ATTACHMENT C-3
BE SMART BUSINESS CONTRACTOR REPORTING RESPONSIBILITIES
BE SMART BUSINESS RESPONSE
How did you hear about our program?
GENERAL BUILDING DATA
Customer name:
Customer address:
Zip Code
Building type (drop down)
Copy of permits
Post rights & remedies
Square footage of building's floor space:
Electric Utility Name:
Natural Gas Utility Name:
Primary energy fuel; (drop down)
COMPLETED BUILDING AUDITS
Contractor provides copy of audit to Be SMART staff.
Date of audit completion:
Audit software/Type (drop down)
Total job hours
Total invoiced audit cost
Estimated electricity saved per year (kWh):
Estimated % savings of kWh per year:
Estimated natural gas savings per year (therms)
Estimated % savings natural gas per year:
IF OTHER FUELS ARE APPLICABLE…INDICATE FUEL: Units for the
energy fuel indicated above:
Expected annual energy savings per year (in units above)
Estimated % savings (in units above) per year:
RETROFIT INFORMATION
Contractor certification 1 (drop down)
Contractor certification 2 (drop down)
Contractor certification 3 (drop down)
Total Retrofit Job Hours
Total Retrofit Invoiced Cost
CHARACTERISTICS OF THE RETROFIT/RENOVATIONS
Did retrofit include an addition:
Did retrofit include an annex:
Did improvements result in a reduction in floor space:
Was an exterior wall or roof replaced:
Was a HVAC upgrade included:
If so, how many heat exchanger replacements were made:
Indicate if any windows were replaced:
Indicate if ceiling insulation was upgraded:
Indicate if wall insulation was upgraded;
Indicate if floor insulation was upgraded:
Be SMART Business Contractor Reporting Responsibilities
ATTACHMENT C-3
ATTACHMENT C-3
BE SMART BUSINESS CONTRACTOR REPORTING RESPONSIBILITIES
OFFICE EQUIPMENT
Note if any office equipment was added, such as; servers, monitors or
computers:
INSTALLED MEASURES/NEW EQUIPMENT
HEATING EQUIPMENT
Furnace (# installed)
Boiler (# installed)
Packaged units (# installed)
Other (Type, efficiency, and model #)
COOLING EQUIPMENT
Packaged terminal air conditioners (# installed):
Packaged units (# installed)
Residential - type central air conditioners (# installed)
Central chillers (# installed)
Other cooling equipment
WATER HEATING EQUIPMENT
Electric water heaters (# installed)
Gas water heaters (# installed)
Solar water heater (# installed)
Other water heating equipment
LIGHTING
T8s (# installed)
T5s (# installed)
LEDs (# installed)
CFLs (# installed)
Lighting controls
Other lighting equipment
COOKING PRODUCTS/LAUNDRY
Ovens ( # installed)
Fryers (# installed)
Steamers (# installed)
Griddles (# installed)
Broilers (# installed)
Dishwashers (# installed)
Clothes washer (# installed)
Clothes dryer (# installed)
Other cooking products/laundry equipment
REFRIGERATION EQUIPMENT
Walk-ins (# installed)
Refrigerated food service equipment (# installed)
Food-grade refrigerators and freezers (# installed)
Other refrigeration equipment
INSTALLED MEASURES/MODELED OR ESTIMATED ENERGY SAVINGS
Source of method of prediction (drop down)
Expected Kwh saved per year for installed measures:
Be SMART Business Contractor Reporting Responsibilities
ATTACHMENT C-3
ATTACHMENT C-3
BE SMART BUSINESS CONTRACTOR REPORTING RESPONSIBILITIES
Expected % savings Kwh for installed measures per year
Expected therms saved per year for installed measures:
Expected % natural gas for installed measures:
OTHER FUELS ARE APPLICABLE:
Units in the energy fuel indicated above:
Expected energy saved per year for installed measures (in units
above):
Estimated % savings (in units above for installed measures per year:
Estimated annual cost savings:
RENEWABLE ENERGY SYSTEMS INSTALLED
Type of renewable installation: (drop down)
Units: (drop down)
Nameplate system capacity:
Total renewable system job hours:
Total renewable energy system invoice cost:
UTILITY ACCOUNT PERMISSIONS
Gas utility account and permission:
Electric utility account permission:
Other fuel suppliers for fuel oil, LPF, etc.:
DAVIS-BACON WAGE RATE COMPLIANCE
Form WH-347 must be completed for individual workers on a weekly
basis at a specific job site.
Print name
Signature Date
Be SMART Business Contractor Reporting Responsibilities
ATTACHMENT C-3
Owner-Occupied Single Family Site Built
Single-Family Rental Site Built
Owner-Occupied Mobile Home
Renter-Occupied Mobile Home