OMB Control No. 2060-0347

EPA Form 5900-195 Page 1 of 3 Version: 11/10/09

 Service and Product Provider (SPP) Partnership

 Application Data Form

PLEASE SUBMIT THIS APPLICATION DATA FORM AND ATTACHMENTS REQUESTED IN QUESTIONS 5, 6, and 7

TO SPP@ENERGYSTAR.GOV, ALONG WITH YOUR COMPLETED PARNERSHIP APPLICATION PACKET.

Date:

Company Name (Web Display): 

Web Address:

1) An unbiased 3-5 sentence description of your company, its services, and products. Description should 

address service and/or product offerings provided to improve energy efficiency of customer buildings.

2) Identify your company type: (Check all that apply)

Architecture or A/E Engineering

Distributor Equipment Manufacturer 

Energy Consultant / Energy Management 

Services

Financial Services

Energy Improvement Contractor On-site Energy Production Services

Energy Information Services Unregulated Energy Retailer and Marketer

Energy Service Company (ESCO)

3) Please identify the market sector(s) that your company actively serves: (Check all that apply)

Commercial Real Estate Industry

Corporate Real Estate (Banks, Financial, 

Consulting, Telecommunications) K-12 Education

Federal Government Local Government

Healthcare (Hospital, Medical Office Building)

Retail (Apparel, Big Box, Convenience Stores, 

Department Stores, Discount Stores-Warehouse 

Clubs, Drug Stores, Restaurants, Supermarkets)

Higher Education Small Business

Hospitality and Entertainment (Hotels, 

Resorts, Stadiums, Theaters, Museums,

Convention Centers)

State Government
OMB Control No. 2060-0347

EPA Form 5900-195 Page 2 of 3 Version: 11/10/09

4) To which SPP partnership category would you like to apply? (SELECT ONE)

Please determine which partnership category reflects the primary area of your business and is the best fit for you 

based on the SPP Partnership Requirements. Please select only one area below.

Existing Commercial Buildings SPP

If selecting this area, answer question 5 only.

Commercial New Construction SPP (i.e. 

Architecture Firms)

If selecting this area, answer question 6 only.

Industrial SPP

If selecting this area, answer question 7 only.

5) Complete this question ONLY if you selected the “Existing Commercial Buildings SPP” partnership category

in Question 4. SPPs in this partnership category conduct business primarily with existing commercial buildings 

clients. Please complete Question 5a and 5b and/or 5c to allow us to verify that you meet requirements for partnership.

a) To help us understand your business, please provide brief descriptions for a minimum of two energy 

efficiency projects completed for your clients.

b) List 10 customer commercial buildings which you have benchmarked using Portfolio Manager in the last 

12 months. To meet the SPP requirement, you must benchmark at least 10 customer buildings – and receive 

energy performance ratings (EPR) and/or energy use intensity (EUI) scores – in the past 12 months.

Please provide an email attachment of a Statement of Energy Performance (SEP) for each facility listed. SEPs

can be generated in Portfolio Manager for all buildings with at least 11 consecutive months of data entered. (Note: 

For SPP partnership application, SEPs are requested as evidence of SPP benchmarking and DO NOT need to be 

reviewed and/or stamped by a Professional Engineer. Information provided will remain confidential, and will be 

used only to verify eligibility in terms of partnership requirements.)

Name of Project/Client Date(s) of project 

completion

Project Scope and/or Energy Efficiency 

Measures Implemented/Recommended

Portfolio Manager 

Building ID# Customer Organization Name

Building 

Received an 

EPR Rating?

Building 

Received an 

EUI Score?
OMB Control No. 2060-0347

EPA Form 5900-195 Page 3 of 3 Version: 11/10/09

c) Please list at least one customer building which your organization has helped to earn the ENERGY STAR 

label in the last 12 months. (Note: In order to receive credit for helping a customer building to earn the ENERGY 

STAR, your organization must be indicated as the primary SPP for the building in Portfolio Manager.)

6) Complete this question ONLY if you selected the “Commercial New Construction SPP” partnership category 

in Question 4. SPPs in this partnership category are comprised of architecture and A/E firms specializing in 

commercial building design.

Determine if design projects are eligible for Designed to Earn the ENERGY STAR by using EPA’s Target Finder, an 

online tool for commercial building designs. List at least one project you plan to submit for the Partnership Application 

requirement. EPA will review and approve eligible projects and applications to activate this Partnership Agreement.

7) Complete this question ONLY if you selected the “Industrial SPP” partnership category in Question 4. SPPs in 

this partnership category work with ENERGY STAR Industrial partners to implement energy efficiency projects. 

List at least one energy efficiency project that you completed for an ENERGY STAR Industrial partner in the 

last 2 years. Please attach a completed “Teaming Profile” outlining the project scope and resulting savings for that

project. Review additional guidelines on creating Teaming Profiles on the ENERGY STAR Web site.

The public reporting burden for this collection of information is estimated to average 30 minutes per response. Send comments on the Agency's need 

for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through 

the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 

Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this 

address.

Name of Building Receiving Label Customer Organization Name Label Year

Name of Design Project Space/Building Type (office, K–12, etc.)

Design 

Completion 

Date

ENERGY STAR Industrial Partner 

Organization Name Brief Project Description Year Project Completed