terms set out in Schedule Ato this Agreement, as may be amended or supplemented by CSA Group from time to time.

7.Appointment of the Authorized Agent

If the Applicant wishes to appoint an Agent to correspond with CSA Group on its behalf, the Applicant must provide CSA Group with a copy of an executed Designation of Authorized Agent Form in the form as attached inSchedule B(the “Agent Authorization”). The onus will be entirely upon the Applicant to inform CSA Group staff of the existence of an Authorized Agent, and to notify CSA Group promptly in writing if the Applicant terminates the Agent’s authorization at any time, in which event CSA Group will take instructions from the Applicant unless or until a new Authorized Agent is appointed by the Applicant in accordance with this Agreement. CSA Group reserves the right, at its sole discretion and at any time: (i) to decline to recognize the Authorized Agent as an authorized representative of the Applicant; and/or (ii) to require renewal of, or amend, the Agent Authorization, in which case a new authorization must be signed by the Applicant and the Authorized Agent. In the event the Applicant appoints an Authorized Agent, the Applicant agrees that CSA Group will take instructions from the Authorized Agent regarding Services to be performed by CSA Group for the Applicant, and the Applicant hereby ratifies, confirms and agrees to honour and to be bound by each and every instruction or undertaking, whether written or verbal, entered into with CSA Group by the Applicant’s Authorized Agent(s) purportedly on the Applicant’s behalf. CSA Group will not be liable for any disputes arising out of, or connected with, the Applicant’s relationship with its Authorized Agent(s) or the execution of the Agent Authorization.

  1. Indemnity and Limitation of Liability

7.1Indemnity

The Applicant agrees to indemnify, hold harmless, and defend CSA Group and its affiliates, and their respective sub-contractors, agents, members, officers, directors, employees and permitted assigns from and against any claims, liabilities, judgments, awards, damages, losses and expenses, including reasonable attorneys’ fees, arising directly or indirectly out of: (i)any violation by the Applicant or its Authorized Agent(s) of any obligations, representations and warranties set out in this Agreement; and/or (ii) performance of the Services by CSA Group, except as arising directly out of the legally proven negligence of CSA Group in performing the Services; and/or (iii) the Applicant’s references to CSA Group and the Registry in accordance with Section 5; and/or (iv) any acts or omissions of the Applicant or itsAuthorized Agent(s).