Energy Star and Energy Audit Survey

OMB No. 2577-XXXX

(exp.XXXX2008)

U.S. Department of Housing and Urban Development

Office of Public and Indian Housing

Public reporting burden or this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Information is needed in order to respond to 42 U.S.C. 8251 et seq. HUD will use the information to report to Congress. Nature of response is voluntary. No confidentiality is assured. This agency may not collect this information, and you are not required to complete this forms, unless it displays a currently valid OMB control number.

A survey is needed in order to respond to Congress and the mandate under the Energy Conservation Policy Act (42 U.S.C. 8251 et seq.) The information collected from the survey will be used to accurately create reports and strategies to reduce utility expenses through energy conservation measures of public housing.

Public and Indian Housing ENERGY STAR^® and Energy Audit Survey

Thank you for participating in the U.S. Housing and Urban Development (HUD) survey on energy conservation efforts in Public and Indian Housing. In accordance with the Federal Energy Policy Act of 2005, HUD must submit a report to Congress documenting substantive steps being taken to reduce energy consumption and costs in Departmental programs. By voluntarily completing this questionnaire you will provide valuable input for this report related to your PHA’s energy-related actions and measures.

Directions: Please complete the following questionnaire by ______. When you have completed the entire survey, click Submit at the bottom of the page to automatically submit it. If you need to save your answers to either complete the survey later or forward the link to another person to complete, click Save for Later at the bottom of the page. If you have any questions, please contact HUD at info@surveywebsite.gov. If you would prefer to fill out a paper copy of the survey, please print this form and when complete, submit it by either mail to Public and Indian Housing Survey, D&R International, 1300 Spring Street Suite 500, Silver Spring, MD 20910 or by fax to 301-588-0854.

Public reporting burden for this collection of information is estimated to average 10 minutes. This includes the time for collecting, reviewing, and reporting the data. This agency may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number.

Section I – ENERGY STAR Products and Procurement

1. Have you ever seen or heard of either of the ENERGY STAR^® labels shown here?

○ Yes

○ No

2. Does your procurement plan specify ENERGY STAR qualified products?

○ Yes --- Skip to Question 4

○ Yes, but only when shown to be cost effective --- Skip to Question 4

○ No

3. Why doesn’t your procurement plan specify ENERGY STAR qualified products? (check all that apply)

○ They are not lifecycle cost effective

○ They are not available from our regular vendors at reasonable prices

○ We just have not gotten around to it (competing priorities)

3. Which of the following ENERGY STAR products have you purchased or will you purchase by the end of FY 2008? (check all that apply)

○ Clothes Washers

○ Dehumidifiers

○ Dishwashers

○ Central Heating and Cooling or HVAC

○ Lighting (Compact Fluorescent Light bulbs or Fixtures)

○ Office Equipment (for PHA administration)

○ Refrigerators

○ Room Air Conditioners

○ Other ENERGY STAR products (enter below)

______________________________________

Section II – Energy and Water Efficiency Audits

3. When was your last energy audit?

○ Within the last two years

○ Two to five years ago

○ More than five years ago

○ We have never received an energy audit – Skip to End

3. How many residential units were included in your last audit?

_________

3. How expensive was your last energy efficiency audit?

○ Less than $1,000

○ $1,000 - $5,000

○ $5,000 - $15,000

○ More than $15,000

○ No cost – included in the program price of energy and water efficiency improvements or an Energy Performance Contract (EPC).

○ Don’t know.

3. Which of the following components were included in your last energy audit (check all that apply)?

○ Appliances

○ Domestic hot water

○ Evaluation of building wall and roof insulation and air leakage

○ Heating and Cooling system (HVAC) and ductwork

○ Lighting

○ Plumbing and plumbing fixtures

○ Windows

3. D id you receive a list of potential improvements, with associated costs, from your last audit?

○ Yes

○ Don’t know yet – Skip to End

○ No -- Skip to End

3. Did you perform or are you planning on performing any of these improvements?

○ Yes

○ Don’t know yet – Skip to End

○ No -- Skip to End

3. Which improvements did you implement or are planning on implementing? (check all that apply)?

○ Appliances

○ Domestic hot water

○ Heating and Cooling system (HVAC) and ductwork

○ Lighting

○ Plumbing and plumbing fixtures

○ Wall and roof insulation and air leakage

○ Windows

Thank you for your time. HUD values your opinion and contribution. If you are interested in learning more about ENERGY STAR, please visit www.energystar.gov.

Do you want to buy ENERGY STAR qualified products in bulk at competitive prices? Then go to QuantityQuotes.net, an online marketplace created by HUD and the U.S. Department of Energy to connect large quantity buyers with suppliers of energy-efficient products. Register now, and use ENERGY STAR Quantity Quotes whenever you need to buy light fixtures, or light bulbs, refrigerators, dehumidifiers, clothes washers, room air conditioners, dishwashers or office equipment.

S ave for Later Submit

Page 4 of 4 Form HUD 52465