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{"sheet":"様式1(共通)","index":0,"n_rows":43,"n_cols":34,"rows_kept":43,"cut":false,"hidden":false,"merged":[[27,11,27,12],[29,11,29,12],[36,11,36,12],[29,13,29,27],[33,13,33,32],[34,13,34,32],[33,11,33,12],[27,13,27,27],[28,11,28,27],[31,11,31,32],[32,11,32,32],[15,25,15,32],[17,25,17,32],[15,7,15,24],[17,7,17,24],[19,11,19,12],[19,13,19,16],[19,17,19,32],[19,5,19,10],[31,7,32,10],[15,2,15,6],[17,2,17,6],[19,2,21,4],[10,2,10,6],[10,7,10,32],[12,2,13,6],[12,7,12,8],[13,9,13,32],[1,25,1,26],[1,28,1,29],[1,31,1,32],[6,0,6,34],[12,9,12,32],[13,7,13,8],[1,23,1,24],[1,17,1,22],[8,2,8,32],[33,7,34,10],[36,2,37,6],[36,7,37,10],[36,13,36,32],[37,11,37,32],[34,11,34,12],[29,7,30,7],[29,8,30,10],[29,28,30,32],[30,11,30,27],[23,2,34,6],[23,7,28,7],[23,8,24,10],[23,13,23,27],[23,28,28,32],[25,8,28,10],[25,21,25,27],[25,11,25,20],[26,11,26,20],[26,21,26,27],[24,11,24,27],[20,5,20,10],[21,5,21,10],[23,11,23,12],[20,11,20,32],[21,11,21,32]],"flags":["formulas_cached_only"]}
[" "]
[{"$nulls":17},"申請日(記入日）",{"$nulls":5},"平成",null,null,null,"年",null,null,"月",null,null,"日"]
[]
[null,"一般社団法人　環境共生住宅推進協議会"]
[null,"会長　竹中　宣雄　殿"]
[]
["平成２９年度 既存建築物省エネ化推進事業\n（省エネルギー性能の診断・表示に対する支援）\n応募・交付申請書"]
[]
[null,null,"以下の内容により、既存建築物省エネ化推進事業の応募・交付を申請します。"]
[]
[null,null,"１．事業名"]
[]
[null,null,"２．提案種別\n （いずれかを選択）",{"$nulls":4},"□",null,"通常補助（補助率１／３以内）として申請"]
[{"$nulls":7},"□",null,"定額補助として申請（波及効果が高いものとして評価を受ける場合）"]
[]
[null,null,"３．補助対象\n　　事業費",{"$nulls":22},"千円（端数切り捨て）"]
[]
[null,null,"４．補助\n　　申請額",{"$nulls":22},"千円（端数切り捨て）"]
[]
[null,null,"５．\n補助対象物件",null,null,"1）棟　数",{"$nulls":5},"合計",{"$nulls":5},"棟"]
[{"$nulls":5},"2）建築物の用途"]
[{"$nulls":5},"3）所 在 地"]
[]
[null,null,"代表提案者\n（注１）（注２）",{"$nulls":4},"法人の場合","法人名",null,null,"ﾌﾘｶﾞﾅ",{"$nulls":16},"印"]
[]
[{"$nulls":8},"代表者名",null,null,"部署名",{"$nulls":9},"役職名"]
[]
[{"$nulls":11},"ﾌﾘｶﾞﾅ"]
[]
[{"$nulls":7},"個人の場合","氏名",null,null,"ﾌﾘｶﾞﾅ",{"$nulls":16},"印"]
[]
[{"$nulls":7},"連絡先",null,null,null,"電話番号又はメールアドレス"]
[]
[{"$nulls":7},"属性\n（いずれかを選択）",null,null,null,"□",null,"建築主（建物所有者）"]
[{"$nulls":11},"□",null,"共同提案者"]
[]
[null,null,"事務代行者\n（注３）",{"$nulls":4},"法人名\nまたは\n氏名",null,null,null,"ﾌﾘｶﾞﾅ"]
[]
[]
[null,null,null,"(注１)","代表提案者は、法人の場合は法人名と代表者名及び連絡先、個人の場合は氏名及び連絡先を"]
[null,null,"　",null,"記載し、捺印してください。"]
[null,null,null,"(注２)","事務代行者がいる場合、法人名又は氏名を記載してください。"]
[null,null,null,"(注３)","事務代行者は代表提案者になることはできません。"]

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["（様式２－１・共通）"]
["フェイスシート"]
["事業名"]
["代表提案者",{"$nulls":5},"名称（又は氏名）"]
[{"$nulls":6},"住所",null,"郵便番号",null,null,null,"〒"]
[{"$nulls":8},"住所"]
["その他の提案者",{"$nulls":5},"名称（又は氏名）"]
["補助を受ける者（予定）",{"$nulls":5},"名称（又は氏名）"]
["事務連絡先",{"$nulls":5},"種別（選択）",{"$nulls":6},"□","提案者",{"$nulls":4},"□","事務代行者"]
[{"$nulls":6},"名称（法人名等）"]
[{"$nulls":6},"部署名"]
[{"$nulls":6},"役職名"]
[{"$nulls":6},"担当者氏名"]
[{"$nulls":6},"住所",null,"郵便番号",null,null,null,"〒"]
[{"$nulls":8},"住所"]
[{"$nulls":6},"電話番号"]
[{"$nulls":6},"FAX"]
[{"$nulls":6},"E-mail"]
["省エネ性能\n表示の対象となる\n住宅・建築物の\n概要\n（補助対象\n物件）",{"$nulls":5},"棟数",{"$nulls":5},"一戸建ての住宅",{"$nulls":8},"棟",null,"共同住宅",{"$nulls":7},"棟"]
[{"$nulls":12},"非住宅建築物",{"$nulls":8},"棟",null,"複合建築物",{"$nulls":7},"棟"]
[{"$nulls":12},"合　　計",{"$nulls":8},"棟"]
[{"$nulls":6},"非住宅・複合\n建築物の用途",{"$nulls":6},"□","事務所等",null,null,null,"□","ホテル等",null,null,null,"□","病院等",null,null,null,"□","百貨店等"]
[{"$nulls":13},"□","学校等",null,null,null,"□","飲食店等",null,null,null,"□","集会所等",null,null,null,"□","工場等"]
[{"$nulls":13},"□","共同住宅",null,null,null,"□","その他",null,null,"（　　　　　　　　　　　　　　　　　　）"]
[{"$nulls":6},"延べ面積（合計）",{"$nulls":16},"㎡"]
[{"$nulls":6},"所在地"]
["省エネ性能\n表示の\n実施計画",{"$nulls":5},"実施棟数",{"$nulls":5}," BELS",{"$nulls":17},"棟"]
[{"$nulls":12}," 省エネ基準適合認定表示（ｅマーク）",{"$nulls":17},"棟"]
[{"$nulls":12}," その他（　　　　　　　　　　　　）",{"$nulls":17},"棟"]
[{"$nulls":12}," 合計",{"$nulls":17},"棟"]
[{"$nulls":6},"補助対象事業費",{"$nulls":23},"千円"]
[{"$nulls":6},"補助申請額",{"$nulls":23},"千円"]
[]
["注１）",null,"「名称（又は氏名）」欄について、法人等の場合は法人名等、個人の場合は氏名を記載してください。"]
["注2）",null,"実施計画の概要：予定棟数、金額等を記載してください。"]
[null,null,"なお、補助対象事業費、補助申請額は合計額とし、様式３－１、様式３－２と金額が一致するように、"]
[null,null,"記載してください。"]

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["複数棟用",{"$nulls":31},"（様式２-２・共通）"]
["補助事業の実施場所の概要"]
["※応募する建物が１棟のみの場合は提出の必要はありません。"]
["※実施場所が確定しているものについて、詳細を記載してください。"]
["事業名"]
[]
["提案建物数",{"$nulls":12},"棟",null,"（うち実施場所が確定しているもの",{"$nulls":15},"棟）"]
["建物１",null,null,"建物名"]
[null,null,null,"所在地",null,null,null,"都道府県",{"$nulls":9},"市区町村"]
[null,null,null,"建築概要",null,null,null,"延床面積",{"$nulls":7},"㎡",null,"階数",null,null,"地上",{"$nulls":4},"階",null,"地下",{"$nulls":4},"階"]
[null,null,null,"建物用途\n（選択）",null,null,null,"□","戸建住宅",null,null,null,"□","共同住宅",null,null,null,"□","事務所等",null,null,null,"□","ホテル等",null,null,null,"□","病院等"]
[{"$nulls":7},"□","百貨店等",null,null,null,"□","学校等",null,null,null,"□","飲食店等",null,null,null,"□","集会所等",null,null,null,"□","工場等"]
["建物２",null,null,"建物名"]
[null,null,null,"所在地",null,null,null,"都道府県",{"$nulls":9},"市区町村"]
[null,null,null,"建築概要",null,null,null,"延床面積",{"$nulls":7},"㎡",null,"階数",null,null,"地上",{"$nulls":4},"階",null,"地下",{"$nulls":4},"階"]
[null,null,null,"建物用途\n（選択）",null,null,null,"□","戸建住宅",null,null,null,"□","共同住宅",null,null,null,"□","事務所等",null,null,null,"□","ホテル等",null,null,null,"□","病院等"]
[{"$nulls":7},"□","百貨店等",null,null,null,"□","学校等",null,null,null,"□","飲食店等",null,null,null,"□","集会所等",null,null,null,"□","工場等"]
["建物３",null,null,"建物名"]
[null,null,null,"所在地",null,null,null,"都道府県",{"$nulls":9},"市区町村"]
[null,null,null,"建築概要",null,null,null,"延床面積",{"$nulls":7},"㎡",null,"階数",null,null,"地上",{"$nulls":4},"階",null,"地下",{"$nulls":4},"階"]
[null,null,null,"建物用途\n（選択）",null,null,null,"□","戸建住宅",null,null,null,"□","共同住宅",null,null,null,"□","事務所等",null,null,null,"□","ホテル等",null,null,null,"□","病院等"]
[{"$nulls":7},"□","百貨店等",null,null,null,"□","学校等",null,null,null,"□","飲食店等",null,null,null,"□","集会所等",null,null,null,"□","工場等"]
["建物４",null,null,"建物名"]
[null,null,null,"所在地",null,null,null,"都道府県",{"$nulls":9},"市区町村"]
[null,null,null,"建築概要",null,null,null,"延床面積",{"$nulls":7},"㎡",null,"階数",null,null,"地上",{"$nulls":4},"階",null,"地下",{"$nulls":4},"階"]
[null,null,null,"建物用途\n（選択）",null,null,null,"□","戸建住宅",null,null,null,"□","共同住宅",null,null,null,"□","事務所等",null,null,null,"□","ホテル等",null,null,null,"□","病院等"]
[{"$nulls":7},"□","百貨店等",null,null,null,"□","学校等",null,null,null,"□","飲食店等",null,null,null,"□","集会所等",null,null,null,"□","工場等"]
["建物５",null,null,"建物名"]
[null,null,null,"所在地",null,null,null,"都道府県",{"$nulls":9},"市区町村"]
[null,null,null,"建築概要",null,null,null,"延床面積",{"$nulls":7},"㎡",null,"階数",null,null,"地上",{"$nulls":4},"階",null,"地下",{"$nulls":4},"階"]
[null,null,null,"建物用途\n（選択）",null,null,null,"□","戸建住宅",null,null,null,"□","共同住宅",null,null,null,"□","事務所等",null,null,null,"□","ホテル等",null,null,null,"□","病院等"]
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["建物６",null,null,"建物名"]
[null,null,null,"所在地",null,null,null,"都道府県",{"$nulls":9},"市区町村"]
[null,null,null,"建築概要",null,null,null,"延床面積",{"$nulls":7},"㎡",null,"階数",null,null,"地上",{"$nulls":4},"階",null,"地下",{"$nulls":4},"階"]
[null,null,null,"建物用途\n（選択）",null,null,null,"□","戸建住宅",null,null,null,"□","共同住宅",null,null,null,"□","事務所等",null,null,null,"□","ホテル等",null,null,null,"□","病院等"]
[{"$nulls":7},"□","百貨店等",null,null,null,"□","学校等",null,null,null,"□","飲食店等",null,null,null,"□","集会所等",null,null,null,"□","工場等"]
["建物７",null,null,"建物名"]
[null,null,null,"所在地",null,null,null,"都道府県",{"$nulls":9},"市区町村"]
[null,null,null,"建築概要",null,null,null,"延床面積",{"$nulls":7},"㎡",null,"階数",null,null,"地上",{"$nulls":4},"階",null,"地下",{"$nulls":4},"階"]
[null,null,null,"建物用途\n（選択）",null,null,null,"□","戸建住宅",null,null,null,"□","共同住宅",null,null,null,"□","事務所等",null,null,null,"□","ホテル等",null,null,null,"□","病院等"]
[{"$nulls":7},"□","百貨店等",null,null,null,"□","学校等",null,null,null,"□","飲食店等",null,null,null,"□","集会所等",null,null,null,"□","工場等"]
["建物８",null,null,"建物名"]
[null,null,null,"所在地",null,null,null,"都道府県",{"$nulls":9},"市区町村"]
[null,null,null,"建築概要",null,null,null,"延床面積",{"$nulls":7},"㎡",null,"階数",null,null,"地上",{"$nulls":4},"階",null,"地下",{"$nulls":4},"階"]
[null,null,null,"建物用途\n（選択）",null,null,null,"□","戸建住宅",null,null,null,"□","共同住宅",null,null,null,"□","事務所等",null,null,null,"□","ホテル等",null,null,null,"□","病院等"]
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["注）記入欄が不足する場合は、適宜、コピーして使用してください。"]

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["１．事業計画"]
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["１．省エネ診断に要する費用",null,null,"1/3",null,"千円未満切り捨て"]
["２．第三者認証等に要する費用",null,null,"1/3",null,"千円未満切り捨て"]
["３．省エネ性能表示に要する費用",null,null,"1/3",null,"千円未満切り捨て"]
["合計"]
[]
["２．補助対象事業費の内訳"]
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[]
["１．省エネ診断に要する費用"]
[null,"○○調査費（外注費）"]
[null,"○○計算費（外注費）"]
[null,"○○○○　（○○○○）"]
[]
[]
[]
[]
["小計　ａ"]
["２．第三者認証等に要する費用"]
["（１）○○申請手数料・評価料"]
["　　","○○"]
[null,"○○"]
[]
[]
[]
["（２）申請代行料等（外注費）"]
[null,"○○"]
[null,"○○"]
[]
[]
[]
["小計　ｂ"]
["３．省エネ性能表示に要する費用"]
[null,"○○"]
[null,"○○"]
[null,"○○"]
[]
[]
[]
[]
["小計　ｃ"]
[]
["注１）消費税等は除いた額を記載してください。"]
["注２）それぞれの項目にて、千円未満は切り捨てとして、金額を記載してください。"]
["注３）複数建築物を対象とする事業で、単価が異なる場合など、適宜、項目を区分して記載してください。"]
["注４）備考欄には、建築物の種別、表示の内容などを記載してください。"]

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["１．事業計画"]
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["２．補助対象事業費の内訳"]
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[]
["１．省エネ診断に要する費用"]
[null,"○○調査費（外注費）"]
[null,"○○計算費（外注費）"]
[null,"○○○○　（○○○○）"]
[]
[]
[]
[]
["小計　ａ"]
["２．第三者認証等に要する費用"]
["（１）○○申請手数料・評価料"]
["　　","○○"]
[null,"○○"]
[]
[]
[]
["（２）申請代行料等（外注費）"]
[null,"○○"]
[null,"○○"]
[]
[]
[]
["小計　ｂ"]
["３．省エネ性能表示に要する費用"]
[null,"○○"]
[null,"○○"]
[null,"○○"]
[]
[]
[]
[]
["小計　ｃ"]
[]
["注１）消費税等は除いた額を記載してください。"]
["注２）それぞれの項目にて、千円未満は切り捨てとして、金額を記載してください。"]
["注３）複数建築物を対象とする事業で、単価が異なる場合など、適宜、項目を区分して記載してください。"]
["注４）備考欄には、建築物の種別、表示の内容などを記載してください。"]

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["【定額補助として申請する場合のみ提出】"]
[]
["事業名",{"$nulls":14},"代表提案者"]
[]
["１．省エネ性能表示（評価書、プレート等による表示）の実施計画"]
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[{"$nulls":14},"ＢＥＬＳ",null,null,null,"ｅマーク",null,null,null,"その他",null,null,null,"合計"]
[]
[]
[]
["合計"]
[]
["２．省エネ性能表示の普及に資する取り組みの波及効果"]
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["波及効果（人／年間）",{"$nulls":4},"波及効果の根拠"]
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["□","見せる"]
[0,{"$nulls":10},0,null,null,"人","・"]
[{"$nulls":11},0,null,null,"人","・"]
["（人／年間）",{"$nulls":10},0,null,null,"人","・"]
["□","学習"]
[0,{"$nulls":10},0,null,null,"人","・"]
[{"$nulls":11},0,null,null,"人","・"]
["（人／年間）",{"$nulls":10},0,null,null,"人","・"]
["□","その他の特記すべき取り組み　（波及効果として人数に換算することが難しい取り組みなど）"]

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[{"$nulls":32},"（様式４-２・定額補助）"]
["審査基準に関する事項 － 省エネ性能表示の普及に関する取り組み内容：その２"]
["【定額補助として申請する場合のみ提出】"]
[]
["事業名",{"$nulls":17},"代表提案者"]
["取り組み\n単位",null,null,null,"□","特定の建築物",{"$nulls":12},"１棟又は複数棟で実施"]
[{"$nulls":4},"□","特定の地域",{"$nulls":12},"街区・エリア単位など、複数棟でまとめて実施"]
[{"$nulls":4},"□","事業者単位",{"$nulls":12},"エリア限定なし（全国、所有物件）の複数棟にて実施"]
[{"$nulls":4},"□","その他",null,null,"（内容：　                                                                                                 )"]
[" ■全体概要"]
{"$rows_empty":22}
["■実施体制"]
{"$rows_empty":19}
["注）本様式（様式４－２）は、採択後にホームページ等で情報公開することを予定しています。"]

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["別紙５"]
[]
["平成29年度既存建築物省エネ化推進事業"]
["（省エネルギー性能の診断・表示に対する支援）"]
["補助事業委託業者等に関する宣誓書"]
[]
[]
[null,"本補助事業において、交付申請者が以下の（1）～（3）の関係にある会社から行う調達"]
[]
[null,"（他の会社を経由した場合、いわゆる下請け会社の場合も含む。）の有無について、"]
[]
[null,"該当する項目にチェックを入れてください。"]
[]
[null,null,null,"（1）","100％同一の資本に属するグループ企業"]
[]
[null,null,null,"（2）","補助金の交付の申請をしようとする者の関係会社(上記(1)を除く）"]
[]
[null,null,null,"（3）","申請者の役員である者又はこれらの者が役員に就任している法人"]
[]
[]
[null,"1）（1）～(3）の関係にある会社からの調達は一切ない。　　☐",{"$nulls":9},"□"]
[]
[null,"2）（1）～(3）の関係にある会社からの調達がある。　　　　☐",{"$nulls":9},"□"]
[]
[]
[]
[null,"　【（1）～(3）の関係にある会社からの調達がある場合】　※上記2）の場合"]
[null,"　①価格の妥当性等を確認するため、3者以上からの見積り結果を交付申請に"]
[null,"　　添付してください。"]
[null,"　②協議会は、前項により提出された見積もり結果について、調達費用の妥当性を"]
[null,"　　確認します。"]
[null,"　③申請者は代表提案者及び委託契約者の連名として、交付申請をしてください。"]
[]
[]
[null,"　本確認書に虚偽の記載をし、記載内容が事実と相違していることが発覚した場合は"]
[null,"補助金の全額返還を求めることがあります。"]
[]
[{"$nulls":10},"平成　　年　　月　　日"]
[]
[]
[null,"事業名"]
[]
[]
[null,"法人の場合","法人名",null,"ﾌﾘｶﾞﾅ",{"$nulls":8},"印"]
[]
[]
[null,null,"代表者名",null,"部署名",{"$nulls":4},"役職名"]
[{"$nulls":4},"ﾌﾘｶﾞﾅ"]
[]
[]
[null,"個人の　場合","氏名",null,"ﾌﾘｶﾞﾅ",{"$nulls":8},"印"]

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["別添５"]
[]
[null,null,null,"事業名："]
[]
[{"$nulls":5},"平成　　年　　月　　日"]
[]
["平成29年度既存建築物省エネ化推進事業"]
["（省エネルギー性能の診断・表示に対する支援）"]
["申請の制限に係る事案の有無等に関する確認書"]
[]
[null,null,null,"代表者(提案者）"]
[{"$nulls":9},"印"]
[]
[]
["１．申請の制限に係る事案について"]
[null,"　平成29年度既存建築物省エネ化推進事業（省エネルギー性能の診断・表示に対する支援）"]
[null,"補助金交付規程第５第２項に基づき、過去３カ年度内に住宅・建築物環境対策事業費補助金"]
[null,"交付要綱第１４（交付決定の取り消し）に相当する理由での補助金の返還の有無について、"]
[null,"以下の通り申告を求めます。なお、該当する事案がある場合には、本補助金への申請が原則"]
[null,"として制限されます。"]
[]
[null," 上記１の申請の制限に係る事案の有無について",{"$nulls":4},"□","有","□","無"]
[]
[null," 補助事業者の名称"]
[null," 事業名"]
[null," 返還命令日"]
[null," 返還日"]
[null," 返還額（円）"]
[null," 返還事由"]
[]
[" ２．暴力団及び暴力団員の排除について"]
["  ","　平成29年度既存建築物省エネ化推進事業（省エネルギー性能の診断・表示に対する支援）"]
[null,"補助金交付規程第5-3に基づき、当該申請を制限される者への該当の有無について申告を求"]
[null,"めます。なお、該当がある場合は、本補助金への申請を制限されます。"]
[]
[null," 上記２の申請の制限に係る事案の有無について",{"$nulls":4},"□","有","□","無"]
[]
[" ３．個人情報の使用について"]
["  ","　平成29年度既存建築物省エネ化推進事業（省エネルギー性能の診断・表示に対する支援）"]
[null,"補助金交付規程第１４（交付決定の取り消し）に該当した場合には、本申請に係る個人情報"]
[null,"について他府省庁・独立行政法人を含む他の補助金担当課に当該返還事案の概要（法人又は"]
[null,"申請者名・補助金名・交付決定額・補助事業の実施期間・返還を生じた理由・講じられた措"]
[null,"置の内容等）を提供することがあります。"]
[]
[null," 上記３の内容について",{"$nulls":4},"□","　同意する"]
[]
[null,"※補助事業者の名称には法人・団体等の名称（個人の場合は氏名）を記入してください。"]
[null,"※本補助金の交付後に１の内容に虚偽等が存することが判明した場合には、本補助金の返"]
[null,"  還（補助金の交付から返還時までの法定利息に係る分を含む）を求めることがあります。"]
[]
[null,"　本確認書の内容について誤りはなく、事実と相違していることが発覚した場合は、"]
[null,"本補助金の全額返金となることがあることについて確認しました。"]
[]
["（注）この用紙の大きさは、日本工業規格Ａ４とすること。"]

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[{"$nulls":21},"（別添様式・通常補助）",{"$nulls":27},"（別添様式２）"]
["提出書類のチェック表（１）"]
[]
["１．通常補助（補助率１／３）として申請の場合"]
["様式",null,"タイトル",{"$nulls":5},"主なチェック項目",{"$nulls":12},"確認"]
["様式1",null,"　応募・交付申請書",{"$nulls":5},"提案種別で「通常補助」を選択しているか",{"$nulls":12},"□"]
[{"$nulls":8},"記載事項に漏れはないか",{"$nulls":12},"□"]
[{"$nulls":8},"代表提案者の捺印をしているか",{"$nulls":12},"□"]
["様式2-1",null,"　フェイスシート",{"$nulls":5},"記載事項に漏れはないか",{"$nulls":12},"□"]
[{"$nulls":8},"事務連絡先の住所、電話番号、Ｅ-mailアドレス等に間違いはないか",{"$nulls":12},"□"]
[{"$nulls":8},"実施計画に記載する「補助対象事業費」「補助申請額」が様式３－１の合計額と一致しているか",{"$nulls":12},"□"]
["様式2-2",null,"　補助事業の実施場所の概要\n　(複数棟で実施の場合のみ)",{"$nulls":5},"実施予定の建物毎に、建物概要を記載しているか",{"$nulls":12},"□"]
["様式3-1",null,"　事業計画及び補助申請額",{"$nulls":5},"消費税を除く額として記載しているか",{"$nulls":12},"□"]
[{"$nulls":8},"各費用は千円未満切り捨てとして記載しているか",{"$nulls":12},"□"]
["別紙5",null,"　補助事業委託業者等に\n　関する宣誓書",{"$nulls":18},"□"]
["原本写し",null,"　補助対象事業費の見積書",{"$nulls":5},"契約時の契約見積書を添付。また、対象事業費以外の項目については、手書きにて「補助対象外」と追記。",{"$nulls":12},"□"]
["任意様式4",null,"　代表提案者の登記簿等\n　事業実態の分かる書類",{"$nulls":5},"３か月以内の原本で提出すること。",{"$nulls":12},"□"]
["別添5",null,"　申請の制限に係る事業の\n　有無等に関する確認書",{"$nulls":18},"□"]
["任意様式5",null,"　共同事業実施規約",{"$nulls":5},"対象者のみ",{"$nulls":12},"□"]
["任意様式9",null,"　その他確認に必要と\n　思われるもの",{"$nulls":18},"□"]
["別添様式",null,"　提出書類のチェック表",{"$nulls":5},"提出書類に不備がないように再度チェックをお願いします。このチェック表をファイルの一番上に綴じてご提出ください。",{"$nulls":12},"□"]

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[{"$nulls":21},"（別添様式・定額補助）",{"$nulls":27},"（別添様式２）"]
["提出書類のチェック表（２）"]
[]
["２．定額補助として申請（波及効果が高いものとして評価を受ける）の場合"]
["様式",null,"タイトル",{"$nulls":5},"主なチェック項目",{"$nulls":12},"確認"]
["様式1",null,"　応募・交付申請書",{"$nulls":5},"提案種別で「定額補助」を選択しているか",{"$nulls":12},"□"]
[{"$nulls":8},"記載事項に漏れはないか",{"$nulls":12},"□"]
[{"$nulls":8},"代表提案者の捺印をしているか",{"$nulls":12},"□"]
["様式2-1",null,"　フェイスシート",{"$nulls":5},"記載事項に漏れはないか",{"$nulls":12},"□"]
[{"$nulls":8},"事務連絡先の住所、電話番号、Ｅ-mailアドレス等に間違いはないか",{"$nulls":12},"□"]
[{"$nulls":8},"実施計画に記載する「補助対象事業費」「補助申請額」が様式３－２の合計額と一致しているか",{"$nulls":12},"□"]
["様式2-2",null,"　補助事業の実施場所の概要\n　(複数棟で実施の場合のみ)",{"$nulls":5},"実施予定の建物毎に、建物概要を記載しているか",{"$nulls":12},"□"]
["様式3-2",null,"　事業計画及び補助申請額",{"$nulls":5},"消費税を除く額として記載しているか",{"$nulls":12},"□"]
[{"$nulls":8},"各費用は千円未満切り捨てとして記載しているか",{"$nulls":12},"□"]
["様式4-1",null,"　省エネ性能の普及に\n　関する取り組み内容\n （その１、その２）",{"$nulls":5},"必要な項目を選択または記載しているか",{"$nulls":12},"□"]
["様式4-2",{"$nulls":7},"各項目で「その他」を選択した場合、内容を記載しているか",{"$nulls":12},"□"]
[{"$nulls":8},"波及効果の人数、根拠等を記載しているか",{"$nulls":12},"□"]
[{"$nulls":8},"全体概要に、スケジュールを含め、具体的な取り組みイメージがわかりやすくまとめられているか",{"$nulls":12},"□"]
[{"$nulls":8},"実施体制に、省エネ性能表示を普及する対象者を含めて図示しているか",{"$nulls":12},"□"]
["別紙5",null,"　補助事業委託業者等に\n　関する宣誓書",{"$nulls":18},"□"]
["原本写し",null,"　補助対象事業費の見積書",{"$nulls":5},"契約時の契約見積書を添付。また、対象事業費以外の項目については、手書きにて「補助対象外」と追記。",{"$nulls":12},"□"]
["任意様式4",null,"　代表提案者の登記簿等\n　事業実態の分かる書類",{"$nulls":5},"３か月以内の原本で提出すること。",{"$nulls":12},"□"]
["別添5",null,"　申請の制限に係る事業の\n　有無等に関する確認書",{"$nulls":18},"□"]
["任意様式5",null,"　共同事業実施規約",{"$nulls":5},"対象者のみ",{"$nulls":12},"□"]
["任意様式9",null,"　その他確認に必要と\n　思われるもの",{"$nulls":18},"□"]
["別添様式",null,"　提出書類のチェック表",{"$nulls":5},"提出書類に不備がないように再度チェックをお願いします。このチェック表をファイルの一番上に綴じてご提出ください。",{"$nulls":12},"□"]