Please read and sign the appropriate agreement(s):
New Appliance Information:
Product
Brand Name (New Unit) Model # (New Unit)_____________________
Product
Brand Name (New Unit) Model # (New Unit)_____________________
Switch Agreement:
Read and sign THIS Agreement if the natural gas appliance(s) listed on the front of this Rebate Form replaced an electric or propane appliance
(i.e.,
if you have
"switched" from electric or propane to natural gas).
TERMS AND CONDITIONS: Rebate applies to newly purchased, qualifying natural gas appliances that have been installed according to local codes. Rebate wil l be
del ivered as credit on Cit y of Perryville Utility bill . Purchases
must be made between January 1, 2020 and October 31, 2024. Installation must be completed by
November 15, 2024, and all rebate submissions must be postmarked by November 30, 2024. No exceptions. Maximum rebate per service address is $500 annually. Good
for the purchase and installation of gas furnaces and water heaters in pre-existing residential homes, manufactured homes, condominiums and townhouses within the City
of Perryville natural gas service territory. This offer is not available for the new construction of apartments, townhouses or commercial establishments.
Furnaces
purchased as part of a Dual Fuel system, as well as conversions from
Dual Fuel systems, do not qualify for rebates.
This offer is only valid for customers of City of
Perryville who have a current u t i l i t y account in good standing. Employees of
the City of Perryville
, Natural Gas Contractors, and retailers are eligible to participate in this
promotion as long as they meet all other criteria. Please allow 8 weeks after your completed claim is received to receive your r e b a t e . All r e b a t es will app ea r on
c u s t o m e r ’ s m o n t hl y i n v o i c e . C i t y o f P e r r y v i l l e is not responsible for lost, late, damaged, postage due, misdelivered or misdirected mail and illegible or
incomplete entries. All entries become the property of City of Perryville. C i t y o f P e r r y v il l e reserves the right to withdraw or terminate this promotion
at any time
upon reasonable notice posted on our website at www.cityofperryville.com or by forms available that specify an end date for purchase. You must provide all the information
requested on the form in order to be eligible, including a copy of proof of purchase (receipt or invoice) and proof of installation (work order or receipt). Incomplete entries
will not be processed and will not be returned. City of Perryville will notify customers submitting incomplete entries of the reason for the denial. Customer will be given
30 days to correct and resubmit valid entries and required supporting documentation. Only one resubmission is allowed per rebate. If resubmissions are not received
within 30 days of the notice, the resubmission is not valid or does not have required supporting documentation, t h e c u s t o m e r w i l l n o t r e c e i v e a reba t e. The City
of Perryville reserves the right to substantiate sales receipts, model numbers, and installation information, and to request additional
documentation. Physical inspection
for verification of claims may be required. Customer will not return, or attempt to return, any appliance for which Customer has
received a rebat e. By submitting this form,
you consent to our collection,
use and disclosure of the information contained in it, together with any information you may subsequently provide to us, to any person or
entity for the purposes of
processing this form or responding to your requests. If multiple purchases that qualify for this promotion are on the same receipt, please include
a fully completed rebate form and supporting documentation in one envelope. Please circle the product and purchase price on the sales receipt. The City of Perryville is in
no way responsible for the installation, quality of installation, or quality of your natural gas appliances for which you submit a
rebate form under this promotion. Any
concerns regarding installation should be directed to your installer. Any concerns regarding your natural gas appliance(s) should
be directed to the manufacturer, retailer or
Natural Gas Contractor from which you purchased the natural gas appliance. F orms may be downloaded from our web site at www.cityofperryville.com. Keep a copy of
your submission for future reference. Offer void where prohibited by law.
I confirm that I have purchased and switched the appliance(s) indicated and the appliance(s) has (have)
been installed at the address shown on the front of this Rebate Form in accordance with the terms and
conditions of this rebate offer.
Signature Date
Replace or New Agreement:
Read and sign THIS Agreement if the natural gas appliance(s) listed on the front of this Rebate Form replaced a natural gas appliance or is new construction.
TERMS AND CONDITIONS: Rebate applies to newly purchased, qualifying natural gas appliances that have been installed according to local codes. Rebate wil l be
del ivered as credit on Cit y of Perryville Utility bill . Purchases
must be made between January 1, 2020 and October 1, 2024. Installation must be completed by
November 15, 2024, and all rebate submissions must be postmarked by November 30, 2024. No exceptions. Maximum rebate per service address is $500 annually. Good
for the purchase and installation of gas furnaces and water heaters in pre-existing residential homes, manufactured homes, condominiums and townhouses within the City
of Perryville natural gas service territory. This offer is not available for the new construction of apartments, townhouses or commercial establishments.
Furnaces
purchased as part of a Dual Fuel system, as well as conversions from
Dual Fuel systems, do not qualify for rebates.
This offer is only valid for customers of City of
Perryville who have a current u t i l i t y account in good standing. Employees of
the City of Perryville
, Natural Gas Contractors, and retailers are eligible to participate in this
promotion as long as they meet all other criteria. Please allow 8 weeks after your completed claim is received to receive your r e b a t e . All r e b a t es will app ea r on
c u s t o m e r ’ s m o n t hl y i n v o i c e . C i t y o f P e r r y v i l l e is not responsible for lost, late, damaged, postage due, misdelivered or misdirected mail and illegible or
incomplete entries. All entries become the property of City of Perryville. C i t y o f P e r r y v il l e reserves the right to withdraw or terminate this promotion
at any time
upon reasonable notice posted on our website at www.cityofperryville.com or by forms available that specify an end date for purchase. You must provide all the information
requested on the form in order to be eligible, including a copy of proof of purchase (receipt or invoice) and proof of installation (work order or receipt). Incomplete entries
will not be processed and will not be returned. City of Perryville will notify customers submitting incomplete entries of the reason for the denial. Customer will be given
30 days to correct and resubmit valid entries and required supporting documentation. Only one resubmission is allowed per rebate. If resubmissions are not received
within 30 days of the notice, the resubmission is not valid or does not have required supporting documentation, t h e c u s t o m e r w i l l n o t r e c e i v e a reba t e. The City
of Perryville reserves the right to substantiate sales receipts, model numbers, and installation information, and to request additional
documentation. Physical inspection
for verification of claims may be required. Customer will not return, or attempt to return, any appliance for which Customer has
received a rebat e. By submitting this form,
you consent to our collection,
use and disclosure of the information contained in it, together with any information you may subsequently provide to us, to any person or
entity for the purposes of
processing this form or responding to your requests. If multiple purchases that qualify for this promotion are on the same receipt, please include
a fully completed rebate form and supporting documentation in one envelope. Please circle the product and purchase price on the sales receipt. The City of Perryville is in
no way responsible for the installation, quality of installation, or quality of your natural gas appliances for which you submit a
rebate form under this promotion. Any
concerns regarding installation should be directed to your installer. Any concerns regarding your natural gas appliance(s) should
be directed to the manufacturer, retailer or
Natural Gas Contractor from which you purchased the natural gas appliance. F orms may be downloaded from our web site at www.cityofperryville.com. Keep a copy of
your submission for future reference. Offer void where prohibited by law.
I confirm that I have purchased and replaced the appliances indicated and they have been installed at the
address shown in accordance with the terms and conditions of this rebate offer.
Signature Date
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