Name:

Email Address:

Phone Number:

Date:

Property Address:

Year Built:

Property Type:

• Residential

• Commercial

• Industrial

• Other (please specify):

HVAC System Type:

• Central

• Split

• Packaged

• Ductless Mini-Split

• Other (please specify):

Insulation Type and

R-Value:

Windows Type:

• Single Pane

• Double Pane

• Triple Pane

• Low-E Coating

• Other (please specify):

Lighting Type:

• Incandescent

• CFL

• LED

• Other (please specify):

Appliance Efficiency:

Renewable Energy Sources:

• Solar power

• Wind power

• Hydroelectric power

• Geothermal energy

• Other (please specify):

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