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Exhibit B: Sample Worksheet For Energy Saving and Costs <br /> EXillElT 8 <br /> Wbrisheet <br /> Gent <br /> Account# Name <br /> Requested Approval Completion <br /> Date: Date: Date <br /> (Cooperative)will fund the energy cooservatiaa measures listed baba-. Prior approval from(Cooperative)fix funds is <br /> mandatory. (Agency}agrees to supply(Cooperative)with total kWh savings for the client. Funds will be disbursed upon <br /> wrtiteraverification of kWh saved. <br /> kWh Actual Coat <br /> Savings <br /> 0%of weatherizatiai up to SX,XXX maximum per home The <br /> percentage listed reflects the percetage of the total home heating <br /> system that is heated using electric heat(1 kWh=3,412 BTUs) <br /> Electric water heater r eplacenazt Must be.90 energy factor. <br /> Up to 51,000 maximum_ (332 kWh savings/water heater) <br /> I ENERGY STARS clothe,washer replaced with Energy Star model. Up to$850 <br /> maximum. (158 kWh savings/clothes washer) <br /> ENERGY STAR room air conditionier. Up to SS00 per unit with r e rcling costs <br /> with recycling costs.Limit hvo units per client <br /> With Rewcling 686 kWhs units = <br /> Nov Purchase SO kWhx units = <br /> ENERGY STAR refrigerator replaced with Energy Star model of equivalent size. Up <br /> toS1,000 maximum. (927 kWh savings/refriger ata) <br /> Replacemert of incandescent light bulbs with up to five Energy Star CFLs installed. <br /> Up to S20 maximum. <br /> 39 kWh a units = <br /> Addition of new microwave oven if one is not presert must have an electric <br /> range,ccoktop,or oven present Up to S200. (682 kWh sayings/men} <br /> ICentral A/C tune-up. Up to$186 maximum plus am-necessary repair, <br /> not to weed S5O_ (106 kWh savings/tune-up) <br /> Energy Efficia cy Kit: (770 kWh savings per kit) <br /> Inches Faucet aerators,hot water temperature card,water efEcie t <br /> showerhead,and talon tape. Other terns upon regsest;caulk,door sweep,LED <br /> night light,pipe insullation,cutlet gaskets,outlet safety caps. <br /> 770 kWh x` 0 units = <br /> Other Efficiency Measures and labor.(1 kWh=3,412 BTUs) <br /> TOTALS 0 $ - <br /> Administranon Fee I 1036 I 5 - <br /> TOTAL FUNDED AMOUNT. <br /> 8 <br /> 89 <br />