Energy Roadmapping Technical Assistance Application Form Energy Roadmapping Technical Assistance Form You must have JavaScript enabled to use this form. If you are a Bay Area local government or special district staff member interested in receiving customized energy planning and technical support through BayREN’s Energy Roadmapping service for your public (municipal) buildings or future Community Resilience Centers (CRCs), please complete and submit this form. For more information about CRCs (also known as resilience hubs), visit: https://resilience-hub.org. General Information First Name Last Name Job Title Department Email Phone Number Local jurisdiction or special district that you work for Does your local government or special district have existing plans or policies, such as a climate or energy action plan, that include energy or resilience goals and actions for your public buildings? Is your local government or special district able to commit up to 20 hours of Public Works (or similar department) staff time to actively participate throughout the roadmapping process AND support the implementation of some of the recommended energy measures in the roadmap within the next three years? Yes No, we are unable to commit the necessary staff time. How did you learn about BayREN’s Energy Roadmapping Service? (select all that apply) Attended a workshop or presentation Previously participated in BayREN program County representative Local Government Partnership Other public agency Contractor Web search BayREN newsletter/website Digital media (social media, online ad) CCA PG&E Letter/postcard Email Other, please specify: General Project Details Select the option that best describes your project focus: Single Building (not a CRC) Single CRC Multiple Buildings (no CRCs) Multiple CRCs Multiple Buildings and CRCs Select the option that best describes your building(s) project status: Existing building(s) retrofit New construction Does your public building(s) receive gas and/or electric distribution service from Pacific Gas and Electric (PG&E)? Community Choice Aggregator (CCA) customers are also eligible to participate. Yes No Please provide details about your goals and project scope for each building project site. Is your local government interested in any of the following recommendations for your building project sites? Energy efficiency upgrades Solar + battery storage Building electrification upgrades Electric vehicle charging infrastructure Other, please specify: This question applies only if your project involves a CRC: Has your local government or special district already conducted community outreach and planning efforts to identify future CRC goals and critical features? Yes No In Progress N/A Leave this field blank