Retro-Commissioning Technical Services Interest Form
Required fields are marked with a
Customer Information
Organization Name:
Parent Company:
Type of Business:
Primary Contact Information
Name:
Title:
Phone:
Email:
Contact Address:
City:
State:
Zip:
Site Information
Facility Name:
Facility Address:
City:
State:
Zip:
Site Contact Information
Name:
Title:
Phone:
Email:
Contact Address:
City:
State:
Zip:
Evaluation Information
What payback criteria must be met to secure capital funding for energy projects?
Please provide a high-level description of facility systems (detailed information can be itemized below).
Please provide a high-level description of the manufacturing process (if applicable). If available, please include benchmarking / production data.
Please describe any areas or systems that you are particularly interested in investigating.
Please describe any energy-saving project opportunities that have already been identified and/or are currently being considered.
Does your facility have executive support to pursue energy-saving opportunities and staff to promote and implement energy saving initiatives?
Select
Yes
No
Does your facility have a building automation system (BAS) or program logic controller (PLC)?
Select
Yes
No
If yes, does your facility have a controls / maintenance contractor?
Select
Yes
No
N/A
Supporting Information
Additional, supporting information that can be provided will streamline program participation and maximize benefits. Please upload supporting documentation such as:
BAS screenshots of relevant systems
Controls drawings and sequences of operation for systems
Test and balance reports
Drawings of relevant systems - equipment schedules, floor plans, diagrams, etc
Previous energy assessments and studies.
Iowa Sales Tax Exemption sheet that includes an equipment schedule
Drag files here...
or...
Release files to upload here...
Facility Information - General
Facility Type
Year Constructed
Number of Occupants
Facility Size (gross area in sq. ft.)
Percent Area Heated
Percent Area Cooled
Percentage of area designated as Office Space:
Percent Area Heated:
Percent Area Cooled:
Percentage of area designated as Manufacturing Space:
Percent Area Heated:
Percent Area Cooled:
Percentage of area designated as Warehouse Space:
Percent Area Heated:
Percent Area Cooled:
Percentage of area designated as Other Space:
Percent Area Heated:
Percent Area Cooled:
Facility Information - Operating Schedule
Example Space Type:
Office
Example Space Schedule:
Mon.-Fri. 6 a.m. to 6 p.m., Sat. 8 a.m. to noon
Space Type:
Space Schedule:
Space Type:
Space Schedule:
Space Type:
Space Schedule:
Space Type:
Space Schedule:
Space Type:
Space Schedule:
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