EWRB Reporting

Property Owner Information

Property Owner Name *

First Last

Full Legal Corporate Name *

Business name / operating as

if different from the legal / corporate name

Phone *

Address *

Street Address Address Line 2 City Province Postal Code

Email *

To authorize a third party representative to place a request on your behalf, complete and sign the section below. As the property owner for the property(s) identified in Part (C), I hereby authorize the third party named in Part (B) to access my aggregated consumption data for that property(s).

Property Owner Signature *

Data Requestor Information

This section is about the person requesting energy consumption data, if different than the property owner. If not the property owner, you are a(n): *

Property manager
Energy consultant

Data Requestors Name *

First Last

Phone *

Email *

Full legal / corporate name *

Business name / operating as

(if different from the legal / corporate name

Address *

Street Address Address Line 2 City Province Postal Code

Property Information

This section is about the property/building for which energy consumption data is requested. Reminder, if you are requesting information for multiple properties at different locations please complete the information in Section C for each property and attach it with your email.

Does the property have multiple buildings with one street address? *

No
Yes

How many buildings? *

Does the building have multiple street addresses? *

No
Yes

Please provide each address *

Heating type at the property? *

Electric
Gas

Type of water heaters used at the property? *

Unmetered electric
Metered electric
Gas

Building name

Ontario EWRB ID

Year for which electricity consumption data is being requested

MPAC assessment roll number

MPAC property code

Gross floor area (square feet)

Year built

Number of floors

Number of units

Number of structures (if it’s a building complex)

Property Address

Street Address Address Line 2 City Province Postal Code

Consent *

By providing your signature below, you are confirming that you have authority to certify the accuracy
of the information on this form. Incomplete forms will not be processed.

Verification of information
I hereby confirm that the information provided in this form is accurate and complete. I am the legal owner of / I
have obtained lawful authority from the legal owner of the large building(s) specified in this form. I agree to notify
Halton Hills Hydro immediately in writing if any of the information I provided here changes.

Disclaimer
I understand and acknowledge that Halton Hills Hydro provides the requested data to me as is available through
the existing metering infrastructure and based on the information that I have provided. I agree not to hold Halton
Hills Hydro and its directors, officers, employees, contractors, agents and other representatives liable under any circumstances for any errors, omissions, or delays in respect of the requested data, including any liability, loss or
damages, which may arise in contract, tort or otherwise.

Collection and use of information
I acknowledge that all information submitted in this process may be used by Halton Hills Hydro in support of
complying with its statutory obligations, including but not limited to the Green Energy Act, 2009, the Electricity Act,
1998, the Ontario Energy Board Act, 1998, all as amended and the regulations thereto, and all applicable Ontario
Energy Board codes and rules, as well as its electricity distribution license.

I certify the above information to be true, correct and complete.

Signature of data requestor

Energy and Water Reporting and Benchmarking for Large Buildings

By July 1, 2018

By July 1, 2019

By July 1, 2020

Step 1: Gather the Necessary Information

Step 2: Complete and Submit This Form

Property Owner Information

Data Requestor Information

Property Information

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