JCM_CL_F_MoC_ver01.0

Section 3: Third-party entity (TPE)
Name of the TPE that conducts validation Japan Management Association(and verification) for the project:
Address (incl. postcode): 3-1-22, Shiba koen, Minato-ku, Tokyo, 105-8522, Japan
Contact person:Mr.

Ms.

Last name: MatsumotoFirst name: Motyoyuki

Title: Director
Department: Verification Administration Dept. & Quality Management Representative GHG
Certification Center
E-mail: motoyuki_matsumoto@jma.or.jp

Telephone: +81-3-3434-1245

Section 4: List of project participants other than nominated focal point entity
Name of project participant(1)

MGM Innova Capital Chile SpA(2)

Universidad Técnica Federico Santa María(3)

NTT DATA INSTITUTE OF MANAGEMENT CONSULTING,Inc.

(4)
(5)
(6)
*Rows may be added, as needed*Contact information of each participant is indicated in Section 5.

1

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JCM Modalities of Communication Statement Form
ANNEX 1This annex is to be used by the nominated focal point to request changes to project participant
status and contact details of a focal point entity following project registration.
Section 1: Project details
Title of the projectIntroduction of 1MW Rooftop Solar Power Systems to University

Country

Chile

Project reference number:

CL001

Date of Submission

17/2/2022

Section 2: Addition/change of name of a project participant
Add project participant
Change name of project participant (if selected, indicate former name below)
The following entity is hereby added as a project participant or is newly named in respect of
the above project. By providing a specimen signature below, the project participant confirms
its acceptance of the current modalities of communication.
Name of entity:
Address (incl. postcode):
Former name of project participant (if applicable):
Telephone:

Fax:

E-mail:Website:Primary authorised signatory:Mr.

Last name:First name:Ms.

Title:
Specimen signature:

Date:

Alternate authorised signatory:Mr.

Last name:First name:Ms.

Title:
Specimen signature:

Date:

Contact person:

Mr.

Last name:First name:Title:
Department:1

Ms.

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Mobile:Direct tel.:E-mail:Direct fax:

Signature of the nominated focal point:
Name:
Specimen signature:

Date:

Section 3: Voluntary withdrawal of project participants
The following entity is registered as a project participant in the above project and hereby
confirms its voluntary consent to be removed.
Name of entity:
Name of authorised signatory:Mr.

Last name:First name:Ms.

Title:
Specimen signature:

Date:*Rows may be added, as needed
Signature of the nominated focal point:
Name:
Specimen signature:

Date:

Section 4: Change of contact details (project participants or focal point entity)
The following entity is an existing project participant/focal point entity in respect of the above
project and hereby requests the following changes to its contact details:☑Project participant☑ Focal point
Name of entity:
Waseda environmental Institute Co., Ltd.
Address (incl. postcode): FAIR WIND Takadanobaba 6F, 2-21-12 Nishiwaseda, Shinjuku-ku,
Tokyo 169-0051, JAPAN
Telephone:

Fax:

E-mail:Website: http://e-wei.co.jp/

Primary authorised signatory:Mr.

Last name:First name:Ms.

Title:
Specimen signature:Date:2