Esperance Energy Transition Project

Supplier Registration of Interest Questionnaire

The Esperance Energy Transition Project will support works associated with transitioning residential customers from the reticulated natural gas network to alternative energy solutions, which may include bottled gas or electrification. Horizon Power is developing an approved list of suppliers to support the works. To express your interest to be included on this list, please provide the following details.

The purpose of this questionnaire is to gather contact details of suitably qualified suppliers. This questionnaire is for registration purposes only and no guarantee of work is made.

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* 1. Please detail registered business name

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* 2. Please insert business ABN

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* 3. Please insert company contact information

Business Contact Name eg Mr Ben Smith

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 4. Please indicate which required services your business can provide

Licenced gas fitting services

Licenced electrician services

Both licenced gas and electric services

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* 5. If applicable please insert your gas licence registration details including registration number and expiry date

Registration Number

Registration Expiry Date

Other information

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* 6. If applicable please insert your electricians licence registration details including registration number and expiry date

Registration Number

Registration Expiry Date

Other information

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* 7. When is your business likely to be available to start allocating resources to any work generated from this project?

Date

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* 8. Please indicate what percentage of your businesses resources could be allocated to work generated from this project in the next 12 months?

Percentage

100%

Clear

i We adjusted the number you entered based on the slider’s scale.

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* 9. How many employees does your business have on the tools to complete this work?

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* 10. Do you have any other comments, questions, or concerns about transitioning Horizon Power customers from the existing gas network, if so please detail here.