8/3/2019 GBI Certification Application Form for Existing Buildings V1.2
http://slidepdf.com/reader/full/gbi-certification-application-form-for-existing-buildings-v12 1/2
APPLICATION &
REGISTRATION FORMFOR EXISTING BUILDINGS
OWNER INFORMATION
PROJECT CONTACT
PROJECT INFORMATION
OWNER’S NAME
COMPANY/ORGANISATION
ADDRESS
POSTCODE
PHONE
NAME
DESIGNATION/JOB TITLE
COMPANY/ORGANISATION
ADDRESS
POSTCODE
PHONE
PROJECT ADDRESS
POSTCODE TOWN/CITY
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EXPECTED RETROFIT START DATE
DATE BUILDING COMPLETED
EXPECTED RETROFIT COMPLETION DATE
Gross Floor Area
PROJECT SIZE
THIS PROJECT IS CONFIDENTIAL
STATE COUNTRY
YES NO
m2
PROJECT NAME
TOWN/CITY
FAX
STATE
MOBILE
COUNTRY
TOWN/CITY
FAX
STATE
COUNTRY
* The Owner o the project must be as it appears on the title deed.
* The Project Contact will be the only point o contact or this application. Generally, this is the person who puts together the submission.
* This name will appear on the Green Building Index Certicate, i certication is acheived.* Excluding car park areas
* Please indicate i this project is condential and should not be discussed outside o GBI.
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VERSION 1.2
BRIEF DESCRIPTION OF PROJECT & MAJOR DESIGN FEATURES
DESIRED GREEN BUILDING INDEX RATINGCONSTRUCTION TYPE
*Attach on a separate sheet i space provided is insucient.
Data Centre Retail Mall Healthcare HotelPlatinum Gold Silver Certied
Residential Non-Residential Industrial
8/3/2019 GBI Certification Application Form for Existing Buildings V1.2
http://slidepdf.com/reader/full/gbi-certification-application-form-for-existing-buildings-v12 2/2
GREEN BUILDING INDEX REGISTRATION FEES
SUPPORTING DOCUMENTATION
APPLICATION SUBMISSION
FOR OFFICIAL USE
* Rates shown are as o the date o the application and registration and may be revised rom time to time as appropriate.* Rates shown are excluding Government Service Tax (GST)
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SIZE OF PROJECTTOTAL GROSS FLOOR AREA
m2
REGISTRATION FEES
RM
SINGLE RESIDENCE Below 2,000 N/A
SMALL Up to 4,000 6,000.00
INTERMEDIATE 4,001 to 10,000 9,000.00
MEDIUM 10,001 to 30,000 12,000.00LARGE 30,001 to 50,000 14,000.00
EXTRA LARGE 50,001 to 100,000 19,000.00
MEGA PROJECT Above 100,000Assessment ee will be determined
on a project-by-project basis
SIGNATURE OF APPLICANT COMPANY/ORGANISATION STAMP
NAME
DESIGNATION DATE
Project Brie
Others
Certicate o Title
PROJECT ASSESSMENT
Fee as per prescribed includes:
1 Design Assessment (DA)•
1 Completion & Verication•
Assessment (CVA)
APPEAL
A fat rate o RM1,000.00 percredit point
* The Application will not be processed unless this orm is completely lled-in and all the required documentation is attached.* The Applicant will be inormed o the Registration Fee payable upon acceptance o the Application & Registration Form.* The Invoice and GBI Agreement will be issued once the Application has been approved.
COMPANY
BILLING ADDRESS
POSTCODE
GBI REGISTRATION NO. DATE OF SUBMISSION
TOWN/CITY STATE COUNTRY
PLEASE SEND THE COMPLETED FORM TO
GREENBUILDINGINDEX SDN BHD
4 & 6 Jalan Tangsi, 50480 Kuala Lumpur, Malaysia
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