Fillable COMMERCIAL AIR SOURCE HEAT PUMPS REBATE APPLICATION (Owatonna Public Utilities)

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COMMERCIAL AIR SOURCE HEAT PUMPS REBATE APPLICATION (Owatonna Public Utilities)

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COMMERCIAL AIR SOURCE HEAT PUMPS REBATE APPLICATION
SECTION A. CUSTOMER INFORMATION (please print)
Account Name Doing Business As (if different from Account Name)
Installation Address City State Zip Code
Mailing Address (if different from above) (rebate check will be mailed here) City State Zip Code
Account Number
o
Send us a rebate check.
o
Apply rebate to our account.
(Rebates $75 and under will be applied to your account. If a box is not checked a bill credit will automatically be issued.)
Type of Business:
o
Church
o
Government
o
Grocery
o
Health
o
Industrial
o
Lodging
o
Multi-family
o
Office
o
Restaurant
o
Retail
o
School
o
Other___________________________
How did you hear about CONSERVE & SAVE
®
?
o
Billboard
o
Chamber of Commerce
o
Contractor
o
Newspaper
o
Radio
o
Retailer/Vendor
o
Social Media
o
TV
o
Utility Newsletter
o
Utility Representative
o
Utility Web Site
o
Other_________________________
SECTION B. CONTACT INFORMATION (please print)/CUSTOMER SIGNATURE
ATTENTION:
ALL INVOICES OR RECEIPTS AND ALL SPECIFICATION SHEETS MUST BE INCLUDED WITH
YOUR FULLY-COMPLETED AND SIGNED APPLICATION OR APPLICATION WILL BE RETURNED.
( )
Contact Name (rebate check will be mailed to contact) Daytime Phone Number
Email
By typing my first and last names in the box below, I am signing this document and certify that all the information in the application (including any associated worksheets)
is correct to the best of my knowledge. I have read and agree to the Terms and Conditions on the back of this application booklet. I understand that if any equipment in
conjunction with this application is ordered, purchased, or installed before approval from The Utility is received, the proposed project may not qualify for a rebate.
Customer’s Signature Date
o
Check here if you DO NOT give us permission to use your business name in advertising our CONSERVE & SAVE
®
programs.
SECTION C. CONTRACTOR/VENDOR INFORMATION (please print)
Company Name Contact Name
Address City State Zip Code
( )
Daytime Phone Number Email
OFFICE USE ONLY
Date Received:__________________________________
Inspected (Date & Initials): Pre:_______________________ Post:________________________
Approval:____________________________________________
Date:_______________________________________________
A/N:_________________________________________________
TOTAL REBATE:
$
MN
MN
MN
MS
2
SEER – Seasonal Energy Efficiency Rating; HSPF – Heating Seasonal Performance Factor; COP – Coefficient of Performance; Tons Cooling Capacity = Btuh Cooling Capacity / 12,000
1
www.ahridirectory.org
2
For multi-head ductless systems, the capacity is the minimum of the total indoor unit capacity or the outdoor unit capacity.
3
ASHPs with an HSPF ≥10 must also meet the miniumum COP requirement to be eligible for the corresponding Base Rebate. Otherwise, the Base Rebate for the 8.5 minimum HSPF unit willbe offered.
4
Total Rebate is per ASHP system and is limited to 50% of equipment cost.
5
Efficiency Bonus Rebate provides an additional incentive for efficiencies above 15.5 SEER.
Qualifying air source heat pumps must have been rated in accordance with the most recent version of AHRI Standard 210/240 and have nameplate data stamped with the SEER and HSPF.
A copy of the manufacturer’s applicable unit rating must accompany this application. The AHRI directory and standards are located at www.ahridirectory.org.
SECTION E. REBATE INFORMATION – AIR SOURCE HEAT PUMPS < 65,000 Btuh (5.4 Tons)
Project Type:
o
NEW CONSTRUCTION
o
RETROFIT IF RETROFIT, IS EXISTING EQUIPMENT STILL OPERATIONAL?
o
YES
o
NO
EXISTING SYSTEM (if operational)
N EW S Y STEM R EBAT E
A
Heating
Type
B
Cooling
Type
C
Equip
Type
D
AHRI
Reference
Number
1
E
System
Cooling
Capacity
2
(Btuh)
F
System
Heating
Capacity
2
(Btuh)
G
Rated
Efficiencies
H
Outdoor
Unit
Model
I
Indoor
Unit
Model
J
Manufacturer
K
Annual
Cooling
Hours
(Table 4)
L
Annual
Heating
Hours
(Table 4)
M
Qty
N
Installation
Date
O
Total
Equipment
Cost
P
Total
Rebate
(calculation below)
(limited to 50%
of equipment cost)
o
Electric Heat
o
Air Source Heat Pump
o
Through-the-Wall
Heat Pump
o
Natural Gas/Other
o
Split System AC
o
Packaged AC Unit
o
Air Source Heat Pump
o
Through-the-Wall AC/HP
o
Room AC
o
ASHP
o
Mini-
Split
ASHP
__________ SEER
___________ EER
__________ HSPF
___________ COP
at 5º F* if ≥10 HSPF
3
REBATE CALCULATION:
Total
Rebate
4
= Base Rebate ________________ + [(Rated SEER) ___________ – 15.5 SEER) X $10]) = _________________ (limited to 50% of new equipment cost)
TABLE 4 – GUIDELINES FOR COOLING AND HEATING HOURS
Business Type Cooling Hours Heating Hours
Convenience Store 986 1,546
Education – Community College 785 1,616
Education – Primary 408 1,916
Education – Secondary 563 2,098
Health/Medical – Clinic 865 1,830
Health/Medical – Hospital 1,298 2,054
Lodging 754 1,934
Manufacturing 589 1,144
Office – Low Rise 446 1,610
Office – Mid Rise 651 1,793
Office – High Rise 1,263 1,760
Other/Miscellaneous 729 1,739
Restaurant 652 1,530
Retail – Large Department Store 686 1,444
Retail – Strip Mall 574 1,393
Warehouse 409 1,533
TOTAL REBATE AMOUNT
$
REBATE IS LIMITED TO 50% OF
NEW EQUIPMENT COST.
TABLE 3 – QUALIFYING EFFICIENCES AND REBATE SCHEDULE
PROJECT
TYPE
EXISTING
HEATING
FUEL/TYPE
ASHP SYSTEM
COOLING
CAPACITY
ASHP
MINIMUM
SEER
ASHP
MINIMUM
HSPF
ASHP
MINIMUM
COP AT 5º F
BASE
REBATE
EFFICIENCY
BONUS
REBATE
5
New Construction/
No Previous Unit/
Replace Failed
Any
< 20,000
15.5
8.5 NA $800 $10
10.0 1.75 $1,000 $10
20,000–65,000 15.5
8.5 NA $1,600 $10
10.0 1.75 $2,000 $10
Replace Working
Equipment
Electric
Heat
< 20,000 15.5
8.5
NA $900
$10
10.0
1.75 $1,100
$10
20,000–65,000 15.5
8.5
NA
$1,800 $10
10.0
1.75
$2,200 $10
Air Source
Heat Pump
< 20,000 15.5
8.5
NA
$125 $10
10.0 1.75 $250 $10
20,000–65,000
15.5
8.5 NA $250 $10
10.0 1.75 $500 $10
Through-
the-Wall
Heat Pump
< 20,000
15.5
8.5 NA $200 $10
10.0 1.75 $350 $10
20,000–65,000 15.5
8.5 NA $400 $10
10.0
1.75
$700 $10
Natural Gas/
Other
< 20,000
15.5
7.7 NA $100 $10
20,000–65,000 15.5 7.7 NA $200 $10
* If AHRI certificate does not verify COP at 5º F, use NEEP's Cold Climate Air Source Heat Pump qualifying list to obtain those ratings. Go to ashp.neep.org and select "End User/Consumer”.
TABLE 1 – Air Source Heat Pumps – Qualifying Efficiencies and Rebate Schedule
Code
Qualifying Equipment
Minimum Base Rebate Efficiency Bonus
1
Efficiency ($/Ton) Rebate ($/Ton)
ASHP1–20 Split Systems & Single Package, 65,001-134,999 Btuh 13.4 IEER & 11.0 EER $50 $5
ASHP2–20 Split Systems & Single Package, 135,000-239,999 Btuh 12.7 IEER & 10.6 EER $50 $5
ASHP3–20 Split Systems & Single Package, 240,000 Btuh and greater 11.8 IEER & 9.5 EER $50 $5
1
Efficiency Bonus Rebate provides an additional incentive for each 0.10 SEER or IEER above the Minimum Efficiency.
3
SEER – Seasonal Energy Efficiency Rating
IEER – Integrated Energy Efficiency Rating
EER – Energy Efficiency Rating
COP – Coefficient of Performance
HSPF – Heating Seasonal Performance Factor
Tons Cooling Capacity = Btuh Cooling Capacity / 12,000
Qualifying Air Source Heat Pumps must have been rated in accordance with the most recent version of AHRI Standard 210/240 if
less than 65,000 Btuh and AHRI 340/360 if 65,000 Btuh or greater, and have nameplate data stamped with the SEER/IEER/EER.
If equipment is larger than the AHRI Standard certification process, it must be listed as a standard combination in manufacturer’s literature.
A copy of the manufacturer’s applicable unit rating must accompany this application. The AHRI directory and standards are located
at www.ahridirectory.org.
TABLE 2 – GUIDELINES FOR COOLING AND HEATING HOURS
Business Type Cooling Hours Heating Hours
Convenience Store 986 1,546
Education – Community College 785 1,616
Education – Primary 408 1,916
Education – Secondary 563 2,098
Health/Medical – Clinic 865 1,830
Health/Medical – Hospital 1,298 2,054
Lodging 754 1,934
Manufacturing 589 1,144
Office – Low Rise 446 1,610
Office – Mid Rise 651 1,793
Office – High Rise 1,263 1,760
Other/Miscellaneous 729 1,739
Restaurant 652 1,530
Retail – Large Department Store 686 1,444
Retail – Strip Mall 574 1,393
Warehouse 409 1,533
EXISTING SYSTEM
(if operational)
N EW S Y STEM R EBAT E
A
Nominal
Cooling
Capacity
(Tons)
B
Rated
EER or SEER
(enter value then
check EER or SEER)
C
Qty
D
Unit
Code
(Table 1)
E
Mfg
Name
F
Model
Number
G
Nominal
Cooling
Capacity
(Tons)
H
Min.
SEER
or IEER
(Table 1)
I
Rated
SEER
or IEER
J
Rated
EER
K
Rated
COP or HSPF
(enter value then
check COP or HSPF)
L
Qty
M
Annual
Cooling
Hours
(Table 2)
N
Annual
Heating
Hours
(Table 2)
O
Equip.
Cost
P
Base
Rebate
($/Ton)
Q
Base
Rebate
(G x L x P)
R
Eligible
Eff.
Bonus
(I – H)
S
Eff.
Bonus
Rebate
1
($/Ton)
T
Eff.
Bonus
Rebate
(R x S)
x (G x L) x 10
U
Total
Rebate
(Q + T))
o
EER
_______
o
SEER
o
COP
_______
o
HSPF
$50
$5
o
EER
_______
o
SEER
o
COP
_______
o
HSPF
$50
$5
o
EER
_______
o
SEER
o
COP
_______
o
HSPF
$50
$5
o
EER
_______
o
SEER
o
COP
_______
o
HSPF
$50
$5
o
EER
_______
o
SEER
o
COP
_______
o
HSPF
$50
$5
TOTAL REBATE AMOUNT
$
SECTION D. REBATE INFORMATION – AIR SOURCE HEAT PUMPS > 65,000 Btuh
Project Type:
o
NEW CONSTRUCTION
o
RETROFIT IF RETROFIT, IS EXISTING EQUIPMENT STILL OPERATIONAL?
o
YES
o
NO
REBATE IS LIMITED TO 50% OF
NEW EQUIPMENT COST.
4
SECTION F. TERMS AND CONDITIONS
1. ELIGIBILITY
Rebates are available to non-residential electric customers of Austin Utilities, Owatonna Public Utilities, and Rochester Public Utilities (herein
referred to as The Utility). All products must be in use in facilities in The Utility service territory.
2. APPLICATION
P
rogram is offered January 1 through December 31 of the respective calendar year. Due to limited funding, this rebate offer can be changed
or withdrawn at any time without notice and is available on a first-come, first-served basis. The entire rebate application must be
read and filled out completely or application will be returned.
3. INSPECTION AND VERIFICATION
The Utility reserves the right to inspect the customer’s facility through on-site visits before and after new equipment installation to verify rebate
eligibility. The Utility reminds you to follow all local permitting and building code ordinances.
4. INSTALLATION AND REBATE AMOUNTS
Q
ualifying energy-efficient equipment installed and operational within six (6) months of the date of purchase are eligible for rebate. Additional
time may be granted subject to the Utility’s pre-approval. In no case will the rebate paid by The Utility exceed the purchase price of the
equipment. The maximum rebate amount is $100,000 per customer location per technology per year.
5. INVOICE AND PAYMENT
Following inspection and verification (see #3) and completed installation, the customer must notify The Utility and submit original invoices spec-
ifying the quantity
and price of all materials purchased, the date ordered, installation costs, and applicable taxes. After satisfactory review of
the application and invoices, a rebate check or bill credit will be issued to the customer. Vendors or contractors are not eligible to receive their
customer’s rebate. Please allow 6-10 weeks from the date of application submission for delivery of rebate check or bill credit. The Utility
reserves the right to apply the rebate to past due accounts.
6. EQUIPMENT ELIGIBILITY REQUIREMENTS
Equipment must be new. Eligible high-efficiency heat pumps must meet or exceed The Utility’s minimum efficiency requirements as identified in
Tables 1 and 3 according to its qualifying equipment description/category.
Qualifying Air Source Heat Pumps must have been rated in accordance with the most recent version of AHRI Standard 210/240 if
less than 65,000 Btuh and AHRI 340/360 if 65,000 Btuh or greater, and have nameplate data stamped with the SEER/IEER/EER.
If equipment is larger than the AHRI Standard certification process, it must be listed as a standard combination in manufacturer’s literature.
A copy of the manufacturer’s applicable unit rating must accompany this application. The AHRI directory and standards are located at
www.ahridirectory.org.Eligible air source heat pumps must replace cooling equipment of lesser efficiencies and of equivalent or greater capacity
(Tons or BTU’s/hr) to qualify for a rebate.
Mini-Split A/C Units: Qualifying AC units must have been rated in accordance with the most recent version of AHRI Standard 210/240 and
have nameplate data stamped with the SEER. A copy of the manufacturer's applicable unit rating must accompany this application. The AHRI
directory and standards are located at www.ahridirectory.org.
7. TAX INFORMATION
The Utility will not be responsible for any tax liability imposed as a result of the rebate payment(s). Customers are advised to consult their tax
advisors for details.
8. DISCLAIMER
The Utility does not guarantee that the implementation of energy-efficient measures or use of the equipment purchased or installed pursuant
to this program will result in energy or cost savings. The Utility makes no warranties, expressed or implied, with respect to any equipment pur-
chased or installed including, but not limited to, any warrant of merchantability or fitness for purpose. In no event shall The Utility be liable for
any incidental or consequential damages. Customers are solely responsible for the proper disposal of existing equipment. Consult the
Minnesota Pollution Control Agency (MPCA) office for details at 800.657.3864.
9. ENDORSEMENT
The Utility does not endorse any particular vendor, manufacturer, product, or system in promoting this rebate program. Listing a vendor or
product does not constitute an endorsement, nor does it imply that unlisted vendors or products are deficient or defective in any way.
10.PRIVACY
Information contained in this rebate application may be shared with the Minnesota Department of Commerce and our co-op partners and
also may be used in our advertising efforts with your permission as granted in Section B of this rebate application.
RETURN COMPLETED APPLICATION 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 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
PLEASE PRINT ON RECYCLED PAPER 0421
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COMMERCIAL AIR SOURCE HEAT PUMPS REBATE APPLICATION (Owatonna Public Utilities)

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Completed 8 June 2021

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