EXHIBIT G
INFORMATION WORKSHEET

RFP No.219F:Remote/virtual online Energy audit Services INFORMATION WORKSHEET for the State Energy Conservation Office (SECO)

Section 1: General information

Respondent

Name:

Federal Employer Identification Number (“FEIN” or “EIN”) and Texas Tax Identification/Registration Number, if any:

Proposer Date:

Mailing Address:

Type of Business Entity:

State of Incorporation or Organization and Principal Place of Business:

Name and location of Texas offices, other major offices, and other facilities that relate to Respondent’s performance under this RFP:

All affiliated companies and subsidiaries, or any joint ventures or other affiliations:

Signing Authority

Name:

Title:

Telephone:

Email Address:

Primary Contact

Name:

Title:

Telephone:

Email Address:

Secondary Contact

  • Name:
  • Title:
  • Telephone:
  • Email Address:

Administrative Contact for Accounting

Name:

Title:

Telephone:

Email Address:

1.A. Subcontractor(s) Information

Provide sufficient documentation on separate sheets of paper to address the following requirements.

  1. List the subcontractors for this contract.
  2. Provide a description of the contractual relationship between primary respondent and each joint respondent or proposed subcontractor(s).
  3. Provide a letter from the proposed subcontractors, signed by an individual authorized to legally obligate each subcontractor, attesting to the fact that it will provide the services as represented in respondent’s proposal attached to this proposal response.
  4. Include the proposed subcontractor(s) submitted ownership information similar to that required of respondents.

Section 2.EVALAUTION CRITERIA - PERSONNEL and Subcontractor QUALIFICATIONSand relevant technical Assitance Experience (35%)

2.A. FIRM Personnel

Provide sufficient documentation on separate sheets of paper to address the following:

  1. Identify key personnel who are to be part of the proposed team.
  2. Describe roles and responsibilities for members of the project team, including external team members, clearly defined.
  3. Provide details to document key personnel qualifications, including:
  • Full name (including full middle name);
  • Five-year employment history;
  • Specific description of relevant qualifications and writing skills that person has with this type of services (limit to one page);
  • Specific indication of what role the individual will have and the percentage of time he/she will devote to these services; and
  • Any additional helpful information to indicate the individual's ability to aid the respondent in successfully completing these services (limit to one page).
  1. Resumes of key personnel.
  2. Organizational chart.

2.b. Staff QUALIFICATIONS

Complete the table below with a list of office locations in Texas, the number of personnel at each location who haveperformed Remote/Virtual Online Energy Audits.

Office Locations in Texas / Does personnel at this location have experience performing Remote/Virtual Online Energy Audits? (Y/N)

2.C.relevant technical assistance experience

Answer the following questions. On separate sheets of paper, provide the back-up documentation to support your answers to questions 1-4.When responding to requests for information regarding relevant prior experience of ‘your firm’ please include any relevant prior experience by any current firm personnel who gained such experience prior to becoming employed by your firm.

  1. How many Remote/Virtual Online Energy Audits have been prepared by your firm within the last five years?
  2. How many Remote/Virtual Online Energy Audits that comply with ASHRAE Level I Guidelines have been prepared by your firm in the last five years?
  3. In the space below, provide a summary of representative Remote/Virtual Online Energy Audits prepared in the last five years.
  1. In the space provided, please describe your firm’s process for preparing a Remote/Virtual Online Energy Audit:
  1. In the space provided, please describe any additional services, processes orfeatures which your firm includes as part of a Remote/Virtual Online Energy Audit which are above and beyond the requirements set forth in Part 2 of this RFP:

Section 4.EVALUATION criteria – internal structure and controls (15%)

  1. In the space provided, describe your firm’s quality control mechanisms for conducting a Remote/Virtual Online Energy Audit, specifically addressing how your firm shall ensure the integrity of data utilized and how your firm will validate all analysis results, observations and recommendations made. Include the normal issues you anticipate arisingin the course of conducting an Audit and how you propose to resolve such issues (use a separate sheet of paper if necessary).
  1. In the space provided, describe what differentiates your firm from other firms that provide similar services.

Section 5. REQUIRED reporting

Successful Respondents will be required to submit the following:

Monthly Reports- Successful Respondent shall provide SECO with a written report each month no later than the 10th day of the following month which shall include, at a minimum and as applicable, the following information:

  • Technical Assistance to the SECO Program Manager, as assigned;
  • Technical assistance to Third-Party Auditees , as assigned;
  • Process Metrics
  • Building Energy Audits including the number of audits performed, the approximate facility square footage, and the projection of energy savings;
  • Additional energy-related technical assistance as requested by SECO;
  • Budget recap.

Quarterly Reports- due on a state quarterly schedule

  • Roll up of monthly reports.

Final Report- due at the contract completion

Do you agree that the deliverables listed above will be submitted in accordance with the scheduled delivery dates? (Y/N) _____