Client Evaluation Form: Strictly Private and Confidential
Client Evaluation Form: Strictly Private and Confidential
Client Evaluation Form: Strictly Private and Confidential
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Attached to this letter is a Client Evaluation Form that we ask all prospective clients to complete. It is an important document, as the information requested on the form will give Klean Industries an understanding of your waste management strategy, allow us to prepare an accurate assessment of the kind of system you require and its likely purchase price, and enable us to provide you with essential information about the system, such as estimated operating and maintenance costs. In addition, the form allows us to obtain basic information about your business and to assess your financial capacity to acquire one of our systems. With this information, we can identify areas in which we may be able to assist you with the purchase of the system. Please complete the entire form in as much detail as possible, as it will enable us to provide a complete solution to your waste management requirements, and a timely and successful implementation. There are several fields on the form that MUST be completed in order for us to accurately determine the most appropriate system for your needs. These fields include:
1.
Feedstock types - Different feedstocks are processed in different ways by our systems. In addition, the particular characteristics of a feedstock relate directly to the quality of our systems products. Therefore, please be as accurate as possible in completing this section. Desired products - It is important that we know and understand the products you wish to obtain from the waste you intend to process. Each of our systems is custom designed for each client, so the information you provide in this regard will enable us to engineer the system so as to maximize the output of the product(s) you are most interested in. Power costs - Please obtain from your electricity power supplier the rate per kilowatt hour applicable to the proposed site of the system. Labour costs - These should be quoted in US$ and on a per annum basis to enable us to accurately calculate annual staffing costs. Documentary confirmation must be provided of contractual relationships for feedstock, as must copies of company incorporation certificates.
2.
3. 4. 5.
All the information contemplated by the form is important but the above fields are especially so and we will not be able to provide you with an accurate assessment and estimate unless those fields are completed in detail. Please note that all information you provide will be kept strictly confidential and will not be used for any purpose other than preparing an assessment and estimate for the system you require. Kind regards, Klean Industries Inc.
Copyright - Klean Industries Inc. 2008-08-20
Company Name: ____________________________________________________ Address: ___________________________________________________________ Web Site: __________________________________________________________ Telephone: _________________________________________________________ Fax: ______________________________________________________________ Email: _____________________________________________________________
Main Contacts: i. __________________________________________________ ii. __________________________________________________ iii. __________________________________________________
Please provide a brief description of your business and, if different, a description of the company that will purchase the system:
2. Business objectives driving the purchase of a Klean solution: 2.1 Outline the key business objectives / expectations you have for a Klean carbonization, pyrolysis, gasification, drying, etc or any other clean-tech solutions.
2.2 Historical / background overview of your organization and project business plan.
2.2.2
2.2.3
2.2.4
2.2.5
Please provide any funding timelines that may impact the proposed purchase of the facility. 1
2.2.6
2.2.7
Provide profiles of the key individuals who will be assigned to the project.
3. The Facility: 3.1 Provide an overview of the site & facility location, amount of land available, and current status of your building plan.
3.3 Is the site leased or owned? Please provide details of registration, title and ownership.
3.4 Please provide a copy of the site plan, including approximate measurements.
3.6 What is the proposed commissioning (start-up) date for the facility?
3.7 What is the desired processing capacity of the facility (in tons per day)?
3.9 Will operation of the facility be compatible with zoning of the site?
3.10 Please outline the main routes to be used for the transportation of input (feedstock) and output (end-products).
3.11 How much land / space is available for storage of both input and output?
3.12 Power Requirements please provide an overview of your power situation, including supply availability, source of power, the cost of electricity in your area, and the projected monthly power budget for the facility.
4. Desired Output / Sales / Marketing / Distribution: 4.1 List the three Klean system outputs that have the most commercial value to you. a. __________________________________________________ b. __________________________________________________ c. __________________________________________________
4.3 Do you plan to sell the output(s) or keep them for internal use?
4.4 If you intend to sell the output(s), what percentage of each output do you intend to
sell?
4.7 What level of commitment do you currently have for the purchase of your output products and how many potential buyers have you identified for these products?
4.8 Please provide a detailed outline and describe the current status of your marketing plan.
5.2 Do you intend to use different types of feedstock in the same system? If so, please provide details.
5.3 Do you intend to increase the feedstock capacity of the facility in the future?
5.5 Outline the level of supplier commitment in detail i.e. feedstock contracts / terms for each.
5.6 Who has responsibility for pick-up / delivery of feedstock you or the supplier?
5.7 Please provide the following details of the volume and composition of the feedstock:
OPERATIONAL DAYS PER YEAR MOISTURE CONTENT % PRESENT DISPOSAL METHOD PRESENT COST OF DISPOSAL (TIPPING OR GATE FEE PER TON)
FEEDSTOCK Tires Oil/Tar Sands Plastic Resin Codes MSW Food Processing Specify Green Garden Agri-Residue Animal Manure Specify Sludge Sewage Sludge Liquid Clinical/Medical Industrial Specify C&D Specify Other Specify
TPD
5.9 Will the feedstock contain any contaminants? If so, please provide details including the types of contaminants and the amount (as a %) present in the feedstock.
6. Operations: 6.1 Outline your proposed organizational structure for the facility, including number of operators, supervisors, management, and other staff.
6.2 Shift duration in hours, and number of shifts per day / month:
6.3 Annual cost (in US$) for a (i) system operator, (ii) shift supervisor, and (iii) facility/plant manager:
6.4 Do you intend to use any of your existing workforce to meet staffing requirements on this project? If so, to what extent?
6.5 Outline plans for (i) receiving, storage, and inputting of feedstock, and (ii) warehousing and/or distributing your output.
7. Regulatory Matters: 7.1 What are the government bodies you need approval from in order to proceed with your project?
7.2 Have you obtained the licences/permits that may be required to import the system
7.3 What licenses and permits have you obtained to date, and what is outstanding?
7.4 Regarding your site and facility related permits (e.g. fuel storage tanks), please outline the current status.
7.5 Is implementation of the system subject to an Environmental Impact Assessment? If one is required, please outline its current status.
7.6
Are there specific environmental protection regulations in your region / country that will apply to the proposed facility? If so, how will they impact the project?
8.
Other information: Please provide us with any other information that you think may be relevant.