Energy Assessment Questionnaire - Energy Profile Tool

1 Energy Assessment 2003 xcel Energy Inc. | xcel Energy is a trademark of xcel Energy Inc. | Northern States Power Company d/b/a xcel Energy | 04-01-101 Energy Assessment QuestionnairePage 2 of 2003 xcel Energy Inc. | xcel Energy is a trademark of xcel Energy Inc. | Northern States Power Company d/b/a xcel Energy | 04-01-101 xcel Customer No.:First Name:Last Name:Company Name:Address:CityState:Zip:Phone:Email Address:You may send me information on Energy -saving ideas, programs and incentivesYesNoFacility type of facility is this?Stand-alone retailStrip mallLarge mallGrocery storeMotel/HotelElementary schoolMiddle/high schoolExtended careHigh-rise officeLow-rise office (3 stories or less) was your facility built? 2000s1990s1980s1970s1960s1950s1940s1930s 1920sprior to is the facility's name? is the facility s address?Address: _____City: _____State: electricity, which fuel type(s) do you typically use?(Do not include fuels for backup heating or generation.)

2 Natural Gas Propane Steam Fuel long ago was a retrofit completed on your facility?Please indicate for each type of retrofit performed.< 2 yr2 5 yr6 10 yr 11-15 yr16-30 yr> 30 yrNeverBuilding ShellLightingHeating, Cooling & VentilationHot WaterEnergy Assessment QuestionnairePage 3 of 2003 xcel Energy Inc. | xcel Energy is a trademark of xcel Energy Inc. | Northern States Power Company d/b/a xcel Energy | 04-01-101 Electrical Billing DataEnter Monthly or Annual dataWho is your electricity provider? xcel EnergyOther UtilityMonthly(If you cannot find a value on your electric utility bill of kW, leavethose spaces blank. You will still get good results)MonthkWhkWTotal Bill ($)January_____February_____March_____Ap ril_____May_____June_____July_____August _____September _____October_____November_____December__ ___Annual_____AnnualIf you have entered monthly data, please disregard annual dataspaces. If you choose to enter annual (rather than monthly) data, notethat annual data is only required for any two of the three annualspaces.

3 The third space calculates for you no matter spaces you useto enter annul $/kWhTotal Bill ($)Annual_____Natural Gas Billing DataEnter Monthly or Annual dataWho is your natural gas provider? xcel EnergyOther UtilityMonthlyMonthThermsTotal Bill ($)January_____February_____March_____Ap ril_____May_____June_____July_____August _____September _____October_____November_____December__ ___Annual_____AnnualIf you have entered monthly data, please disregard annual dataspaces. If you choose to enter annual (rather than monthly) data, notethat annual data is only required for any two of the three annualspaces. The third space calculates for you no matter spaces you useto enter annul $/ThermTotal Bill ($)Annual_____Energy Assessment QuestionnairePage 4 of 2003 xcel Energy Inc. | xcel Energy is a trademark of xcel Energy Inc. | Northern States Power Company d/b/a xcel Energy | 04-01-101 Steam Billing DataEnter Monthly or Annual dataWho is your steam provider? xcel EnergyOther UtilityMonthlyMonthMlbsTotal Bill ($)January_____February_____March_____Ap ril_____May_____June_____July_____August _____September _____October_____November_____December__ ___Annual_____AnnualIf you have entered monthly data, please disregard annual dataspaces.

4 If you choose to enter annual (rather than monthly) data, notethat annual data is only required for any two of the three annualspaces. The third space calculates for you no matter spaces you useto enter annul $/MlbsTotal Bill ($)Annual_____Energy Assessment QuestionnairePage 5 of 2003 xcel Energy Inc. | xcel Energy is a trademark of xcel Energy Inc. | Northern States Power Company d/b/a xcel Energy | 04-01-101 Facility Information is your facility located?Select the region in which your facility is located:East North Central (IL, IN, OH, MI, WI)West North Central (IA, KS, MO, MN, NE, ND, SD)Middle Atlantic (CT, NJ, NY, PA)New England (MA, ME, NH, RI, VT)East South Central (AL, KY, MS, TN)South Atlantic (DC, DE, FL, GA, MD, NC, SC, VA, WV)West South Central (AR, LA, OK, TX)Mountain (AZ, CO, ID, MT, NM, NV, UT, WY)Pacific (AK, CA, HI, OR, WA)Which city's weather patterns are most similar to your location? AtlantaHoustonPhoenixBostonLos AngelesSacramentoChicagoMemphisSan FranciscoDallasMinneapolisSeattleDenverN ew is the floor area of your facility that is heated or cooled?

5 (Do not include garages or other unheated spaces.) type of system do you use to heat and cool your facility?Choose the selection which most closely matches your situation.(Note: Selections vary by building type)Elementary School selectionsElectric heating coil w/single speed fan, with or without local elec heat Fossil boiler or furnace with single speed fan, with local elec heatFossil boiler or furnace with single speed fanFossil boiler with multiple heat pump units distributed throughout facilityElectric boiler with multiple heat pump units distributed throughout facilityFossil boiler or furnace with multiple fans distributed throughout facilityExtended Care selectionsElectric heating coil with single speed fan, with or without local elec heat Fossil boiler or furnace with single speed fan, with local elec heatFossil boiler or furnace with single speed fanElectric heating coil serving roof top unit(s), with local electric heatFossil boiler or furnace serving roof top unit(s), with local elec heatFossil boiler or furnace serving roof top unit(s)

6 , with local hot water heatFossil boiler with multiple heat pump units distributed throughout facilityElectric boiler with multiple heat pump units distributed throughout facilityFossil boiler or furnace with multiple fans distributed throughout facilityEnergy Assessment QuestionnairePage 6 of 2003 xcel Energy Inc. | xcel Energy is a trademark of xcel Energy Inc. | Northern States Power Company d/b/a xcel Energy | 04-01-101 Facility Information (cont.)Grocery Store selectionsElectric heating coil w/single speed fan, with or without local elec heat Fossil boiler or furnace with single speed fanHigh-Rise Office selectionsElectric heating coil w/single speed fan, with or without local elec heat Fossil boiler or furnace with single speed fan, with local elec heatFossil boiler or furnace with single speed fanElectric boiler with multiple heat pump units distributed throughout facilityFossil boiler with multiple heat pump units distributed throughout facilityElectric heating coil with multiple fans distributed throughout facilityFossil boiler or furnace with multiple fans distributed throughout facilityVariable speed fan or variable dampers and/or vents with all electric heatingFossil boiler/furnace w/var spd fan/dampers/vents & supplemental local elec heatFossil boiler or furnace with variable speed fan or variable dampers/ventsHotel/Motel selectionsElectric heating coil with single speed fan and elec baseboard heating in suitesFossil boiler/furnace w/single speed fan & local electric heat in suitesFossil furnace w/single spd fan & elec baseboard heat & local elec heat in suitesFossil boiler with multiple heat pump units distributed throughout facilityFossil boiler or furnace with multiple

7 Fans distributed throughout facilityElectric heating coil with single speed fan and individual wall units in suitesFossil-fired in-suite units onlyFossil boiler/furnace with single speed fan and individual wall units in suitesElectric heating coil with single speed fan and indiv. heat pump units in suitesFossil furnace w/single spd fan & elec baseboard heat plus heat pumps in suitesLarge Mall selections Single speed fan with electric heating coils and cooling coilsSingle speed fan with non-electric heating coils and cooling coilsElectric boiler with multiple heat pump units distributed throughout facilityFossil boiler with multiple heat pump units distributed throughout facilityRoof Top Unit electric heating coil with single speed fanHeat pump units with or without supplemental electric heatRoof Top Unit fossil furnace with single speed fanLow-Rise Office selectionsElectric heating coil w/single speed fan, with or without local elec heat Fossil boiler or furnace with single speed fan.

8 With local elec heatFossil boiler or furnace with single speed fanElectric boiler with multiple heat pump units distributed throughout facilityFossil boiler with multiple heat pump units distributed throughout facilitySingle speed fan with electric heating coils and cooling coilsSingle speed fan with non-electric heating coils and cooling coilsVariable speed fan or variable dampers and/or vents with all electric heatingFossil boiler/furnace w/var spd fan/dampers/vents & supplemental local elec heatFossil boiler or furnace with var speed fan or variable dampers and/or ventsEnergy Assessment QuestionnairePage 7 of 2003 xcel Energy Inc. | xcel Energy is a trademark of xcel Energy Inc. | Northern States Power Company d/b/a xcel Energy | 04-01-101 Facility Information (cont.)Middle School/High School selectionsElectric heating coil w/single speed fan, with or without local elec heat Fossil boiler/furnace with single speed fan, with local elec heatFossil boiler or furnace with single speed fanElectric boiler with multiple heat pump units distributed throughout facilityFossil boiler with multiple heat pump units distributed throughout facilityFossil boiler or furnace with multiple fans distributed throughout facilityVariable speed fan or variable dampers and/or vents with all electric heatingFossil boiler/furnace w/variable fan/dampers/vents.

9 Supplemental local elec heatFossil boiler or furnace with var speed fan or variable dampers and/or ventsStand Alone Retail selectionsSingle speed fan with electric heating coils and cooling coilsSingle speed fan with non-electric heating coils and cooling coilsHeat pump units with or without supplemental electric heatRoof Top Unit electric heating coil with single speed fanRoof Top Unit fossil furnace with single speed fanElectric boiler with multiple heat pump units distributed throughout facilityFossil boiler with multiple heat pump units distributed throughout facilityStrip Mall selectionsSingle speed fan with electric heating coils and cooling coilsSingle speed fan with non-electric heating coils and cooling coilsRoof Top Unit electric heating coil with single speed fanHeat pump units with or without supplemental electric heatRoof Top Unit fossil furnace with single speed fanElectric boiler with multiple heat pump units distributed throughout facilityFossil boiler with multiple heat pump units distributed throughout your facility air-conditioned?

10 Is the number of weekly, normal operating hours of the facility? many people occupy the facility during the main operating hours? many months per year is the facility in use? Energy Assessment QuestionnairePage 8 of 2003 xcel Energy Inc. | xcel Energy is a trademark of xcel Energy Inc. | Northern States Power Company d/b/a xcel Energy | 04-01-101 Facility Shell Information at the outside of your facility, how much of the wall area is made up of windows?None0 10%11 20%21 30%31 40%41 50%51 60%61 70%71 80%81 90%91 100% type of windows do you have (overall window U-value)?I don't know (use typical value)Not applicable1 pane, aluminum frame, no thermal break ( , )1 pane, aluminum frame, thermal break ( , )2 panes, alum. frame, no thermal break ( , )2 panes, alum. frame, thermal break ( , )2 panes, curtain wall system ( , )2 panes, wood or vinyl frame ( , )2 panes, low-e, curtain wall system ( , )2 panes, low-e, aluminum frame ( , )2 panes, low-e, wood or vinyl frame ( , )3 panes, low-e, aluminum frame ( , )3 panes, low-e, wood or vinyl frame ( , ) is the color or tint of your windows (average shading coefficient)?