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Energy Savings <br />Calculated <br />Solution # <br />Baseline <br />Usage (kWh) <br />Installed <br />Usage (kWh) <br />Energy <br />Savings (kWh) <br />Incentive <br />Rate ($ /kWh) <br />Energy. <br />Incentive ($) <br />1 <br />2 <br />2 <br />4 <br />3 <br />5 <br />4 <br />5 <br />On -Peak Demand Reduction <br />Calculated Baseline <br />Solution On -Peak <br /># from above Demand (KW) <br />Installed <br />On -Peak <br />Demand (KW) <br />On -Peak <br />Demand <br />Reduction (KW) <br />Peak Demand <br />Reduction <br />Incentive ($) <br />1 <br />2 <br />3 <br />4 <br />5 <br />Calculated Energy Savings Totals <br />Calculated Savings Incentives <br />On -Peak Demand Reduction (kW) <br />SA# 3- 000 - 8761 -23 <br />UPN# 353 -15- 0500765634 <br />NOTE: For projects requiring M &V, attach any required <br />baseline or post- instartatlon measurements and analysis, as <br />specified in Your approved M &V plan. <br />;k 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 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 />0 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 />rted savings calculations, where applicable. <br />as of invoices for implementation, as proof of the Customer's implementation costs. <br />Training Completion Form, including the training agenda, training materials, list of attendees, and measure persistence <br />the RCx Program Guidelines for more information on these items. <br />1. HVAC Permit (if required). If a permit is required for any HVAC Installation /replacement, 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 installation/replacement, 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 Contractor- Name ' p ease prm Date <br />I, the Customer or Authorized Agent below, certify that (1) 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 (ii) 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 please print Title Date <br />22a —9 <br />