5900-18 ENERGY STAR - Service and Product Provider Company Profi

OMB Control No. 2060-0347

Service and Product Provider Company Profile

Date:

Company Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Web Address:
States in which your organization has offices:
Contact Name:
Contact Phone:
Contact Fax:
Contact Email:

Please include:

1. An unbiased 3-5 sentence description of your company:

2. A description of the markets your company services, i.e. commercial, institutional, residential, industrial, or small businesses (organizations with 100,000 total square feet or less of space). Also state whether or not your company actively sells or promotes products or services to customers located in the United States.

3. If your company services the commercial market, please identify the sector(s) that the organization services: (Check all that apply)

Please type an ‘X’ where it applies

X		X
	Commercial Real Estate		Industry
	Corporate Real Estate (Banks, Financial, Transportation, Consulting, Telecommunications, & Other Services)		K-12 Education
	Federal Government		Local Government
	Healthcare (Hospital, Medical Office Building)		Retail (Apparel, Big Box, Convenience Stores, Department Stores, Discount Stores-Warehouse Clubs, Drug Stores, Home Centers, Restaurants, and Supermarkets.)
	Higher Education		Small Business (clients whose facilities comprise less than 100,000 square feet)
	Hospitality and Entertainment (Hotels, Lodging, Resorts, Casinos, Stadiums, Theaters, TV Stations, Museums & Convention Centers)		State Government

3. Identify your organization type and the products and/or services offered by your organization.

Primary Organization Type: (Check all that apply)

Please type an ‘X’ where it applies

X		X
	Architecture or A/E Firm (Buildings)		Energy Service Companies (ESCO)
	Banking and Financial		Engineering
	Contractor		Equipment Manufacturer
	Distributor		Unregulated Energy Retailer and Marketer
	Energy Management Services / Consultant

Types of Products: (Check all that apply)

Please type an ‘X’ where it applies

X		X
	Building Envelope		Heating and Cooling Equipment
	Commercial Appliances		HVAC Distribution / Air Handling
	Compressed Air Systems / Components		HVAC Maintenance & Replacement Components
	Electrical Power / Controls / Distribution		Indoor Air Quality Technologies
	Energy HVAC Controls / Automation Systems		Industrial Process Equipment
	Energy Management Systems		Lighting
	ENERGY STAR Qualified Products		Motors and Motor Drives
	Energy Systems / Thermal Storage / CHP / Fuel Cells		Piping / Duct Insulation
	Energy Tracking and Monitoring Software		Pumps
	Geothermal Heat Pumps		Solar / Photovoltaics
	Heat Exchangers / Cooling Towers		Steam / Distribution / Components

Types of Services: (Check all that apply)

Please type an ‘X’ where it applies

X		X
	Architecture Building Design and Specification		Equipment Installation / Maintenance
	Automated ENERGY STAR Performance Ratings (Benchmarking)		Financing for Energy Efficiency Upgrades
	Commissioning & Tuning		Hazardous Materials Monitoring / Handling
	ENERGY STAR Performance Ratings (Benchmarking)		Indoor Air Quality (IAQ) Analysis
	ENERGY STAR Professional Engineer Verifications for Labeled Buildings		Industrial Production Management
	Energy Auditing		Measurement & Verification
	Energy Information Management Service		Performance Contracting
	Energy Operations & Management		Project / Construction Management
	Energy Procurement		Removal / Recycling / Disposal
	Energy Simulation		Training and Seminars
	Engineering Design & Specification		Trial / Pilot Installations
	Environmental Quality

3. In a separate file, an electronic version of your company’s logo in a standard graphic format (gif, jpeg).

The government estimates the average time needed to fill out this form is 30 minutes and welcomes suggestions for reducing this level of effort. Send comments (referencing OMB control number) to the Director, Collection Strategies Division, U.S., EPA (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460.

EPA Form 5900-18

Page 3 of 3