JULY 05
SOLICITATION FOR OFFERS
OUTPATIENT CLINIC
SFO NO. V101-183R-xxx-xxx-xx
[INSERT LOCATION OF FACILITY]
CERTIFICATION OF BUILDING ENERGY PERFORMANCE
LOCATION:
PROJECT TITLE:
PROJECT NUMBER:
PROJECT MANAGER:
I certify that the energy performance of the above project fully satisfies the energy efficiency
requirements of DOE regulations, 10 CFR Part 435, "Energy Conservation Voluntary Performance
Standards for Commercial and Multi-Family High Rise Residential Buildings; Mandatory for New Federal
Buildings."
_____________________________________
___________
NAME & TITLE
DATE
Name and Address of Architect-Engineer Firm:
Title/Position:
Professional Registration No.:
State Where Registered (use seal):
Part IX Forms
Lessor __________ Gov't. __________
__________ of __________ Pages
CERTIFICATION OF BUILDING ENERGY PERFORMANCE
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