5900-377 Final Energy Questionnaire

ENERGY STAR^® National Building Competition Final Report Questionnaire – Energy Savings

OMB Control No. 2060-0347

Congratulations on being identified as a potential top finisher in EPA’s 2014 ENERGY STAR National Building Competition! EPA is compiling a report to highlight the energy- and water-saving strategies of buildings that most successfully worked off their waste. EPA will distribute this report during the winner announcement, and also refer media and others to it throughout the year for real-world examples of energy and water efficiency in action. Examples of past “wrap up” reports are available at https://www.energystar.gov/buildings/learn-past-winners

Please send your completed questionnaire and a high-resolution photo of your building or team to [email protected] by Friday, April 17, 2015.

1. Please provide the following information so that it can be included in the wrap up report.

   1. Building Name:

   2. City, State, Zip Code:

   3. Contact Name:

   4. Contact Email Address:

   5. Contact Phone #:

2. What’s the best advice you would give to someone starting an energy management program?

(50 word maximum)

3. Describe the project that saved the most energy for your building during the competition period.

(200 word maximum)

4. Briefly describe your other efforts to save energy that resulted in your impressive savings.

(200 word maximum)

5. Please attach a high resolution (min 300 dpi) photo of one of the following subjects with your response email. (You may submit multiple photos, but only one will be used in the report.)

   1. Your building

   2. Your energy team

   3. Example communications promoting your participation in the competition (e.g., banners, posters, signs)

The public reporting and recordkeeping burden for this collection of information is estimated to average 30 minutes per response. Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.

EPA Form No. 5900-377