GEMP 1-A

GOVERNMENT ENERGY MANAGEMENT PROGRAM (GEMP)

SURVEY OF GOVERNMENT AIRCONDITIONING UNITS AND GENERATORS
(In compliance with R.A. 11285 and its IRR)

Name of Government Agency/Office : _______ Contact No.: ______________

Address : _______ Date: _________

AIRCONDITIONING UNIT
Nameplate Rating Operation
Category
Status
Area Type Quantity (Inverter, Energy
(Operational, Non- Cooling Capacity Power Year of
No. Location (dimension per (Window, Split, (No. of Non- Efficiency Purchase Hours per Days per
Operational, Capacity Rating Input
room, sqm) Package/Floor Type) unit) Inverter Ratio Day Week
Stand-by) (KJ/hr) (HP or TR) (KW)
Type) (EER)
WINDOW TYPE NON-
1 ASSESSOR'S OFFICE CARRIER OPERATIONAL 1 INVERTER 1.5 HP 8 5

2 ASSESSOR'S SPLIT TYPE OPERATIONAL 1 NON- 1 HP 8 5

HEAD OFFICE CARRIER INVERTER
3 ASSESSOR'S WINDOW TYPE OPERATIONAL 1 INVERTER 8800 1 HP 660 W 8 5
STORAGE ROOM CONDURA
SPLIT TYPE
4 TREASURER'S OFFICE DAIKIN OPERATIONAL 1 INVERTER 2.5 HP 6.45 KW 8 5

5 TREASURER'S WINDOW TYPE OPERATIONAL 1 INVERTER .8 HP 8 5

HEAD OFFICE CARRIER
6 TREASURER'S OFFICE SPLIT TYPE OPERATIONAL 1 INVERTER 2.5 HP 8 5
CARRIER
TREASURER'S OFFICE SPLIT TYPE
7 KITCHEN CARRIER OPERATIONAL 1 INVERTER 7250-12000 1 HP 8 5

8 ACCOUNTING OFFICE SPLIT TYPE OPERATIONAL 1 INVERTER 2 HP 6.45 KW 8 5

DAIKIN
9 ACCOUNTING HEAD SPLIT TYPE OPERATIONAL 1 INVERTER 1.5 HP 3.52 KW 8 5
OFFICE DAIKIN
ACCOUNTING OFFICE WINDOW TYPE NON-
10 KITCHEN CARRIER OPERATIONAL 1 INVERTER 1 HP 8 5

11 BUDGET OFFICE FLOOR TYPE OPERATIONAL 1 INVERTER 37980 3 TR 186 W 8 5

CARRIER
12 INFORMATION OFFICE FLOOR TYPE OPERATIONAL 1 INVERTER 37980 3 TR 186 W 8 5
CARRIER
TRAFFIC MANAGEMENT SPLIT TYPE
13 OFFICE DAIKIN OPERATIONAL 1 INVERTER 2 HP 35 W 8 5

14 LICENSING OFFICE FLOOR TYPE OPERATIONAL 2 INVERTER 3 TR 186 W 8 5

CARRIER
15 CIVIL REGISTRAR'S SPLIT TYPE OPERATIONAL 1 INVERTER 1.5 HP 4.50 KW 8 5
OFFICE CARRIER
CIVIL REGISTRAR'S WINDOW TYPE
16 HEAD OFFICE CARRIER OPERATIONAL 1 INVERTER 1.5 HP
 CIVIL REGISTRAR'S WINDOW TYPE NON-
OPERATIONAL 1 1 HP
OFFICE CARRIER INVERTER
WINDOW TYPE NON-
ONE STOP SHOP OFFICE CARRIER OPERATIONAL 1 INVERTER 1.5 HP
MUNICIPAL TRIAL COURT WINDOW TYPE OPERATIONAL 1 INVERTER 1 HP
JUDGE OFFICE EVEREST
SPLIT TYPE
MUNICIPAL TRIAL COURT OPERATIONAL 1 INVERTER 2 HP 6.45 KW
DAIKIN
COA OFFICE SPLIT TYPE OPERATIONAL 1 INVERTER 1.5 HP
CARRIER
MICT OFFICE WINDOW TYPE OPERATIONAL 1 NON- 1 HP
CONDURA INVERTER
SPLIT TYPE
MICT OFFICE OPERATIONAL 1 INVERTER 2000-15000 1.5 HP 145 KW
CONDURA
MICT SERVER ROOM SPLIT TYPE OPERATIONAL 1 INVERTER 2000-15000 1.5 HP 145 KW
CONDURA
MICT SERVER ROOM WINDOW TYPE OPERATIONAL 1 NON- 1.5 HP
CONDURA INVERTER
WINDOW TYPE NON-
HRMO OPERATIONAL 1 1 HP
EVEREST INVERTER
HRMO SPLIT TYPE OPERATIONAL 1 INVERTER 1 HP 4.5 KW
CARRIER
HRMO WINDOW TYPE OPERATIONAL 1 NON- 1 HP
CONDURA INVERTER
WINDOW TYPE NON-
ELECTRICAL ROOM OPERATIONAL 1 1 HP
CARRIER INVERTER
ENGINEERING OFFICE SPLIT TYPE OPERATIONAL 1 INVERTER 9200-18750 2 HP 625-1520W
CARRIER
ENGINEERING OFFICE SPLIT TYPE OPERATIONAL 1 INVERTER 8600 1 HP 650 W
CARRIER
WINDOW TYPE
ENGINEERING OFFICE OPERATIONAL 1 INVERTER 1 HP
MIDEA
ENGINEERING OFFICE SPLIT TYPE OPERATIONAL 1 INVERTER 1.5 HP
CARRIER
ENGINEERING OFFICE WINDOW TYPE OPERATIONAL 1 NON- 24150 1 HP 2220 W
CARRIER INVERTER
WINDOW TYPE NON-
LEGAL OFFICE OPERATIONAL 1 2 HP
GREE INVERTER
17
 TOTAL BUILDING GROSS FLOOR AREA (m²) TOTAL AIR-CONDITIONED FLOOR AREA (m²)

GENERATORS

Brand Quantity Capacity (kW) Status Remarks

(Please use another sheet if necessary)

Prepared By: (Name and Designation) Approved By:

__________________________________ __________________________________
Energy Efficiency and Conservation Officer Head of Agency
 GEMP 2

GOVERNMENT ENERGY MANAGEMENT PROGRAM (GEMP)

SURVEY ON LIGHTING SYSTEM
(In compliance with R.A. 11285 and its IRR)

Name of Government Agency/Office : _______________________________________ Contact No.: __________________________

Address : _______________________________________________________________ Date: ________________________________

LIGHTING SYSTEM
Type of Fixture

Type of Lamp Wattage Surface Type of Ballast

No. Location Quantity Recessed with Suspended
(FL, IB, CFL, LED) (W) Recessed with Surface mounted Suspended with mounted with (Magnetic,
Reflector & with reflector Open Remarks
Reflector with Reflector reflector reflector & Electronic,
Diffuser & Diffuser
Diffuser Rapid-Start)

(Please use another sheet if necessary)

Prepared By: (Name and Designation) Approved By:

Energy Efficiency and Conservation Officer Head of Agency

 GEMP FORM -2
Region : III
GOVERNMENT ENERGY MANAGEMENT PROGRAM (GEMP)
INVENTORY OF VEHICLES
(In compliance with R.A. 11285 and its IRR)

Name of Government Agency/Office : MUNICIPALITY OF GUIGUINTO Contact No.: (044) 794-1664 loc. 200
Address : POBLACION GUIGUINTO BULACAN Date: NOVEMBER 14, 2022

VEHICLE NO. 1
MANUFACTURER TYPE/SERIES 2021 FUEL CONSUMPTION (L)
NO. OF LITERS ODOMETER BY FUEL EFFICIENCY
MONTH
CONSUMED END OF MONTH (KM) (KM/L)
JANUARY
PLATE NO. FUEL TYPE FEBRUARY
MARCH
APRIL
YEAR MODEL BODY TYPE MAY
JUNE
JULY
GROSS WEIGHT NET WEIGHT AUGUST
SEPTEMBER
OCTOBER
NOVEMBER
DECEMBER
VEHICLE NO. 2
MANUFACTURER TYPE/SERIES 2021 FUEL CONSUMPTION (L)
NO. OF LITERS ODOMETER BY FUEL EFFICIENCY
MONTH
CONSUMED END OF MONTH (KM) (KM/L)
JANUARY
PLATE NO. FUEL TYPE FEBRUARY
MARCH
APRIL
YEAR MODEL BODY TYPE MAY
JUNE
JULY
GROSS WEIGHT NET WEIGHT AUGUST
SEPTEMBER
OCTOBER
NOVEMBER
DECEMBER
*Please provide historical data from 2021-present
 GEMP FORM -3
Region : ____
GOVERNMENT ENERGY MANAGEMENT PROGRAM (GEMP)
INVENTORY OF VEHICLES
(In compliance with R.A. 11285 and its IRR)

Name of Government Agency/Office : _______________________________________ Contact No.: __________________________

Address : _______________________________________________________________ Date: ________________________________

ODOMETER READING (KM)

NO. MANUFACTURER TYPE/SERIES PLATE NO. TRANSMISSION BODY TYPE YEAR MODEL FUEL TYPE
AS OF DECEMBER 31, 2020
1 TOYOTA INNOVA ABC-1234 MANUAL TRANSMISSION WAGON/AUV 2018 GASOLINE 1,234
 GOVERNMENT ENERGY MANAGEMENT PROGRAM (GEMP)
INVENTORY OF OTHER OFFICE EQUIPMENT
(In compliance with R.A. 11285 and its IRR)

Name of Government Agency/Office : _______________________________________

Address : _______________________________________________________________

STATUS OPERATION
NO. LOCATION OFFICE EQUIPMENT TYPE BRAND/MODEL (Operational/ QUANTITY RATING (WATTS)
Non-Operational) HOURS PER DAY DAYS PER MONTH
1 Accounting Office Computer Set CPU: Acer / Monitor: Acer Operational 11 8 22
Laptop Asus Operational 1 8 22
Printer Epson L360 Operational 3 8 22
Printer Epson L3110 Operational 2 8 22
Printer Epson Cat a8 Operational 3 8 22
Printer HP 3110 Operational 1 8 22
Printer Epson L3210 Operational 2 8 22
Tablet Alcatel Operational 1 8 22
Television Samsung Operational 1 1 22

MIS NGA's server Acer Operational 1 8 22

(Please use another sheet if necessary)

Prepared By: (Name and Designation) Approved By:

Energy Efficiency and Conservation Officer Head of Agency

 GEMP 5

REMARKS

Head of Agency

Desktop Computer
Laptop
Printer
Scanner
Refrigerator
Hot and Cold Water Dispenser