Fillable COMMERCIAL GUEST ROOM ENERGY MANAGEMENT SYSTEM REBATE APPLICATION (Owatonna Public Utilities)

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COMMERCIAL GUEST ROOM ENERGY MANAGEMENT SYSTEM REBATE APPLICATION (Owatonna Public Utilities)

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COMMERCIAL GUEST ROOM ENERGY MANAGEMENT SYSTEM 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 Contact Name
Address City State Zip Code
( )
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
MS
click to sign
signature
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SECTION D. REBATE INFORMATION
P
roject Type:
o N
ew Construction
o R
etrofit
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). 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, if the new equipment is not listed on the Qualifying Equipment Tables but meets the
efficiency requirements for that equipment, sufficient data must be provided to prove that it qualifies. 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 equipment must be new. Replacement or upgrades of existing guest room control systems are not eligible for this prescriptive rebate. Only occupancy sensor controlled guest
room energy management systems qualify for a rebate. At a minimum, the system must be used to automatically control the operation of the guest room heating/cooling equipment
when the room is vacant (automatic control of the lighting is optional).
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
PLEASE PRINT ON RECYCLED PAPER 0220fillable
GUEST ROOM ENERGY MANAGEMENT SYSTEM REBATE
A B C D E F G H I
Total Guest Room Guest Room Is Lighting Rebate per
Manufacturer Model Number of Heating Cooling Controlled Project Controlled Total
Name Number Controlled System Type System Type by EMS? Cost Guest Room Rebate
Guest Rooms (select one) (select one) (select one) (Table 1) (C x H)
o Electric Heat o PTAC o No
o Heat Pump o PTHP o Yes $ $ $
o Natural Gas o Chilled Water
Fan Coil
TABLE 1 – Rebate Schedule
Controlled Heating/Cooling System Type Rebate per Controlled Guest Room
Electric/Heat Pump Heating and Electric Cooling $65
Natural Gas Heating and Electric Cooling $25
Note: Only occupancy sensor controlled guest room energy management systems qualify for a rebate. See terms and conditions for other requirements.
PTAC = Packaged Terminal Air Conditioner
PTHP = Packaged Terminal Heat Pump
EMS = Energy Management System
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COMMERCIAL GUEST ROOM ENERGY MANAGEMENT SYSTEM REBATE APPLICATION (Owatonna Public Utilities)

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Completed 8 June 2021

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