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Green Power Partnership Yearly Reporting Form | |||||||||||
This Yearly Report form should be used to update the EPA on your organization's green power usage. Please complete the report, save the file, and return to your account manager or Blaine Collison at your earliest convenience. Blaine Collison's email address is [email protected]. | |||||||||||
All fields are required unless noted otherwise | |||||||||||
Contact Information | |||||||||||
Primary Contact | Public Relations Contact | ||||||||||
Contact Name | |||||||||||
Title | |||||||||||
Street Address | |||||||||||
City/State/Zip | |||||||||||
Email Address | |||||||||||
Phone Number | |||||||||||
Organizational Information | |||||||||||
Partner Name | |||||||||||
Website Link | |||||||||||
Green Power Related Web Page (e.g. environmental or sustainability page) Optional |
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Industry | |||||||||||
Organizational Electricity Use | |||||||||||
Annual Electricity Use (kWh/yr) | |||||||||||
Scope of Reported Electricity Use (select from picklist) | |||||||||||
Please Identify Reporting Facility or Group of Facilities (only if "Single Facility or Subset" is selected above) | |||||||||||
Reporting Period (Optional): The electricity and green power information contained in this report covers the following 12-month period. Partners may choose to report most recent calendar year, fiscal year, other 12-month period, or forward-looking data. | |||||||||||
Reporting Period Start Date | |||||||||||
Reporting Period End Date | |||||||||||
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Note: If the "Next Page" button does not work, please navigate through the other worksheets by clicking on the "Green Power Information" and "Partner Profile" tabs at the bottom of the screen. | |||||||||||
Chemical | |||||||||||
Clothing & Textile | |||||||||||
Constr. & Eng. Srvcs. | |||||||||||
Consulting Srvcs. | |||||||||||
Consumer Products | |||||||||||
Education (Higher) | |||||||||||
Education (K-12) | |||||||||||
Educational (Other) | |||||||||||
Energy Services | |||||||||||
Food & Beverage | |||||||||||
Govt. (Federal) | |||||||||||
Govt. (Local, Municipal) | |||||||||||
Govt. (State) | |||||||||||
Green Power Community | |||||||||||
Health Care | |||||||||||
Hotels & Lodging | |||||||||||
Industrial Goods & Srvcs. | |||||||||||
Insurance | |||||||||||
IT & Telecom | |||||||||||
Legal Services | |||||||||||
Marketing, Advtg. & PR | |||||||||||
Media & Publishing | |||||||||||
Museums, Parks & Zoos | |||||||||||
Non-profit (NGO) | |||||||||||
Other | |||||||||||
Printing & Packaging | |||||||||||
Real Estate | |||||||||||
Recreation | |||||||||||
Religious | |||||||||||
Restaurants & Cafes | |||||||||||
Retail | |||||||||||
Shipping | |||||||||||
Sports Teams & Venues | |||||||||||
Transportation | |||||||||||
Tribal Nations | |||||||||||
Wineries & Breweries |
Green Power Information | ||||||||||||||||
Select the appropriate check box(es) below: | yes | |||||||||||||||
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We are purchasing green power or renewable energy certificates (RECs) from a provider. | no | ||||||||||||||
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We are producing green power onsite. | |||||||||||||||
Please update the information below with your current green power product purchase information. If you are purchasing more than one green power product or REC product, list each purchase on a separate row. | ||||||||||||||||
Product's Resource Mix (should total 100%) | ||||||||||||||||
Green Power Provider(s) One provider per row |
Product Name Optional |
Green Power Purchase (kWh/year) | Bio- gas (%) |
Bio-mass (%) | Geo- thermal (%) |
Hydro (%) | Solar (%) | Wind (%) | Unknown (%) | Total (%) | 3rd Party Certified? | % New Renew-ables* | Contract Begin Date (mm/dd/yy) | Contract End Date (mm/dd/yy) | Is this provider also supplying your electricity? | |
0 | ||||||||||||||||
0 | ||||||||||||||||
0 | ||||||||||||||||
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Total: | 0 | * % of product from facilities placed in service after January 1, 1997. | |||||||||||||
Please update the information below with your current onsite green power production information. If you use more than one onsite generation type, list each onsite resource type on a separate row. | ||||||||||||||||
Onsite Generation Technology One onsite resource type per row |
Green Power Production (kWh/year) | Rated Capacity (kW) Optional | Year Installed Optional | Location (ZIP Code) Optional |
3rd Party Ownership? Optional | |||||||||||
Total:![]() |
0 | * EPA will only count as green power the kWh output from on-site installations for which the Green Power Partner owns the rights to the renewable energy certificates (RECs). | ||||||||||||||
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Total Green Power | 0 | |||||||||||||||
Percent Green Power | 0.00% | |||||||||||||||
Partner Profile (Optional) |
All Green Power Partners have the opportunity to have a Partner Profile on the Partnership's Web site. The Partner Profile is a short paragraph (200 word limit) that briefly describes a Partner’s organization, its decision to purchase green power, its experience to date with green power, and may include a quote about the benefits of green power to the organization. (Please be sure to include the name and title of the person the quote is attributed to.) You may revise your existing Partner Profile below. |
Current Profile for Your Organization: |
You can find your current Partner Profile Page at: |
http://www.epa.gov/greenpower/partners/index.htm |
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File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |