SECTION C. EQUIPMENT & SERVICE INFORMATION (This section to be completed by contractor.) PLEASE PRINT
CENTRAL AIR CONDITIONER EQUIPMENT INFORMATION:
Manufacturer Serial Number Quantity
Model Name Model Number
Age of Central Air Conditioner Unit Cooling Capacity (tons) SEER Rating
SERVICE INFORMATION: Date of Service: ____________________________________ Cost of Service: ____________________________________________
Service Checklist: TECHNICIAN: Please sign the front of this application to certify all checklist items have been completed!
o
Check voltage/amperage
o
Clean and inspect condenser coil
o
Check thermostat operation and control sequence
o
Clean condensate drain line
o
Inspect belt condition
o
Clean, inspect, and lubricate motors
o
Inspect and lubricate blower
o
Clean or replace air filter
o
Check coolant level and pressure
o
Confirm proper air flow
o
Perform visual inspection of entire air conditioner system
SECTION D. REBATE APPLICATION CHECKLIST
This program offers a $25 rebate for the completion of a professional clean and tune-up of your central air conditioner. Use this checklist
to complete the steps to receive your rebate:
o 1. Read the following terms and conditions to determine if you are eligible for a rebate:
• Only one service address per application per year. This program is only for existing homes and small commercial customers with central
air conditioners or air source heat pumps less than or equal to 5.5 tons (66,000 btu’s). New construction is not eligible. Customers are
eligible for a tune-up rebate every two years. Customers
who have a service agreement with an HVAC dealer are eligible provided that the
service contract is provided with the rebate application.
• The Utility reserves the right to apply rebates to past due accounts. Rebates $75 and under will be applied to your account. Rebates will
not exceed the cost of service.
• Central Air Conditioner Clean & Tune-Up must be performed on equipment connected to an electric service supplied by Austin Utilities,
Owatonna Public Utilities, or Rochester Public Utilities and is subject to inspection.
•
The Central Air Conditioner Clean & Tune-Up service must be performed by a professional HVAC service technician. Austin Utilities, Owatonna
Public Utilities, and Rochester Public Utilities assume no liability for any incidental or consequential damages resulting from the Central Air
Conditioner Clean & Tune-Up service provided by the service technician. The Utility reserves the right to reject any rebate application submitted
as a result of work performed by a contractor who has failed to adhere to the terms and conditions established for the rebate program.
• The Central Air Conditioner Clean & Tune-Up service must meet the Minimum Service Requirements as specified in this rebate application
Section C. EQUIPMENT & SERVICE INFORMATION.
• Due to limited funding, this rebate offer can be withdrawn at any time without notice. Applications will be processed on a first-come,
first-served basis. All applications from this year’s purchases (2021) must be received by March 31, 2022.
• Rebates can only be offered on Central Air Conditioner Clean & Tune-Up services that are completed while funding is in effect. In the
event our program is discontinued due to depleted funds, we will not provide a rebate for Clean & Tune-Up services completed between
the discontinued date and the end of that year.
o 2. Customer must complete Section A. Contractor must complete Sections B and C making sure to fill out all required sections in detail. Allow
6-8 weeks for processing. Missing or incorrect information will increase the processing time
.
o 3.
Include a final, detailed copy of the original service receipt or invoice showing the customer name as well as the date, description, and cost of service.
o 4. Sign the application.
o 5. Information contained in this rebate application may be shared with the Minnesota Department of Commerce and our co-op partners.
o 6. Mail completed forms and required documentation to your utility provider:
Austin Utilities Owatonna Public Utilities Rochester Public Utilities
Attn: Rebate Processing Attn: Rebate Processing Attn: Rebate Processing
1908 14th St NE PO Box 800 4000 E River Rd NE
Austin, MN 55912-4904 Owatonna, MN 55060-0800 Rochester, MN 55906-2813
507-433-8886 507-451-2480 507-280-1500
www.austinutilities.com www.owatonnautilities.com www.rpu.org
or email: rebates@austinutilities.com or email: rebates@owatonnautilities.com or email: rebates@rpu.org
2
PLEASE PRINT ON RECYCLED PAPER 0121
SECTION B. CONTRACTOR INFORMATION (This section to be completed by contractor.) PLEASE PRINT
ALL SERVICE WORK MUST BE PERFORMED BY A PROFESSIONAL HVAC SERVICE TECHNICIAN.
Business Name Technician Name
Mailing Address City State Zip Code
Contact Phone Number (with area code) E-mail Address
(For multiple units, attach
a list of serial numbers
for each unit serviced.)
