Fillable Project Tracking Bonus Request Form printable pdf download

Energy Solutions Partner Program - Upstate NY Commercial & Industrial

Project Tracking & Bonus Request Form

GET CREDIT FOR SUCCESS!

Participants in National Grid’s Energy Solutions Partner (ESP) Program use this from to:

1) Report a project completed under ANY of National

2) Request a Bonus for projects completed under National Grid’s Electric

Grid’s Commercial/ Industrial Energy Initiative

Energy Initiative Program. Only ESP Tier 1 partners are eligible to request

Programs. Projects should list all ESP partners that

bonus payments. Bonus payments will be paid directly to the Requestor listed on

contributed to the project’s completion. Each partner will

this form. Per the Terms and Conditions for the National Grid ESP Program. The

receive equal kWh and/or Dt credit for the energy savings

Requestor has the discretion to distribute the bonus payment to third parties.

associated with the completed project. Savings will be

Independent of a bonus payment, each ESP partner listed on the form will receive

credited toward each partner’s ESP goals to maintain or

equal kWh and/or Dt energy savings associated with the completed project. Savings

elevate their current ESP Tier Status.

will be credited toward their ESP goals to maintain or elevate their current ESP Tier

Status.

Requestor Information (Bonus will be paid to Tier 1 Partners only)

Energy Solutions Partner Company Name:

Contact Name:

Title:

Address

(Where bonus will be mailed)

City:

State:

ZIP Code:

Telephone:

Company Federal ID:

Project Information

Name of Customer Completing Project:

Address of Customer:

City:

State:

ZIP Code:

National Grid InDemand Application Number:

Project Classification (check one)

Electric Large Industrial > 2MW Program

Gas Commercial/Industrial Program

Electric Midsize < 2MW Program

Other Partners Involved with the Project (Use separate sheet to list additional partners)

Company Name:

Company Federal ID:

Address:

City:

State:

ZIP Code:

Company Name:

Company Federal ID:

Address:

City:

State:

ZIP Code:

Company Name:

Company Federal ID:

Address:

City:

State:

ZIP Code:

National Grid Energy Solutions Partner Program

300 Erie Blvd West C-3, Syracuse, NY 13202 Attn: Patrick Donnelly

Email:

Tel: (866) 340-5181

For Internal Use Only:

Processor Initials: _____________

Date Received: ____________

Date Co. Commit. Auth.: ___________

Bonus Paid: $ ___________

Date EE Incentive Paid: ____________

Bonus Paid: $____________

Gross kWh: _____________

Gross Dt: ______________

Invoice#: _____________

Invoice#: ____________

Payment Request #: ____________

Project Tracking & Bonus Request Form v3 05.10.2012

Project Tracking Bonus Request Form

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