DOE F 540.9 E&I Form - QPR

DOE F 540.9 OMB Control No. 1910-5157

Expiration Date: xx/xx/2023

U.S. Department of Energy

WEATHERIZATION ASSISTANCE PROGRAM ENHANCEMENT AND INNOVATION (E&I)

QUARTERLY PROGRAM REPORT

Grantee: _______________ Budget period: / / - / / Grant Number:________________

I. GRANT OUTLAYS - FUNDS SUBJECT TO DOE PROGRAM RULES (rounded to the nearest dollar)

Reporting Period Quarter	/ - /	/ - /	/ - /	/ - /	Total To Date
	Q1	Q2	Q3	Q4
A. OUTLAYS BY FUND SOURCE
DOE
Other funds included in grant budget, section A
Total Grant Outlays
B. OUTLAYS BY FUNCTION
Administration
Health and Safety
Training and Technical Assistance
Program Operations
Liability Insurance
Financial Audits
Vehicles and Equipment
Total Grant Outlays
C. OUTLAYS IN UNDERSERVED COMMUNITIES
Total DOE funds
Job training funds
Other funds included in grant budget, section A
Total Grant Outlays

Notes: Total grant outlays must equal outlays reported on the Federal Financial Report, line 10.e.

U.S. Department of Energy

WEATHERIZATION ASSISTANCE PROGRAM ENHANCEMENT AND INNOVATION (E&I)

QUARTERLY PROGRAM REPORT

Grantee: _______________________ Budget period: / / - / / Grant Number:________________

II. GRANT PRODUCTION

Quarter	Q1	Q2	Q3	Q4	Total to Date
A. TOTAL E&I UNITS (includes other funds if included in DOE budget) – Planned ##
UNITS IN UNDERSERVED COMMUNITIES – Planned ##
UNITS BY LEVEL OF HOUSESHOLD INCOME
Up to 50%
51 – 100%
101 – 150%
151 – 200%
3. UNITS BY TYPE
Owner-Occupied Single Family
Renter-Occupied Single Family
Owner-Occupied 2-4 units per site
Renter Occupied 2-4 units per site
Multifamily, 5 or more units per site
Owner-Occupied Manufactured Home
Renter-Occupied Manufactured Home
Shelter
4. UNITS BY PRIMARY HEATING FUEL**
Natural Gas
Fuel Oil
Electricity
Propane/LPG
Kerosene
Wood
Other Fuel
No Heating System
5. UNITS BY OCCUPANCY
Elderly-Occupied
Disabled-Occupied
Native American-Occupied
Children-Occupied
High Residential Energy User
Household with a High Energy Burden
B. LEVERAGED UNITS (units completed with other funds not included in DOE budget)
C. TOTAL PEOPLE ASSISTED WITH GRANT FUNDS (all funds in approved budget)
Elderly
Persons with Disabilities
Native Americans
Children

** “Primary Heating Fuel” is the fuel that provides the most space heat and/or cooling in the home.

III. E&I METRICS

Quarter	Q1	Q2	Q3	Q4	Total to Date
Client Education (total hours)
Number of Minority Serving Institutions, Minority Business Enterprises, Minority Owned Businesses, Woman Owned Businesses, Veteran Owned Businesses Contracting with Grantee
WEATHERIZATION-READINESS
Number of units rehabilitated to be weatherization-ready – Planned ##
Owner-Occupied Single Family
Renter-Occupied Single Family
Owner-Occupied 2-4 units per site
Renter Occupied 2-4 units per site
Multifamily, 5 or more units per building
Owner-Occupied Manufactured Home
Renter-Occupied Manufactured Home
Shelter
Deferral Reason (# of Units)
Roof Repair or Replacement
Electrical Repair
Plumbing Repair
Remediation of Environmental Hazard
Other
Number of units made electrification-ready
Owner-Occupied Single Family
Renter-Occupied Single Family
Owner-Occupied 2-4 units per site
Renter Occupied 2-4 units per site
Multifamily, 5 or more units per building
Owner-Occupied Manufactured Home
Renter-Occupied Manufactured Home
Shelter
ENHANCE INDOOR ENVIRONMENTS
Health and Safety Measures Installed (# of units)
Mold and Moisture Remediation
Suspected Asbestos Testing and Treatment
Address Occupant Health Conditions
Lead Paint Testing and Remediation
Accessibility Improvements
Other
WORKFORCE DEVELOPMENT
Total number of Full Time Equivalent (FTE) workers hired – Planned ##
Total number of FTE workers retained – Planned ##
Number of FTE workers hired by demographic
Minorities
Women
Veterans
Persons with Disabilities
Socioeconomically Disadvantaged
Number of FTE workers trained or certified by demographic
Minorities
Women
Veterans
Persons with Disabilities
Socioeconomically Disadvantaged
Number of FTE workers retained by demographic
Minorities
Women
Veterans
Persons with Disabilities
Socioeconomically Disadvantaged
RENEWABLE ENERGY & NEW TECHNOLOGY
Technologies Installed (# of units)
Solar Photovoltaic
Solar Water Heater
On-demand Water Heater
Heat Pump Water Heater
Air or Ground Source Heat Pump (heating and cooling)
Home Energy Management System
Smart Devices
Other
Clean Energy - Total Installed Capacity (Kw)
Clean Energy – Total Installed Capacity in Underserved Communities (Kw)
ENERGY BURDEN
Total Annual Household Energy Expenditures (in dollars)
Total Annual Household Energy Expenditures in Underserved Communities (in dollars)

IV. COMMENTS

Submitted by_________________________________________________________________ Date_____________

Type name___________________________________________________________________

Title ___________________________________________________________________

OMB Burden Disclosure Statement

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U.S. Department of Energy

WEATHERIZATION ASSISTANCE PROGRAM ENHANCEMENT AND INNOVATION (E&I)

QUARTERLY PROGRAM REPORT

INSTRUCTIONS

The Quarterly Program Report format is designed to gather production and expenditure data. This report is to be submitted quarterly to the applicable Department of Energy 30 days after the end of the reporting period.

1. GRANT OUTLAYS - FUNDS SUBJECT TO DOE E&I PROGRAM RULES

   1. By fund source: Outlays this quarter and program year to date for

      1. DOE funds

      2. All other funds listed in the grant budget, Section A, including federal, state, local, and private funds that are part of the approved DOE grant budget.

   2. By function: Outlays this quarter and program year to date for each function in the DOE grant budget, section B. Total must equal total in A.2 above.

   3. In underserved communities: Outlays in underserved communities this quarter and program year to date for

      1. Total DOE funds

      2. T&TA funds

      3. All other funds listed in the grant budget, Section A, including federal, state, local, and private funds that are part of the approved DOE grant budget.

2. GRANT PRODUCTION

Enter figures only for the quarter being reported except to correct previous quarter information.

1. E&I units completed this quarter with all funds included in the approved DOE grant budget, all sources.

   1. Units in underserved communities: Total number of units completed this quarter in underserved communities. The sum should be less than or equal to the total units completed with funds in the approved DOE budget.

   2. Units by level of household income: Number of completed units this quarter by level specified. The sum should equal total units completed with funds in the approved DOE budget.

   3. Units by type: Number completed this quarter by type specified. The sum should equal total units completed with funds in the approved DOE budget. A completed unit in a building containing five or more units should be reported as a Multi-Family unit. A completed unit in a building containing four units or less should be reported under one of the two Single-Family categories.

   4. Units by primary heating fuel: Number of units completed by category of primary heating fuel. Primary heating fuel is the fuel that provides the most space heat in the home.

   5. Units by occupant: Number of units completed by category of occupant. The sum will not equal total units completed.

2. Persons assisted with funds included in the DOE grant budget, all sources: Total and by category. Sum of persons by category will not equal total persons assisted.

3. Leveraged units completed with other funds not included in the DOE budget, provided any part of the definition of an E&I unit has been met.

3. E&I METRICS

   1. Client Education: Total hours provided this quarter.

   2. Number of MBEs and Minority, Women or Veteran-Owned Businesses: Number of new contracts executed by Grantee this quarter, and year to date.

   3. Weatherization-Readiness: E&I Metrics for Grantees with awards to make homes weatherization-ready. This is a heading, no data reported in this row.

      1. Number of units rehabilitated: Number of units rehabilitated to be weatherization-ready by unit type specified. The sum should be equal to or less than total units completed with funds in the approved DOE budget. A completed unit in a building containing five or more units should be reported as a Multi-Family unit. A completed unit in a building containing four units or less should be reported under one of the two Single-Family categories.

      2. Deferral Reason: Number of units completed this quarter by reason specified. The sum may be higher than the total units completed with funds in the approved DOE budget, if units have multiple deferral reasons.

      3. Number of units made electrification-ready: Number of units rehabilitated to be electrification-ready by unit type specified. The sum be equal to or less than total units completed with funds in the approved DOE budget. A completed unit in a building containing five or more units should be reported as a Multi-Family unit. A completed unit in a building containing four units or less should be reported under one of the two Single-Family categories.

   4. Enhancing Indoor Environments: E&I Metrics for Grantees with awards to enhance indoor environments. This is a heading, no data reported in this row.

      1. Health and Safety Measures Installed: Number of units completed this quarter by the specified measure category. Units may receive multiple measures so the sum may be higher than the total units completed with funds in the approved DOE budget.

E. Workforce development: E&I Metrics for Grantees with awards to hire, train and retain weatherization workers. This is a heading, no data reported in this row.

1. Total number of FTE workers hired: Sum of FTE workers hired this quarter.

2. T&TA outlays in underserved communities: Total T&TA funds expended this quarter that benefited workers located or working in underserved communities. Sum must not exceed T&TA outlays reported in I. GRANT OUTLAYS B. Training and Technical Assistance above.

3. Total number of FTE workers retained: Sum of FTE workers reported as hired under this E&I grant award and retained this quarter.

4. Number of workers hired by demographic: Number of Full Time Equivalent (FTE) workers hired this quarter by the categories specified. Workers may be counted in multiple categories and sum may exceed total workers hired. This is a heading, no data reported in this row.

5. Number of workers trained by demographic: Number of FTE workers that completed a training and/or earned a certification this quarter by the categories specified. Workers may be counted in multiple categories and sum may exceed total workers hired. This is a heading, no data reported in this row.

6. Number of workers retained by demographic: Number of FTE workers reported as hired under this E&I award and retained this quarter by the categories specified. Workers may be counted in multiple categories and sum may exceed total workers retained. This is a heading, no data reported in this row.

F. Renewable Energy and New Technology: E&I Metrics for Grantees with awards to install renewable energy and new technologies. This is a heading, no data reported in this row.

1. Technologies installed: Number of units receiving renewable energy and new technologies, by technologies specified. The sum may be higher than the total units completed with funds in the approved DOE budget, if units receive multiple technologies.

2. Clean Energy – Total Installed Capacity: Report the total installed capacity for jobs reported as complete this quarter, in kilowatts.

3. Clean Energy – Total Installed Capacity in Underserved Communities: Report the total installed capacity for jobs reported as complete this quarter in underserved communities, in kilowatts.

G. Energy Burden: E&I Metrics for Grantees with awards to install measures in eligible households. This is a heading, no data reported in this row.

1. Total Annual Household Energy Expenditures: For units completed this quarter, report the sum of each household’s annual energy use expenses (in dollars) prior to installation of any E&I measures.

2. Total Annual Household Energy Expenditures: For units completed in underserved communities this quarter, report the sum of each household’s annual energy use expenses (in dollars) prior to installation of any E&I measures.

4. COMMENTS

Include here any additional information needed to clarify grant outlays and production reported this quarter.

Submitted by: Signature of the person submitting the report.

Date signed.

Typed name and title of the submitter.

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