Fillable COMMERCIAL CENTRAL CHILLERS REBATE APPLICATION (Owatonna Public Utilities)

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COMMERCIAL CENTRAL CHILLERS REBATE APPLICATION (Owatonna Public Utilities)

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COMMERCIAL CENTRAL CHILLERS 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
I 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
Address City State Zip Code
( )
Contact Name Daytime Phone Number
Email
TEAMING UP TO SAVE YOU MONEYTTETEATEAMTEAMITEAMINTEAMINGTEAMING TEAMING UTEAMING UPTEAMING UP TEAMING UP TTEAMING UP TOTEAMING UP TO TEAMING UP TO STEAMING UP TO SATEAMING UP TO SAVTEAMING UP TO SAV ETEAMING UP TO SAV E TEAMING UP TO SAVE YTEAMING UP TO SAVE YOTEAMING UP TO SAVE YOUTEAMING UP TO SAVE YOU TEAMING UP TO SAVE YOU MTEAMING UP TO SAVE YOU MOTEAMING UP TO SAVE YOU MONTEAMING UP TO SAVE YOU MONETEAMING UP TO SAVE YOU MONEY
OFFICE USE ONLY Date Received:____________________
Inspected (Date & Initials): Pre:__________________ Post:___________________
Approval & Date:_____________________________________
Internal Account Number:_____________________________
TOTAL REBATE:
$
MN
MN
MN
click to sign
signature
click to edit
2
TABLE 2 – GUIDELINES FOR COOLING HOURS
Business Type Estimated Hours
Convenience Store 986
Education – Community College 785
Education – Primary 408
Education – Secondary 563
Health/Medical – Clinic 865
Health/Medical – Hospital 1,298
Lodging 754
Manufacturing 589
Office – Low Rise 446
Office – Mid Rise 651
Office – High Rise 1,263
other/Miscellaneous 729
Restaurant 652
Retail – Large Department Store 686
Retail – Strip Mall 574
Warehouse 409
TABLE 1 – QUALIFYING EFFICIENCIES AND REBATE SCHEDULE
Path A – Water and Air Cooled Chillers with Fixed Speed / No Demand Limiting Controls
Code
Qualifying Equipment Min. FLV Eff. Min. IPLV Eff. Base Rebate $/Ton
C1-20A
Water-Cooled Screw/Scroll Chiller – Less than 75 Tons 0.730 kW per Ton
0.580 kW per Ton
$15
C2-20A
Water-Cooled Screw/Scroll Chiller – 75 to less than 150 Tons 0.725 kW per Ton 0.565 kW per Ton $15
C3-20A
Water-Cooled Screw/Scroll Chiller – 150 and less than 300 Tons 0.630 kW per Ton
0.530 kW per Ton
$15
C4-20A
Water-Cooled Screw/Scroll Chiller – 300 Tons and Greater 0.570 kW per Ton 0.490 kW per Ton $15
C5-20A
Water-Cooled Centrifugal Chiller – Less than 150 Tons 0.618 kW per Ton 0.576 kW per Ton $15
C6-20A
Water-Cooled Centrifugal Chiller – 150 and less than 300 Tons 0.618 kW per Ton
0.576 kW per Ton
$15
C7-20A
Water-Cooled Centrifugal Chiller – 300 and less than 600 Tons 0.560 kW per Ton
0.529 kW per Ton
$15
C8-20A
Water-Cooled Centrifugal Chiller – 600 Tons and Greater 0.554 kW per Ton 0.519 kW per Ton $15
C9-20A
Air-Cooled Chiller – Less than 150 Tons 9.74 EER
14.0 EER
$8
C10-20A
Air-Cooled Chiller – 150 Tons and Greater 9.74 EER 14.3 EER $8
SECTION D. REBATE INFORMATION – WATER & AIR COOLED CHILLERS (FOR SPACE COOLING) For PATH A Chillers (fixed speed/no demand limiting)
Project Type:
o
NEW CONSTRUCTION
o
RETROFIT IF RETROFIT, IS EXISTING EQUIPMENT STILL OPERATIONAL?
o
YES
o
NO
FLV – Full Load Value; IPLV – Integrated Part Load Value; EER – Energy Efficiency Rating; Cooling Tons = BTUh cooling capacity/12,000
Note: Qualifying chillers must be used for space cooling and the meet efficiency requirements shown in Table 1 above to be eligible. Documentation is required. This can be a printout from the AHRI directory (www.ahridirectory.org)
showing the nominal capacity (tons), and the the IPLV efficiency and FLV efficiency. If the chiller has not been tested by AHRI, manufacturer documentation must show the nominal capacity (tons), and the IPLV efficiency and FLV
efficiency at AHRI standard 550/590 rating conditions. For water cooled centrifugal chillers not tested at AHRI standard 550/590 rating conditions, manufacturer documentation must show the nominal capacity (tons), and the IPLV
efficiency, FLV efficiency, leaving chilled water temperature, entering condenser water temperature, and condenser gpm at operating conditions so we can determine eligibility and rebate amount.
EXISTING CHILLER (if operational)
N EW C H I LLE R R EBATE
A
Unit
Code
(Table 1)
B
Nominal
Capacity
(Tons)
C
Rated FLV
Efficiency
(enter value and
select units)
D
Rated IPLV
Efficiency
(enter value and
select units)
E
Qty.
F
Unit
Code
(Table 1)
G
Manufacturer
Name
H
Model
Number
I
Nominal
Capacity
(Tons)
J
Min.
FLV Eff.
(Table 1)
K
Rated
FLV Eff.
L
Min.
IPLV Eff.
(Table 1)
M
Rated
IPLV Eff.
N
Qty.
O
Annual
Cooling Hours
(Table 2)
P
Equipment
Cost
Q
Rebate
(
calculations below
)
(limited to 50% of
new chiller cost)
–––––––––––––––––
o
EER
o
kW/ton
–––––––––––––––––
o EER o kW/ton
$ $
–––––––––––––––––
o
EER
o
kW/ton
–––––––––––––––––
o EER o kW/ton
$ $
–––––––––––––––––
o
EER
o
kW/ton
–––––––––––––––––
o EER o kW/ton
$ $
TOTAL
$
REBATE CALCULATIONS:
WATER COOLED CHILLERS:
(Tested at AHRI standard 550/590 rating conditions?
o
YES
o
NO
AIR COOLED CHILLERS:
New Qty ____________ x New Tons ____________ X $15 = ____________ REBATE New Qty ____________ x New Tons ____________ X $8 = ____________ REBATE
REBATE IS LIMITED
TO 50% OF NEW
CHILLER COST.
TABLE 3 – QUALIFYING EFFICIENCIES AND REBATE SCHEDULE
Path B – Water and Air Cooled Chillers with Variable Speed / Demand Limiting Controls
Code
Qualifying Equipment Min. FLV Eff. Min. IPLV Eff. Base Rebate $/Ton Efficiency Bonus Rebate $/Ton
C1-20B Water-Cooled Screw/Scroll Chiller – Less than 75 Tons 0.800 kW per Ton
0.550 kW per Ton
$15 $2.00
C2-20B Water-Cooled Screw/Scroll Chiller – 75 to less than 150 Tons 0.790 kW per Ton 0.536 kW per Ton $15 $2.00
C3-20B
Water-Cooled Screw/Scroll Chiller – 150 and less than 300 Tons 0.718 kW per Ton
0.490 kW per Ton $15 $2.00
C4-20B Water-Cooled Screw/Scroll Chiller – 300 Tons and Greater 0.639 kW per Ton 0.440 kW per Ton $15 $2.00
C5-20B
Water-Cooled Centrifugal Chiller – Less than 150 Tons 0.639 kW per Ton
0.430 kW per Ton $15 $2.00
C6-20B
Water-Cooled Centrifugal Chiller – 150 and less than 300 Tons
0.639 kW per Ton 0.430 kW per Ton $15 $2.00
C7-20B Water-Cooled Centrifugal Chiller – 300 and less than 600 Tons 0.600 kW per Ton 0.380 kW per Ton $15 $2.00
C8-20B Water-Cooled Centrifugal Chiller – 600 Tons and Greater 0.590 kW per Ton 0.380 kW per Ton $15 $2.00
C9-20B
Air-Cooled Chiller – Less than 150 Tons 9.562 EER
14.0 EER
$8 $2.00
C10-20B
Air-Cooled Chiller – 150 Tons and Greater 9.562 EER
14.3 EER $8
$2.00
3
TABLE 4 – GUIDELINES FOR COOLING HOURS
Business Type Estimated Hours
Convenience Store 986
Education – Community College 785
Education – Primary 408
Education – Secondary 563
Health/Medical – Clinic 865
Health/Medical – Hospital 1,298
Lodging 754
Manufacturing 589
Office – Low Rise 446
Office – Mid Rise 651
Office – High Rise 1,263
other/Miscellaneous 729
Restaurant 652
Retail – Large Department Store 686
Retail – Strip Mall 574
Warehouse 409
SECTION E. REBATE INFORMATION – WATER & AIR COOLED CHILLERS (FOR SPACE COOLING) For PATH B Chillers (variable speed or demand limited)
Project Type:
o
NEW CONSTRUCTION
o
RETROFIT IF RETROFIT, IS EXISTING EQUIPMENT STILL OPERATIONAL?
o
YES
o
NO
* Efficiency Bonus Rebate provides an additional incentive for each 0.01 kW per Ton below the Minimum IPLV Efficiency for water-cooled chillers), or for each 0.1 EER above the minimum IPLV efficiency for air-cooled chillers.
FLV – Full Load Value; IPLV – Integrated Part Load Value; EER – Energy Efficiency Rating; Cooling Tons = BTUh cooling capacity/12,000
Note: Qualifying chillers must be used for space cooling and the meet efficiency requirements shown in Table 3 above to be eligible. Documentation is required. This can be a printout from the AHRI directory (www.ahridirectory.org)
showing the nominal capacity (tons), and the the IPLV efficiency and FLV efficiency. If the chiller has not been tested by AHRI, manufacturer documentation must show the nominal capacity (tons), and the IPLV efficiency and FLV
efficiency at AHRI standard 550/590 rating conditions. For water cooled centrifugal chillers not tested at AHRI standard 550/590 rating conditions, manufacturer documentation must show the nominal capacity (tons), and the IPLV
efficiency, FLV efficiency, leaving chilled water temperature, entering condenser water temperature, and condenser gpm at operating conditions so we can determine eligibility and rebate amount.
EXISTING CHILLER (if operational)
N EW C H I LLE R R EBATE
A
Unit
Code
(Table 3)
B
Nominal
Capacity
(Tons)
C
Rated FLV
Efficiency
(enter value and
select units)
D
Rated IPLV
Efficiency
(enter value and
select units)
E
Qty.
F
Unit
Code
(Table 3)
G
Manufacturer
Name
H
Model
Number
I
Nominal
Capacity
(Tons)
J
Min.
FLV Eff.
(Table 3)
K
Rated
FLV Eff.
L
Min.
IPLV Eff.
(Table 3)
M
Rated
IPLV Eff.
N
Qty.
O
Annual
Cooling Hours
(Table 4)
P
Equipment
Cost
Q
Rebate
(
calculations below
)
(limited to 50% of
new chiller cost)
–––––––––––––––––
o EER o kW/ton
–––––––––––––––––
o EER o kW/ton
$ $
–––––––––––––––––
o EER o kW/ton
–––––––––––––––––
o
EER
o
kW/ton
$ $
–––––––––––––––––
o EER o kW/ton
–––––––––––––––––
o
EER
o
kW/ton
$ $
TOTAL $
REBATE CALCULATIONS: WATER COOLED CHILLERS: (FLV and IPLV must be in kW/ton) (Tested at AHRI standard 550/590 rating conditions?
o
YES
o
NO
New Qty __________ x New Tons __________ X { $15 + [ $200 X ( __________ Minimum IPLV – __________ Rated IPLV) ] } = _______________ REBATE
AIR COOLED CHILLERS: (FLV and IPLV must be in EER)
New Qty __________ x New Tons __________ X { $8 + [ $20.00 X ( __________ Rated IPLV – __________ Minimum IPLV) ] } = ______________ REBATE
REBATE IS LIMITED
TO 50% OF NEW
CHILLER COST.
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
Program 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-serve 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
Qualifying 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
specifying the quantity and price of all materials purchased, the date ordered, installation costs, and applicable taxes. Additionally,
SEER/EER (Rooftop, Packaged, and Condensing A/C Units) certification data or manufacturer’s kW per Ton (Central Chillers) is required
to be submitted with invoices. 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
Eligible high-efficiency cooling equipment must be new and meet or exceed The Utility’s minimum efficiency requirements as identified in
Tables 1 and 3 according to its respective characteristics. Eligible high-efficiency cooling units must replace units of lesser efficiencies and
of equivalent or greater capacity (Tons or Btu’s/hour) to qualify for a rebate.
Central Chillers: Qualifying chillers must meet the efficiency requirements shown in Table 3 to be eligible and have kW per Ton ratings
stamped on the nameplate. Documentation is required. This can be a printout from the AHRI directory (www.ahridirectory.org) or if the
chiller has not been tested by AHRI, manufacturer documentation must show the rated capacity (tons), and the IPLV efficiency and the
full-load efficiency at AHRI standard 550/590 rating conditions:
• 44º F leaving chilled water temperature
• 85º F entering condenser water temperature (for water cooled chillers)
• 95º F entering condenser air temperature (for air cooled chillers)
For water cooled centrifugal chillers not tested at AHRI standard 550/590 rating conditions, manufacturer documentation must show
the nominal capacity (tons), and the IPLV efficiency, full-load efficiency, leaving chilled water temperature, entering condenser water
temperature, and condenser gpm at operating conditions.
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 purchased 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 55060-0800 Rochester, MN 55906-2813
507.433.8886 507.451.2480 507.280.1500
www.austinutilities.com www.owatonnautilities.com www.rpu.org
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COMMERCIAL CENTRAL CHILLERS REBATE APPLICATION (Owatonna Public Utilities)

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Completed 8 June 2021

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