This form establishes the formal evaluation and permitting process for the installation of multi-dock electric vehicle charging infrastructure within corporate parking garage facilities. Complete all sections with precise technical and operational data to ensure comprehensive risk assessment and compliance verification.
Vendor Company Legal Name
Primary Vendor Contact Person
Vendor Contact Email
Vendor Contact Phone
Proposal Submission Timestamp
Project Identification Number
Total Number of Charging Docks Proposed
Charging Levels Included in Proposal
Level 2 AC (7-22kW)
DC Fast Charging (50-150kW)
DC Ultra-Fast (150kW+)
Wireless/Inductive
Other
Total Estimated Project Capital Expenditure
Estimated Project Duration (Calendar Days)
Provide comprehensive facility and electrical infrastructure metadata to establish baseline conditions and spatial context for the proposed EV charging installation. Accurate geolocation and transformer specifications are critical for utility coordination and load planning.
Corporate Facility Official Name
Facility Full Street Address
Building Classification Type
Commercial Office Tower
Industrial Warehouse
Mixed-Use Development
Research & Development Campus
Data Center Facility
Other
Total Parking Garage Levels
Target Installation Level(s) Identifier
Available Parking Spaces on Target Level(s)
Proposed EV-Designated Parking Spaces
Structural Load Capacity of Target Deck (kg per sq meter)
Primary Electrical Transformer Asset ID(s)
Transformer Age (Years from Installation)
Is transformer age exceeding 20 years?
Transformer Rated Capacity (kVA)
Current Average Transformer Load Percentage
Does current load exceed 70% of rated capacity?
Transformer Manufacturer and Model
Last Major Maintenance or Inspection Date
Upload Certified Transformer Specification Sheet
Upload Architectural Garage Layout Plan (CAD/PDF)
Upload Photographs of Proposed Installation Area (Minimum 3 angles)
Upload Photographs of Existing Transformer Location
Conduct detailed electrical load analysis and grid capacity verification to ensure proposed EV charging infrastructure will not compromise building power quality or trigger excessive demand charges. Include third-party inspection validation.
Utility Service Provider Name
Service Connection Voltage Configuration
Utility-Confirmed Available Capacity for EV Load (kVA)
Proposed Total Charging Infrastructure Capacity (kW)
Per-Dock Power Demand Calculation Matrix
Charging Level Type | Number of Ports | Power per Port (kW) | Simultaneous Usage Factor % | Calculated Demand (kW) | Peak Amperage Draw (A) | |
|---|---|---|---|---|---|---|
Level 2 AC | 16 | 7.2 | 80 | 92.16 | 111 | |
DC Fast Charge | 4 | 60 | 60 | 144 | 173 | |
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Building Peak Electrical Demand Time (Typical)
Current Peak Building Load Excluding EV (kW)
Current Demand Charge Rate per kVA
Proposed Load Balancing & Peak Shaving Strategy
Static Load Limiting
Dynamic Load Management (DLM)
Battery Energy Storage System (BESS) Integration
Scheduled Charging Windows
Utility Demand Response Program
No Active Load Management
Will installation require utility service upgrade?
Third-Party Electrical Inspector Name
Grid Capacity Inspection Date & Time
Grid Capacity Inspection Result
Pass - Within Safe Operating Parameters
Pass with Minor Observations
Conditional Pass - Remediation Required
Fail - Critical Capacity Issues
Upload Grid Capacity Inspection Report
Verify full compliance with municipal electrical codes and fire safety regulations. All permits must be secured and inspections passed prior to installation commencement. Document all interactions with authorities having jurisdiction.
Primary Electrical Permitting Authority
Electrical Permit Application Number
Electrical Permit Status
Not Yet Applied
Under Review
Approved - Permit Issued
Approved with Conditions
Denied
Under Appeal
Fire Authority Having Jurisdiction (AHJ)
Fire Safety Permit Number
Applicable Fire Code Version or Standard
Fire Safety Requirements Checklist (Select All Applicable)
Fire Detection and Alarm System Integration
Emergency Shutdown System (ESS)
Thermal Runaway Detection
Enhanced Ventilation for Battery Storage
Fire Suppression System (Sprinkler/Water Mist)
Emergency Responder Access Route
Hazardous Materials Storage Compliance
Smoke Control System Interface
Explosion Venting Calculation
None of the Above
Does garage have adequate ventilation per charging equipment heat dissipation calculations?
Rate Fire Suppression System Adequacy for Proposed EV Infrastructure
Is emergency egress clearance maintained per code with charging equipment installation?
Electrical Inspector Name and License Number
Electrical Inspection Date
Fire Inspector Name and Badge Number
Fire Safety Inspection Date
Inspection Results Summary
Fail | Pass with Major Deficiencies | Pass with Minor Observations | Full Pass | |
|---|---|---|---|---|
Electrical Code Compliance | ||||
Fire Code Compliance | ||||
Structural Safety | ||||
Ventilation Adequacy | ||||
Emergency Systems Integration |
List All Identified Deficiencies and Corrective Actions Required
Estimated Total Remediation Cost
Upload Approved Electrical Permit Document
Upload Fire Authority Inspection Report
Final Compliance Certificate Number
Define commercial and technical parameters for employee payment processing and tariff structures. Ensure integration with corporate financial systems and establish transparent cost recovery mechanisms with full audit trails.
Payment Gateway Service Provider
Integration Architecture
API-Direct Integration
Hosted Payment Page
Mobile Wallet SDK
Corporate Card-On-File System
Hybrid Multi-Gateway
Transaction Processing Fee Percentage
Fixed Transaction Fee per Charge Session
Primary Employee Tariff Structure Model
Flat Rate per kWh
Time-of-Use (TOU) Pricing
Tiered Consumption Pricing
Monthly Subscription Unlimited
Session-Based Flat Fee
Hybrid Multi-Component
Comprehensive Tariff Calculation Framework
Employee Tier Classification | Base Connection Fee | Energy Rate (per kWh) | Session Initiation Fee | Idle Fee (per hour after charging) | Monthly Cap (max charge) | |
|---|---|---|---|---|---|---|
Executive Staff | $0.50 | $0.35 | $0.00 | $5.00 | $75.00 | |
General Employees | $0.50 | $0.40 | $1.00 | $8.00 | $50.00 | |
Visitors/Contractors | $1.00 | $0.50 | $2.00 | $10.00 | $0.00 | |
Peak Hours Surcharge Percentage (if applicable)
Off-Peak Discount Percentage (if applicable)
Will corporation subsidize employee charging costs?
Monthly Corporate Subsidy Budget Cap
Financial Viability & Payback Analysis
Cost/Benefit Item | Monthly Value | Annual Projection | 10-Year NPV | |
|---|---|---|---|---|
Charging Revenue (Gross) | $4,200.00 | 50400 | $2,116,800,000.00 | |
Gateway Fees | $420.00 | 5040 | $21,168,000.00 | |
Electricity Cost | $2,100.00 | 25200 | $529,200,000.00 | |
Net Revenue | $1,680.00 | 20160 | $338,688,000.00 | |
$0.00 | ||||
$0.00 | ||||
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$0.00 | ||||
$0.00 |
Payment Gateway Integration Testing Status
Not Started
In Progress
Successfully Completed
Failed - Requiring Redesign
Employee Authentication Methods (Select All Applicable)
Corporate ID Badge RFID
Mobile App QR Code
License Plate Recognition
Credit Card Pre-registration
Single Sign-On (SSO) Corporate Login
Guest Code Generation
Employee Billing Cycle
Real-Time per Session
Weekly Consolidated
Monthly Payroll Deduction
Quarterly Invoice
Prepaid Wallet
Upload Payment Gateway API Integration Documentation
Final technical validation and operational readiness certification by senior facilities leadership. This section confirms that all engineering, safety, and operational prerequisites have been satisfied and that the installation is authorized to proceed under specified conditions.
Chief Building Engineer Full Legal Name
Chief Building Engineer Professional License Number
Chief Building Engineer Email Address
Chief Building Engineer Sign-Off Timestamp
Chief Building Engineer Digital Signature
Chief Building Engineer Technical Validation Checklist
Strongly Disagree | Disagree | Neutral | Agree | Strongly Agree | |
|---|---|---|---|---|---|
Electrical capacity analysis is accurate and conservative | |||||
Transformer loading projections are validated | |||||
Structural mounting plans are sound | |||||
Fire safety integration is complete | |||||
Load management strategy is robust | |||||
Maintenance access is adequate | |||||
Vendor technical competency is confirmed |
Does Chief Building Engineer recommend proceeding with installation?
Facilities Operations Director Full Legal Name
Facilities Operations Director Title
Facilities Operations Director Email Address
Facilities Operations Director Sign-Off Timestamp
Facilities Operations Director Digital Signature
Operational Readiness Confirmation Checklist
Operations staff training plan approved
24/7 monitoring system access configured
Preventive maintenance schedule established
Spare parts inventory identified
Vendor support SLA contract executed
Employee communication plan published
Helpdesk escalation procedures documented
Insurance and liability coverage verified
Has comprehensive operations training been completed?
Final Authorization Status
Full Unconditional Approval
Conditional Approval - Minor Modifications
Conditional Approval - Major Modifications
Rejected - Significant Issues Remain
Specify Any Conditions, Limitations, or Operational Restrictions
Final Comments and Project Authorization Statement
Upload Consolidated Risk Assessment Report
Upload Final Approved Single-Line Electrical Diagram
Establish critical path milestones and accountability framework for project execution. Timeline must align with permit validity periods and utility coordination schedules.
Permit Application Submission Date
Permit Approval Receipt Date
Planned Installation Start Date
Target Commissioning & Go-Live Date
Permit Validity Duration (Days)
Rank Critical Success Factors by Importance
On-time completion | |
Budget adherence | |
Safety record | |
Code compliance | |
Employee satisfaction | |
System reliability | |
Financial ROI |