Energy Efficiency Supplier Review Request Form
Use this form to request a structured review of an energy efficiency supplier, including project context, supplier details, ratings, supporting documents, and follow-up preferences.
Requester Information
Full Name
*
First Name
Middle Name
Last Name
Organization / Company Name
*
Job Title / Role
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Contact Method
*
Email
Phone
Either
Property and Project Context
Property Type
*
Please Select
Single-family home
Multi-family building
Commercial office
Retail
Industrial
Institutional
Mixed-use
Other
Property Address or General Location
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Building Size (Approx. Square Footage)
Current Utility Type(s)
*
Electricity
Natural Gas
Heating Oil
Propane
District Heating
Other
Project Description / Review Goal
*
Supplier and Service Details
Supplier or Company Name
*
Service Category or Offering
*
Please Select
Audits
Retrofits
HVAC Optimization
Lighting Efficiency
Controls and Automation
Energy Management Software
Building Envelope
Renewable Integration
Other
Engagement Timeline
Review Stage
*
Initial Screening
Active Supplier Review
Ongoing Performance Review
Relevant Service Date or Milestone
-
Month
-
Day
Year
Date
Review Criteria and Ratings
Pricing Clarity
*
Very Poor
1
2
3
4
5
6
7
8
9
Excellent
10
1 is Very Poor, 10 is Excellent
Communication Quality
*
Very Poor
1
2
3
4
5
6
7
8
9
Excellent
10
1 is Very Poor, 10 is Excellent
Proposal Quality
*
Very Poor
1
2
3
4
5
6
7
8
9
Excellent
10
1 is Very Poor, 10 is Excellent
Technical Expertise
*
Very Poor
1
2
3
4
5
6
7
8
9
Excellent
10
1 is Very Poor, 10 is Excellent
Project Responsiveness
*
Very Poor
1
2
3
4
5
6
7
8
9
Excellent
10
1 is Very Poor, 10 is Excellent
Estimated Savings Credibility
*
Very Poor
1
2
3
4
5
6
7
8
9
Excellent
10
1 is Very Poor, 10 is Excellent
Implementation Support
*
Very Poor
1
2
3
4
5
6
7
8
9
Excellent
10
1 is Very Poor, 10 is Excellent
Reporting Transparency
*
Very Poor
1
2
3
4
5
6
7
8
9
Excellent
10
1 is Very Poor, 10 is Excellent
Overall Assessment Matrix
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Pricing clarity was satisfactory
1
2
3
4
5
Communication was timely and clear
6
7
8
9
10
Proposal met the project needs
11
12
13
14
15
Technical guidance was credible
16
17
18
19
20
Response times were acceptable
21
22
23
24
25
Savings estimates were believable
26
27
28
29
30
Implementation support was adequate
31
32
33
34
35
Reporting was transparent
36
37
38
39
40
Overall satisfaction was high
41
42
43
44
45
Supporting Documents and Follow-Up
Proposal Upload
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Audit Report Upload
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Invoice Summary or Savings Estimate Upload
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Other Supporting Documents
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Additional Notes or Review Comments
Follow-Up Preference
No follow-up
Email follow-up
Phone follow-up
Preferred Follow-Up Timing
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
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