ENERGY ANALYSIS QUESTIONNAIRE
Title ____________________________
Daytime Phone ___________________
E-mail _____________________
Fax _____________________
Building Information
Building Name _______________________
Address _______________________
City/ST/Zip _______________________
# Floors ______________________
Utility Rates: Electricity Billing Information (or include copy of bill)
Energy Cost per kWh $____________________________
(If you have Demand Cost, please include per kW $ )_____________
Window Envelope
Window Area Construction Thickness Appearance
North _______sq ft o Single o Double Pane o 1/4” o 1/8” o Clear
South _______sq ft o Single o Double Pane o 1/4” o 1/8” o Clear
East ________sq ft o Single o Double Pane o 1/4” o 1/8” o Clear
West________ sq ft o Single o Double Pane o 1/4” o 1/8” o Clear
Comments___________________________________
_______________________________________________
Your solar control specialist / tinter will complete this portion during your film assessment call
Film Choice_____________________________
Installation_____________________________
Expected Cost to Install (film plus labor) $ ____________
Approximate Timeframe _______________________
Return this from for your building energy analysis via fax, e-mail, or postal service
713.681.3000 877.989.3456 (FILM)
713.681.3040 Fax
http://www.solarcontrolfilmsinc.com/buildingenergyauditform.html
Midwest Tint Distribution Center
1220 N. Price Road St. Louis, MO 63132
314.993.8468 / 866.973.3456
Window tint does not cost you, it saves you energy and money
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