Fillable COMMERCIAL COOLING EQUIPMENT REBATE APPLICATION (Owatonna Public Utilities)

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COMMERCIAL COOLING EQUIPMENT REBATE APPLICATION (Owatonna Public Utilities)

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COMMERCIAL COOLING EQUIPMENT 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
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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
SECTION D. REBATE INFORMATION – ROOFTOP, PACKAGED, AND CONDENSING A/C UNITS
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
Restaurant 652
Retail – Large Department Store 686
Retail – Strip Mall 574
Warehouse 409
TABLE 1 – QUALIFYING EFFICIENCIES AND REBATE SCHEDULE
Unit Code
Qualifying Equipment
Minimum
Efficiency
Base
Rebate
($/Ton)
Eff. Bonus
Rebate**
($/Ton)
Base Efficiency
for Existing Equipment
UT1A–20 DX Split Units less than 65,000 BTU/hour
14.5 SEER*
$50 $5
13.0 SEER
UT1B–20
DX Packaged Units less than 65,000 BTU/hour
15.5 SEER* $50 $5 14.0 SEER
UT2–20 DX Units 65,000 - 134,999 BTU/hour
13.9 IEER*
$50 $5
12.7 IEER
UT3–20 DX Units 135,000 - 239,999 BTU/hour
13.3 IEER*
$50
$5 12.2 IEER
UT4–20 DX Units 240,000 - 759,000 BTU/hour
12.6 IEER*
$50 $5 11.4 IEER
UT5–20 DX Units 760,000 BTU/hour and greater
10.5 IEER*
$50
$5 9.6 IEER
UT6–20
DX Condensing Units greater than 135,000 BTU/hour
15.5 IEER* $50 $5 14.0 IEER
PTAC1–NC–20
Packaged Terminal A/C Units (new construction – less than 7,000 BTU/hour)
13.0 EER*
$50 $5
11.9 EER
PTAC2–NC–20
Packaged Terminal A/C Units (new construction – 7,000 – 15,000 BTU/hour)
15.0 - (0.3 x Btuh Capacity/1000) EER*
$50
$5 14.0 - (0.3 x Btuh Capacity/1000) EER
PTAC3–NC–20
Packaged Terminal A/C Units (new construction – greater than 15,000 BTU/hour)
11.3 EER* $50 $5 9.5 EER
PTAC1–R–20
Packaged Terminal A/C Units (replacement – less than 7,000 BTU/hour)
10.5 EER*
$50 $5
9.4 EER
PTAC2–R–20
Packaged Terminal A/C Units (replacement – 7,000 – 15,000 BTU/hour)
11.9 - (0.213 x Btuh Capacity/1000) EER*
$50
$5 10.9 - (0.213 x Btuh Capacity/1000) EER
PTAC3–R–20
Packaged Terminal A/C Units (replacement – greater than 15,000 BTU/hour)
9.5 EER* $50 $5 7.7 EER
PTHP1–NC–20
Packaged Terminal Heat Pump Units (new construction – less than 7,000 BTU/hour)
13.3 EER*
$50 $5
11.9 EER
PTHP2–NC–20
Packaged Terminal Heat Pump Units (new construction – 7,000 – 15,000 BTU/hour)
15.0 - (0.3 x Btuh Capacity/1000) EER*
$50
$5 14.0 - (0.3 x Btuh Capacity/1000) EER
PTHP3–NC–20
Packaged Terminal Heat Pump Units (new construction – greater than 15,000 BTU/hour)
11.3 EER* $50 $5 9.5 EER
PTHP1–R–20
Packaged Terminal Heat Pump Units (replacement – less than 7,000 BTU/hour)
10.5 EER* $50 $5 9.3 EER
PTHP2–R–20
Packaged Terminal Heat Pump Units (replacement – 7,000 – 15,000 BTU/hour)
11.9 - (0.213 x Btuh Capacity/1000) EER*
$50 $5
10.8 - (0.213 x Btuh Capacity/1000) EER
PTHP3–R–20
Packaged Terminal Heat Pump Units (replacement – greater than 15,000 BTU/hour)
9.5 EER*
$50
$5 7.6 EER
Project Type:
o
NEW CONSTRUCTION
o
RETROFIT IF RETROFIT, IS EXISTING EQUIPMENT STILL OPERATIONAL?
o
YES
o
NO
EXISTING SYSTEM
N E W S Y S T E M
R E B A T E
(if operational)
A B C D E F G H I J K L M N O P Q R S
Unit Existing Qty. Unit Manufacturer Model Unit AHRI Minimum Actual Qty. Annual Equipment Base Base Eligible Bonus Bonus Total
Size SEER* Code Name Number Size Ref Number Efficiency SEER* Cooling Cost Rebate Rebate Efficiency Rebate** Rebate Rebate
(Tons) IEER* (Table 1) (Tons) (Table 1) IEER* Hours $/Ton (G x K x N) Bonus $/Ton (P x Q) x (O + R)
or EER* or EER* (Table 2) (Table 1) (J – I) (Table 1) (G x K) x 10
1.
o
SEER
o
SEER $ $ $ $ $ $
o
IEER
o
IEER
o
EER
o
EER
2.
o
SEER
o
SEER $ $ $ $ $ $
o
IEER
o
IEER
o
EER
o
EER
3.
o
SEER
o
SEER $ $ $ $ $ $
o
IEER
o
IEER
o
EER
o
EER
TOTAL
$
*In Columns B and J, please enter Existing and Actual SEER, IEER, or EER value, respectively, and then check SEER, IEER, or EER.
SEER=Seasonal Energy Efficiency Rating; IEER=Integrated Energy Efficiency Rating; EER=Energy Efficiency Rating
**Efficiency Bonus Rebate provides an additional incentive for each 0.10 SEER/IEER/EER above the Minimum Efficiency.
Note: Qualifying unitary A/C units must have been rated in accordance with the most recent version of AHRI Standard 210/240 if under 65,000 BTU/hour and AHRI 340/360 if above 65,000 BTU/hour,
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.
REBATE IS LIMITED TO 50% OF
NEW EQUIPMENT COST.
3
TABLE 4 – GUIDELINES FOR COOLING & HEATING HOURS
Business Type Cooling Hours Heating Hours
Convenience Store 986 1,546
Education – Community College 785 1,616
Education – Primary 408 1,961
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
TABLE 3 – QUALIFYING EFFICIENCIES AND REBATE SCHEDULE
Code
Qualifying Equipment
Minimum Efficiency Rebate/Unit Efficiency Bonus Rebate*
DM1-17 Cooling Capacity less than 20,000 Btuh 14.5 SEER
$100 $20
DM2-17 Cooling Capacity 20,000–65,000 Btuh 14.5 SEER
$200
$20
SECTION E. REBATE INFORMATION – MINI-SPLIT AC UNITS
Project Type:
o
NEW CONSTRUCTION
o
RETROFIT IF RETROFIT, IS EXISTING EQUIPMENT STILL OPERATIONAL?
o
YES
o
NO
SEER=Seasonal Energy Efficiency Rating
* Efficiency Bonus Rebate provides an additional incentive for efficiencies above 14.5 SEER
Qualifying air conditioners must be rated in accordance with the most recent version of ARI 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.
EXISTING SYSTEM (if operational)
N EW S Y S TEM
R EBATE
A
Type
B
Efficiency
(if efficiency is known,
enter value then
check SEER or EER)
C
Unit
Code
(Table 3)
D
AHRI
Reference
Number
1
E
Cooling
Capacity
2
(Btuh)
F
Rated
Efficiency
G
Mini-Split
Manufacturer
H
Outdoor
Unit
Model
I
Indoor
Unit
Model
J
Furnace
Manufacturer
K
Furnace
Model
L
Annual
Cooling
Hours
(Table 4)
M
Annual
Heating
Hours
(Table 4)
N
Qty
O
Installation
Date
P
Total
Equipment
Cost
Q
Total
Rebate
(
see calculations
below)
o
Central AC
o
Through-the-Wall AC
o
Mini-Split
o
Other/Unknown
––––––––––––––––––––––
o
SEER –OR–
o
EER
–OR–
o
EFFICIENCY UNKNOWN
__________ SEER
___________ EER
(if available)
$ $
o
Central AC
o
Through-the-Wall AC
o
Mini-Split
o
Other/Unknown
––––––––––––––––––––––
o
SEER –OR–
o
EER
–OR–
o
EFFICIENCY UNKNOWN
__________ SEER
___________ EER
(if available)
$ $
TOTAL
$
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.
REBATE CALCULATIONS:
DM1-17 (Cooling Capacity less than 20,000 Btuh): Qty _______________ X ($100 + [(Rated SEER) _______________ - 14.5 SEER) X $20]) = _________________
DM2-17 (Cooling Capacity 20,000–65,000 Btuh): Qty _______________ X ($200 + [(Rated SEER) _______________ - 14.5 SEER) X $20]) = _________________
REBATE IS LIMITED TO 50% OF
NEW EQUIPMENT 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
r
eferred 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 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.
Rooftop, Packaged, and Condensing A/C Units: Qualifying unitary A/C units must have been rated in accordance with the most recent
version of AHRI Standard 210/240 if under 65,000 BTU/hour and AHRI 340/360 if above 65,000 BTU/hour, and have nameplate
data stamped with the SEER/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.
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 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 COOLING EQUIPMENT REBATE APPLICATION (Owatonna Public Utilities)

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