TEP EasySave Plus - Small Projects

Project Name:

Day of Week Start Time End Time Daily Hours

Monday 8:00 AM 5:00 PM 9.00 Holidays Closed per Year 1Tuesday 8:00 AM 5:00 PM 9.00 Weeks Closed per Year 0.14

Wednesday 8:00 AM 5:00 PM 9.00

Thursday 8:00 AM 5:00 PM 9.00 Weeks/Year 52.00

Friday 8:00 AM 5:00 PM 9.00 Hours/Week 45.0

Saturday 0.00 Hours/Year 2,339.9

Sunday 0.00

45.0

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INCAN 100 6 4/30/2013 LED_Fix Int 35,000 6 9.5 $735.45 $146.11

INCAN 57 60.0 Lamp-Light LED-PAR38-17W800-30SA 9/3/2013 LED_Bulb Int 25,000 57 17.0 $1,284.25 $642.13

INCAN 76 100.0 Lithonia Versi Lite FMML740 5/14/2013 LED_Fix Int 60,000 76 10.2 $7,220.00 $1,836.45

T8 13 56.0 Cree Can Light CR6-625L 9.5w 5/3/2013 LED_Bulb Int 50,000 19 9.5 $1,489.41 DNQ

MH 8 128.0 RAB Lighting Flood FFLED 18W 11/29/2012 LED_Fix Ext 50,000 8 22.0 $1,480.00 $198.42

HPS 6 295.0 LeoTek Ext EC4-14M 130W 1/18/2013 LED_Fix Ext 100,000 6 130.0 $2,550.00 $231.65

4

Rebates cannot exceed 50% of incremental measure cost.

Specifications

SAMPLE: CREE CR4-575L-27K

http://www.energystar.gov/productfinder/

The DesignLights Consortium Product Listings are located on their website at: http://www.designlights.org/QPL

Operating Schedule

For HELP hover mouse over light gray shading for additional information. Yellow shaded cells indicate Data Entry.Custom Lighting Incentive Worksheet

Incentives

In order for a custom lighting project to be eligible for an incentive, the project must be deemed cost effective. The method used to determine cost effectiveness is called the Societal Cost Test. All of the information requested in the table below is required to perform the Societal Cost Test (SCT). If the custom lighting project does not pass the Societal Cost Test, the incentive will show DNQ (Does Not Qualify). Incentives are calculated at $0.10/kWh and are capped at a maximum of 50% of the measure cost.

1. Please note that operating schedule is applied to all fixtures listed in the table below. Addtional copies of this worksheet can be saved for different lighting schedules.2. All work shall be performed in accordance with all applicable professional standards and comply with all applicable federal, state, and local laws, ordinances, codes and regulations.

Replacement Light Bulbs & FixturesThis measure consists of replacing existing incandescent, HID, compact fluorescent, metal halide, and high or low pressure sodium fixtures or lamps with more efficient fixtures or lamps. 1. LED Type: All LED replacement lamps/bulbs must be Energy Star Certified and the Energy Star certification date reported in the Installed Measures table below. All replacement fixtures must be either DesignLights Consortium Listed or Energy Star Certified and the DesignLights Consortium listing date or Energy Star Certification date reported in the Installed Measures table below.2. CFL Type: All screw-in CFLs must be ENERGY STAR® Certified. Any lamp receiving a retail buy-down by TEP is not eligible. The lamp/ballast combination must have an efficacy ≥ 40 lumens per watt (LPW). For screw-in CFLs, electronic ballasts are required for lamps ≥ 18 watt. For hardwired CFLs, only complete new fixtures or modular retrofits with hardwired electronic ballasts qualify. The CFL ballast must be programmed start or programmed rapid start with a PF ≥ 90 and THD ≤ 20%. Only non-prescriptive CFL projects are eligible for an incentive using this Custom Application. Prescriptive projects using this Application will be deemed ineligible.3. T5 or T8 lamps must have a color rendering index (CRI) ≥ 80. The electronic ballast must be high frequency (≥ 20 kHz), UL listed, and warranted against defects for 5 years. Ballasts must have a power factor (PF) ≥ 0.90. Ballasts for 4- foot lamps must have total harmonic discharge (THD) ≤ 20% at full light output. For 2- and 3-foot lamps, ballasts must have THD ≤ 32% at full light output. T5 and T8 lamps are not required to be DLC or Energy Star Certified and should enter "NA" in the listing date column. Only non prescriptiveT5/T8 projects are eligible for an incentive using this Custom Application. Prescriptive projects using this Application will be deemed ineligible. 4. Induction Type: Induction type lamps/bulbs or fixtures are not required to be DLC or Energy Star Certified and should enter "NA" in the listing date column. 5. All submittals must include a) the manufacturer's specification (catalog/cut sheet), and b) a printing (or pdf) of the DLC Listing or Energy Star Certification for each fixture or bulb being claimed as a savings measure, and c) invoices from the Contractor. A room-by-room survey or lighting plan indicating the existing fixtures and proposed fixtures must be provided for lighting projects over 30 fixtures and all delamping projects.

1234567890TEP Account No:Sample Project

Note: LED bulbs/fixtures listed/certified as a family, or for one color temperature, may be acceptable for other color temperatures that do not consume more energy. Use the family/listed color temperature in the application submittal documentation.

Energy Star Certified lighting fixtures and light bulbs are listed on the website at:

Installed Lighting Fixtures/BulbsBuilding Type:

Project Completion Date

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DLC Sample Screencap & Website Instructions

(click for more information)

DLC Sample Spreadsheet Download & Website

Instructions(click for more information)

Energy Star Website Screencap & Instructions(click for more information)

Energy Star Spreadsheet Download and Sample

(click for more information)

Enter Operating Schedule and Days Closed Below

Office < (Select Building Type) Lump Sum Calculation?

Estimated Incentive

June 4, 2014 $2,908.65

Application Version: 5/16/2014

Measure 1 2.99-0.59-3719.06-1284.25-6595.3-3664.04-2931.23-11-2.9

Measure 2 8.33-0.72-20378.25-7220-18364.5-10202.52-8162.01-26-2.82

Measure 3 0.67-0.13-1460.15-1489.41-1473.2-818.47-654.77-21-0.98

Measure 4 0.85-0.08-1873.28-1480-1984.2-1102.34-881.87-21-1.27

Measure 5 0.99-0.09-2882.59-2550-2316.5-1286.93-1029.54-30-1.13

This page must accompany any

APPLICATION INTEGRITY CHECKSUMS

printed Application submittals.

FOR OFFICE USE ONLY - REVIEWER NOTES

Application Version: 5/16/2014

4/4/2014 ENERGY STAR Certified Light Bulbs | EPA ENERGY STAR

http://www.energystar.gov/productfinder/product/certified-light-bulbs/details/2190937 1/2

ENERGY STAR Certified Light Bulbs

Product Details: Lamp-Light - LED-PAR38-

17W800-30SA

Want more information?

Access the full product list in

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Specifications Additional Model Information

Home » Products » Product Finder Home » ENERGY STAR Certified Light Bulbs » Product Details: Lamp-Light - LED-PAR38-17W800-30SA

ENERGY STAR Partner : Guangdong Foreign Trade Imp. & Exp. Corp.

Bulb Type : PAR - Parabolic Aluminum Reflector

Base Type : E26 (Medium)

Technology : LED

Energy Used (Watts) : 17.0

Bulb Life (hours) : 25000

Brightness (lumens) : 800

Power Factor : 0.97

Appearance/Correlated Color Temperature (K) : 3000.0

Color Quality (CRI) : 91

Warranty (years) : 3

Date Qualified : 09/03/2013

Date Available on Market : 02/15/2013

Markets : United States

No additional information provided

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Catalog Number

Notes

Type

Decorative Indoor

Versi Lite™ 7" LED Flush

HIGH-PERFORMANCE LED

SpecificationsHeight: 1-3/4 (4.4)Width: 7-1/4 (18.4)

All dimensions are inches (centimeters) unless otherwise indicated.

FEATURES & SPECIFICATIONSINTENDED USE — Provides general illumination in commercial and residential applications. Ideal for use in closets, foyers, hallways, corridors, bedrooms, offices, utility work areas, stairways and much more.

CONSTRUCTION — This contemporary shaped fixture features a matte white acrylic diffuser and white or textured bronze aluminum housing.

OPTICS — Produces the following lumens at 50,000 hours life:2700K 612 lumens3000K 642 lumens4000K 660 lumens

ELECTRICAL — Fixture operates at 120 volts, 60 Hz. Standard input = 9.3 watts, 70 lumens per watt.

Works with most standard incandescent dimmers (see list of suggested dimmers on page 2).

INSTALLATION — All mounting hardware included.

LISTINGS — CSA certified to US and Canadian standards and listed suitable for damp or wet locations.

U.S. Patent No. D691,763

WARRANTY — 5-year limited warranty. Complete warranty terms located at www.acuitybrands.com/CustomerResources/Terms_and_conditions.aspx

Note: Specifications subject to change without notice.

DECORATIVE INDOOR & OUTDOOR FMML

FMML 7

Series Size CRI Color temperature Fixture finish Option

FMML LED Versi Lite flushmount 7 7" diameter 8 >80 40 4000K (660 lumens)30 3000K (642 lumens)27 2700K (612 lumens)

(blank) WhiteDDBT Textured bronze

WL Wet location

ORDERING INFORMATION For shortest lead times, configure product using standard options (shown in bold). Example: FMML 7 840 WL

LIGHTING FACTS

FMML 7 840

PHOTOMETRICS

FMML

DECORATIVE INDOOR & OUTDOOR: One Lithonia Way, Conyers, GA 30012 Phone: 800-748-5070 Fax: 770-860-3903 www.lithonia.com © 2013-2014 Acuity Brands Lighting, Inc. All rights reserved. Rev. 04/17/14

FMML 7 test no. LTL22758, tested in accordance to IESNA LM-79.

0° 20°

40°

60°

80°

90°

0°0°0° 90°

180°

100

200

Coefficients of Utilizationpf 20%pc 80% 70% 50%pw 70%50%30% 50%30%10% 50%30%10%

119108988981756964595552

119103897869615550464239

11998826960524641373331

116100877667605449454138

11696806859524641373330

11692756252453935312825

11196837365585248444037

11192786657504540363330

11189736152443934312825

RC

R

0123456789

10

Zonal Lumen SummaryZone Lumens % Lamp % Fixture0° - 30°0° - 40°0° - 60°0° - 90°90° - 120°90° - 130°90° - 150°90° - 180°0° - 180°

1702794956542222

656

26.042.575.599.70.30.30.30.3

100.0

26.042.575.599.70.30.30.30.3

100.0

CP Summary0° 90

0°5°15°25°35°45°55°65°75°85°90

21921821119617314611683502111

21921821119617414611684502011

Suggested Dimmers

The FMML is designed to operate with most standard Triac Based (Forward Phase-Control or Leading Edge) dimmers and is not compatible with 0-10v dimming systems. The following is a list of dimmers tested and does not imply any guarantee or warranty of compatibility with a particular application. Unlisted dimmers do not imply non-compatibility.

Manufacturer Part Number (s) Manufacturer Part Number (s)

Leviton 6633P Lutron DVELV 300P

Leviton IPL06 Lutron Skylark 300P

Leviton 6674P Lutron NTELV 300

Leviton IPE04 Lutron NLV 600

Leviton Trimatron 600W Synergy ISD 600 I 120

Product DescriptionThe CR6™ LED downlight delivers up to 800 lumens of exceptional 90+ CRI light while achieving up to 67 lumens per watt. This breakthrough performance is achieved by combining the high efficacy and high-quality light of Cree TrueWhite® Technology. The CR6 is available in a warm color temperature and has a variety of trim options. It easily installs into most standard six-inch recessed IC or non-IC housings, making the CR6 perfect for use in both residential and light commercial, new construction or retrofit, applications.

Performance Summary

Utilizes Cree TrueWhite® Technology

Delivered Light Output: 625, 800 lumens

Input Power: 9.5, 12 watts

CRI: 90

CCT: 2700K, 3000K, 3500K, 4000K

Warranty: 5 years†

Lifetime: Designed to last 50,000 hours

Dimming: Dimmable to 5%*

Housings & AccessoriesReference Housing & Accessory documents for more details.

Trims & Reflectors

CT6A Diffuse silver reflector

CT6AW Diffuse wheat reflector

CT6AB Diffuse black reflector

CT6BB

Flat black flange and reflector

Housings (GU24 Only)

H6 Architectural

RC6 New Construction

RR6Retrofit

SC6 Cylindrical Surface Mount

SC6-CMCylindrical Cord Mount

SC6-WMCylindrical Wall Mount

6.25"

7.5"

CR6™

CR6™Six-Inch LED Downlight

Rev. Date 05/15/2013

T (800) 236-6800 F (262) 504-5415US: www.cree.com/lighting T (800) 473-1234 F (800) 890-7507Canada: www.cree.com/canada

Ordering InformationExample: CR6-800L-27K-12-E26

CR6

Series Size Source Lumen Output CCT Voltage Base Type

CR 6 6 inch 625L 625 Lumens 27K 2700K 12 120 Volts E26 Edison Base

30K 3000K GU24 GU24 Base (Title 24 Compliant)

35K 3500K

40K 4000K

CR 6 6 inch 800L 800 Lumens 27K 2700K 12 120 Volts E26 Edison Base

30K 3000K GU24 GU24 Base (Title 24 Compliant)

35K 3500K

40K 4000K

* Reference www.cree.com/lighting for recommended dimmers. † See www.cree.com/lighting for warranty terms.

© 2013 Cree, Inc. All rights reserved. For informational purposes only. See www.cree.com/patents for patents that cover these products. Cree®, and the Cree logo are registered trademarks, and CR6™ is a trademark of Cree, Inc. ENERGY STAR® and the ENERGY STAR logo are registered trademarks of the U.S. Environmental Protection Agency. The UL logo is a registered trademark of UL LLC.

Zonal Lumen Summary

Zone Lumens % Lamp % Fix

0-30 336 42.10% 42.10%

0-40 516 64.60% 64.60%

0-60 724 90.60% 90.60%

0-90 800 100% 100%

Intensity (Candlepower) Summary

Angle Mean CP

0° 456

5° 453

15° 432

25° 386

35° 293

45° 174

55° 85

65° 42

75° 25

85° 6

90° 0

Reference www.cree.com/lighting for detailed photometric data.

Product Specifications

CREE TRUEWHITE® TECHNOLOGYA revolutionary way to generate high-quality white light, Cree TrueWhite® Technology mixes the light from the highest performing red and unsaturated yellow LEDs. This patented approach delivers an exclusive combination of 90+ CRI, beautiful light characteristics, and lifelong color consistency, all while maintaining high luminous efficacy—a true no compromise solution.

CONSTRUCTION & MATERIALS• Durable upper housing protects LEDs, driver and power supply.

Adjustable flip clips resist heat while providing retention for flush ceiling fit.

• Thermal management system uses both upper housing and lower reflector to conduct heat away from LEDs and transfer it to the plenum space for optimal performance. LED junction temperatures stay below specified maximum even when installed in insulated ceilings.

• Suitable for insulated and non-insulated ceilings.

• One-piece aluminum lower reflector redirects light while also conducting heat away from LEDs. It creates a comfortable visual transition from the lens to the ceiling plane and easily accommodates CT6 snap-in trims.

OPTICAL SYSTEM• Unique combination of reflective and refractive optical components

achieves a uniform, comfortable appearance while eliminating pixelation and color fringing. This ensures smooth light patterns are projected with no hot spots and minimal striations.

• Components work together to optimize distribution, balancing the delivery of high illuminance levels on horizontal surfaces with an ideal amount of light on walls and vertical surfaces. This increases the perception of spaciousness.

• Diffusing lens shields direct view of LEDs while lower reflector balances brightness of lens with the ceiling to create a low-glare high angle appearance.

ELECTRICAL SYSTEM• Integral, high-efficiency driver and power supply.

• Power Factor > 0.9

• Input Voltage: 120V, 60Hz

• Dimming: Dimmable to 5% with most incandescent dimmers. Reference www.cree.com/lighting for recommended dimmers.

REGULATORY & VOLUNTARY QUALIFICATIONS• ENERGY STAR® qualified.

• cULus Listed

• Exceeds California Title-24 high efficacy luminaire requirements.

• Suitable for wet locations.

Photometry

CR6 BASED ON ONSPEX REPORT #: 30014047-3 CR6-625L: MULTIPLY BY 0.78

Installation• Designed to easily install in standard 6"

downlight housings from Cree and other manufacturers.*

• Quick install system utilizes a unique retention feature. Simply attach socket to CR6. Move light to ready position and slide into housing.

Open Space

Spacing Lumens Wattage LPW w/ft2 Average FC

4 x 4

625 9.5 61

0.60 36

6 x 6 0.28 18

8 x 8 0.15 10

10 x 10 0.10 7

4 x 4

800 12 67

0.76 47

6 x 6 0.35 22

8 x 8 0.19 13

10 x 10 0.13 8

10' Ceiling, 80/50/20 Reflectances, 2.5 workplane. LLF: 1.0 Initial. Open Space: 50' x 40' x 10'

Corridor

Spacing Lumens Wattage LPW w/ft2 Average FC

4' on Center

625 9.5 61

0.40 13

6' on Center 0.27 9

8' on Center 0.20 7

10' on Center 0.17 6

4' on Center

800 12 67

0.51 17

6' on Center 0.34 11

8' on Center 0.25 8

10' on Center 0.21 7

10' Ceiling, 80/50/20 Reflectances, Light levels on the ground. LLF: 1.0 Initial. Corridor: 6' Wide x 100' Long

Application Reference

NOTE: Reference www.cree.com/lighting for detailed installation instructions.

*Reference www.cree.com/lighting for a list of compatible housings.

0

150

300

450

20

40

60

CR6TM

T (800) 473-1234 F (800) 890-7507 T (800) 236-6800 F (262) 504-5415US: www.cree.com/lighting T (800) 473-1234 F (800) 890-7507Canada: www.cree.com/canada

PATOLE

Sample Medium

TM

L E D F L O O D L I G H T

Replaces70 WattMetal HalideFloodlightwww.rabweb.com • 888-722-1000

Meet the New Faceof Floodlights

www.rabweb.com • 888-722-1000

FFLED18

Dimensions

SpecificationsUL Listing Suitable for wet locations.Suitable for mounting within 4’ of the ground. LEDs Three multi-chip 6W, high-output, long-life LEDs

Driver Constant Current, Class 2, 100 - 277V, 50 - 60 Hz, 100 - 277VAC: 0.4 Amps

Input Watts 22Output Lumens* 1624Lumens Per Watt* 73Surge Protection 6 KV

Cold Weather Starting The minimum starting temperature is -40°C.

Heatsink Superior heat sinking with external Air-Flow fins

Housing Die-cast aluminum housing, lens frame and mounting arm

Mounting Heavy-duty mounting arm with “O” ring seal & stainless steel screw

Color Stability RAB LED products significantly exceed Energy Star Requirements for Chromatic Stability during LM-80 Testing.

Color Accuracy 70 CRI

Color Temperature (Nominal CCT) 5000K

Color Uniformity RAB’s range of CCT (Correlated Color Temperature) follows the guidelines of the American National Standard for Specifications for the Chromaticity of Solid State Lighting (SSL) Products, ANSI C78.377-2008.

Reflector Semi-specular anodized aluminum

Gaskets High-temperature silicone gaskets

Finish Chip and fade resistant polyester powder coat finish in bronze or white

Green Technology Mercury and UV free

IESNA LM-79 & LM-80 Testing RAB LED luminaires have been tested by an independent laboratory in accordance with IESNA LM-79 and LM-80, and have received the Department of Energy “Lighting Facts” label.

California Title 24 FFLED18 complies with California Title 24 building and electrical codes.

* Values shown for cool temperature. Visit www.rabweb.com for neutral and warm.

7”

8 5/8”

5 1/8”

Catalog Numbers & AccessoriesFFLED18 Bronze, Cool LightFFLED18W White, Cool LightFFLEDN18 Bronze, Neutral LightFFLEDN18W White, Neutral LightFFLEDY18 Bronze, Warm LightFFLEDY18W White, Warm Light

GDFFLED18W Wire GuardGDFFLED18P Shield

• 18 Watt High-Performance LED• Replaces 70W MH Floodlights• Highly Efficient: 73 Lumens Per Watt• 50,000 Hour Life Based on LM-80 Tests• Air-Flow Technology Heatsink• 5-Year Warranty• NEMA Type - 7H x 6V

PhotometricsFFLED18

10’ Mounting HeightAimed 30° Below Horizon

0 0

1 1

22

33

0 1 212

70W MH10’ Mounting Height

Aimed 30° Below Horizon

Multiples of Mounting Height. Values shown in Footcandles.

WPLED20

JOB NAME:

DATE:

TYPE:

DESCRIPTIONLED 20 Watt Wallpacks

SPECIFICATIONSUL ListingSuitable for wet locations. Suitable formounting within 4' of the ground.Cold Weather StartingThe minimum starting temperature is-40F/-40CTotal Harmonic DistortionTHD = 8.4%DriverAutomatic Voltage Sensing Driver for 120 _277 voltsAmbient TemperatureSuitable for use in 50C (122F) ambienttemperaturesFixture Efficacy65 Lumens per WattColor Accuracy70 CRIColor Temperature (Nominal CCT)5000 K (Daylight)LED Light EngineTwo Multi-chip 10W high output long lifeLED Driver Constant Current, Class 2HeatsinkIntegral cast aluminum mounting pad andexternal fins for optimal heat sinking toensure cool operation with maximum LEDlife and light output.HousingPrecision die cast aluminum housing, lensframe and moutning plate.Two Mounting OptionsJunction Box with 5 Conduit Entry Pointsand Threaded Plugs for surface mountingplus Cover Plate for mounting over 4"recessed junction box included withWPLED20

FinishChip and fade resistant polyester powdercoat finish.Color StabilityRAB LEDs exceed industry standards forchromatic stability.Color UniformityRAB's range of CCT (Correlated colortemperature) follows the guidelines of theAmerican National Standard forSpecifications for the Chromaticity of SolidState Lighting (SSL) Products, ANSIC78.377-2008.Green TechnologyRAB LEDs are Mercury, Arsenic and UVfree.Dark Sky ApprovedThe International Dark Sky Association hasapproved this product as a full cutoff, fullyshielded luminaire.For use on LEED BuildingsIDA Dark Sky Approval means that thisfixture can be used to achieve LEED Creditsfor Light Pollution Reduction.PatentsThe LPACK design is protected underpatents pending in the U.S., Canada, China,Taiwan and Mexico.IESNA LM-79 & IESNA LM-80 TestingRAB LED luminaires have been tested by anindependent laboratory in accordance withIESNA LM-79 and 80, and have receivedthe Department of Energy "Lighting Facts"label.GasketsHigh Temperature SiliconeWarrantyRAB LED fixtures give you peace of mindbecause both the fixture and light enginecomponents are backed by RAB's 5 YearWarranty. For more information,

DIMENSIONS

ORDERING INFORMATIONLED Total

WattsLamp Type

Lamp Base Ballast

Starting Amps/ Operating Amps120V 208V 240V 277V

Input Watts

LAMP ANSI

Initial Lumens

Lamp HoursLamp supplied with fixture

20 LED Heat-sink

Constant Current 0.19 0.12 0.10 0.08 22.0 N/A 1401 50000

Factory Installed OptionsAdd suffix to Catalog Number

Photocontrol for 277V (/PC2) Photocontrol for 120V (/PC)

RAB Lighting, Inc. • 170 Ludlow Ave• Northvale, NJ 07647 • Tel: 888 RAB-1000 • Fax: 888 RAB-1232 • www.rabweb.com© 2012

Note: Specifications may change without notice

PATOLE

Sample Medium

PATOLE

Sample Medium

PATOLE

Sample Medium

SAMPLE PROJECT

Lighting Controls

# Area New Fixture ActionExist. Quan.

New Quan.

Exist Contrl Exist Contrl Quan

% Fixt on Exist Contrl

New Control ActionNew

Contrl Quan.

% Fixt on New Contrl

1 DiningRetrofit -- 2 lamp 4' T12 w/ 2 lamp 4' T8, 32W, SXL, PS, LBF

6 6

2 DiningRetrofit -- 4 lamp 4' T12 w/ 2 lamp 4' T8, 32W, SXL, PS, NBF

6 6

3 KitchenRetrofit -- 4 lamp 4' T12 w/ 2 lamp 4' T8, 32W, SXL, PS, NBF

7 7

4 StorageRetrofit -- 2 lamp 4' T12 w/ 2 lamp 4' T8, 32W, SXL, PS, LBF

1 1

5 RestroomRetrofit -- 2 lamp 4' T12 w/ 2 lamp 4' T8, 32W, SXL, PS, LBF

1 1

6 Exterior Replace -- 150W HPS w/ 53W LED 1 1789

101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657

22 22

Location

Scope of Work

TOTAL

Required Information:

� INVOICE NUMBER AND DATE

� VENDOR NAME & ADDRESS

� ITEMIZED LIST OF EQUIPMENT MODEL NUMBER, MANUFACTURER, UNIT PRICE AND QUANTITY

� CUSTOMER NAME AND ADDRESS

� IF INVOICE IS FROM A VENDOR TO A CONTRACTOR, THECUSTOMER AND/OR ADDRESS WHERE INSTALLATIONOR SERVICE WAS PERFORMED SHOULD BE REFERENCED

� TOTAL AMOUNT DUE

SAMPLE LIGHTING INVOICE

Total Due: $2,070�

Quantity Manufacturer Model Description Unit Price Total

10 SYLVANIA 49867 QHE4X32T8/UNVISL-SC 4 LAMP F32T8 UNV VOLT BALLAST $15 $150

66 PHILIPS F32T8/ADV/850/ALTO HIGH LUMEN F32T8 LAMP $20 $120

2 WATTSTOPPER CI-305 Ceiling mt occupancy sensor $100 $200

10 GE 72266 GE232 MAX-N/ULTRA 2 LAMP F32T8 UNIV VOLT BALLAST $15 $150

1 PARAGON 1748E 6 LAMP T8 HIGH BAY FIXTURE $120 $120

10 LITHONIA 2ES8P 232 BILP L835HT8 2 X4 HIGH EFF. FIXT w/low BF ballast $133 $1330and high lumen lamps included

Remit to: XYZ Lighting Contractor, 111 Lighting Expert Road, Anytown, WI 53523

Installing Contractor:XYZ Lighting Contractor 111 Lighting Expert RoadAnytown, WI 53523

Sold To:John Q. Sample Corporation123 Save Energy WayAnytown, WI 53590

Invoice #: 00001Date: 04/22/09�

Ship To:John Q. Sample Corporation123 Save Energy WayAnytown, WI 53590

Project Name (customer if different from above):WI EnergySaver, Inc.�

�

�

�