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Ratepayer Application form By completing this application and attached agreement, you are applying to the South Waikato District Council Heat Swap scheme for a particular property in the South Waikato district. To be eligible you must be the ratepayer(s) of the property, according to the definition of ratepayer in Section 10 of the Local Government (Rating) Act 2002. Details of services applied for (Applicant to complete): Ratepayer s name (all legal property owner/s) (the Applicant) Address of property Postcode: (the Property) If there is more than one dwelling on the property, describe which dwelling(s) are to have clean heat installed. Description of existing main source of heating in the dwelling(s) Postal address (if different from above) Postcode: Daytime phone number Mobile phone number

Email If Council needs to contact you, what is your preferred method? [please tick] Property rate account number Email Daytime phone Mobile phone By mail (letter) Name of approved service provider and quotation number (quote must be attached to this form or emailed) Cost of Heat Swap solution including any building permit or other fees (inc GST) Amount of EECA grant (inc GST) as detailed on quote Amount Council will contribute (inc GST)** Amount to be funded by applicant (inc GST)*** ** Council will recover the cost of the Heat Swap Solution plus an administration fee and first year interest less the amount of EECA grants over time through a targeted rate on the property *** Any amounts agreed between the applicant and the approved service provider above the ECCA grant and agreed Council assistance Please read and sign this Application Form. The names of all the owners of the property must be entered in this form above and all those named must sign below, or have someone sign on their behalf with their authority. I/we, being the ratepayer(s) of the property specified above, apply for services from South Waikato District Council. The details of the services I/we are applying for are set out in this application form. SIGNED by the ratepayer(s): Ratepayer/Director/Trustee Ratepayer/Director/Trustee Date: / /20 Date: / /20

Heat Swap South Waikato Agreement BETWEEN Applicant (please print name clearly) AND SOUTH WAIKATO DISTRICT COUNCIL, a body corporate under the Local Government Act 2002 ( Council ) INTRODUCTION The Energy Efficiency and Conservation Authority (EECA) Heat Smart programme assists homeowners and landlords by offering subsidies to install clean heat solutions (and if required insulation) in their homes. The Heat Swap South Waikato programme is a joint project between Council and the EECA and offers a rates incentive scheme, as detailed in this contract, to make the installation of a clean heat solution more affordable. You are applying to Council s Heat Swap scheme. If approved you are entitled to contract an EECA approved supplier to provide a clean heat solution (and if required insulation) for your property. There is a limit of one Clean Heat appliance per dwelling. When both Council and you have signed this agreement Council has approved your application and created a binding agreement with you. Your application has specified a particular Heat Swap Clean Heat solution to be installed. Council will contract the EECA approved service provider to install this Heat Swap Clean Heat solution. OPERATIVE PROVISIONS The Applicant and Council agree as follows: 1. Term This Agreement shall commence on the date that the parties sign it, and shall expire on the date that the Applicant makes the final payment of the targeted rate provided for in Clause 6 below. 2. Council to provide a Clean Heat solution

2.1 Council accepts the Applicant s application (attached), and will contract the approved service provider to install the approved part of the Heat Swap scheme at the property. 2.2 Once the Applicant has selected a preferred supplier from the list of approved EECA suppliers and Council has notified the Applicant that their application has been approved and the, Council will instruct the approved EECA service provider to liaise directly with the Applicant in relation to the practical details of installing the Heat Swap solution. The approved service provider should confirm contract and payment terms with the Applicant for any work not covered by the South Waikato s approved contract price and the EECA grant. 2.3 Once the approved service provider has installed the Heat Swap solution, it will invoice Council for the work undertaken and the approved service provider will seek payment from the Applicant for any additional amounts not covered by the approved part of the installation. 3. The applicant agrees: 3.1 That they are the ratepayer of the property that the Heat Swap Clean Heat solution will be installed in and that all owners of the property have signed this agreement, or that it has been signed with their written authority. 3.2 That it has obtained an approved EECA Heat Smart scheme application and will comply with the terms of that EECA agreement. 3.3 That the applicant has provided a signed Heat Swap South Waikato Ratepayer Application Form dated and confirms this application as being the Contract Price as defined in this agreement. 3.4 That the Applicant will not have any rates payments overdue at the time of applying for the Heat Swap scheme for any property they are responsible to pay rates for in the South Waikato District. 3.5 That the Clean Heat solution will only be installed in an urban or rural dwelling. 3.6 To install approved insulation (if required to obtain the EECA grant funding after inspection by the approved service provider) as well as a clean heat product. 3.7 That the dwellings current main heating source is non-compliant heating. 3.8 That the approved service provider will remove or make inoperable the non-compliant heating that is being replaced with the clean heat solution. 3.9 To provide approved dry wood storage as defined in this contract. Your approved service provider will make an assessment of the suitability of your dry wood storage before they will agree to install a Heat Swap Clean Heat solution. 3.10 To pay the targeted rate assessed on the property based on the terms of this agreement over nine years. 3.11 To notify EECA if the approved service provider s work has not been completed to a satisfactory standard.

3.12 Notwithstanding that the risk in the Heat Swap solution supplied to the Applicant shall pass to the Applicant when the Approved Service Provider has completed the installation thereof, ownership of the Heat Swap solution shall not pass to the Applicant unless and until payment of the whole amount of the Total Investment referred to in this Agreement has been made by the Applicant. 3.13 The Applicant shall not call upon the Council to pay, or contribute to the payment, for any servicing of, or repairs to, the Heat Swap solution. 3.14 The Applicant shall insure the Heat Swap solution against all usual risks for its full insurable value with a reputable insurer and shall pay the premiums for such insurance promptly as and when they become due for payment. 4. Liability for defective work 4.1 Subject to clause 4.4 the Applicant agrees that: 4.1.1 Council has no liability to the Applicant whatsoever, whether in contract, tort, breach of statutory duty or otherwise, arising out of or in connection with the provision of the Heat Swap solution to the property, and 4.1.2 The Applicant is not entitled to any compensation from Council in respect of defects or damage to, or arising as a consequence of the provision of the Heat Swap solution, the property. 4.2 Clause 4.1 does not affect any liability the approved service provider may have to the Applicant in contract, tort or otherwise, and may not be relied on by the approved service provider as limiting the approved service provider s liability in any way. 4.3 The Applicant acknowledges that this agreement does not limit or restrict any of the rights, powers, remedies and immunities from liability which Council now or in the future possesses, or is entitled to by virtue of any statute or at common law. 4.4 To the extent that the parties are not, by law, able to limit or exclude liability or obligations, Clause 4.1 will not limit or exclude that liability or those obligations. 5. Payment of the approved service provider 5.1 Council will, as part of its contract with the approved service provider, pay the approved service provider the contract price for installing the Heat Swap solution. 5.2 The Applicant agrees to pay any amounts owing to the approved service provider in relation to the installation of the Heat Swap solution at the property above the contract price agreed by Council and the EECA grant in accordance with the Applicant s separate arrangements with the approved service provider. 6. South Waikato District to assess targeted rate on the property 6.1 The Applicant acknowledges that Council will assess a targeted rate (plus GST) on the property each year, for a period of nine years, to pay for the Clean Heat solution. That targeted rate will be used to recover all of Council s total investment in relation to your Clean Heat solution including the cost of borrowing to fund the total investment. 6.2 The targeted rate under this Agreement shall be included on any Land Information Memorandum (LIM) issued for the property.

6.3 If the Applicant intends to sell the property in the period after this agreement has been entered into and while a targeted rate will be, or is being, assessed against the property, the Applicant must advise the prospective purchaser about the targeted rate, and include a record of the existence of the targeted rate as a provision in any agreement to sell the property. (This is important because the targeted rate will continue to be charged against the property and therefore the new owner). 6.4 Applicants wishing to terminate the agreement may make an early repayment in full at any time during the period of the agreement as long as the ratepayer has no rates arrears on any property they have in the South Waikato District. Early repayment will be calculated as the balance owing as at the settlement date less interest to be charged on any remaining instalments not yet invoiced for that rating year. See also clause 6.3. 6.5 If the Applicant fails to pay any rates invoice for the property by the due date, the provisions of the Local Government (Rating) Act 2002 apply and the Applicant will incur penalties in the usual way in accordance with Council s policy. 6.6 On the date of the last installment of the Total Investment having been paid to the Council under this Agreement, ownership of the Heat Swap solution automatically passes to the Applicant. 7. Information issues 7.1 Any information which the Applicant supplies to Council for the purposes of this agreement may be disclosed to EECA. 7.2 In accordance with the Privacy Act 1993, the Applicant is entitled to have access to their personal information held by Council in connection with this agreement and to request correction of that information. 8. Definitions used in this agreement Applicant The person(s) named as the ratepayer(s) in the rating information database and the district valuation roll for the property. Application The Heat Swap South Waikato Ratepayer Application Form submitted by the Applicant with the signed copy of this agreement. Approved dry wood storage A permanent structure with a solid roof that complies with building standards (if applicable) appropriate to store fire wood in a dry condition. Approved part That part of the total heating and insulation installation project that Council has agreed to fund under this Heat Swap scheme, and installed by the approved service provider for the contract price.

This includes removing the firebox, removing the flue, fixing the hole in ceiling and roof and any remedial plastering. The heating appliance must comply with the definition of clean heat in this agreement. Examples of items that Council will not fund are: more than one heating appliance, wet-back water heating systems, portable heating appliances; heat transfer and ventilation systems; a new plinth; fire surround; painting and building modifications not required for the installation of the approved heating solution. Approved service provider The company providing clean heating (and if appropriate insulation) that has been approved by EECA and Council and is specified in this application. Clean heat Externally flued gas heaters, efficient log burners, pellet fires and heat pumps as specified by EECA as being compliant. Any wood burners must be included on Ministry for the Environment s national list of authorised wood burners. Contract price An amount Council has or will contract with the approved service provider to pay for installing the approved part of the Heat Swap solution. This is also the amount requested by the Applicant on this application. This is the amount which the approved service provider is entitled to charge for that installation under the terms of their quote (which, to avoid doubt, will not be fixed as the quoted amount if the quoted amount was expressly provided as an estimate only and the quote specified how the actual amount would be calculated). This cost will include some, or all, of the following: EECA compliant heating appliance and installation EECA approved insulation and installation (as required by the EECA contract) any building permit or other fees removing or making inoperable the existing non-compliant heating appliance. Cost of borrowing to fund the investment Council will charge interest on the outstanding balance of the unpaid total value of the contract price; the initial administration fee; and first year interest. The targeted rate will be set so that the total value of the contract price; the initial administration fee; first year interest and the cost of borrowing to fund the investment will be recovered over nine rating years. Council South Waikato District Council. Council Interest Rate The Council interest rate will be used to calculate the amount of interest payable for the cost of borrowing to fund the investment and for the first year interest. This interest rate will be set as part of the Annual Planning process and will apply for the total of the following year. The interest rate will be an approximation of the expected interest rate Council would pay for borrowing funds from an external source. EECA The Energy Efficiency and Conservation Authority.

EECA Heat Smart / EECA grant The grant which EECA is required to pay to the approved service provider in relation to installing the Heat Swap solution under the Warm Up New Zealand: Heat Smart programme for the heating appliance and insulation if required. First year interest Interest will be charged at the Council interest rate on the total of the contract price for the period of time outlined below. Interest will be charged from the day that the approved service provider s invoice is paid to the start of the first day of the financial year (July to June) that the targeted rate will be charged to the rate payer. Heat Swap South Waikato/Heat Swap solution The approved part of the clean heat (and if required insulation) solution which Council has approved and will contract with an approved service provider to install at the property as specified in this application. Insulation Ceiling and floor insulation, as specified by EECA. To obtain the EECA grant and thereby comply with the terms of the Heat Swap contract EECA may require the Applicant to install insulation. The approved service provider is responsible for arranging insulation and other associated activities (such as building permits) and will provide one quote and invoice for all the required work. Initial administration fee A one-off fee of $100 (excluding GST) to contribute to Council s costs of establishing and administering the Heat Swap scheme included in the total investment at the beginning of the scheme. Non-compliant heating 1. An open fireplace, or 2. A wood burner that is not recorded on the Ministry for the Environment s national list of authorised wood burners. Property The property where the Heat Swap solution is to be installed, as specified in this application. Quote In relation to the installation of the Heat Swap solution, the quote provided by the approved service provider to the Applicant for carrying out the installation, and which was provided by the Applicant to Council with the application. Ratepayer The person(s) named as the ratepayer(s) in the rating information database and the district valuation roll for the property. Targeted rate The rate which Council will set and assess against the property to recover costs relating to the total investment. The targeted rate will be set so that the total value of the contract price; the initial administration fee; first year interest and the cost of borrowing to fund the investment will be recovered over nine rating years. This targeted rate is planned to be equally spread over the full nine years after the initial year of installation of the Heat Swap solution. It may be adjusted as the cost of borrowing to fund the investment changes as a result of adjustments to Council interest rates.

Total Investment The total amount that future targeted rate calculations will be based on. This includes the cost of: the contract price (including any permit and consent fees) the initial administration fee from Council of $100.00 (excluding GST) first year interest cost of borrowing to fund the total investment. NOTE Council is required to hold records of all legal signatories who are responsible for paying rates on this property. For more information, contact Council on 07 885 0340 or info@southwaikato.govt.nz Checklist Please tick the following: All person(s) named on the property s rates assessment have completed and signed the Council application form Person(s) named on the property s rates assessment have completed and signed the Council installation agreement I have included either a physical or email copy of the approved service provider s quote My rate payments are up to date

(Sign on this page if the Applicant is a natural person or persons ie NOT a corporate) SIGNED by the parties on the day of 201 SIGNED by the Applicant, being the ratepayer(s) of the property: Signed by the said: Name Signature Name Signature in the presence of: Witness (signature) Occupation Address SIGNED for and behalf of South Waikato District Council by BENJAMIN ERIC SMIT pursuant to delegated authority in the presence of: BENJAMIN ERIC SMIT Witness (signature) Occupation Address

(Sign on this page if the Applicant is a Corporate eg registered company, incorporated society, registered trust WITH ONE PERSON SIGNING.) SIGNED by the parties on the day of 201 SIGNED for and on behalf of the Applicant, being the ratepayer of the property: (Sign here if the ratepayer is a corporate. If only one person is signing, their signature must be witnessed as follows:) Signed: Name Signature Position in the presence of: Witness (signature) Occupation Address SIGNED for and behalf of South Waikato ) District Council by BENJAMIN ERIC SMIT ) pursuant to delegated authority in the ) presence of: ) BENJAMIN ERIC SMIT Witness (signature) Occupation Address

(Sign on this page if the Applicant is a Corporate eg registered company, incorporated society, registered trust WITH TWO OR MORE PERSONS SIGNING.) SIGNED by the parties on the day of 201 SIGNED for and on behalf of the Applicant, being the ratepayer of the property: (Sign here if the ratepayer is a corporate. If two or more persons are signing, their positions in the organisation must be entered, eg managing director, trustee, chairman etc) Signed: Name Signature Position Signed: Name Signature Position SIGNED for and behalf of South Waikato District Council by BENJAMIN ERIC SMIT pursuant to delegated authority in the presence of: BENJAMIN ERIC SMIT Witness (signature) Occupation Address