Geothermal Heat Pumps

**Units that do not qualify include:Window heat pumps, “Thru-the-wall” heat pumps (hotel-type machines) and Ductless Mini-Split Heat Pumps when only used for sunrooms, room additions or other small areas.

Appliance Recycling• $50 per appliance rebate• Must be a working refrigerator or freezer

between 10 and 30 cubic feet• Residential only, no commercial• Limit of two appliances per household

Ask your Co-op about these other Energy Saving Programs

Water Heaters

Air source, Ductless Mini Split, or Dual Fuel Heat PumpsHEAT PUMP REPLACING GAS, EXISTING AC OR HEAT PUMP OR NEW CONSTRUCTION INSTALL**Dual/Variable/Multi-Speed Compressor ONLY $750

HEAT PUMP REPLACING 100% ELECTRIC RESISTANCE HEAT (Must be replacing primary heat source for whole home)

Not qualified for 100% Electric Resistance Replacement:Heat pump with electric resistance, space heaters, gas furnace, wood stove, wood pellet, A/C, back-up heat

Single Speed Compressor $800

Dual/Variable/Multi-Speed Speed Compressor $1,500

k Desuperheater or “hot water assist” required on new installations with electric resistance water heater.

NEW CONSTRUCTION OR REPLACING ELECTRIC RESISTANCE HEAT, $1,500GAS, HEAT PUMP OR GEOTHERMAL

k Minimum 40 gal.k All-in-one units

NEW CONSTRUCTION OR REPLACING GAS OR ELECTRIC $500

PLEASE NOTE:Your electric cooperative reserves the right to approve, deny or select the appropriate incentive. Prior approval from your electric co-op is required for electric resistance incentives.

To qualify, the home in which the equipment is installed must be occupied year-round (12 months)and an energy management switch must be installed on rebated equipment.

To receive an incentive from your cooperative, homeowners must provide AHRI (Air conditioning, Heating and Refrigeration Institute) validation for all SEER ratings. This can be obtained from the installing heating and cooling dealer. No incentive will be awarded based on SEER rating listed on the HVAC dealer bid specifications, promotional material of dealer, manufacturer or any other source than AHRI.

Homeowners must complete a request form and provide proof of purchase (invoice or receipt) to receive any 2019 incentive.

Deadline to apply for 2019 Rebate Program is Dec. 15, 2019

Visit www.teamuptosave.com for more information

2019 Residential REBATE

PROGRAM

* Mobile/manufactured homes are defined as:o Factory assembled; Transportable; Designed for transportation on

own chassis; Can be placed on temporary or permanent foundation; Intended for year-round occupancy.

o Note: Modular homes are considered residential single family homes.

(Heat Pump or Hybrid)

Minimum Efficiency Requirements

Stick Built or Modular Housing k 9.0 HSPF; 16 SEER Mobile/Manufactured Housing* k 8.0 HSPF; 14 SEER

LED Online Co-op Store• 75% (up to $3) instant rebate available for small LED lamps

and reflector floods + FREE SHIPPING• 75% (up to $6) instant rebate available for large LED

reflector floods or specialty lamps + FREE SHIPPING

Energy Management Savings Switch• Receive up to $75 per year in bill credits for participating in

the Energy Mangement Program.

2019 Residential Rebate ApplicationReturn completed application to: Dubois REC, 1400 Energy Drive, P.O. Box 610, Jasper, IN 47547 • Phone: 812-482-5454 • FAX: 812-482-7015

If the rebate is to be mailed to the contractor instead of being claimed by the member, please complete the following section:

Member Applicant Assignment of Payment to Non-Applicant/Contractor/Vendor:By initialing and checking below, I assign the full Team Up incentive amount pursuant to this application to the individual or entity designated as “Contractor/Installer” on the first page ofthis application, agree that such assignment can only be amended or modified in writing acknowledged by member cooperatives and Hoosier Energy, and further agree to hold harmlessand indemnify member cooperatives and Hoosier Energy from any claim made for such incentive amount or from any loss resulting from the payment of the incentive amount to theassignee.

q Make rebate payment to Contractor/Vendor Member applicant initials:_________________

Name: ______________________________________________

Account #: __________________________________________

Meter Number: _______________________________________

Street Address: ______________________________________

City, State and Zip: ____________________________________

Email Address: _______________________________________

Home Phone: ________________________________________

Cell Phone: __________________________________________

Contractor’s Name: ____________________________________

Contractor’s Mailing Address: ____________________________

___________________________________________________

Building Type (check one)

q Residential: Mobile/Manufactured q Residential: Single Family

Occupancy Status:

q Owner q Renter q Vacant q Tenant q Landlord

Construction Type:

q New Construction q Existing Home

Housing Type:

q Stick-built or Modular q Mobile or Manufactured Home

Year Home was Built: ___________

Total Project Invoice Cost: _____________

Member Information

Please provide the necessary information pertaining to your particular request. Rebates cannot be processed without complete information and proof of purchase (invoice or receipt).

Please read and sign below to indicate you understand and agree to the following conditions:1. All rules and requirements of this program have been followed.

2. Applicant has read and agrees to the Residential Rebate Program Terms and Conditions at www.duboisrec.com.

3. Applicant is a residential member of Dubois REC, an electric cooperative member of Hoosier Energy.

4. The rebated equipment has been installed and operational prior to submission of this application.

5. Dubois REC is providing the electric service to the installation site address listed on this application. Rebated equipment is installed in the primary

residence of the applicant.

6. Applicant understands and agrees that neither Hoosier Energy nor Dubois REC assumes any responsibility or liability arising out of or related to

applicant’s participation in Team Up programs.

7. Applicant will allow inspection of the rebated equipment (if requested).

8. Applicant understands applicant will not receive a rebate if applicant and/or applicant’s contractor fails to provide required program documentation.

9. Applicant agrees to purchase power from Dubois REC for a period not less than the deemed measured useful life of rebated equipment. Should the

applicant receive power from any source other than the electric cooperative, including generation owned by the customer, before the end of the

equipment’s deemed useful life, the applicant agrees to refund the full amount of the rebate to the distribution cooperative.

10. Applicant gives permission to Hoosier Energy to obtain usage information from their electric cooperative. Applicant understands that Hoosier Energy

may use the usage information provided for program evaluation and analysis. If signing in a capacity other than an individual capacity, the individual

signing below hereby represents and warrants that s/he is duly authorized to execute and deliver this application on behalf of the applicant.

11. Dubois REC reserves the right to approve, deny or select the appropriate rebate amount.

Signed: ______________________________________________________________________________ Date: ______________________

HVAC Installation Date: __________________________________

Installation Type: Equipment must be installed in primary residenceq Replacing existing A/C or HEAT PUMP; or New Construction Install

(ASHP, MSHP, or GHP heat pump type)

q Existing home new HEAT PUMP install

q New residential construction install

q Replacing existing A/C

q Replacing existing HEAT PUMP

q Replacing 100% Electric Resistance*(HPRER or DMSHP heat pump type)Must be primary heat source to home.

What type of heat is being replaced?

(Required if replacing electric resistance)

q Electric Coil Furnace q Baseboard q Ceiling Cable

q Other: _________________________________________ (Description of “other” required.)

*Not qualified for 100% Electric Resistance Replacement:Heat pump with electric resistance, space heaters, gas furnace, wood stove, wood pellet, A/C, back-up heat

Heat Pump Type:q Air Source (ASHP) $750 Dual/Variable/Multi-speed compressor is required

q Ductless Mini-Split Heat Pump (DMSHP)** $750 Dual/Variable/Multi-speed compressor is required

q Geothermal Heat Pump (GHP) $1,500 q Single Speed Compressor

q Dual/Variable/Multi-Speed Compressor

(GHP) Desuperheater installed? qYes qNo(GHP) Propane/gas back-up? qYes qNo

q Electric Resistance Replacement Air Source/Dual Fuel (HPRER) q Single Speed Compressor $800

q Dual/Variable/Multi-Speed Compressor $1,500

q Electric Resistance Replacement Ductless Mini-Split (DMSHP)** q Single Speed Compressor $800

q Dual/Variable/Multi-Speed Compressor $1,500

Does the heat pump have a gas furnace (Dual Fuel): qYes qNo

Gas Furnace AFUE: _______________________________________ Fossil Fuel Type: _________________________________________

**Whole house installations ONLY

2019 Residential Rebate ApplicationReturn completed application to: Dubois REC, 1400 Energy Drive, P.O. Box 610, Jasper, IN 47547 • Phone: 812-482-5454 • FAX: 812-482-7015

Total HVAC Rebate Amount: $ ___________

Enrollment Number: ____________________

Enrollment Date: _______________________

FOR OFFICE

USE ONLY

HVAC Equipment Information

Quantity of Outdoor Units Installed: ________________________

Quantity of Indoor Units Installed: _________________________

Manufacturer: _______________________________________

Purchased from: _____________________________________

Heat Pump Equipment Cost (Excluding labor costs) : ____________

BTUs: ______________________________________________

Size (Tons): __________________________________________

AHRI SEER Rating: _____________________________________

AHRI HSPF Rating: ____________________________________

q AHRI Certificate is attached (Required)q Invoice or Receipt is attached (Required)

Outdoor Unit Model #: _________________________________

Outdoor Unit Serial#: __________________________________

Indoor Unit Model #: ___________________________________

Indoor Unit Serial#: ____________________________________

Installed by: _________________________________________

Building Contractor’s Name: _____________________________

Note: HVAC contractor MUST indicate on the invoice, whether a single or dual/variable speed compressor was installed.

Submission of application expressly indicates member understanding and agreement to the following conditions:Limit of two rebates (per type) per household. Rebates for HVAC equipment are availablefor whole house installations only. To receive a rebate, all homeowners must provide AHRI (Air conditioning, Heating and Refrigeration Institute) validation for all SEER and HSPF ratings that can be obtained from the installing heating and cooling dealer. No rebate will be awarded based on HVAC dealer bid specifications, promotional material of dealer, manufacturer or any other source than AHRI. A certificate of AHRI-certified performance must be submitted.

All homeowners must complete a rebate request form and provide proof of purchase to receive any 2019 rebate. Deadline to apply for 2019 Rebate Program is Dec. 15, 2019.

All homeowners and future homeowners receiving rebates from the electric cooperative agree to the future installation of an energy management switch on these rebated appliances to allow future peak demand energy management procedures. The cooperative reserves the right to approve, deny or select the appropriate rebate. The co-op also reserves the right to inspect and verify installation of equipment receiving a rebate.

Total Water Heater Rebate Amount: $ ______

Enrollment Number: ____________________

Enrollment Date: _______________________

FOR OFFICE

USE ONLY

Water Heater Installation Date: ___________________________

Number of Units Installed: ______________________________

Equipment Cost (Excludes labor) : _________________________

Manufacturer: _______________________________________

Purchased from: _____________________________________

Unit Model #: ________________________________________

Unit Serial #: ________________________________________

Size (gallons): ________________________________________

Efficiency Rating: _____________________________________

Type of Home HVAC: ___________________________________

Installed by: _________________________________________

Building Contractor: ___________________________________

Note: Rebate available only for Heat Pump or Hybrid Water Heaters, minimum 40 gal. There is no incentive for electric resistance tank or tankless water heaters. Limit of 2 water heater rebates per household.

Water Heater Information

Submission of application expressly indicates member understanding and agreement to the following conditions:

Limit of two rebates (per type) per household. All homeowners must complete a rebate request form and provide proof of purchase to receive any 2019 rebate. Deadline to apply for 2019 Rebate Program is Dec. 15, 2019.

All homeowners and future homeowners receiving rebates from the electric cooperative agree to the future installation of an energy management switch on these rebated appliances to allow future peak demand energy management procedures. The cooperative reserves the right to approve, deny or select the appropriate rebate. The co-op also reserves the right to inspect and verify installation of equipment receiving a rebate.

Bright ideas for energy efficient lighting

Residential members can visit our LED Lighting Store for instant savings on LED bulbs (and future savings on their electric bill.)

Your electric cooperative also has a special online store for Small Business/Agriculture lighting products.

Go to teamuptosave.com/lighting or duboisrec.com.

Looking for incentive programs for your business?

Check out our commercial and industrial programs. Rebates and incentives available for many applications:

• Lighting • HVAC • Motors • Compressed Air • New Construction

Get more information at teamuptosave.com/commercial or duboisrec.com

2019 Residential Rebate ApplicationReturn completed application to: Dubois REC, 1400 Energy Drive, P.O. Box 610, Jasper, IN 47547 • Phone: 812-482-5454 • FAX: 812-482-7015