Project Finance Connect - Program

Contact Information
First name:
Last name:
Organization:
Job title:
Address:
City:
State:
ZIP:
Country:
Phone:
Cell phone:
Fax:
E-mail:
Note: In addition to the contact information, the following information may be made available to conference attendees if organization is invited to participate in program.
Organization Information
Company or Organization:
Website URL:
Organization size: / [ ] 1 - 19
[ ] 20 - 99
[ ] 100 - 499
[ ] 500 - 2499
[ ] 2500 or more
On-site Information
Primary conference attendee, if different from contact above.
First name:
Last name:
Job title:
Phone:
E-mail:
What role does this person play in the project team? / [ ] Developer
[ ] Installer
[ ] Panel Manufacturer
[ ] Power Purchaser
[ ] Referral Party
[ ] Other
If other, please describe
20 words max.
Project Proposal Details
List as you want printed in the program.
Project Title:
Brief Executive Summary:
50 words max.
Select Project Type / [ ] Solar Power
[ ] Wind Power
[ ] Biomass Power
[ ] Water Power
[ ] Geothermal Power
[ ] Hydrogen & Fuel Cells
[ ] Smart Grid/Distribution
[ ] Efficiency & Buildings
[ ] Transportation & Fuels
[ ] Manufacturing
[ ] Water Management
[ ] Carbon Offsets
[ ] Emission Reduction
[ ] Other
If other, please describe
50 words max.
Is your Project Located in Hawaii / [ ] Yes
[ ] No
Does you Project have Military Applications / [ ] Yes
[ ] No
Project Location
50 words max.
Development Status: / [ ] Commissioned (project is built and looking for permanent financing)
[ ] Shovel Ready (ready for construction – project fully permitted, PPA and all contracts signed)
[ ] Near Shovel Ready (perfunctory permits remaining and/or contracts signed – no anticipated issues to preclude construction)
[ ] Early Stage Development (project identified, most permits, financing, partners and contracts required)
Project Size: / [ ] Pilot Scale-1 (under $200k)
[ ] Pilot Scale-2 ($200k - $2M)
[ ] Project Scale-1 ($2M - $20M)
[ ] Project Scale-2 (over $20M)
If applicable, do you have a
Power Purchase Agreement / [ ] Yes
[ ] No
[ ] Not Applicable
If YES, What stage is the PPA?: / [ ] Signed PPA
[ ] Signed Letter of intent with agreed final form of PPA
[ ] Signed Letter of intent with terms outlined for PPA
[ ] Verbally agreed to terms of PPA
[ ] Verbal expression of interest in PPA
[ ] Not Applicable – No Power Purchaser
If applicable, what kind of entity is the power purchaser? / [ ] Utility/Energy Company
[ ] Power Broker
[ ] Commercial Entity (for-profit)
[ ] Federal Agency
[ ] State Agency or Municipality
[ ] School District
[ ] Non-Profit Organization
[ ] Not Applicable – No Power Purchaser
If applicable, do you have a land agreement / [ ] Yes
[ ] No
[ ] Not Applicable
Describe details or status
If yes, please provide agreement details. 200 words max.
If applicable, summarize your Technology Provider or Partners
Who are your identified technology and engineering vendors? What is your contracting status? 200 words max.
Team & Experience:
Describe your Top 3 Executive Team Members & Experience. No more than 150 words per individual. 500 words max.
Pipeline:
What projects (if any) and project size do you have underway? What projects have you completed in the past (size and details)? 300 words max.
Detailed Project Summary:
Provide a detailed description of your project proposal including pertinent status on land/location, technology, developer, PPA, engineering? If a Power Generation Proposal, provide the energy distribution summary. If a Pilot Scale, describe partner and funding needs and post-pilot scale-up plan. 500 words max.
What stage of financing is required to complete this project? / [ ] Permanent Financing Only (financing for commissioned system only)
[ ] Construction & Permanent Financing (financing to construct system and permanent financing required upon commissioning of system)
[ ] Late Stage Development, Construction & Permanent Financing (financing required to finalize shovel ready status, construct system and permanent financing required upon commissioning of system)
[ ] Early & Late Stage Development, Construction & Permanent Financing (financing required to develop and construct system and permanent financing required upon commissioning of system)
[ ] Pilot Stage Funding and/or Partner (proof of concept or pilot scale project)