Efficient Building Grant Application – PGW EnergySense

1

Primary Application Contact

Person submitting application may be the building owner's technical advisor.

Affiliation with Applicant Building Owner*

Other*

Affiliation with Applicant Building Owner

Company/Organization*

Applicant Contact Name*

First Last

Title

Email*

Enter Email Confirm Email

(Used to send status updates regarding this application)

Opt-in for PGW EnergySense updates

Yes

I'd like to learn more about PGW's EnergySense programs and offers.

Phone*

2

Business Information for Applicant Building Owner

Company/Organization*

Applicant/Building Owner Legal Name*

First Last

Applicant Title

Phone

Phone*

Email

Email*

Enter Email Confirm Email

(Used to send status updates regarding this application)

Opt-in for PGW EnergySense updates

Yes

I'd like to learn more about PGW's EnergySense programs and offers.

Nature of Business/Organization

Address

Street Address City State ZIP Code

3

Building for Efficiency Improvements

Address*

Street Address City State ZIP Code

Year Building Built*

Do you have a PGW Account for this address?*

Yes
No

PGW Account Number*

Building Type*

If Multi-family, number of units*

Building Gross sq. ft.*

Number of Floors*

Heating Fuel Source*

Additional major gas equipment currently present*

Hot Water Heater
Cooking
Process Equipment
Other

Other option for additional major gas equipment currently present*

Age of Existing Heating Equipment to be Replaced (if Applicable)

Estimated Project Installation Start Date*

Estimated Project Installation Completion Date*

Brief project description summarizing proposed energy efficiency measures

Has an energy audit or other analysis been performed to quantify the project's energy savings? If so please provide a copy of the analysis as an attachment.

Yes
No
In process

Energy Audit/Analysis attachment*

Drop files here or

At what stage are the architectural/engineering plans for the project?

4

Project Budget and Financing

Have you received contractor estimates for the planned work?

Yes
No
In process

1

Upgrade 1

Estimated Cost

Example: 200000.00

2

Upgrade 2

Estimated Cost

Example: 200000.00

3

Upgrade 3

Estimated Cost

Example: 200000.00

4

Upgrade 4

Estimated Cost

Example: 200000.00

Estimated Total

This total will add together all of the above estimated numbers, so ensure you're only using numbers in the above "Estimated Cost" fields.

5

Project Information Sharing

PGW is proud of the work done by its customers to make energy conservation a goal and, in some cases, would like to share the details about Efficient Building Grant projects for:

Press and media purposes, including but not limited to press conferences and press releases
Case studies that PGW will share through email and its website, in presentations, and on printed flyers

Check here if you do not approve of us utilizing your project information for the above purposes.

I don't approve

6

How Did You Learn About the Program?

How did you hear about PGW Grants?

Other

I agree to the Terms & Conditions.*

Yes, I understand and agree to the terms and conditions.

To read the terms & conditions click here.

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Name

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