                                                  Energy Data Verification Form
                                                      OMB Control No. 2060-0347
Due to EPA 4/17/2015
Step 1: Verify building name and address
Property Name (note that this is the name that will be used on 		Yes, the property name is correct.
the recognition certificate and any outreach materials): 			 No, this is incorrect. I would like the name of the property
3190 Fairview Park	to be listed as: 

Portfolio Manager Building ID#:					____________________________ 
1345536								 Yes, the building address is correct
								 No, this is incorrect.  I have corrected the address in Portfolio Property Address:							Manager to read:
3190 Fairview Park Drive, Falls Church, Virginia 22042	___________________________
	 

Step 2: Verify gross floor area: 260924 sq. ft.


Does this square footage include all supporting functions such as kitchens and break rooms used by staff, storage areas, administrative areas, elevators, stairwells, atriums, vent shafts, etc.?

Also note that existing atriums should only include the base floor area that they occupy. Interstitial (plenum) space between the floors should not be included in the total.

Finally, gross floor area is not the same as leasable space. Leasable space is a subset of gross floor area.

 Yes, this is correct.

 No, this is incorrect. I have added and/or corrected this data in my Portfolio Manager account, and resubmitted my property data using this link: https://portfoliomanager.energystar.gov/pm/reports/dataRequest/accept/41005f7b-d45e-4039-bd34-34fef7cf633e





Step 3: Verify meter data

Verify that each energy meter entry that appears in Portfolio Manager for the baseline and competition periods (January through December of 2013 and 2014) is correct and matches the actual meter readings as reported by the utility.  

Also verify that ALL energy use associated with this property is represented in Portfolio Manager, and that no meter is shared with another property. Also verify that the property was operating business as usual throughout the competition period.
 Yes, all meters are represented and all entries are correct.

 No, one or more meters, or meter entries, is incorrect or missing. I have added and/or corrected them in my Portfolio Manager account, and resubmitted my property data using this link: 
  https://portfoliomanager.energystar.gov/pm/reports/dataRequest/accept/41005f7b-d45e-4039-bd34-34fef7cf633e









              Professional Engineer or Registered Architect Stamp

Step 4: Signature of Professional Engineer or Registered ArchitectI certify that the information contained on this form is true and accurate to 
the best of my knowledge. 

Name: _______________________________	Date: ________________		


Signature: ____________________________________________________



Step 5: Send form to EPA
Send a signed, scanned PDF of this document to EPA by April 17.  If this is a 
EPA Form No. 5900-375
hardship, please contact EPA to make other arrangements prior to April 17.  All correspondence can be sent to: BattleOfTheBuildings@cadmusgroup.com
The public reporting and recordkeeping burden for this collection of information is estimated to average 1.5 hour 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.


EPA Form No. 5900-375
