ASSOCIATE COMMISSIONING PROFESSIONAL APPLICATION

A. Building Commissioning Certification Board 1600 NW Compton Drive, Ste. 200 Beaverton, OR 97006 www.bcxa.org

B. Phone: 1 (877) 666-2292 E-mail: [email protected]

APPLICATION INSTRUCTIONS

 Download the application, fill it out, and submit it by email to [email protected].  The name you enter on the application will be the way your name will appear on your admission-to-test notice. Your name must match the name on the government-issued picture identification that you must present at the test center in order to be admitted to take the certification examination.  The address you enter should be the address to which you want your certificate sent. This may be either your personal address or your business address.  Your personal information, such as date of birth, gender, and ethnicity are used by the BCCB only for record tracking and/or for statistical purposes. Your answers will not affect your eligibility. All information you provide on this application will be kept strictly confidential.  The instructions and requirements on this application should be read in their entirety prior to submittal. The application fee will not be refunded.  You must complete this application form in its entirety and ensure that all required supporting documentation is submitted. Missing information or documentation may cause your application to be rejected.  You will only be eligible to sit for the CCP exam after your complete application is approved by the BCCB. The ACP exam is offered electronically through our testing provider; test locations can be found at www.isoqualitytesting.com/mlocations.aspx.

Frequently Used Acronyms BCA: Building Commissioning Association BCCB: Building Commissioning Certification Board CCP: Certified Commissioning Professional ACP: Associate Commissioning Professional I. APPLICATION STATUS

Date of application: Click here to enter a date.

Please check one of the two statements below.

☐ This is my first application for the Associate Commissioning Professional (ACP) credential.

☐ I have previously applied for the ACP credential.

Date of your last application (mm/yyyy) Click here to enter text.

Reason you are reapplying:

☐ I submitted an incomplete application or did not pay the full application fee.

☐ The BCCB determined I was ineligible when it reviewed my application.

Explain briefly why you feel you will now be found eligible for certification:

Click here to enter text.

☐ I did not pass the certification examination.

Date I last took the certification examination (mm/yyyy) Click here to enter text.

☐ I previously earned this credential but did not renew the certification every three years, as required.

Explain briefly why you allowed the credential to lapse: Click here to enter text.

*If this application is being submitted within 24 months of the date on which the BCCB received your prior application, you do not need to complete this form in its entirely. Simply fill in any information that may have changed since your last application, such as a new employer. You do not have to resubmit client references, project documentation, or academic transcripts. However, you must sign the applicant affirmations in section XIII of this application.

If this application is being submitted more than 24 months from the date on which the BCCB received your prior application, you must complete this application in its entirety, submit all required supporting documentation, and pay the full application fee.

Page 2 Associate Commissioning Professional – Application 10/2013 II. SELF-DETERMINATION OF ELIGIBILITY

This section is included for the sole purpose of helping you to make a reasonable determination of whether you should proceed with this application. You are not guaranteed admission to candidacy solely on the basis of your answer to this section. The BCCB will evaluate your entire application and make a final determination of your eligibility. The decision of the BCCB will be final.

Educational Level and Experience Refer to the table below and find the amount of building-related experience you must have, based on the highest educational degree you have attained. Check the space to the right, to indicate if you meet the minimum experience requirement. If you do not meet the minimum requirement, please do not submit an application at this time. Building- Select Highest Degree Related One Attained Experience Needed (1) Four-year undergraduate or graduate degree in a building sciences 1 full year ☐ field 2

Four-year undergraduate degree or graduate degree in a non- 3 full years ☐ building sciences field 2 ☐ Two-year undergraduate degree in a building sciences field 2 3 full years ☐ Technical school degree (building-related) 2 3 full years ☐ Completion of apprenticeship program (building-related) 2 3 full years ☐ Two-year undergraduate degree in a non-building sciences field 2 5 full years ☐ High school diploma or GED 10 full years

1 Building-related experience includes your experience as a commissioning provider as well as other related experience, such as serving as a project engineer, building operations supervisor, contractor, etc. 2 Acceptable fields of study in building science include mechanical engineering, electrical engineering, construction science, construction management, architecture, and other majors/fields of study designed to train people for careers in the building industry. If you do not have the required minimum experience for your degree level, as shown in the table, you are not currently eligible for certification. Please do not submit an application. If you satisfy the experience requirements for your degree, continue with Part III. Approved Commissioning Training Program The “Commissioning Authority Training”, powered by PECI has been accepted as an approved commissioning training program to supplement a portion of the building related experience required of an ACP applicant. Candidates who have completed both the online and lab portion of this training may reduce the building related experience in the table above by 50%. Completion of this course is optional and not required of candidates.

I have completed the “Commissioning Authority Training”, powered by PECI, including the lab.

Page 3 Associate Commissioning Professional – Application 10/2013 ☐Yes ☐ No If yes, please submit your completion certificate with your application. III. GENERAL APPLICANT INFORMATION

Name: Click here to enter text. (Last, First, Middle)

Former Name (if applicable): Click here to enter text.

Gender (optional): ☐M ☐F

Ethnicity (optional): ☐African American ☐ Asian American ☐ Caucasian, not Hispanic ☐ Hispanic American ☐ Native American/American Indian ☐ Other

Mailing Address: Click here to enter text.

Daytime Phone Number: Click here to enter text.

E-mail: Click here to enter text.

This contact information is for my ☐ home ☐ business.

Current Employer (as you would like it listed on online ACP list): Click here to enter current employer

Primary City of Business (as you would like it listed on online ACP list): Click here to enter City, State.

Are you a current BCA Member? ☐ Yes ☐ No

Is your current employer a BCA Corporate Member? ☐ Yes ☐ No

How would like your name printed on your ACP certificate? Click here to enter text.

C. D. E.

F. Note: It is your responsibility to update the BCCB should your contact information change at any point during the application process or while you hold your certification with the BCCB. G. H.

Page 4 Associate Commissioning Professional – Application 10/2013 IV. EMPLOYMENT HISTORY

Starting with your current employer, document your work history. To determine the number of years of work history you must provide, refer to the chart on page 4 of this application. You must provide a work history to cover the minimum number of years of total building-related work experience you need for your particular academic degree level. However, all applicants, regardless of their academic degree level, must provide at least a five-year history. If you have been self- employed during any period of your provided employment history, please so indicate.

A. Current Employer: Click here to your current employer

Address: ☐ Same as general information Click here to enter their address Telephone number: Click here to enter phone number E-mail: Click here to enter their email Principal business of company: Click here to enter text Position/title: Click here to enter your position/title Employed at company since (mm/yyyy): Click here to enter the date Have held current position/title since (mm/yyyy): Click here to enter the date Supervisor’s name and title: Click here to enter your supervisor’s name

Are you self-employed? ☐ No ☐ Yes

B. Previous Employer: Click here to your previous employer Address: Click here to enter their address Telephone number: Click here to enter phone number Principal business of company: Click here to enter text Last position/title held: Click here to enter your position/title Employed at company from (mm/yyyy): Start date to (mm/yyyy): End date Supervisor’s name and title: Click here to enter your supervisor’s name

Were you self-employed? ☐ No ☐ Yes

Page 5 Associate Commissioning Professional – Application 10/2013 I. C. Next Previous Employer: Click here to enter your previous employer Address: Click here to enter their address Telephone number: Click here to enter phone number Principal business of company: Click here to enter text Last position/title held: Click here to enter position/title Employed at company from (mm/yyyy): Start date to (mm/yyyy): End date Supervisor’s name and title: Click here to enter your supervisor’s name

Were you self-employed? ☐ No ☐ Yes J. K. D. Next Previous Employer: Click here to enter your previous employer Address: Click here to enter their address Telephone number: Click here to enter phone number Principal business of company: Click here to enter text Last position/title held: Click here to enter your position/title Employed at company from (mm/yyyy): Start date to (mm/yyyy): End date Supervisor’s name and title: Click here to enter your supervisor’s name

Were you self-employed? ☐ No ☐ Yes L. M. E. Next Previous Employer: Click here to enter your previous employer Address: Click here to enter their address Telephone number: Click here to enter phone number Principal business of company: Click here to enter text Last position/title held: Click here to enter your position/title Employed at company from (mm/yyyy): Start date to (mm/yyyy): End date Supervisor’s name and title: Click here to enter your supervisor’s name

Were you self-employed? ☐ No ☐ Yes N. If necessary, please attach additional sheets for earlier work history and provide information in the same format as above.

Page 6 Associate Commissioning Professional – Application 10/2013 V. EDUCATION

List all institutions of higher learning you attended, even if you did not receive a degree. List the last school attended first. Do not include other types of training—such as seminars, continuing education, or certificate programs—in this section.

School City/State Major/Field of Years Building Degree Study Attended Related Earned (yyyy-yyyy) Degree

School Location Major Years ☐Y ☐N ☐Y ☐N

School Location Major Years ☐Y ☐N ☐Y ☐N

School Location Major Years ☐Y ☐N ☐Y ☐N

School Location Major Years ☐Y ☐N ☐Y ☐N

Official Transcript

Have the institution from which you received the highest degree in a building sciences field send a transcript. If you do not have a degree in the building sciences field, have the institution from which you received the highest degree listed send a transcript. If High School/GED is your highest degree attained, no transcript need be submitted.

The transcript must be an original copy with the school’s stamp or seal. A photocopy is not acceptable. The BCCB will review your transcript only for the purpose of verifying that you earned the degree claimed. Note: The school must send the transcript directly to the BCCB. Transcripts mailed by applicants will not be accepted.

Transcripts should be sent to: BCCB 1600 NW Compton Drive, Ste. 200 Beaverton, OR 97006

Page 7 Associate Commissioning Professional – Application 10/2013 VI. PROFESSIONAL CREDENTIALS

List all professional credentials you earned that are relevant to your professional work in building commissioning. Include licenses, certifications, accreditations, and other programs for which you were awarded a credential.

Currently Awarding Jurisdiction, Agency, Year Designation Hold the Association, or Organization Awarded Credential?

Designation Name Year ☐Y ☐N

Designation Name Year ☐Y ☐N

Designation Name Year ☐ Y ☐ N

Designation Name Year ☐ Y ☐ N

Designation Name Year ☐ Y ☐ N

Designation Name Year ☐ Y ☐ N

Designation Name Year ☐ Y ☐ N

VII. OTHER TRAINING

List other training programs, courses, or seminars you took that are relevant to your work in building commissioning. Such training may be given in a classroom or at a meeting, be available online, or offered in a self-study format. Attach additional sheets, if necessary.

1. Name of training program or course: Click here to enter the name of training program or course

Organization providing the training: Click here to enter the organization

Date/Location of training program or course: Date Location

Describe briefly the training content: Click here to enter text

Approximate number of training hours: Click here to enter the approximate number of hours

Was a final examination given? ☐Yes ☐ No

Was a certificate awarded? ☐Yes ☐ No If certificate was awarded, please attach a copy to this application

Page 8 Associate Commissioning Professional – Application 10/2013 2. Name of training program or course: Click here to enter the name of training program or course

Organization providing the training: Click here to enter the organization

Date/Location of training program or course: Date Location

Describe briefly the training content: Click here to enter text

Approximate number of training hours: Click here to enter the approximate number of hours

Was a final examination given? ☐ Yes ☐ No

Was a certificate awarded? ☐ Yes ☐ No If certificate was awarded, please attach a copy to this application

3. Name of training program or course: Click here to enter the name of training program or course

Organization providing the training: Click here to enter the organization

Date/Location of training program or course: Date Location

Describe briefly the training content: Click here to enter text

Approximate number of training hours: Click here to enter the approximate number of hours

Was a final examination given? ☐ Yes ☐ No

Was a certificate awarded? ☐ Yes ☐ No If certificate was awarded, please attach a copy to this application

4. Name of training program or course: Click here to enter the name of training program or course

Organization providing the training: Click here to enter the organization

Date/Location of training program or course: Date Location

Describe briefly the training content: Click here to enter text

Approximate number of training hours: Click here to enter the approximate number of hours

Was a final examination given? ☐ Yes ☐ No

Was a certificate awarded? ☐ Yes ☐ No If certificate was awarded, please attach a copy to this application

Page 9 Associate Commissioning Professional – Application 10/2013 VIII. PROFESSIONAL MEMBERSHIPS

List professional associations, trade associations, and other organizations in which you currently hold membership and which are relevant to your work in building commissioning. Do not include organizations with which you are no longer affiliated. Indicate if you have served as an officer in an organization or served on one or more committees.

Organization Member since Held office? Committee(s)

Organization MM/YYYY ☐Y ☐N Committee(s).

Organization MM/YYYY ☐ Y ☐ N Committee(s).

Organization MM/YYYY ☐ Y ☐ N Committee(s).

Organization MM/YYYY ☐ Y ☐ N Committee(s).

Organization MM/YYYY ☐ Y ☐ N Committee(s).

Organization MM/YYYY ☐ Y ☐ N Committee(s).

Page 10 Associate Commissioning Professional – Application 10/2013 IX. BUILDING COMMISSIONING AND RELATED EXPERIENCE

Tell us about your commissioning-related professional experience.

A. Years of practice as a commissioning provider. (Do not round up. For example, if you have worked 3 years and 11 months as a commissioning provider, answer “3.”) ☐ 0 ☐ 3 ☐ 8–9 ☐ 1 ☐ 4-5 ☐ 10 or more ☐ 2 ☐ 6–7

B. Number of buildings commissioned ☐ 0 ☐ 3 ☐ 10 or more ☐ 1 ☐ 4–6 ☐ 2 ☐ 7–9

C. Types of commissioning projects completed (Check any that apply.) ☐ Large scale ☐ New building commissioning ☐ Public sector ☐ Major building renovation ☐ Private sector ☐ Existing building commissioning ☐ Other (specify) Click here to enter text. ☐ Not applicable

D. Technical specialty area(s) (Check any that apply.) ☐ Design ☐ Building envelope ☐ Mechanical systems ☐ Information systems ☐ Electrical ☐ Fire and life safety ☐ HVAC ☐ Security systems ☐ Energy conservation ☐ A/V systems ☐ Other (specify) Click here to enter text. ☐ Not applicable

E. Work experience prior to working as a commissioning professional (Check any that apply.) ☐ Design engineer ☐ Heating and air conditioning engineer ☐ Construction engineer ☐ Facility manager ☐ Mechanical engineer ☐ Maintenance supervisor ☐ Electrical engineer ☐ Building operations ☐ Other (specify) Click here to enter text. Page 11 Associate Commissioning Professional – Application 10/2013 ☐ Not applicable

X. BCA Essential Attributes of Building Commissioning

You will be asked in the following section if you as a commissioning professional can adhere with the BCA Essential Attributes which the BCA and BCCB consider fundamental to effective building commissioning. Please read these carefully prior to moving on to the Affirmations of the Applicant section.

1. The commissioning authority (CxA) is in charge of the commissioning process and makes the final recommendations to the owner regarding functional performance of the commissioned building systems. 2. The CxA is an objective, independent advocate of the owner. If the CxA's firm has other project responsibilities, or is not under direct contract to the owner, a conflict of interest exists. Wherever this occurs, the CxA discloses, in writing, the nature of the conflict and the means by which the conflict shall be managed. 3. In addition to having good written and verbal communication skills, the CxA has current engineering knowledge, and extensive and recent hands-on field experience regarding: a. Building systems commissioning b. The physical principles of building systems performance and interaction c. Building systems start-up, balancing, testing and troubleshooting d. Operation and maintenance procedures e. The building design and construction process 4. For each project, the commissioning purpose and scope are clearly defined in the CxA contract. 5. The CxA recommends the commissioning roles and scope for all members of the design and construction teams be clearly defined in: a. Each design consultant's contract b. The construction manager's contract c. General Conditions of the Specifications d. Each division of the specifications covering work to be commissioned e. The specifications for each system and component for which the suppliers' support is required 6. Each project is commissioned in accordance with a written commissioning plan that is updated as the project progresses. The commissioning plan: a. Identifies the systems to be commissioned b. Defines the scope of the commissioning process c. Defines commissioning roles and lines of communications for each member of the project team d. Estimates the commissioning schedule 7. On new building commissioning projects, the CxA reviews systems installation for commissioning-related issues throughout the construction period. 8. All commissioning activities and findings are documented as they occur. These reports are distributed as they are generated, and included in the final report. 9. The functional testing program objectively verifies that the building systems perform interactively in accordance with the project documents. Written, repeatable test procedures, prepared specifically for each project, are used to functionally test components and systems in all modes of operating conditions specified for testing. These tests are documented to clearly describe the individual systematic test procedures, the expected systems response or acceptance criteria for each procedure, the actual response or findings, and any pertinent discussion. 10. The CxA provides constructive input for the resolution of system deficiencies. 11. Every commissioning project is documented with a commissioning report that includes: a. An evaluation of the operating condition of the systems at the time of functional test completion b. Deficiencies that were discovered and the measures taken to correct them c. Uncorrected operational deficiencies that were accepted by the owner d. Functional test procedures and results e. Reports that document all commissioning field activities as they progress A description and estimated schedule of required deferred testing Page 12 Associate Commissioning Professional – Application 10/2013 XI. AFFIRMATIONS OF APPLICANT

Read each of the following statements carefully. By signing and dating below, you are affirming that each statement is true. If you cannot truthfully attest to all of the statements, you are not eligible to apply. Please note that, should the BCCB determine that you have falsified any attestation, your application may be rejected, your examination scores may be canceled, and/or your certification may be revoked.

A. I certify that the information provided in this application is true, accurate, and verifiable to the best of my knowledge. Further, I agree to notify BCCB of any material change in the information provided in this application or of the occurrence of any event or development bearing upon my eligibility for certification, including, but not limited to any criminal conviction or disciplinary action by a licensing board or professional organization. B. I certify that I have not been convicted by any court, licensing board, or registration board of violating the law in conjunction with the performance of my professional work. C. I understand that, once the BCCB certification staff begins review of this application, the application fee is non- refundable. However, my exam fee will be refunded if I do not qualify to sit for the exam. D. I understand that I have two (2) years from the date the BCCB receives my application to fulfill all application requirements and six (6) months from the date the BCCB approves my application to take the examination. E. I understand I am personally responsible for maintaining the confidentiality of the examination content and may not discuss or document the exam content in any format except with BCCB staff. I also understand that I have the opportunity to request special accommodation for the examination with appropriate documentation of a disability. F. I understand that BCCB certification is valid for a period of three (3) years. Should I be granted certification, I understand that if I seek recertification, it is my responsibility to demonstrate evidence of my continued competence in the field of building commissioning. I will notify the BCCB of changes in contact information so that I can be reached regarding recertification. G. I understand that I may apply to advance my BCCB certification to the Certified Commissioning Professional at any time. I understand that to do so I will be required to submit the CCP application and a discounted application fee, but I will not be required to retake the exam provided I hold an active ACP. H. I understand that BCCB reserves the right to verify any or all information on this application and that any incorrect or misleading information may constitute grounds for rejection of my application, revocation of my ACP certification, or other disciplinary action. I authorize BCCB and their officers, directors, employees, agents, and assigned examiners to review my application to determine whether I have met BCCB’s standards for certification. I. I understand and agree that BCCB reserves the right to use my examination score and certain data from my application to prepare summary statistical analyses, some of which may be published. BCCB will endeavor to ensure that individual data is not made public. J. I indemnify and hold harmless BCA, BCCB and their officers, directors, employees, agents, and assigned examiners from the decision made on my application as long as such decision was made in good faith and does not constitute gross negligence by BCA, BCCB or their officers, directors, employees, agents and/or assigned examiners. K. I affirm that I adhere to the Essential Attributes of Building Commissioning (as detailed in section X) whenever I serve as a project’s Commissioning Authority. L. I acknowledge that I have read this application and BCCB’s certification standards, and I understand that it will be my responsibility to remain in compliance with all of BCCB’s certification standards.

Signature ______Date ______Page 13 Associate Commissioning Professional – Application 10/2013 XII. APPLICATION FEE

The following non-refundable application fees are in effect: Please Select One Status Cost ☐ Current member of the BCA $350 ☐ Current employer is a Corporate Member of the BCA $350 ☐ Non-member of the BCA $550 All applicants are charged the Exam Fee at time of application. Exam Fee + __X__ (The exam fee will be refunded if you do not qualify to sit for the exam.) $150

Total $ Total

The BCCB must receive your fee in full (including exam fee) before your application is processed. We accept money orders, cashier’s checks, checks drawn on a company account, personal checks, and credit card payments. We do not accept cash.

If you are paying by check or money order, please enclose it with this application. If you wish to pay by credit card, please enter the information below.

Payment Method ☐ Visa ☐ MasterCard ☐ Check Number Enter check #t.

Name as it appears on the card: Click here to enter text.

Card Number: Click here to enter text. Expires (mm/yyyy): Click here to enter text.

Billing Address: Click here to enter text.

Billing City, State, Postal Code: Click here to enter text.

Signature of cardholder ______Date Click here to enter a date. Your signature authorizes the BCCB to charge the application fee to your credit card.

XIII. SUBMISSION CHECKLIST

Use this checklist before sending your application to verify that you have completed the required steps and are submitting all required documentation.

☐ Completed all sections of the application form ☐ Requested a transcript from the school from which you received your highest building science degree or, lacking a building science degree, your highest degree attained. ☐ Signed the applicant affirmations ☐ Included payment or filled out the information for payment by credit card Page 14 Associate Commissioning Professional – Application 10/2013