Lead by Example Clean Energy Awards Application Form

Select your nomination category:

State Agency

Municipality

Quasi-public Agency

Public School

Other

Project Name:

Project Location:

Street:

City:

Project Owner (State Agency, Municipality, Quasi-Public, Public School):

Project Contact:

Name:

Phone:

Email:

If possible, please attach two (2) high-resolution jpg images related to the project.

Nominator:

Phone:

Email:

Narrative Questions:

Please describe the energy project (energy efficiency and/or renewable energy or alternative clean energy transportation project), including the following information where applicable:

a. Description of the energy efficiency measure(s) installed, annual energy savings, total cost of the project(s), installation date(s), incentives/programs leveraged, and any other funds leveraged/used.

b. Description of the Renewable Energy Project(s), nameplate capacity, expected annual generation, total cost(s), incentives/programs leveraged, installation date(s), and any other funds leveraged/used.

c. Description of the clean energy transportation project, number of zero-emission vehicles (ZEV) purchased, electric vehicle charging stations (EVSEs) installed, tons of CO2 avoided, and any funds leveraged/used.