This document discusses achieving 30% energy savings above ASHRAE 90.1-2010 baseline for a sample 150,000 square foot mid-rise medical office building project in Cincinnati. Ten energy conservation measures were modeled, achieving 26% savings. Additional measures discussed include separate outdoor air treatment, energy recovery, efficient elevators and minor model refinements. The process of developing schematic energy models, refining assumptions through design, and ensuring model assumptions are reflected in construction documents and submittals is outlined. Questions from the audience about LEED experience and other resources for high energy savings guidance are invited.