Fillable COMMERCIAL CUSTOM ELECTRIC EFFICIENCY REBATE APPLICATION (Owatonna Public Utilities)

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COMMERCIAL CUSTOM ELECTRIC EFFICIENCY REBATE APPLICATION (Owatonna Public Utilities)

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The COMMERCIAL CUSTOM ELECTRIC EFFICIENCY REBATE APPLICATION (Owatonna Public Utilities) form is 2 pages long and contains:

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COMMERCIAL CUSTOM ELECTRIC EFFICIENCY 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.
X
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/PROFESSIONAL ENGINEER INFORMATION (please print)
Company Name Registration Number (if applicable)
Address City State Zip Code
( )
Contact Name Daytime Phone Number
Email
I certify that I am a professional engineer licensed in the state in which the aforementioned facility is located. I represent to the Company that I have reviewed the
measures and calculations proposed in this application and all associated worksheets. They are, in my professional opinion, appropriate for the type and purpose
of the facility in which they will be installed. The information contained in this application and associated worksheets is true, accurate, and complete to the best
of my knowledge.
Engineer’s Signature: Date:
PROFESSIONAL
ENGINEER STAMP:
OFFICE USE ONLY Date Received:____________________
Inspected (Date & Initials): Pre:__________________ Post:___________________
Approval & Date:_____________________________________
Internal Account Number:_____________________________
TOTAL REBATE:
$
MN
MN
MN
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SECTION D. REBATE INFORMATION – CUSTOM REBATES
REBATE IS CALCULATED USING ANNUAL ENERGY SAVINGS AT $0.045kWh SAVED. REBATE WILL NOT EXCEED THE INCREMENTAL COST OF THE ENERGY EFFICIENT EQUIPMENT.
GUIDELINES: The Utility must pre-approve custom rebate applications. Applications should include project plans prepared by a registered professional engineer with all appropriate technical
documentation. Engineering calculations submitted for energy and cost savings are subject to review by The Utility. A general description of proposed project should be provided below.
Project Type:
o
EQUIPMENT FOR A NEW BUILDING OR ADDITION
o
REPLACE FAILED EQUIPMENT
o
ADD NEW EQUIPMENT
o
RETROFIT OR REPLACE WORKING EQUIPMENT
Please provide a brief description of your proposed project.
Detailed energy savings and cost savings must also be provided and should be attached to this form as separate studies and engineer or contractor calculations, etc.
SECTION E. 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). Projects eligible under existing prescriptive
rebate programs are not eligible to receive a custom rebate. Projects that involve switching from one
fuel type to another (fuel switching) are not eligible. Projects where the energy savings result from
reduced production, change in operating hours, or equipment retirement are not eligible. All equipment
must be new and in use 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. Data contained in the application or attached
materials must be sufficient to verify the costs and the demand (kW) and energy savings (kWh) described
in the application. The utility reserves the right to perform an independent evaluation to confirm savings
at the customer’s expense.
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 also reserves the right to perform pre- and
post-installation monitoring of the installed measure in order to determine actual demand (kW) reduction
and energy (kWh) savings. The Utility reminds you to follow all local permitting and building code ordi-
nances.
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.
Custom rebates are based on the first-year annual energy savings. In no case will the rebate paid by
The Utility exceed the total project cost (for projects that retrofit or replace working equipment) or the
incremental project cost (for all other project types). 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 including
equipment discounts, 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
To be eligible for a rebate, all equipment to be purchased as part of the custom measure shall include
documentation as to the type, make, model, and efficiency. This may require documentation of nameplate
data and/or applicable test data.
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 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 CUSTOM ELECTRIC EFFICIENCY REBATE APPLICATION (Owatonna Public Utilities)

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Completed 8 June 2021

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