CONTACT

PRE-ANALYSIS
Fill out the form so we can learn a little bit about your company and give you a personalized pre-analysis.


	General Information
*	Company
*	Contact Number
*	E-mail
*	Telephone			Fax
*	Address
*	Neighborhood
*	City
*	State		*	Zip (00000-000)

	Average Monthly Expenses (R$)
	Electricity	R$		Fuel	R$
	Gas	R$		Other (specify)	R$
	Specifications

	Eletricity
	Briefly summarize the areas of equipment or utilities you think could be a opportunity to implement an Energy Efficiency Project:


	The Electric Bill information is very important for us to evaluate the situation. If you would like, you can send this information by fax or email, or just by filling out the fields below.

	Electricity Contract
	Consumer			Rate
	Do you have more than one power input?			Feed
	Peak Demand
	Off-Peak Demand

	Power Factors
	Charge for exceeding returns			Bank of Capcitators
	State			Total Power of Banks Installed	kvar-h

	Motors
	Average Age of Motors	anos		Any Reverse Motors?
	Quantity of Power Classes			Do you have any Motors?
	0,25 cv a 10 cv	units		High Performance	units
	10 cv a 50 cv	units		With Inverters	units
	50 cv a 100 cv	units		With Soft Starter	units
	> 100 cv	units
	General State

	Refrigeration and Climatization
	Is cold water used in the process?			Average Age of Equipment	years
	Type of Refrigeration Fluid	Indicate if it is R12, R22, Ammonia , 134, Propane, etc.		Installed Capacity	TR BTU/h
	Quantity of Industrial System Equipment of Refrigeration:
	Water-Cooled Centrifugal Chiller			Water-Cooled Screw Chiller
	Air-Cooled Screw Chiller			Alternative Water Chiller
	Self Contained Água			Self Contained Air
	Condensate Pump			Cold Water Pump
	Cooling Tower			Evaporative Condenser
	Quantity of Climatization System Equipment:
	Water-Cooled Centrifugal Chiller			Water-Cooled Screw Chiller
	Air-Cooled Screw Chiller			Alternative Water Chiller
	Self Contained Água			Self Contained a Ar
	Single-room air conditioning			Splits
	Cooling Tower			Condensate Pump
	Cold Water Pump

	Heating (furnace, stove and heaters)
	Do you use fuel during the process?	Electricity,LPG, Natural Gas, etc.		Monthly Consumption of Fuel:	Indicate unity
	Monthly Fuel Expense (R$)
	Type of Use (describe the heating purpose)


	Steam
	Do you have a Boiler?			Fuel	GLP, Natural Gas, BPF Oil, etc.
	Monthly Fuel Consumption			Nominal Flow
	Nominal Pressure			Monthly Fuel Expense

	Energy Management
	Do you have a power manager?			Does it control the load?
	Make			Model

	Illumination
	Illumination Systems
	Type of Light Bulb	Quantity		Power	Daily Hours of Operation
	Incandescent			w
	Mixed			w
	Sodium			w
	Fluorescent			w
	Mercury			w
	Metallic			w
	Condensed			w

	Ventilation, Insufflations and Exhaust
	Quantity in the Power Classes
	0,25 Cv A 10 Cv			10 Cv A 50 Cv
	50 Cv A 100 Cv			>100 Cv
	Type of Use (describe the purpose of ventilation)


	Compressed Air and Vacuum
	Amount of Compression:			Average Nominal Flow of Each Compressor
	Operational Compression			Type of Compressor

	Compressor in the Process
	Quantity in the Power Classes
	0,25 Cv A 10 Cv			10 Cv A 50 Cv
	50 Cv A 100 Cv			>100 Cv
	Types of Compressors and Fluids Used in the Process (Describe)


	Pumps in the Process
	Quantity in the Power Classes
	0,25 Cv A 10 Cv			10 Cv A 50 Cv
	50 Cv A 100 Cv			>100 Cv
	Types of Pumps and Fluids involved in the Process (Describe)


	Power Generators
	Quantity			Power
	Fuel			Used During Peak Hours?

	For Hospitals
	Number of Beds			Type of Heating
	Quantity of Showers			Central Heating
	Shower Flow

	For Hotels
	Number of Rooms			Type of Heating
	Quantity of Showers			Central Heating
	Quantity of Bath Tubs			Shower Flow

	*Required Information

	I declare that I have authorized the furnishing this information for the pre-analysis elaborated by MGD.

Rua Dona Ana Pimentel, 157
CEP 05002-040
São Paulo - SP