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Preliminary Installation Report (Excel)

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					Colorado Springs Utilities, Business Peak Demand Rebate Program: Preliminary Installation Report

Preliminary Installation Report (PIR) Checklist
Participant Profile

Fill in the shaded cells only.


                                            Project Name:                                                           Date:


Please use this checklist to ensure that your PIR is complete. Please complete and submit the paperwork in hard copy as well as in electronic format to the following
address:

                                        Colorado Springs Utilities, Business Peak Demand Rebate (BPDR), Program Manager
                                                                              2855 Mesa Rd.
                                                                    Colorado Springs, CO 80904-1174
                                                                        Rich Swope 719-668-5760
                                                                              rswope@csu.org




Please submit the following forms for each project:
      Project Information (PIR.1)
                Participant Information
          Site Information


         Project Measures (PIR.2)
                Summary of proposed demand reduction measures
                Installation Schedules


         Projected Savings (PIR.3)
                Summary of estimated energy savings
                Estimated project cost
      Please submit the appropriate forms for ALL existing and proposed equipment involved the project:
      Include standard equipment schedule forms, if applicable:
                Lighting equipment form (LE Form)
           Motor equipment schedule
                Cooling equipment schedule
      These forms may be found at:                          http://www.csu.org/business/rebates/Pages/peakdemandrebate.aspx
      For projects other than those listed above submit a worksheet consistant with your M&V plan showing pre and post retrofit kW.


         Project Measurement and Verification Plan (PIR.4)


         Signed Customer Agreement (PIR.5)




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Colorado Springs Utilities, Business Peak Demand Rebate Program: Preliminary Installation Report

Project Information
Participant Profile


              Company Name:
             Primary Contact:
               Main Address:
              Contact Phone:                                               Contact Cell:
                 Contact Fax:
              Contact E-mail:

         Optional
            Contractor Name:
          Contractor Contact:
               Main Address:
           Contractor Phone:                                            Contractor Cell:
              Contractor Fax:
           Contractor E-mail:

Installation Site Informatioon

         Site Number:                                   1                                  2                 3
         Electric Account Number(s):
         Site Contact:
         Site Street Address:
         Contact Phone:
         Contact Fax:
         Contact E-mail:
         Building Type (office, retail, etc.):
         Building Operating Schedule:
         Building Occupancy (%):
         Number of Floors:
         Building Floor Area (sq. ft.):
         Estimate Building Age in Years:
         Cooling System Description:

         Site Number:                                   4                                  5                 6
         Electric Account Number(s):
         Site Contact:
         Site Address:
         Contact Phone:
         Contact Fax:
         Contact E-mail:
         Building Type (office, retail, etc.):
         Building Operating Schedule:
         Building Occupancy (%):
         Number of Floors:
         Building Floor Area (sq. ft.):
         Estimate Building Age in Years:
         Cooling System Description:

         Site Number:                                   7                                  8                 9
         Electric Account Number(s):
         Site Contact:
         Site Address:
         Contact Phone:
         Contact Fax:
         Contact E-mail:
         Building Type (office, retail, etc.):
         Building Operating Schedule:
         Building Occupancy (%):
         Number of Floors:
         Building Floor Area (sq. ft.):
         Estimate Building Age in Years:
         Cooling System Description:




      f5c3eee6-90f1-4afb-85eb-fee82cf315f0.xlsx                                                Page 2 of 6       4/4/2012
Colorado Springs Utilities, Business Peak Demand Rebate Program: Preliminary Installation Report

Project Demand Reduction Measures Summary
Installation Schedule for Proposed Demand Reduction Measures

Please complete the table below for each measure to be installed under the project.


                                                                                      Projected installation start   Projected installation
             Site Number                         Measure (select from list)
                                                                                                 date                  completion date




Project Description
Please describe the project in summary form. Add as many additional sheets as necessary.




     f5c3eee6-90f1-4afb-85eb-fee82cf315f0.xlsx                                               Page 2 of 6                                      4/4/2012
Colorado Springs Utilities, Business Peak Demand Rebate Program: Preliminary Installation Report

Project Savings Estimates
         Project Name:



The following program rules must be considered when

    1)      The incentive for the proposed demand reduction measures is $400/kW.
    2)      The rebate may not exceed 50% of the project costs; (this includes equipment and labor).
    3)      Peak Demand Reduction is defined as the average demand savings realized during the Summer Peak Period - Monday through Friday (excluding
            federal holidays), 3 p.m. to 6 p.m., June 15 through September 15.
    4)      Existing equipment kW rating may be used to calculate the baseline energy and demand usage.
    5)      The minimum Peak Demand Reduction per project is 20 kW. Participants may submit multiple projects or combine multiple sites within a single
            project so long as the 20 kW minimum is met.

Fill in the Shaded cells only.
                                                 Estimated Energy Savings
                                                                             kW and kWh savings as determined on
  Site number (from        Proposed measures (from Project Summary            equipment and M&V Spreadsheets
Project Measures page)                      page)
                                                                               kW Saved         kWh Saved per Year




                                                             TOTALS           0.00                  0.00
Please provide calculations and spreadsheets used to estimate the demand savings. Attach separate sheets and/or
electronic files as necessary. These will include lighting, motor, HEAC equipment forms and any other M&V
spreadsheets as appropriate.


                                                    Estimated Rebate

           Estimated Project Cost                                           Estimated Rebate

                                                                                $0.00




     f5c3eee6-90f1-4afb-85eb-fee82cf315f0.xlsx                                Page 3 of 6                                                   4/4/2012
Colorado Springs Utilities, Business Peak Demand Rebate Program: Preliminary Installation Report

Measurement and Verification Plan
Please attach a measurement and verification (M&V) plan for the proposed energy efficiency measures. The M&V plan should address the
items below in the order shown. The Participant should identify an M&V methodology and develop an M&V plan that is appropriate for the
retrofits being performed at each individual site. The M&V plan will be reviewed and must be approved by Springs Utilities.


M&V Plan Contents*


  1) Project Description: Describe the project site and the project measures; include information on how each proposed measure saves
     energy and what key variables affect the realization of savings.

 2) M&V Approach: Describe the M&V approach to be used. If the program M&V guidelines outlined in the PDR Program Manual are
    followed, please describe the approach briefly. If proposing a separate methodology, please explain the approach in detail.



 3) M&V Personnel: Indicate who will conduct the M&V activities and prepare the M&V analyses and documentation.


 4) Savings Calculations: Define the details of how calculations will be made. For instance, list analysis tools, such as DOE-2 computer
    simulations, and show all equations to be used. A complete “path” should be defined indicating how collected survey and
    metering/monitoring data will be used to calculate savings.

  5) Metering Specifications: Specify what metering equipment will be used, who will provide the equipment, and its accuracy and
     calibration procedures. Include a metering schedule describing metering duration and when it will occur, and how data from the
     metering will be reported, including data formats. Electronic, formatted data read directly from a meter or data logger is recommended
     for any short- or long-term metering.



  6) Key Assumptions: Define what key assumptions will be made about significant variables or unknowns. Describe any stipulations
     that will be made and the source of data for the stipulations.

  7) Baseline Adjustments: Define how any baseline adjustments will be made.
  8) Sampling: Describe any sampling that will be used, why it is included, sample sizes, how sample sizes were selected, and
     information on how random sample points will be selected.

  9) Quality Assurance: Indicate how quality assurance will be maintained and replication confirmed. For instance: “The data being
     collected will be checked every month,” or “to ensure sufficient accuracy, results will be subjected to third-party review by the ABC
     company.”


* The list above is adapted from the 1997 International Performance Measurement & Verification Protocol.




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Colorado Springs Utilities, Business Peak Demand Rebate Program: Preliminary Installation Report

Host Customer Agreement
A Host Customer Agreement must be completed and signed even in the event that the Participant and the Customer are one in the same.

By signing this document, you, the Customer, acknowledge that Colorado Springs Utilities has discussed with you or others within your organization the
implementation of demand side management (DSM) measures within your facility or facilities. Your signature also indicates that if your business is
successful in obtaining financial incentives from Springs Utilities:


         1) Your company intends to move forward with the installation of these measures by estimated Date of Completetion:


         2) You have the necessary authorization within your firm to approve the installation of these measures.

         3) You agree to allow Colorado Springs Utilities to verify the demand savings achieved as a result of the installed measures by providing
            reasonable access during normal business hours to inspect the DSM measures and associated records for a period of up to two years following
            completion of the project. Colorado Springs Utilities's review or inspection of any DSM measures will not constitute any representation as to
            the technical or economic quality of the DSM measures. Colorado Springs Utilities, its officers, employees, and contractors will not be liable
            for the performance of these measures. Colorado Springs Utilities will not release any propriety information about your business without
            your permission.

If you have any questions, please contact Colorado Springs Utilities BPDR Program Manager at (719) 668-5760.


Company Name & Company Representative (printed):


Company Representative Signature:                                                                                      Date:


Title:


Company Address:




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