Name     
E-mail   
Tel      
FAX       
FLOOR AREA (FT2)   
ASPECT RATIO (E-W WIDTH / N-S WIDTH)      
NUMBER OF STORIES       
BUILDING AZUMUTH (DEGREES)        

UTILITY RATES  

ELECTRICITY     

ENERGY COST PER KWH      
DEMAND COST PER KW       
MINIMUM DEMAND COST PER KW   
FIXED COST PER MONTH      
MINIMUM COST PER MONTH       
MAXIMUM EFFECTIVE RATE PER KWH        

NATURAL GAS     

ENERGY COST PER THERM      
FIXED COST PER MONTH       
MINIMUM COST PER MONTH   
MAXIMUM EFFECTIVE RATE PER THERM           

OCCUPANT DENSITY
NUMBER OF OFFICES   
     

LIGHTING     

INDOOR OCCUPANCY SENSORS(checkmark for YES)   
     

INDOOR LIGHTING (W/FT2)     
OFFFICES  

OUTDOOR LIGHTING          

TYPE     

MERCURY VAPOR      

HIGH PRESSURE SODIUM LAMPS      

METAL HALIDE LAMPS      

ELECTRICAL EQUIPMENT

OFFICES  

THERMOSAT SETTING (F)

HEATING SETBACK      
COOLING SETBACK       
HEATING OFFICES   
COOLING OFFICES     

ENVELOPE

C

CEILING/ROOF INSULATION (R-VAL)       
ROOF ABSORPTANCE   

AIR CURTAIN ENTRANCE 

ADJACENT SHADING YES/NO (CHOOSE IF APPLICABLE)

NORTH  EAST SOUTH  WEST  

WINDOW AREA (FT2)
NORTH      
EAST       
SOUTH   
WEST      

WINDOW SETBACK
NORTH      
EAST       
SOUTH   
WEST      

WINDOW SHADING
NORTH      
EAST       
SOUTH   
WEST      

WINDOW GLASS TYPE
NORTH      
EAST       
SOUTH   
WEST      

EQUIPMENT
EFFICIENT OFFICE COPIERS  

DHW HEATER TYPE-CHOOSE ONE
    GAS 
    ELECTRIC 
    POINT OF USE 
    HEAT PUMP 

DHW HEATER EFFICIENCY =DEFAULT=.8  

DHW TANK INSULATION 
  
DHW PIPE INSULLATION 
     
DHW CIRCULATION PUMP TIMECLOCK 
    

AIR DISTRIBUTION

AIR HANDLER TYPE
   CONSTANT VOLUME REHEAT 
   VARIABLE AIR VOLUME 
   POWERED INDUCITON UNITS 

VENTILATION RATE   

OVERSIZED COILS 
 
DUCT INSULATION 
   
AIR SIDE ECONOMIZER 

   

HVAC CONTROL
HVAC SYSTEM CLOCKS 
  
ENERGY MANAGEMENT SYSTEM 
   
DEADBAND THERMOSTATS 
    

CENTRAL PLANT

HEATING PLANT 
   GAS BOILERS 
   NONE 
   ELECTRIC BOILERS 

COOLING PLANT
CHOOSE ONE:
   CENTRIFUGAL CHILLERS 
   RECIPROCATIONG CHILLERS 
   VARIABLE SPEED DRIVE CHILLERS 
   DOUBLE-BUNDLE CHILLERS 
   GAS ABSORPTION CHILLERS 

COOLING TOWER
   NONE 
   CENTRIFUGAL FANS 
   PROPELLER FANS 
   TWO SPEED PROPELLER FANS 
   VARIABLE SPEED PROPELLER FANS 

HEATING PLANT EFFICIENCY (DEFAULT .75) 
COOLING PLANT EFFICLIENCY (DEFAULT 4.5)   

HOT WATER RESET 
  
CHILLED WATER RESET 
   
VSD HOT WATER PUMPS 
   
VSD CHILLED WATER PUMPS 
 
FLUE HEAT RETRIEVER 

INFRARED SPACE HEATERS 
 
CHILLER STRAINER CYCLE 

CHILLER OPTIMIZER 

THERMAL ENERGY STORAGE 

INDIRECT EVAPORATIVE PRE-COOLING