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Application to join the Carbonetix Sub-contractor's Register

BUSINESS DETAILS
Business Name:
ABN:
Contact Name:
Position:
Business Phone:
Business Fax:
Mobile Phone:
Mail Address:
Business Address:
Email Address:
Web-site:
Years in operation:
Number of technical staff:
Details of relevant Memberships & Registrations:
Insurances Held & Amounts:
Guarantees Provided:
Standard hours of operation:
Areas serviced:


TECHNICAL DETAILS

Please indicate if you have relevant skills & experience by checking the appropriate box.

Electrical
  Building Automation Systems (BAS) / Building Management Systems (BMS)
  Commercial lighting
  Data
  HVAC
  Industrial control (e.g. Programmable Logic Controllers)
  Power Factor Correction
  Refrigeration
  Sensors
  Soft starters
  Variable speed drives
  Voltage Reduction
  Voltage Reduction


Plumbing
  Commercial rainwater capture
  Commercial swimming pools
  Evaporative coolers
  Heating control systems
  Hydronic heating systems (major maintenance, balancing, commissioning)
  Low flow shower heads
  LPG to natural gas conversions
  Retrofit of pipe insulation
  Roof mounted, wind-powered ventilators
  School heating appliances
  Solar hot water (commercial)


Air Conditioning
  Fresh air balancing
  Damper adjustment to meet fresh air requirements
  Evaporative coolers
  HVAC controls
  Hydronic system balancing
  Packaged systems
  Refrigeration controls
  Split systems
  Swimming pool hall heating and ventilation
  VAV aircon systems


BUSINESS DETAILS

Please provide details for three customers/clients who would be willing to provide a reference over the phone:

Reference 1:

Business Name:
Contact Name:
Contact Number:
Work performed:


Reference 2:
Business Name:
Contact Name:
Contact Number:
Work performed:


Reference 3:
Business Name:
Contact Name:
Contact Number:
Work performed:


Safety Record

  1. Have you ever received any warnings or been fined by Energy Safe Victoria (and its predecessor organisations e.g. Office of the Chief Electrical Inspectors)?
    Yes / No
  2. Have you or any of your staff ever been seriously injured while at work?
    Yes / No

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