2016 Rebate Application for Commercial & Large Multifamily LED Lighting

Step 2 of 5: Complete Customer & Facility Information

Property Owner or Account Holder (Check will be payable to this name):

Installation Address:

Contact Person: Phone:

Mailing Address (if different): City/State:

Contact Email: Mailing Zip:

Website: Fax No:

Facility InformationConvenience/Grocery/Restaurant Church/Warehouse Industrial/Manufacturing

Multifamily (4+ Units)/Lodging Education/Office/Retail Agriculture/Farm Building

Approx. year built: Building Sq. Ft. Owner-occupied Rental Property

Step 3 of 5: Complete Project & Dealer Information Replacement/Retrofit (existing) New Construction New Installation

Dealer Installed Customer Installed

Installing Dealer Information

Dealer/Company:

Mailing Address: City/State:

Contact Person: Mailing Zip:

Phone: Contact Email:

Dealer Agreement

I certify that all equipment and installation information provided on this application is correct and accurate.

Installer/Dealer Signature: Date:

Step 4 of 5: Read Terms & Conditions and Sign ReleaseThe undersigned agrees that the stated energy efficiency measure(s) was (were) installed and in operation at the job site address listed above as part of the CFU Program and that the information contained in this application is accurate and complete. I have read and agree to the Terms & Conditions within this application. The undersigned agrees to indemnify, defend, and hold harmless and release CFU from any claims, damages, liabilities, costs and expenses (including reasonable attorneys' fees) arising from or relating to the removal, disposal, installation or operation of any equipment or related materials in connection with the programs described in this application, including any incidental, special or consequential damages.

Customer Signature: Date:

Page 1 of 4 (2016)

Step 1 of 5: Contact CFU if pre-approval is needed (see questions below).

Does rebate exceed $5,000?

No. Go to Step 2.

Yes. Contact CFU at 319-268-5355.

Is it listed anywhere in Tables 2-4 on pages 3 and 4?

No. Go to Step 2.

Yes. Contact CFU at 319-268-5355.

CFU 2016 LED LIGHTING REBATES TERMS & CONDITIONS: n Applicant must be a current Cedar Falls Utilities (CFU) customer and CFU must supply electricity to the equipment for which the cash rebate is being paid. This program is intended for multifamily units with more than 4 units per building & nonresidential facilities. Payments will be made to property owners or account holders, not to builders, energy service companies, or contractors. n Incentives are available on a first-come, first-served basis. CFU may modify or end any cash rebate program at any time without notice. Neither pre-approval of a project, nor any other action by CFU, entitles applicant to a rebate payment until and unless this application is approved by CFU. The most current rules of this program are on the application forms posted at www.cfu.net. To evaluate your application, CFU will use the rules listed on the application form that was posted on the day CFU receives your application. n Purchase and installation must be completed between January 1, 2016 and December 31, 2016. Equipment or improvements must be installed and operating on the premises before you apply for a rebate. Submit your application no later than March 31, 2017. Allow two to eight weeks for application review and funding of approved rebates. Incomplete applications may be delayed or rejected. CFU reserves the right to award rebates in the form of utility bill credits or directly mailed checks. In no event will the rebate award from CFU exceed 50% of the total eligible, reasonable project costs or reduce the simple payback of a project to less than 12 months. Reasonableness determined by CFU. See the application form for additional rules applying to new construction projects on certain lighting technologies. n CFU reserves the right to inspect and verify the installation through an on-site inspection; ask you to complete a customer survey; and/or meter the specified equipment or process, at no cost to the customer, in order to determine the actual energy saved for up to 12 months after the installation. CFU may publicize your participation in this program unless you request otherwise in writing. Rebate application information may be shared with state agencies or departments. Projects must comply with all applicable federal, state, and local codes, standards, and regulatory requirements. Limit one rebate payment per piece of qualifying equipment or project expense. All equipment must be new; used or rebuilt equipment is not eligible. Existing equipment must be removed and may not be resold. n Cedar Falls Utilities: 1) does not endorse any provider, manufacturer, product, labor or system design by offering this program; 2) is not responsible for any tax liability arising from customer's receipt of a rebate payment; 3) does not expressly or implicitly warrant the performance of installed equipment or contractor's quality of work (contact your contractor or vendor for warranty information); 4) is not responsible for the proper disposal/recycling of any waste generated by this project; 5) is not liable for any incidental or consequential damages caused by the installation of the equipment or for any damage caused by the malfunction of the installed equipment; and 6) does not guarantee that a specific level of energy or cost savings will result from the implementation of energy efficiency measures or the use of products funded under this program. n All projects exceeding $10,000 in CFU Commercial/Multifamily Lighting Rebates will qualify for CFU's Custom Program and specified incentives instead of the CFU Commercial/Large Multifamily Lighting Rebates prescriptive program. n DIRECTIONS: For each project, submit a completed and signed rebate application with invoices and documentation as described below to either energyservices@cfu.net or Cedar Falls Utilities, Attn: Energy Services, P.O. Box 769, Cedar Falls, IA 50613. Steps: 1) Make sure your project does not need pre-approval: Your project needs pre-approval if either 1) the rebate amount exceeds $5,000; 2) it is one of the technologies listed in Tables 2 or 3 ; OR 3) the project uses technologies listed in the "Custom Rebates" table (Table 4) on page 4. Contact CFU for pre-approval before submitting this application. 2) Complete application after project completion and attach supporting documentation: You must provide an invoice for each type of lighting fixture, lamp, or occupancy sensor purchased. Each invoice must show: n Date of purchase n Vendor name & address n Customer name & address n Total Amount Due n Itemized quantity and pre-tax purchase price of each type of fixture, lamp, or sensor purchased n If invoice is from a vendor to a contractor: invoice must show the customer name or installation address. 3) Comply with additional requirements. For A-lamps, Par lamps, and Interior Fixtures: For each different type of equipment, invoice must clearly show the make and model of each lighting product OR a single UPC code from each type of product packaging must be enclosed with the application. If you replace compact fluorescent lighting, also comply with disposal requirements below For projects replacing HID, CFL, or linear fluorescent lighting: You must provide an invoice or receipt documenting proof of disposal of old HID, CFL, or fluorescent tube lighting and ballasts. Each invoice or receipt must show: n Customer (your company) name & address n Date of Transaction n Name of landfill, contractor, or waste management provider n Types & amounts of lighting and ballasts recycled

Page 2 of 4 (2016)

Additional Comment Regarding Disposal for HID Fixtures, CFLs, and Fluorescent Ballasts and Lighting Products As of July 1, 2010, CFU requires that old lighting replaced through its Commercial Lighting and Custom Incentives programs is properly recycled, and is not used at another location or sold to another party. This policy applies to all old fluorescent tubes (including low-mercury brands), compact fluorescent light bulbs (CFLs), high-intensity discharge (HID) lamps replaced, as well as all replaced ballasts, as these products and others used by businesses contain a small amount of mercury or other chemicals. Disposing of these lighting products in trash is prohibited by federal regulations for commercial customers; by recycling them you prevent mercury contamination and allow the glass and metals they contain to be recycled. A list of local and state recyclers is available upon request from CFU; you are also welcome to use another organization of your choice. See Terms & Conditions for instructions on how to submit proof of recycling or disposal with your application.

Page 3 of 4 (2016)

Step 5 of 5: Complete application below and attach all invoices, receipts, and proof of disposal.Table 1: LED A-Lamps, Interior Fixtures, Exit Signs, Refrigerated Case and Strip Lighting - from non-CFU instant buy down retailers only. New and existing construction are eligible. Must provide proof of disposal of old lighting, including CFLs (see page 2 of this application). In no event will the rebate award from CFU exceed 50% of the total eligible, reasonable project costs or reduce the simple payback of a project to less than 12 months. Reasonableness determined by CFU.

Light or Fixture Type

Brand/Manufacturer

Model Watts Watts Replaced

Hours of Operation per Year

Cost per Item Incentive

Quantity¥

Date Installed

Par lamps and A-lamps, Type 1*

50% of purchase price, $15 max.

Par lamps and A-lamps, Type 2*

50% of purchase price,

$15 max.

Interior Fixtures** 50% of purchase price, $25 max.

Refrigerated case lighting

$50 per case door

Exit signs (existing construction only)

$5 per sign

* Must be ENERGY STAR® qualified, screw-in base bulbs. Purchases made from local retailers participating in CFU's instant rebate point of purchase program for LEDs (Be Bright) are ineligible for additional CFU rebates. ** Must be ENERGY STAR qualified. Must be interior lighting fixture that is hardwired to the location (desk or other portable lamps are not eligible). Eligible fixture types include recessed downlight fixtures or retrofit kits, under-cabinet or shelf-mounted task lighting, surface and pendant-mounted downlights, and ceiling mounted with diffusers.

**Must be DesignLight Consortium-listed new fixture in one of its Indoor Luminaire primary use categories and replace existing lighting systems; all projects must be pre-approved by CFU. Tube-style LEDs and retrofit kits, including those replacing all reflectors, optical systems, and ballasts, are not eligible for the rebates in Table 2, but may qualify for CFU Custom Rebates. Screw-in (Mogul/E39) lamps intended as HID replacements are not eligible for any CFU lighting rebates. This rebate is for one-for-one replacement projects only. Lighting redesigns where the quantity of lamps or fixtures is changed may be eligible for a rebate through CFU's Custom Rebates Program. In no event will the rebate award from CFU exceed 50% of the total eligible, reasonable project costs or reduce the simple payback of a project to less than 12 months. Reasonableness determined by CFU.

Table 2: LEDs Replacing High Intensity - CFU pre-approval required; call CFU at 319-268-5355 to get started. Projects must Discharge (HID) Fixtures be in existing facilities and must be new indoor fixtures only. New construction facilities or projects replacing outdoor fixtures may be eligible for CFU Custom Rebates. See information below for definition of new fixtures and equipment eligibility. Must also provide proof of disposal of replaced lighting and ballasts (see bottom of page 2).

Type of HID Replaced

Brand/Manufacturer Model Lamp

WattageWatts

Replaced

Operating Hours per

Year

Total Labor Cost

Total Fixture

CostIncentive Quantity

Installation Date:

< 100 W HID**50% of

fixture cost ($100 max)

100-249 W HID**50% of

fixture cost ($150 max)

250-400 W HID**50% of

fixture cost ($250 max)

> 400 W HID** Custom

Light or Fixture Type

Brand/Manufacturer

Fixture Model Number

New Fixture

Wattage

Watts Replaced

Hours of Operation

per Year

Total Equipment

Cost

Total Labor Cost Incentive Quantity

Installation Date:

Integrated-style retrofit kits for

linear fluorescent replacements¥* (plug and play tube

replacements not eligible)

$50/kit

2 x 2 Troffer¥** (see New Construction

NOTE below)

50% of fixture costs, up to

$100

Number of T-12 fixtures replaced: (additional $50 rebate per T-12 fixture replaced)

2 x 4 Troffer¥** (see New Construction

NOTE below)

50% of fixture costs, up to

$100

Number of T-12 fixtures replaced: (additional $50 rebate per T-12 fixture replaced)

Page 4 of 4 (2016)

¥ All projects must be pre-approved by CFU. Tube-style LEDs and some retrofit kits are not eligible for the rebates in Table 3 but may qualify for CFU Custom Rebates. Screw-in (Mogul/E39) lamps intended as HID replacements are not eligible for any CFU lighting rebates. This rebate is for one-for-one replacement projects only. Lighting redesigns where the quantity of lamps or fixtures is changed may be eligible for a rebate through CFU's Custom Rebates Program. Must provide proof of disposal of all replaced lighting and ballasts. In no event will the rebate award from CFU exceed 50% of the total eligible, reasonable project costs or reduce the simple payback of a project to less than 12 months. Reasonableness determined by CFU.

* Must be fully integrated "insert" style kits only. This means that the product 1) is UL/cUL classified for use in enclosed or recessed fluorescent light fixtures; and 2) is DesignLight Consortium-listed in one of the DesignLight Consortium (DLC) Retrofit Kit Primary Use categories: "Integrated Retrofit Kits for 2x2 Luminaires", "Integrated Retrofit Kits for 1x4 Luminaires", or "Integrated Retrofit Kits for 2x4 Luminaires". Must use driver; cannot use ballast (new or existing) that powers the existing fixture. Products in the following categories do not qualify for this rebate but may qualify for CFU Custom Rebates: "Linear Retrofit Kits for 2x2 Luminaires", "Linear Retrofit Kits for 1x4 Luminaires", "Linear Retrofit Kits for 2x4 Luminaires".

** Must be DesignLights Consortium (DLC)-listed new fixture in the following primary use categories: "2x2 Luminaires for Ambient Lighting of Interior Commercial Spaces", "1x4 Luminaires for Ambient Lighting of Interior Commercial Spaces", "2x4 Luminaires for Ambient Lighting of Interior Commercial Spaces". This includes products that replace all reflectors, optical systems, and ballasts. Retrofit kits are not eligible for the rebates in Table 3, but may qualify for CFU Custom Rebates.

New Construction NOTE: For new construction properties, in no event will the rebate exceed 50% of the incremental fixture cost as compared to a current code compliant lighting fixture of CFU's choosing.

Table 3: LED Troffer and Surface - CFU pre-approval required; call CFU at 319-268-5355 to get started. Projects in existing Mounted Fixtures and new construction facilities are eligible. Indoor fixtures only. Exterior lighting projects may be eligible for CFU Custom Rebates. Replacement projects must also provide proof of disposal of replaced lighting and ballasts (see bottom of page 2).

Table 4: Custom LED Rebates - LED lighting projects and technologies below either must be pre-approved or may be eligible for CFU Custom rebates instead of CFU prescriptive lighting incentives. Use the CFU Custom Rebate Registration form to start the pre-approval process for your project.

All prescriptive rebates costs more than $10,000 in CFU rebates Controls of LED lighting systems Certain tube-style and retrofit kit LED lighting products Exterior lighting (i.e., pole-mounted lights, roadway fixtures, wall packs, canopy fixtures, and parking lot/garage fixtures) Comprehensive lighting redesign projects Other cost-effective or high bay retrofits that aren't eligible for CFU's prescriptive LED rebates