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Form | Contact Information - Program for Non-Affected Residents

Built Environment Resilience and Adaptation Program – Personalized Support Service

A) Applicant Identification

1. Applicant’s name

2. Mailing address

3. Telephone

4. Email

B) Applicable Situations (Please check and complete)

Yes

Date:

If water damage occured during the torrential rain events of August 9, 2024, and/or July 13, 2025, a different program may apply. Please consult the Inspection and Subsidy Program for Affected Residents for further details.

C) Services Requested

A. Personalized Work Plan (Fee: $540)
The basic package includes an analysis of the questionnaire, a diagnostic assessment, and the delivery of a personalized work plan via email, including a virtual or telephone appointment with the consultant.

B. Virtual or Telephone Appointment (Fee: $360 per appointment)

A virtual or telephone appointment with the consultant to review the bids received in accordance with the personalized work plan.

Written communication summarizing the recommendations to help facilitate the selection of contractors.

D) Applicant Declaration

I declare that the information provided in this form is, to the best of my knowledge, complete and accurate.

I acknowledge that I have read and understood the services offered and the applicable fees.

I understand that fees will be charged and that services will be provided upon receipt of payment.

E) Signature

Signature

By submitting this application, I expressly acknowledge that the City of Dorval, its employees, and its representatives shall not be held liable in any way for the content of the documents that will be provided, nor for the recommendations that may be issued by the authorized agent retained by the City within the context of the Inspection and Subsidy Programs. I further assume full responsibility for any work that I choose to have carried out by the contractor of my choice. I also acknowledge having read and understood the eligibility requirements of the Programs and agree to accept any sanctions that may be imposed in connection with any potential non-compliance. Finally, I acknowledge that the purpose of the proposed work is to improve the resilience of the building identified above and that, notwithstanding the implementation of such measures, a new disaster may nevertheless occur.

Date

Important Notice: Only one application per person is permitted. Multiple applications submitted by the same individual may not be processed.

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