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Metrics Collection Form

Thank you for taking the time to fill out NYSERDA’s metrics reporting form. Please make every effort to fill out all fields that are relevant to your project and engagement with NYSERDA. If you have a question about filling out this form or need any assistance or support, please send an email to metricshelp@NYSERDA.ny.gov

Please be aware that the reporting form has no save function, meaning that once you start filling it in, you will have to complete it in that sitting. With this in mind, we have linked below to a guidance document the complete list of the metrics you will be asked to provide. Please review the list and gather all the data necessary before you begin filling out the form. Once you have all the data the form should take approximately 20 minutes to fill out.

Please click here for the guidance document.

Please note: Partially completed information cannot be saved, be sure to have all details with you before beginning the form. For the best form completion experience, use the Google Chrome browser.

Contact Information

Project Type

Company Name

Contract Number

Report Contact Email

NYSERDA Project Manager

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Events

If during the course of reporting year 2015 you attended an event to present the results of your research or to promote your technology or products, please provide those details below. If you did not attend an event, please enter N/A in the first Event Type field below. If you have a question about filling out this form or need any assistance or support, please contact your NYSERDA Project Manager or send an email to metricshelp@NYSERDA.ny.gov

Event Type 1

Name of Event

Name of Organization Hosting Event

Number of Attendees at Event

Event Type 2

Name of Event

Name of Organization Hosting Event

Number of Attendees at Event

If there were additional events, please include below:

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Publications

Please only include publications from reporting year 2015. If you did not have any publications please enter N/A in the Publication Type 1. If you have a question about filling out this form or need any assistance or support, please contact your NYSERDA Project Manager or send an email to metricshelp@NYSERDA.ny.gov

Publication Type 1

Publication Title

Name of Authors (first and Last)

Date Published

Periodical Name

Was the publication cited in gov.policy?

Publication Type 2

Publication Title

Name of Authors (first and Last)

Date Published

Periodical Name

Was the publication cited in gov.policy?

If there are additional publications, please include below:

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Investment Metrics

Please include any grants (non-NYSERDA) and private investment that is not debt for the reporting year 2015. If you have a question about filling out this form or need any assistance or support, please contact your NYSERDA Project Manager or send an email to metricshelp@NYSERDA.ny.gov

List non-NYSERDA government grants your company, organization, or institution has received in reporting year 2015.

Awarding Agency 1

Amount

Notes

Awarding Agency 2

Amount

Notes

List all non-debt investment secured by your company, organization, or institution has received in reporting year 2015.

Investment Type 1

Name of Investor

Amount

Notes

Investment Type 2

Name of Investor

Amount

Notes

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Product Metrics

Please provide the following product metrics pertaining to reporting year 2015. If product metrics do not apply to your contract, please answer N/A in the Product Name field below. If you have a question about filling out this form or need any assistance or support, please contact your NYSERDA Project Manager or send an email to metricshelp@NYSERDA.ny.gov

Product Name

Current Development Stage of Project

Number of Units Sold Worldwide

Total Gross Sales Worldwide (in Dollars)

Number of Units Sold in New York

Total Gross Sales in New York (in Dollars)

Has a patent been issued during / or subsequent to the completion of this project?

Patent Date

Patent Number or Patent Application Number

Abstract or brief description of Patent

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Company Metrics

Please provide the following company metrics pertaining to reporting year 2015. If company metrics do not apply to your contract, please enter zero below. If you have a question about filing out this form or need any assistance or support, please contact your NYSERDA Project Manager or send an email to metricshelp@NYSERDA.ny.gov

Number of Full-time equivalent jobs retained in reporting year 2015 as a result of the NYSERDA contract

Number of Full-time equivalent jobs created in reporting year 2015 as a result of the NYSERDA contract

Annual income for full-time equivalent employees in NYS

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Demonstration / Deployment Metrics

Only answer the following questions if you have a demonstration project. If this section does not apply to your contract, please answer N/A in the Installation Status field below. If you have a question about filling out this form or need any assistance or support, please contact your NYSERDA Project Manager or send an email to metricshelp@NYSERDA.ny.gov

Installation Status

Expected duration (years) of installation of equipment (20 years max)

Were there additional installations of the technology or product beyond the NYSERDA supported demonstration project?

If yes, indicate year of first replication

If yes, on how many sites have units been deployed

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Demonstration Metrics - Resources Saved

Only fill out the below information if the product/or technology has been deployed or piloted. Please provide information on resources saved as a result of the deployment pilot or demonstration. If you have a question about filling out this form or need any assistance or support, please contact your NYSERDA Project Manager or send an email to metricshelp@NYSERDA.ny.gov

Energy

Resource Type 1

Unit of Measurement

Number of Units

Dollars

Resource Type 2

Unit of Measurement

Number of Units

Dollars

If there are additional energy savings, please include below:

Emissions

Resource Type 1

Unit of Measurement

Number of Units

Dollars

Resource Type 2

Unit of Measurement

Number of Units

Dollars

If there are additional emissions savings, please include below:

Non-Energy

Resource Type 1

Unit of Measurement

Number of Units

Dollars

Resource Type 2

Unit of Measurement

Number of Units

Dollars

If there are additional non-energy savings, please include below:

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Demonstration Metrics - Resources Used

Only fill out the below information if the product/or technology has been deployed or piloted. Please provide information on resources used as a result of the deployment pilot or demonstration. If you have a question about filling out this form or need any assistance or support, please contact your NYSERDA Project Manager or send an email to metricshelp@NYSERDA.ny.gov

Energy

Resource Type 1

Unit of Measurement

Number of Units

Dollars

Resource Type 2

Unit of Measurement

Number of Units

Dollars

If there is any additional energy usage, please include below:

Emissions

Resource Type 1

Unit of Measurement

Number of Units

Dollars

Resource Type 2

Unit of Measurement

Number of Units

Dollars

If there are additional emission, please include below:

Non-Energy

Resource Type 1

Unit of Measurement

Number of Units

Dollars

Resource Type 2

Unit of Measurement

Number of Units

Dollars

If there is any additional non-energy usage, please include below:

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