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Corporate VerificationQuestionnaire
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Corporate VerificationQuestionnaire
CORPORATE: GREENHOUSE GAS (GHG) EMISSIONS
VERIFICATION QUESTIONNAIRE
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Please fill out the questionnaire below which allows Carbon Free Zone to prepare a quote for GHG emissions consulting and verification.
Date
Month
Day
Year
Section 1
1.1 Client Contact Information
Name of Key Contact
(Required)
First
Last
Role of Key Contact
Contact Phone
(Required)
Contact Email
(Required)
Legal Entity Name
Legal Entity Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Ã…land Islands
Country
1.2 Nature of Work
What is the Nature of Work
GHG verification services
GHG consultancy services
1.3 Declaration of Impartiality
Has Carbon Free Zone Provided Any Services to Company/Project?
Yes
No
If Yes, Provide the Details
Authorized Person Name
First
Last
Date
Month
Day
Year
Section 2
2.1 Verification Scope
Indicate which scope(s) are to be included in the GHG emissions verification.
Scope 1
Stationary and fugitive emissions
Mobile emissions (estimated number of vehicles)
Scope 2
Purchased electricity, heat and/or steam
Purchased renewable energy attributes or similar
Scope 3 - Upstream
Purchased Goods & Services
Capital Goods
Fuel & Energy Related Activities
Upstream, Transport & Distribution
Waste Generated in Operations
Business Travel
Employee Commuting
Upstream Leased Assets
Scope 3 - Downstream
Downstream Transport & Distribution
Processing of Sold Products
Use of Sold Products
End of Life Treatment of Sold
Downstream Leased Assets
Franchises
Investments
2.2 Sinks and Reservoirs
Describe any Sinks and/or Reservoirs Included in the Scope of the Verification (e.g. carbon sequestration)
2.3 GHG Emissions Criteria & Standards
Policy, Procedure or Requirement Used as a Reference for Verification Purposes
ISO 14064-1
ISO 14064-2
Other, please specify:
Please Specify
2.4 Level of Assurance
Degree of Assurance the Intended User Requires for the Verification
Reasonable Assurance Engagement
Limited Assurance Engagement
2.5 Degree of Materiality
Degree of Deviation Resulting from Omissions, Errors and Misrepresentation of Data Against GHG Assertions Expected by the Intended Users
NOT required by the GHG Program, thus determined to be less than 5%
Required by the GHG Program to be LESS than 5%
Required by the GHG Program to be MORE than 5%
2.6 Verification Time Period
Baseline
Reporting
Other
Section 3
3.1 Organizational Boundary
Approach
Control Approach (financial/operational control)
Equity Share Approach
Control Approach is applicable only if organization accounts for all quantified GHG emissions and/or removals from facilities over which it has financial or operational control.
Equity Share Approach is applicable only if organization accounts for its portion of GHG emissions and/or removals from respective facilities.
3.2 Facilities Information
Complete the table below for each facility type (e.g. office, warehouse, manufacturing, distribution center, etc.) in your organization that is included in the verification.
FACILITY #1
Facility Type (of facility #1)
Number of Facilities (of facility #1)
Locations (of facility #1)
(Region/Countries)
Estimated Emissions (of facility #1)
(kgCO2eq.)
FACILITY #2
Facility Type (of facility #2)
Number of Facilities (of facility #2)
Locations (of facility #2)
(Region/Countries)
Estimated Emissions (of facility #2)
(kgCO2eq.)
FACILITY #3
Facility Type (of facility #3)
Number of Facilities (of facility #3)
Locations (of facility #3)
(Region/Countries)
Estimated Emissions (of facility #3)
(kgCO2eq.)
FACILITY #4
Facility Type (of facility #4)
Number of Facilities (of facility #4)
Locations (of facility #4)
(Region/Countries)
Estimated Emissions (of facility #4)
(kgCO2eq.)
3.3 GHG Calculation Methodology
GHC Calculation Methodology
GHG activity data multiplied by GHG emission or removal factors
Measurement (either continuous or intermittent)
Combination of measurement and calculation
3.4 Data Collection Method
Please Choose Data Collection Method
Manual database system (e.g. excel workbook)
Combined manual and computerized database
Computerized database system (e.g. 3rd party tracking software or system)
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