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Energy Savings <br />Calculated Baseline Installed Energy Incentive Energy <br />Solution # Usage (kWh) Usage (kWh) Savings (kWh) Rate ($IkWh) Incentive ($) <br />1 <br />2 <br />3 <br />4 <br />5 <br />Calculated Baseline Installed On -Peak Peak Demand <br />Solution On -Peak On -Peak Demand Reduction <br /># from above Demand (f(W) Demand (KW) Reduction (KNO Incentive ($) <br />Total Project Cost ($) <br />Calculated Energy Savings Totals <br />Calculated Savings Incentives <br />On -Peak Demand Reduction <br />1 1 1 1 SA# 3-010-7153-96 <br />2 UPN # 353-16-0500831244 <br />3 <br />4 NOTE: For projects requiring M&V, attach any required <br />5 baseline or post -installation measurements and analysis, as <br />Check appropriate boxes: <br />No changes to the proposed solutions have been made since the Project Application Review and Approval and the Authorized agent verifies <br />that the Application approved savings calculations are correct. <br />O <br />Due to changes to the proposed measures, appropriate adjustments in the savings calculations have been made. <br />For measures with changes made during installation, use this section, and Sections 5 & 6 on page 2, to calculate the revised installed energy usage, <br />O energy savings, peak demand reduction, and incentives. Attach the appropriate calculation backup: the output from the Estimation Software, <br />Calculate Energy Savings Total or the calculation sheets that document the engineering calculations. <br />Attach the following supporting documentation with this Installation Report, or email it to the SCE RCx program manager: <br />Verification data as evidence of Implementation. <br />Updated savings calculations, where applicable. <br />Copies of invoices for implementation, as proof of the Customer's implementation costs. <br />RCx Training Completion Form, including the training agenda, training materials, list of attendees, and measure persistence <br />strategies. <br />See the RCx Program Guidelines formore information on these Items. <br />1. HVAC Permit (if required). If a permit is required for any HVAC installationlreplacement, I have provided the permit number below. (If no permit <br />is required, leave this section blank.) Permit # Agency <br />2. Contractor Certification. If a contractor was used for any HVAC installationtreplacement, this section must be completed by the contractor. <br />By checking this box, I certify I am a licensed contractor and have followed applicable permitting requirements and, if required, that the HVAC <br />❑ permit information above is correct. <br />Signature of ontractor Name pease print ate <br />I, the Customer or Authorized Agent below, certify that (i) the Energy Efficiency Solutions have been completely installed, functionally tested and proven capable of <br />operating and being maintained to perform in conformity with their design intent, and (it) that a licensed contractor was used, where applicable, and all applicable <br />permitting requirements for this installation were followed. The installation date of operation of the Energy Efficiency Solutions and any required monitoring data <br />collection per approved M&V plan, are also certified. <br />Signature Name pease print rte Date <br />258210 <br />