DOE F 540.15 Better Buildings Challenge Financial Allies Website Prof

OMB Control No. 1910-5141

Exp. Date 10/31/2022

DOE F 540.15

Background: DOE will highlight Better Buildings Challenge Financial Allies with profile pages on the program website. Please complete the information below.

1. Organization Name

Please confirm how you would like your organization to be referenced on the program website and other program material.

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2. Background

Provide 2-3 sentences of background information on your organization. Suggested maximum of
100 words.

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3. Markets Served

Please describe the sectors, regions, and other markets that you serve. Suggested maximum of
200 words.

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4. Products and Services

Please describe the specific financial products and services that you offer. Suggested maximum of 100 words.

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5. Financial Commitment

Provide the total dollar value of your financial commitment.

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6. Target Market/Description of Customers

Occupancy Type: (Check applicable boxes)

☐ Owner-occupied ☐ Tenant-occupied

Sectors Served: (Check applicable boxes)

☐ Affordable Multifamily ☐ Commercial Office

☐ Data Centers ☐ Education

☐ Food Service ☐ Government

☐ Hospitality ☐ Healthcare

☐ Industrial ☐ Multifamily

☐ Non-profit ☐ Retail

Financing Structures: (Check applicable boxes)

☐ Bonds

☐ Commercial PACE

☐ ESAs & Service Agreements

☐ ESPCs

☐ Grants

☐ Leases

☐ Loans & Debt

☐ On-bill Financing/Repayment

☐ Performance Insurance

☐ PPAs

☐ Residential PACE

☐ Secondary Market Investment & Services

Types of Projects Financed: (Check applicable boxes)

☐ Efficiency Retrofits

☐ Efficient New Construction

☐ Renewables and Generation

What are the target markets and specific customer groups you serve? (Please select all that apply)

7. Learn More

Contact information for a point person. This information will be published on the U.S. DOE BBC website (including the Navigator) and will be used for any project referrals.

• Name: Click here to enter text.

• Title: Click here to enter text.

• Telephone Number: Click here to enter text.

• Email Address: Click here to enter text.

8. Logo & Photo

Provide your organization’s logo as attachments for placement on your profile page.

File type options: high resolution .eps, .png, .jpg

This data is being collected to support the Department of Energy Better Buildings Initiative. The data you supply will be used for developing best practices to facilitate reductions in energy intensity by commercial, manufacturing, and community organizations.

Public reporting burden for this collection of information is estimated to average 0.5 hours 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, Enterprise Policy Development & Implementation Office, IM-22, 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.

Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid OMB control number.

Submission of this data is voluntary.

Learn more at energy.gov/betterbuildingschallenge