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Cavity Pre-installation Building Inspection Survey Sheet Customer Information:Name: AMOL ROKADEAddress:407,arihant apartmentFront Elevation Rear ElevationLeft Elevation Right Elevation Total Wall Area Main (excl windows) :........0.....0....0............ Total Main CWI Area Insulated:........7...6......5...0............... Reason:............................................................................. Total Wall Area Extension 1 (excl windows).......0......0...0....... Total Area Extension Insulated...........1......0...0............. Reason:..............................................................................Total Wall Area Extension 2 (excl Windows).....0......3...0...... Toatl Area Extension Insulated......1......0....0....... Reason:..................................................................................................Surveyors Signature: Date: 21/10/1992Notes/Area Calculation: TOTAL AREA OF PROPERTY TOTAL INSULATED AREAMAIN 0.30 WIN+DOOR 0.30 0.30 0.30 POPT 78.50EXT 1 0.30 WIN+DOOR 0.00 26166.67EXT 2 0.30 WIN+DOOR

Title: Mr First Name AMOL Surname ROKADECustomer Address: 407,arihant apartmentDate of Birth: 21/10/1992 DWP NO: CDFV343R4324 Pre Date: 21/10/1992Customer Tel Number: 5434453434355435 Landlord Tel Number 55848548548548548548541If House/bungalow: Detached Semi Mid terrace End terraceIf Flat/maisonette: 3+ external walls 2-external walls8. Bedrooms: 1 23 4 5 6+9. Tenure Social housing tenant Private owner Private tenant10. What is the pre-main heating source2?Gas boiler Electric storage Oil boiler LPG boiler Solid fossil Electric boiler heaters fuel boilerGas room heaters Solid fuel room Electric room Gas fire with Gas back boiler to radiators heaters heaters back boilerMain property Cavity 0.00 CWI 76.50 SWIExt 1 N/A 1.00 SWIExt 2 N/A 0.00 CWI 1.00 SWI 10Ext 3 10Ext 4 B/A= 26166.67 % 0.30 CWI SWI SWI 20CWI POPT C/A= 524242 % CWISWI POPT 542542 78.50 B SWI CWI DOCC POMI: 10 Total wall areas 0.30 A CWI C 10 Final CWI POPT rounded to nearest 10% % % Final SWI POPT rounded to nearest 10% DOCC POPT: 254 Post Date: 21/10/2018POMI Reason: POMI Reason: Restricted access to elevation Landlord Tel: 55848548548548548548541POPT Reason: POPT Reason: Restricted access to elevationLandlord Name: JOHN DEOLandlord Address: NEWYORK CITYEco Score Start: 21/10/2017 Eco Score End 21/10/2018

Job reference number_________________________ March 2017 - ECO2 Version 2.0ECO2t Help to Heat Group and Private Domestic Premises Checklist For additional information on help to heat group eligibility and evidence requirements, please refer to Ofgem's help to heat group guidance note: https://www.ofgem.gov.uk/publications-and-Customer address Company name updates/eco2t-help-heat-group-guidance-note. Green Eco Company(Building number/name, 407,arihant apartment Name of representativeStreet name, Town, City,County, Postcode) (title, first name, surname) AMOL ROKADECustomer Details - Owner Occupier / Tenant Sign box 18Title Mr First name AMOL Surname ROKADE o Privately rentedDaytime phone no. 5434453434355435 E-mail Address  Next steps Go to 12 HGMHG6547657657657651484848484854 Property owner occupied or o Owner occupied Go to 9 or 10 if ESAS / DWP verifiedAlternate phone no. privately rented Go to 12 Go to 9 or 10 if ESAS / DWP verifiedDetails for Benefit Recipient – tick the boxes where appropriate  Evidence collected Go to 12 Name of benefit (tick one) Go to 9 or 10 if ESAS / DWP verified Benefit entitlement letter / WHD Core Group (2 ) / ESAS / Go to 12 1 Pension Guarantee Credit (1) DWP Go to 9 or 10 if ESAS / DWP verified Go to 72 Income based Job Seekers Allowance Benefit entitlement letter (2) / ESAS / DWP Go to 9 or 10 if ESAS / DWP verified Go to 83 Income Support Benefit entitlement letter (2) / ESAS / DWP Go to 9 or 10 if ESAS / DWP verified4 Income related Employment and Support Allowance Benefit entitlement letter (2) / ESAS / DWP Yes. Go to 12 No. Go to 115 Tax Credit Benefit entitlement letter (2) / ESAS / DWP (includes Working Tax Credit and Child Tax Credit) Joint or single claim Number of qualifying children as indicated in 7.6 Universal Credit Benefit entitlement letter (2) / ESAS / DWP Joint or single claim Number of qualifying children as indicated in 8. Tax Credits Tick the appropriate total annual gross income threshold based on the household composition. Number of qualifying children 0 1 2 3 4 or more7 Single claim £13,200 o £17,400 o £21,600 o £25,800 o £30,000 o Joint claim £19,800 o £24,000 o £28,200 o £32,400 o £36,600 o Is the household’s total income below the appropriate threshold for the household, ticked above? Universal Credit 4 or more Tick the appropriate monthly net earned income threshold based on the household composition. £2,500 o £3,050 o Number of qualifying children 01 2 38 Single claim £1,100 o £1,450 o £1,800 o £2,150 o Yes. Go to 12 No. Go to 11 Joint claim £1,650 o £2,000 o £2,350 o £2,700 o Is the household’s monthly income below the appropriate threshold for the household, ticked above?9 ESAS matched reference 8 digit Unique Reference Go to 12 Number 10 DWP matched reference 10 digit Unique Reference Number CDFV343R4324 Go to 12 11 (10 digits indicate a 3 digit user prefix isDetails for Private Domestic Premises included. Q This person does not appear to be eligible for HHCRO but may be eligible for CERO Q12 Is the property a park home? o No. Go to 13 o Yes. Provide supporting evidence showing that the named owner resides at the premises (2) , and then go to 1613 Is the property registered on the relevant land registry? (3) o No. Provide screenshot to show that property is not registered on the Land Registry and then go to 14 o Yes. Provide a search from the Land Registry (2) to identify that the property is a private domestic premise and then go to 1614 Is the property owner occupied? o No. Go to 15 o Yes. take a copy/photo of the title deeds or mortgage statement (2) (addressed to the owner occupier) or complete Ofgem template 4 or 5 (4) (if template used, supporting evidence (2) showing that the named owner resides at the premises, must be provided) and then go to 16 o No. Go to 1115 Is the property privately rented, or is there an occupancy agreement in place (owner o Yes. Take a copy/photo of a current tenancy agreement (4) or complete Ofgem template 1, 2 or 3 (5) (if landlord)? (6) template used, supporting evidence showing that the named tenant resides at the premises, must be provided) and then go to 1616 Is the proof of benefit addressed to an occupier of the private domestic premises? o No. Go to 17 o Yes. Go to declaration 1817 Provide a copy of utility bill, phone bill, bank statement, mortgage statement or council tax letter for the benefit recipient to evidence occupancy (2) Go to declaration 18 Company Representative Declaration: I confirm that I have seen original copies of evidence of the benefits ticked above and all other evidence as applicable and have taken copies.18 AMOL ROKADE Signed X_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _X Date: 21/10/1992 Full Name(1) People in receipt of both Pension Savings Credit and Pension Guarantee Credit are eligible.(2) Document confirming eligibility to be dated no more than 18 months before installation (subject to funding provider agreement).(3) For England and Wales this should be the Land Register maintained by her Majesty's Land Registry. For Scotland this should be the Land Register of Scotland or the Register of Sasines.(4) Ofgem HHCRO templates available at: https://www.ofgem.gov.uk/publications-and-updates/eco2t-hhcro-templates-evidence-private-domestic-premises.(5) Including as a minimum, the address, name of tenant, name of landlord, start date of tenancy, length of tenancy and signature of both parties.(6) The landlord is not a housing trust, housing cooperative, registered social landlord, housing association, local authority or charity.

March 2017 Version 1.1Energy Company Obligation (ECO): Part 1 - privacy notice, Part 2 - consent statementPart 1 – Privacy NoticeYour personal information that will be collected and shared includes:  Your full name, date of birth and address and contact details.  Proof of identity.1  Where required: the Department for Work and Pensions (DWP) will provide a YES/NO response via the Energy Savings Trust to verify whether or not you or a member of your household are in receipt of the relevant benefits to be eligible for support under the ECO scheme.  Where required: Copies of documents showing proof of benefits and income supplied to you by the DWP and HMRC, this will be limited to information relating to your entitlement to assistance.  Where relevant: the amount of any financial contribution towards the cost of the installation.To check eligibility and gain funding for the Energy Company Obligation (ECO) scheme and to check that asupplier is meeting its obligations under the scheme we need to collect and share your information with otherorganisations including:  Where required: The DWP Scheme Organisations including:  The Office of Gas and Electricity Markets (Ofgem) who will share your information in order to fulfil its statutory duties as well as with the installer of the measure (on request) in order to verify whether it has been notified to Ofgem. Ofgem may share your information with third parties contracted to carry out audits on behalf of Ofgem and the promoting energy company.  The installation company and companies supporting the installation such as building specialists, software providers, guarantee companies, technical monitoring agents, the installer’s accreditation body, local authorities or their intermediaries/contractors; and charities, social housing providers, building control inspectors, the property owner or managing agent (where applicable), and the energy company promoting the measure.Company DetailsType of company (delete as applicable):[ installation company/ lead generation company/ energy company/ / other (please specify) ]Full Name of company2: Green Eco CompanyFull Company address:Unit 4, Bridge Street, Accrington, BB5 4HU Tel no: Email: 0753 4446008 [email protected] Name of person completing this Signature: form with customer:AMOL ROKADE1 This may be collected to evidence a supporting component for benefit evidence.2 Notes:(1) s.4, paragraph 2(3)(a), of Part II to Schedule 1 of the Data Protection Act 1998 requires that any fair processing noticeexplicitly sets out the identity of the data controller. As such, once this is known, the data controller’s details should be inserted here;(2) as from 25 May 2018, consumers should be provided with the data processing information required by article 13 of the GeneralData Protection Regulation (GDPR). A such,this version 1.0 of the privacy should not be relied upon after 25 May 2018, as it requiresupdating to capture the new requirements of the GDPR. ECO Reporting Working Group document. May not be accepted if amended.

March 2017 Version 1.1Part 2 - Consent Statement Customer Details – please note that separate consent forms must be provided for each individual whose information will be shared. For example the Help to Heat Group member providing eligibility and the named individual on the Declaration of Completed Conformity handover must provide separate consent forms unless they are the same person.Title: First Name: Surname: Date of Birth:Mr AMOL ROKADE 21/10/1992Type of customer: Main applicant Benefit recipientOther (please specify) ______________________Full Customer Address:407,arihant apartmentTel no: Email:5434453434355435Access to your information and correctionYou have the right to request a copy of the information that we hold about you. If you would like a copy of some orall of your personal information, email or write to us using the details listed in the company details section above.We may make a small charge for this service. We want to make sure your personal information is accurate and upto date. You may ask us to correct or remove any information you think is inaccurate.Security of the information providedAll organisations which collect and use your information under ECO are bound by the provisions of the DataProtection Act 1998 including requirements for keeping your details secure.a) Checking eligibilityI understand that you need to check that I am eligible for the ECO scheme:I agree to any of the ECO scheme organisations contacting me to verify the information I have provided.Where applicable to confirm that I am on a qualifying benefit:I agree to my information being shared with the Department for Work and Pensions via the EST toconfirm whether I am in receipt of a qualifying benefit.b) Checking the installationI understand my information may be shared with the scheme organisations listed above to: Arrange surveys required and the installation. Check the installation meets the requirements of the scheme and the appropriate installation standards. Carry out a customer satisfaction survey to look at how their services or the delivery of ECO can be improved. You don’t have to take part in these surveys but your feedback would be appreciated.Signature: Date: 21/10/2018If you change your mind before any installation is completed you can withdraw from the ECO scheme bycontacting the company listed above. Please note that once your measure has been installed you are unableto withdraw your consent for your data being shared under the scheme.Your information will only be used as the law allows. To find out more about how Ofgem uses information:Ofgem’s ECO Privacy Policy can be found at: www.ofgem.gov.uk/publications-and-updates/ECO-privacy-and-information-use.ECO Reporting Working Group document. May not be accepted if amended.

April 2017 Version 1.0ECO2t: Deemed Scores Survey1Questions 1-10 are mandatory.Questions 11-23 must be completed for the relevant measure type, and may be completed by adifferent operative at survey or post installation stage.1. Date of survey: 21/10/19922. Name of operative: AMOL ROKADE3. Full name of customer: AMOL ROKADE4. Address of installation: 407,arihant apartment5. Post code: HHCRO CERO CERO Rural6. Customer type7. Property type: House Bungalow Flat Maisonette Single park Double parkIf House/bungalow: Mid terrace home homeIf Flat/maisonette: 3+ external walls Detached Semi End terrace 2-external walls8. Bedrooms: 12 3 4 5 6+9. Tenure Private owner Private tenant Social housing tenant10. What is the pre-main heating source2?Gas boiler Electric storage Oil boiler LPG boiler Solid fossil Electric boiler heaters fuel boilerGas room heaters Solid fuel room Electric room Gas fire with Gas back boiler to radiators heaters heaters back boilerIf other, specify the heating source and what deemed scores proxy is being used? Roof insulation measures onlyEnter areas with a different roof type or where a different roof insulation measure/depth is being installedas extensions. For RIRI, the total residual loft area should be included in the RIR area recorded below. Forfurther information on scoring a RIRI measure please see chapter 7 of ECO2t Guidance.11. Are you proposing to insulate the roofs? (enter details below) Yes/NoProperty Roof type Roof M2 and type of insulation to be installed3section area M2Main Flat/pitched/RIR ≤ 100mm > 100mm FRI RIRIExt 1 ≤ 100mm > 100mm FRI RIRIExt 2 ≤ 100mm > 100mm FRI RIRIExt 3 ≤ 100mm > 100mm FRI RIRIExt 4 ≤ 100mm > 100mm FRI RIRI Total roof areas A ≤ 100mm B > 100mm C FRI D RIRI3 E≤ 100mm POPT B/A= % Final ≤ 100mm POPT rounded to nearest 10% % %> 100mm POPT C/A= % Final > 100mm POPT rounded to nearest 10% %FRI POPT D/A= % Final FRI POPT rounded to nearest 10%RIRI POMI4 F %RIRI POPT (E x F)/A= % Final RIRI POPT rounded to nearest 10% %If Room in roof insulation, will you be insulating the residual area? Yes/No1 Please note that you may be required to provide photo verification alongside this document.2 For heating measures, this should be the source that you are replacing.3 For RIRI, ‘E’ refers to the floor area of the RIR + the residual area, not the amount of insulation installed. Theelements of the RIR that have been insulated should be recorded elsewhere to calculate the POMI.4 For RIRI, POMI should be calculated outside of this document and recorded here.ECO Reporting Working Group Document. May not be accepted if amended.

April 2017 Version 1.0 Heating measures only12. Main wall construction type > 50% cavity wall > 50% solid wall13. Pre-existing heating controls Room stat Yes/No Programmer Yes/NoEnter number of radiators Number of TRVs present14. What heating measure is being installed?15. What fuel is the new heating system using?16. Is it qualifying? Yes/No17. Will the new heating heat 100% of the property? Yes/NoIf “No” please enter the % of property to be treated POPT= % (Round to nearest 10%)Wall insulation measures onlyEnter each different type of wall area as an extension. Wall area must include areas already insulated and areas that cannot be insulated18. Are you proposing to insulate the walls? (enter details below) Yes/NoProperty section Wall construction Wall area M2 (excl Cavity/solid stone/solid brick/system/timber/park windows) M2 of insulation to be installed home 0.00 CWI 76.50 SWIMain property CavityExt 1 N/A 0.00 CWI 1.00 SWI 10 CExt 2 N/A 0.30 CWI 1.00 SWI 10Ext 3 N/A SWI %Ext 4 N/A CWI 78.50 B SWI CWI SWI 20CWI POPT B/A=26166.67 % Total wall areas 0.30 A CWI 10 Final CWI POPT rounded to nearest 10%SWI POPT C/A= 524242 % Final SWI POPT rounded to nearest 10% 10 %19. Approximate build year or age band & reasoning (SWI measures only):20. Are you proposing to insulate any cavity Yes/No/Not applicable PWI POPT % party walls? Floor insulation measures only21. Are you proposing to insulate the floors? (enter details below) Yes/NoProperty section Floor construction e.g. timber suspended/solid Area M2 M2 of insulation to be installedMain propertyExt 1Ext 2Ext 3Ext 4 Total floor area A BFloor insulation POPT B/A= % Final FI POPT rounded to nearest 10% %22. Are you also installing any other measures? Yes/No (please list below) %Additional measure 1 %Additional measure 2 POPT %Additional measure 3 POPT POPTRecommended date stamped pre photographic evidence (suppliers’ requirements may vary)All properties – Front/side/rear elevations, main heating type and fuel source e.g. gas meter/oil tank/LPG tankWall insulation – wall thicknesses with tape measure and brick patterns where visibleRoof insulation – Depth of any existing insulation with tape measure and loft declaration if <100mmRIRI - External shot of roof showing neighbouring roofs, roof room internally from all 4 corners, shot of fixedstaircase leading to roof room and shot inside flat ceiling and residual areasFloor insulation - Shot of underfloor prior to insulation if applicableHeating measures - Pre existing heating controls and pre existing storage heaters or radiatorsNotes:ECO Reporting Working Group Document. May not be accepted if amended.

23. Draw a rough sketch of the floor plan, for each storey of the property, showing the locaAtpioriln2s01o7fVtehrseiomn 1a.0in heating system elements and bedrooms (below or on additional sheets as required):KeyHS – Main heatingsystem/boilerOHS – Other heatingsystemRAD - RadiatorESH – Electricstorage heaterRH – Room heater(only where mainheating source for aroom)BR# - Bedroom &numberLR – Living roomK – KitchenD – Dining areaBTH – Bathroom___ - Solid wall=== - Cavity wall//// - Party (Shared)WallXXX – Wall adjacentto unheated space(eg unheatedcorridor)□ – Window or doorPlease confirm all the details recorded above, on both pages, by ticking and signing below I confirm that, to the best of my knowledge, the information provided on this form has been recordedon site and is accurate.Assessor signature: Date: 21/10/1992Customer signature: Date: 21/10/1992Deemed Score Starting Value (100%): 21/10/2017 tCO2 / £LTS* tCO2 / £LTS*Deemed Score Finishing Value: 21/10/2018 *Delete as appropriate(After POPT Applied & POMI (RIR Only) applied)ECO Reporting Working Group Document. May not be accepted if amended.

March 2017 - Version 1.0Declaration of Conformity and Completed InstallationName of installation company Green Eco Companyand address: Unit 4, Bridge Street, Accrington, BB5 4HUPAS1 certification no. OCEI09713Customer’s full name AMOL ROKADEContact phone number 5434453434355435Address/es of 407,arihant apartmentmeasure installation(Inc. UPRN where UPRN:available) If multiple premises: The number of premises must be stated here along with the file name of the multiple premises spreadsheet. Each premises covered by this form must have the same measures installed and the samePre-main heating landlord. The multiple premises spreadsheet must be attached and include the address and the information listedsource2: in the Measure Section below for those additional premises.Measure Section: Gas BoilerSelect measure type andtick/enter variant i.e. as per deemed scores in matrix.installed (if applicable) PAS1  Product details: manufacturer, Enter Enter Date Date ofCavity wall insulation name, serial number percentage percentage of installed handover annex of measure property treated 0.027  0.033  0.04 e.g. Insulation Inc, ECO therm, dd/mm/yyyy dd/mm/yyyy 12/3456 installed (POPT)Party cavity wall insulation (POMI) % 3 (rounded to the nearest 10%) B1 Isothane Cavity Wall System 97/3426 542542 21/10/22011/180/2018 254 B1Draught proofing B2External wall insulation B4Thickness installed:______mmFlat roof insulation B5 B8Room in roof insulation4Residual loft insulated Internal wall insulationThickness installed:______mmLoft insulation B9Please enter the relevant start depth: _________ mmPlease select () the relevant finish depth (mm):  <2505  250  270  300  350  ≥400Loft insulation (rafters) B10 3 4 5  6  Other: 3 4 5  6  Other:Gas Boiler replacement C2 C6Pre-existing heating controls Heating controlsNon-gas boiler replacementPre-existing heating controls Electric storage heaters D1 Slimline  Fan  HHRPlease select () the number of ESH at property: 1 2 2Please select () the number of ESH replaced/repaired:  1Other:The declarations below are required to confirm conformity to the Publicly Available Specification as referenced in the ECO2 Order andthe relevant version of PAS and should be signed by both the installer and the customer (owner occupier/ tenant) or landlord (wheremultiple premises) on completion and handover of the energy efficiency measure.If certified to PAS 2030:2014 Edition 1 complete the declaration from Section A and one from Section B 6:Section A:The installation of [energy efficiency measure]_________________________________________________________________________________________________________________________ at [location ofinstallation]___________________________________________________________ and handed over on [date(dd/mm/yyyy)]_______________________ has been undertaken by [name of installer]_____________________________ using an installation process complying with PAS 2030:2014*, includingAnnex(es) [insert references to relevant measure-specific Annex(es)]________ ______________________Section B:ECO Reporting Working Group document. May not be accepted if amended. Page 1 of 3

March 2017 - Version 1.0Installer validation declarations:1. The design and installation of [energy efficiency measure(s)]_____________________________ at [location ofinstallation] ______________________________________________________ and handed over on [date ofhandover]_____________________________ has been undertaken by [name of installer]________________________________ using a process complying with PAS 2030:2017, including Annex(es) [insertreferences to relevant measure-specific Annex(es)]________________________________. Self-validated.OR2. The installation of [energy efficiency measure(s)]_____________________ at [location ofinstallation]_______________________________ and handed over on [date of handover]_______________ has beenundertaken by [name of installer]________________________ in accordance with a design provided by [name ofdesigner]_____________________________ using a process complying with PAS 2030:2017, including Annex(es)[insert references to relevant measure-specific Annex(es)]. Self-validated.Other party validation declarations3. The installation of [energy efficiency measure(s) _________________________________ at [location ofinstallation]__________________________________________ and handed over on [date ofhandover]_______________________ has been undertaken by [name of installer]_________________________ inaccordance with a design provided by [name of designer] using a process complying with PAS 2030:2017, includingAnnex(es) [insert references to relevant measure-specificAnnex(es)]______________________________________________. [Insert unambiguous identification of thevalidation body] ______________________________________________ validated.OR:4. The design and installation of [energy efficiency measure(s)]_______________________ at [location ofinstallation]__________________________________ and handed over on [date of handover]_____________ has beenundertaken by [name of installer]________________________ using a process complying with PAS 2030:2017,including Annex(es) [insert references to relevant measure-specific Annex(es)]_______________. [Insert unambiguousidentification of the validation body]_____________________________ validated.If certified to PAS 2030: 2017 Edition 1 complete relevant declaration in section C (only complete one):Section C:The installation of [energy efficiency measure(s)]____C__a_v_it_y_W__a_ll_In_s_u_l_a_ti_o_n________ at [location ofinstallation]_4_0__7_,_a_r_i_h_a__n_t_a__p_a__rt_m__e__n_t___________________ and handed over on [date ofhandover]__2_1_/_1__0_/_2_0_1__8_ has been undertaken by [name of installer]_______G_r_e_e_n_E_c_o__C_o_m__p_a_n_y________________ in accordance with a design provided by [name of designer]________Is_o_t_h_a_n_e_L_td__________________ using a process complying with PAS 2030:2017, including Annex(es) [insertreferences to relevant measure-specific Annex(es)] ____B__1________. [Insert unambiguous identification of thecertification body] ____O_c_e_a_n__C_e_r_ti_fic_a_t_io_n__L_td__(6_0_7_5_)______ certified.OR:The design and installation of [energy efficiency measure(s)] ________________________ at [location of installation]_________________________________________ and handed over on [date of handover] __________________ hasbeen undertaken by [name of installer] __________________________ using a process complying withPAS 2030:2017, including Annex(es) [insert references to relevant measure-specific Annex(es)]______________________. [Insert unambiguous identification of the certification body] __________ certified.For measures not referred to in PAS please complete the declaration in section D:The installation of [energy efficiency measure]_______________________________________ at [location ofinstallation]___________________________________________________________ and handed over on [date(dd/mm/yyyy)]_______________________ has been undertaken by [name of installer]______________________________ using an installation process complying with [*delete as appropriate]* MCS001:2015, MCS 023:2015 and MIS 3001:2015* (for Solar Thermal), * or MIS 3002:2015 (for Solar PV) * or MIS3004:2015 (for Biomass) * or MIS 3005:2015 (for Heat Pumps) [insert references to relevant measure-specificAnnex(es)]________ ________ or for other measures using an installation process complying with building regulationsand any other regulations that relate to the installation of the measure.ECO Reporting Working Group document. May not be accepted if amended. Page 2 of 3

March 2017- Version 1.0Installer Declaration7 (to be completed on site) Please confirm all the statements below by ticking and signing below: The installation date(s) recorded next to the measure(s) described on the previous page or on the attached spreadsheet is/are true and correct. The handover included copies of all relevant warranties, manuals and verbal instructions were given on how to use and maintain the product. For loft insulation measures with ≤ 100m pre-existing insulation only I confirm that a loft declaration is secured in the loft, near the hatch.For unoccupied premises only:To the best of my knowledge, the property was built before 1 April, 2017.For any measures where less than 100% was installed please provide further information below:Detailed reasons for installing less than 100% of the measure (including % installed and photos attached/uploadedto verify where possible): POMI Percentage: 542542POMI Reason: Restricted access to elevationPOPT Reason: Restricted access to elevation POPT Percentage: 254Full name of operative Sohail RazakOperative signature Date: 21/10/2018Where a landlord or non-resident owner completes this declaration and the premises wereconstructed after 31 March 2017: Please confirm the statement below by ticking and signing below:I confirm that the premises were occupied before the date of completed installationCustomer Declaration Please confirm all the statements below by ticking and signing below:The installation date(s) recorded next to the measure(s) described on the previous page or on theattached spreadsheet is/are correct.The installer has demonstrated and explained the use and maintenance of any equipment andprovided operating instructions and system documentation for the installed measure(s) describedon the previous page.To the best of my knowledge, I am satisfied that the works are complete and that the installation(s)was/were completed to an acceptable standard.If I have requested less than 100% of the measure to be installed, I confirm that the reason why Irequested part of the work not to be done was:POMI Reason: Restricted access to elevation POMI: Percentage: 542542POPT Reason: Restricted access to elevation POPT Percentage: 254Customer details Occupier Landlord8 Managing Agent9 Name of company or managing agent:Customer print name AMOL ROKADECustomer signature10 Date: 21/10/2018Subsidies are provided by ECO obligated energy suppliers. Their contact details are available at www.ofgem.gov.uk/eco1 The Publicly Available Specification sets out requirements for the installation of energy efficiency measures (EEM) in existing buildings and is intended for use by any entity undertaking the installation of any products and/or systems designed to improve the energy efficiency of existing buildings. This PAS includes requirements in respect of installation processes, process management and service provision and includes criteria relating to installation methods, equipment, tools, product or system and material suitability, the commissioning of installed measures and the training, skills and competence of the people undertaking such installation.2 For heating measures, pre main heating system should be the system that is being replaced.3 100% of the area relevant to that measure type has been installed. If you have entered less than 100% for any of the measure types please ensure that you have filled in the relevant part of the installer declaration.4 Enter the relevant PAS annex. This should be the PAS annex that you are working in accordance with.5 Must still meet building regulations and cannot support a secondary measure.6 For measures installed in April and May 2017 a declaration from section B may not need to be signed.7 To be completed by the qualified operative who completes the installation in accordance with PAS. One measure type per form unless the same qualified operative completes the installation of all measures on the same day.8 Including Social Housing Providers.9 Landlord’s authorised property management agent.10 If you are signing on behalf of the customer you must not be the installer, energy supplier or any other party in the supply chain responsible for this measure. By signing this, you do not sacrifice any rights to remedy.ECO Reporting Working Group document. May not be accepted if amended. Page 3 of 3

Example template 2: Landlord & occupier statement where no written tenancyagreement existsThis statement confirms an occupancy agreement between the landlord [insert name]_J_O__H_N__D__E_O_______________ and the occupier [insert name] A_M__O_L_R_O_K__A_D_E_____ _____at the property [insert address]: 407,arihant apartmentThere is no current or expired written tenancy agreement for this occupier. The occupierlisted above currently resides at the property listed above, pays rent to the landlord and hasthe right to occupy the property until a date notified by the landlord. Landlord7: JOHN DEO Address: NEWYORK CITY Name8 JOHN DEO Signature: Date: 21/10/2018 Occupier: AMOL ROKADE Address: 407,arihant apartment Name: AMOL ROKADESignature: Date: 21/10/20187 If the landlord is a corporation or other association, please insert the name of the corporation or association.8 Where more than one executor/administrator of the estate exists, only one is required to sign this declaration.ECO2t Home Heating Cost Reduction Obligation (HHCRO): Templates to evidence private domestic premises v.1.0March 2017

Job reference number_________________ March 2017 - Version 1.0Landlord Or Management Company PermissionName of installation Green Eco Companycompany If multiple premises, please see attached Multiple Premises spreadsheet Mr AMOL ROKADEFull name ofcustomer(title, first name, surname)Address/es of works 407,arihant apartment(building number/name,street name, town/city, If multiple premises, attach a completed Multiple Premises spreadsheet. Add the file name ofcounty, postcode) the spreadsheet above with the number of properties.Measure(s) name Measure(s) to be installed (tick all that apply)Cavity wall insulationElectric storage heater repairElectric storage heater replacementDraught proofingExternal wall insulationParty Cavity Wall InsulationFlat roof insulationInternal wall insulationLoft insulationLoft insulation (rafters)Room in Roof insulationUnder floor insulationWindow glazingBoiler repairBoiler replacementHeating controlsInsulation to all primary pipe workOther ECO measure (please state)Other ECO measure (please state)Other ECO measure (please state)Landlord1 / Management Company Declaration:I confirm that I am the landlord / management company of the above property/properties andhereby give my consent for the works as indicated above to be completed. I understand thatI may be contacted by any organisation carrying out the installation works or providing thefunding, Ofgem or an energy supplier to verify this letter of permission. By signing this letterI acknowledge that funding is being claimed through the Energy Companies Obligation(ECO) and I will not seek to claim any ECO funding elsewhere for these installations.Company name JOHN DEO(landlord or management company) NEWYORK CITYCompany address(Building number/name,street name, town, city, county, postcode)Daytime phone number 55848548548548548548541Signatory’s full name JOHN DEOSignature Date 21/10/20181Landlord includes property owner and social housing providers (SHPs).ECO Reporting Working Group document. May not be accepted if amended. Page 1 of 1