Fillable Form 1.: REBATE APPLICATION OKLAHOMA NATURAL GAS Rebate (Oklahoma Natural Gas)

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Form 1.: REBATE APPLICATION OKLAHOMA NATURAL GAS Rebate (Oklahoma Natural Gas)

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The Form 1.: REBATE APPLICATION OKLAHOMA NATURAL GAS Rebate (Oklahoma Natural Gas) form is 5 pages long and contains:

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  • 2 check-boxes
  • 54 other fields

Country of origin: US
File type: PDF

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Applicant Name:
Oklahoma Natural Gas Account Number :
Mailing
Address:
City: State: Zip:
Email (preferred):
Daytime Phone
: ( ) Evening Phone: ( )
Applicant
Signature:
Date:
1.
Rebate Applicant Information
(as it appears on account, if Oklahoma Natural Gas customer)
(if applicable)
Dealer/Conversion Company Name:
Address:
City: State: Zip:
Email (preferred): Phone: ( )
Vehicle’s CNG system conforms with EPA/CARB certification If No, the vehicle does not meet the rebate requirements.
Dealer/Conversion Signature: Date:
2.
Dealer Information
Your account number is located on
your bill. If you are an Oklahoma
Natural Gas customer, the application
cannot be processed without this
number present on this form.
213380656 2611285 00
Oklahoma Natural
Gas Customer
Non-Customer
Application is required for each requested rebate:
CUSTOMER NAME
Yes No
CNG St.
REBATE APPLICATION
COMPRESSED NATURAL GAS (CNG)
OKLAHOMA NATURAL GAS
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signature
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The Following conditions must be met before applicant qualifies for a rebate:
1. Purchase of a dedicated or bi-fueled NGV. NGV must be an “Original Equipment Manufacturer” (OEM) CNG vehicle or contain an Environmental
Protection Agency/California Air Resources Board (“EPA/CARB”) Certified Kit;
2. A Class 1 or 2 dedicated natural gas vehicle must be an Original Equipment Manufacturer (“OEM) CNG vehicle or contain an Environmental
Protection Agency/California Air Resources Board (“EPA/CARB”) Certified Kit.
3. A Class 1 or 2 bi-fueled natural gas vehicle:
(a) Must be a model year less than or equal to one (1) year from the rebate application year; or
(b) May be a model year less than or equal to three (3) years from the rebate application year if the vehicle has been converted within
the last twelve (12) months.
(c) Class 1 & 2 Max Number of Rebates per year is two (2).
(d) Class 3 through 8 Max Number of Rebates per year is five (5).
(e) Oklahoma Natural Gas may exceed this cap at its sole discretion if surcharge recoveries are available at calendar year end.
*Vehicle Class based on Gross Vehicle Weight Rating
*Class 1: Defined as 6,000 lbs. or less. Rebate up to $5,000
*Class 2: Defined as 6,001 to 10,000 lbs. Rebate up to $5,000
*Class 3 through 8: Defined as 10,001 lbs. and above. Rebate up to $10,000
4. A Class 3 through 8 dedicated or bi-fueled natural gas vehicle must be a model year less than or equal to three (3) years from the rebate
application year.
5. A dedicated or bi-fueled vehicle will qualify for only one rebate during its lifetime regardless of ownership.
6. A Class 1 through 8 dedicated or bi-fueled natural gas vehicle must have been purchased or converted within ninety (90) days of the applicant’s
request for a rebate subject only to the cap exception in the Company’s sole discretion.
7. Residential, Commercial, and Industrial CNG fueling system;
8
. The purchase of dedicated and bi-fueled natural gas vehicles and the purchase of residential CNG fueling systems must occur after the
Oklahoma Corporation Commission approval of this tariff.
9. Dealers/installers do not qualify. Any business whose primary purpose is the sale, resale, renting or leasing of automobiles and trucks
does not qualify.
10. Oklahoma Natural Gas requires each applicant to present a completed application and is unable to process incomplete applications. Applications
must include the following information:
a) Vehicle Identification number (“VIN”);
b) Verification of liability insurance information;
c) Evidence of vehicle ownership such as the assigned Manufacturer’s Certificate of Origin, purchase contract or bill of sale; and
d) Copy of the Application for Oklahoma Certificate of Title.
e) Conversion kit Serial Number; and
f) Conversion Invoice
11. Applications and additional information are available at www.OklahomaNaturalGas.com/CNG.
12. Oklahoma Natural Gas reserves the right to verify the applicant’s eligibility for a rebate. Oklahoma Natural Gas issues rebates in the form of checks,
not utility credits. Oklahoma Natural Gas is not responsible if the dealer/installer or retailer fails to provide accurate information about the amount of
a rebate or eligibility. Rebate checks will be mailed approximately six to eight weeks after approval, subject to availability of program funds.
13. Rebates are reviewed and processed on a first-come, first served basis until program funds are depleted. Rebate qualifications and amounts are
subject to change. Rebates shall not exceed the purchase price of the vehicle or home-fueling unit. Rebate funds are limited. Funding guidelines for
these rebates may be changed or discontinued at any time without notice. Please check for rebate updates at www.OklahomaNaturalGas.com/CNG.
14. All CNG conversions and equipment installations must comply with National Fire Protection Association (NFPA) Code 52.
15. Class 1 vehicles are defined as small pickup, car, van and SUV, 6,000 pounds or less. Class 2 vehicles are defined as full size pickup (half-ton),
step/utility van, minivan, 6001 to 10,000 pounds. Class 3 vehicles are defined as heavy duty pickup (three-fourths to one-ton), delivery van,
10,001-14,000 pounds. Class 4-8 are defined as step van, beverage truck, school bus, cement mixer, refuse truck, 14,001 pounds and above.
Vehicle class and rebate amount awarded is determined solely by Gross Vehicle Weight Rating (GVWR).
16. Additional information is available at https://www.oklahomanaturalgas.com/media/ONG/Tariffs/707.pdf.
Oklahoma Natural Gas is unable to process incomplete applications. Applications must include all required documentation.
3.
Eligibility Requirements
CNG Fueling Unit Rebate Amount Max No. of Rebates
CNG Fueling Unit Install
Plumbing/Electrical
Up to $5,000
Up to $2,500
1/year
1/year
4.
Available Rebates for CNG
5.
Review and Submit Your Application
Mail completed application(s) along with required documentation within 90 days of installation or service to:
Oklahoma Natural requires each customer to present a completed rebate application and is unable to process incomplete applications.
Applications and additional information are available atwww.OklahomaNaturalGas.com/CNG.Oklahoma Natural reserves the right to verify all
information provided.Oklahoma Natural issues rebates in the form of checks, not utility credits. Oklahoma Natural is not responsible if the
dealer/installer or retailer fails to provide accurate information about the amount of a rebate or eligibility.Rebate checks will be mailed
approximately six to eight weeks after approval, subject to availability of program funds.
Rebates are reviewed and processed on a first-come, first-served basis until program funds are depleted. Rebate qualifications and amounts are
subject to change. Rebate funds are limited. Funding guidelines for these rebates may be changed or discontinued at any time without notice.
Please check for rebate updates at www.OklahomaNaturalGas.com/CNG.
Oklahoma Natural Gas
Compressed Natural Gas Rebate Program
P.O. Box 401
Oklahoma City, OK 73101-0401
1-855-604-3258 (Fax)
NATURAL GAS VEHICLE Make/Model/Year ________________________________________________________________________________
(Dedicated or Bi-Fuel) VIN Number ____________________________________________________________________________________
Must include: (a) * Evidence of vehicle ownership (purchase contract/bill of sale).
AND copy of the application for Oklahoma Certificate of Title.
(b) * Verification of Liability Insurance.
(c) Conversion Invoice
Conversion Manufacturer _________________________________________________________________________
Conversion Kit Serial Number _____________________________________________________________________
Please select your vehicle
class below:
Class 1-2: Up to $5,000
Class 3-8: Up to $10,000
Install of Electrical/
Plumbing: Up to $2,500
Home Refueling Appliance Manufacturer Name _____________________________________________________________________________
(HRA: up to $5,000) Model Number __________________________________________________________________________________
Serial Number __________________________________________________________________________________
Must include: (a) * Date of
Purchase/Receipt_________________________________________________________________
Address Installed_________________________________________________________________
(b) Electrical and/or plumbing installation receipts.
*Copies of this information will need to be attached to the application in order to be processed. Must include attached receipt of electrical and/or
plumbing installation cost for reimbursement.
Applicant Signature: Date:
7.
Acceptance of Terms
I hereby certify that all information is accurate, including claims of customer and equipment information. My signature below indicates I have read,
understand and agree to all terms and conditions on this application and acknowledge that Oklahoma Natural Gas may verify all the information provided.
Terms and Conditions
As you decide whether to participate in Oklahoma Natural’s Compressed Natural Gas (CNG) Rebate program, please review the following terms and conditions.
1. To qualify for the CNG Rebate program, individual Oklahoma residents or any commercial or industrial company doing business in Oklahoma must complete a
CNG Rebate application form and provide all information required by the application. Applications and additional information are
available at www.OklahomaNaturalGas.com/CNG.
2. Any new or used CNG vehicle or residential CNG fueling system must comply with the additional terms and conditions included in the CNG Rebate application
form. By completing the CNG Rebate application form, a customer represents and warrants to Oklahoma Natural that the customer’s natural gas vehicle or CNG
fuel system qualifies for the CNG Rebate program in all respects, including without limitation that (a) the customer has not claimed more than the maximum
allowable rebates in any calendar year, (b) if the rebate is being claimed for a natural gas vehicle, that neither the customer, nor to the customer’s knowledge
anyone else, has previously claimed a rebate for such vehicle or any conversion kit in such vehicle during its lifetime, and (c) that the customer is not a dealer
or installer, as applicable, of natural gas vehicles, natural gas conversion kits, or CNG fueling systems. Any business whose primary purpose is the sale, resale,
renting or leasing of automobiles and trucks do not qualify. Oklahoma Natural reserves the right to verify all information provided.
3. Oklahoma Natural does not sell or manufacture the vehicles, natural gas conversion kits, or CNG fueling systems that qualify for rebates under the CNG Rebate
programs, nor does it endorse or recommend any particular vehicle, conversion kit, or fueling system. Oklahoma Natural is not responsible for any decision
regarding the selection of vehicles, conversion kits, or CNG fueling systems to qualify for rebates under our CNG Rebate program. OKLAHOMA NATURAL
THEREFORE DOES NOT MAKE AND HEREBY DISCLAIMS ANY EXPRESS OR IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS FOR A
PARTICULAR PURPOSE FOR ANY VEHICLE, CONVERSION KIT, OR FUELING SYSTEM CHOICE THE CUSTOMER MAKES. The customer is responsible for
the full cost and, if applicable, installation, of any vehicle, natural gas conversion kit or CNG fueling system.
4. Oklahoma Natural will not install any natural gas conversion kit(s) into the customer’s vehicle or any CNG fueling system at the customer’s home, nor is
Oklahoma Natural responsible for the performance of installation services by the customer or any third party. If a customer decides to install a natural gas
conversion kit or CNG fueling system, Oklahoma Natural encourages its customers to carefully research and select a qualified professional to do so. Oklahoma
Natural is not responsible for any damage caused when (a) a contractor enters a customer’s premises or during installation, (b) by poor workmanship or (c)
failure to complete projects. Oklahoma Natural will not intervene in disputes between a customer and his or her selected contractor. Oklahoma Natural also
strongly encourages participating customers to be sure any installation conforms to all applicable codes, permit requirements and manufacturer installation
recommendations and requirements. Oklahoma Natural is not responsible for determining whether a conversion kit or a CNG fueling system has been installed
correctly or safely into the customer’s vehicle or home.
5. Oklahoma Natural makes no warranty concerning whether use of a natural gas vehicle will accomplish any projected or targeted fuel cost savings. Further, in
determining whether to purchase a natural gas vehicle or convert an existing vehicle to natural gas, Oklahoma Natural advises its customers to consider the
proximity and availability of retail CNG outlets and stations.
6. Oklahoma Natural issues rebates in the form of checks, not utility credits. Oklahoma Natural is not responsible if the dealer/installer or retailer fails to provide
accurate information about the amount of a rebate or eligibility. Rebate checks will be mailed approximately six to eight weeks after approval, subject to
availability of program funds.
7. CNG Rebates for natural gas vehicles are available to any individual Oklahoma resident; any commercial or industrial company doing business in Oklahoma;
or any local governmental entities including state, county, city, schools and federally recognized tribal governments within the state of Oklahoma. Oklahoma
Natural encourages each participant to review all program eligibility requirements.
8. Completed rebate applications will be reviewed and processed by Oklahoma Natural on a first-come, first-served basis until program funds are depleted.
Rebate qualifications and amounts are subject to change. Rebates funds are limited. Funding guidelines for these programs may be changed or discontinued
at any time without notice. Please check www.OklahomaNaturalGas.com/CNG for updates.
6.
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REBATE CERTIFICATION CHECKLIST
TASK YES NO
1. Customer Information/Oklahoma Natural account information.
2. Completed rebate forms.
5. Read and approved terms and conditions.
6. Attached proof of ownership. (Purchase contract, bill of sale, copy of application for Oklahoma
Certificate of Title, copy of Oklahoma vehicle title)
7. Attached copy of verification of liability insurance.
8. Application must be within 90 days of purchase/install.
9. Read and understand the CNG Tariff. (oklahomanaturalgas.com/media/ONG/Tariffs/707.pdf)
3. EPA/CARB Certified kit is required for approval.
10. Vehicle class is determined.
11. Attach (HRA/electrical/plumbing) receipts of Home Refueling Appliance (HRA).
Oklahoma Natural Gas is unable to process incomplete applications. Applications must include all required documentation.
4. A Class 1 or 2 bi-fueled natural gas vehicle:
(a) Must be a model year less than or equal to one (1) year from the rebate
application year; or
(b) May be a model year less than or equal to three (3) years from the rebate
application year if the vehicle has been converted within the last twelve (12) months.
A Class 3 through 8 dedicated or bi-fueled natural gas vehicle must be a model year
less than or equal to three (3) years from the rebate application year.
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Form 1.: REBATE APPLICATION OKLAHOMA NATURAL GAS Rebate (Oklahoma Natural Gas)

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Completed 23 July 2021

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