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OMB 1910-5141
Expiration date: TBD |
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| Better Buildings Challenge: Financial Ally Reporting |
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| Periodic Update |
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| Portfolio Investment Products |
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| Background: DOE will provide semi‐annual updates on the success of Better Buildings Challenge Financial Allies to fund energy efficiency projects. Please complete a separate copy of this form for each project that has closed since your last semi‐annual submission. The information provided will be published on the program website. |
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| Ally Organization |
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| Reporting Period Start Date |
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| Reporting Period End Date |
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| Product Designation |
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| Form Submission Date |
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| Investment / Project Aspects |
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Using the dropdown menu, select from the CBECS Building Use categories. For multi-use buildings, select the dominant use. |
Per building, total will be generated from # of buildings * sq ft |
Calculation = Number of Buildings * Square Feet per Building |
Financial Aspects |
Estimated or typical, aggregated |
Estimated or typical, aggregated |
Estimated or typical, aggregated |
Estimated or typical, aggregated |
Total Project Cost should be the sum of the above cells |
Projected Annual Energy Savings |
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Energy Conservation Measures |
Identify the measures implemented in the building(s) to improve efficiency and reduce overall energy consumption, to the degree possible. |
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| Specific Investment / Project Identifier (replace placeholder below) |
Number of States in which Funds will be Invested |
Please attempt to describe where the funds are to be invested. If the funds are to be invested across more than 5 states, please add lines as needed. |
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State |
Number of Buildings (estimate if unknown) |
Approximate percentage of funds by State |
Building Owner (if identifiable) |
Primary Use |
Square Feet per Building |
Total Square Feet, All Buildings |
Funds Invested through Financial Ally |
Building Owner Capital Employed |
Incentives / Subsidies Captured |
Other Sources of Financing |
Description of Other Sources of Funding |
Total Project Cost |
Dollars |
kWh |
Heating, Ventilation, Air-Conditioning (HVAC) |
Building Envelope (including windows, doors, roof, insulation, etc.) |
Controls (including energy management control systems, sensor, etc.) |
Lighting |
Active Building Management (including software services, continuous commissioning, equipment maintenance, operator training, occupant education, etc.) |
Other measures |
| Investment 1 |
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State 1 |
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0 |
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$- |
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State 2 |
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0 |
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$- |
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State 3 |
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0 |
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$- |
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State 4 |
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0 |
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$- |
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State 5 |
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0 |
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$- |
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| Investment 2 |
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State 1 |
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0 |
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$- |
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State 2 |
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0 |
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$- |
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State 3 |
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0 |
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$- |
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State 4 |
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0 |
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$- |
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State 5 |
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0 |
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$- |
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| Investment 3 |
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State 1 |
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0 |
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$- |
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State 2 |
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0 |
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$- |
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State 3 |
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0 |
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$- |
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State 4 |
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0 |
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$- |
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State 5 |
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0 |
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$- |
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Public reporting burden for this collection of information is estimated to average 25 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Office of the Chief Information Officer, Records Management Division, IM-23, Paperwork Reduction Project (1910-5141), U.S. Department of Energy, 1000 Independence Ave SW, Washington, DC, 20585-1290; and to the Office of Management and Budget (OMB), OIRA, Paperwork Reduction Project (1910-5141), Washington, DC 20503.
In furtherance of the objectives of the Better Buildings Challenge, the Department of Energy (DOE) intends to publicly post information submitted in response to this template on the Better Buildings Challenge website. Information submitted to DOE will be handled in accordance with all applicable federal laws, rules, or regulations, including but not limited to the Trade Secrets Act, 18 U.S.C. §1905, and the Freedom of Information Act (FOIA), 5 U.S.C. §552, and DOE's implementing regulations at 10 CFR 1004. Participation in the Better Buildings Challenge is voluntary. Do not include any personal or confidential commercial and financial information in response to this template. Commercial and financial information is considered to be confidential when its release would be likely either to harm the submitterís commercial interests or to affect the agencyís ability to obtain information in the future. This statement serves as your written notice that DOE intends to publicly post this information. By submitting information in response to this template, you are certifying that this information does not contain confidential commercial or financial information.
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