commercial refrigeration rebate form - efficiency …€™t forget to include a copy of your...

How to apply

� Read the Terms and Conditions to determine if you are eligible for a rebate.

� Verify that the product(s) you are going to purchase and install meet the eligibility requirements listed in the corresponding product section, or contact us.

� Purchase and install qualifying product(s) during the rebate eligibility term (January 1, 2018 - June 30, 2018).

� Complete and sign the application. If you prefer to submit online, visit https://rebates.efficiencyvermont.com/refrigeration.

� Include a copy of your invoice(s) as proof of purchase.

� Submit completed application form and invoice(s).

Need help?For more information or to confirm

eligibility, call 888-921-5990 or email

[email protected].

Efficiency Vermont and Burlington

Electric Department can help finance

your project at a low rate with no

collateral down. Please call us for

more information.

Please note:This rebate form is no

longer applicable for new

construction projects.

Contact us today to enroll

your project and maximize

impact and incentives.

In this form, you can find rebate information for:

› Evaporator Fan Motor Controls

› Door/Frame Heater Controls

› Floating Head Pressure Controls

› Refrigerator & Freezer Case Light Sensors

› Refrigerator & Freezer LED Case Light Fixtures

› ENERGY STAR® Ice Machines

› Display Case Strip-Curtain & Continuous Covers

› Reach-In Refrigerators & Freezers

Efficiency Vermont and Burlington Electric Department offer technical assistance and rebates to help businesses make cost-effective improvements. We also partner with distributors to offer discounted products in their stores. Please contact us with any questions or for additional assistance.

Commercial Refrigeration Rebate FormValid January 1, 2018 - June 30, 2018

Don’t forget to include a copy of your invoice(s)

Commercial RefrigerationRebate Form

Rebate Payee InformationStep 2

Payee’s Federal Tax ID Number (TIN) — check one and provide EIN/TIN or SSN:

Corporation or Tax-Exempt Organization (provide TIN) City, County, or State Dept., Govt. or Agency (provide TIN) Other (provide EIN/TIN or SSN)

Rebate check payable to (must match EIN/TIN or SSN below):

Contact information same as above

Contact Name:

Mailing Address:

City/Town: State: Zip:

Customer Information & AgreementStep 1

I certify that all equipment for which I am requesting a rebate has been installed, that I meet the eligibility requirements of this rebate program, and that all information submitted as part of this application, including proof of purchase and Federal Tax ID Number, is correct to the best of my knowledge. I agree to the terms and conditions listed on the back of this form.

CUSTOMER SIGNATURE (required even if rebate is going to vendor) Date

Business Name: Contact Name/Title:

Installation Address: City/Town: State: Zip:

Mailing Address (if different): City/Town: State: Zip:

E-mail Address: Telephone #:

Check to receive energy-saving offers and updates via e-mail.

Electric Utility Account # (of installation location)Electric Utility Company

I certify that the “Payee Information” above, including Federal Tax ID Number, is correct to the best of my knowledge. I acknowledge that as Payee I am responsible for any tax liability associated with my receipt of the rebate payment.

Employer Identification Number

or

Social Security Number

PAYEE SIGNATURE (if different from customer)

New construction projects cannot use this rebate form. Call Efficiency Vermont for more information.

Project #

For Internal Use W

Commercial Refrigeration Rebate Form: January 1, 2018 - June 30, 2018

Refrigeration Temperature CodesPlease refer to this table when filling out sections below

Door/Frame Heater Controls

Evaporator Fan Motor Controls

2

1

Eligibility Requirements ∞ Must be humidity- or conductivity-based anti-sweat controls.

∞ Must be retrofit to existing units.

Fill Out Below

Temperature Code

(from table above)

Installation Date

A = Quantity of Doors

B = Rebate/Door

A x B = Rebate Amount

$50

Total Rebate Section 2 $

Eligibility Requirements ∞ Must be installed in walk-in cooler or refrigerated warehouse application.

∞ Must control synchronous or brushless DC motor.

∞ Controls must cycle or reduce fan air flow to ensure energy savings.

∞ Visit https://contractors.efficiencyvermont.com/programs/refrigeration to get information on instant off incentives for evaporator fan motors.

Fill Out Below

Installation Date

Motor being controlled

Temperature Code

(from table above)

A =# of Fans

Controlled

B =Rebate/Fan


n Brushless DC

n Synchronous$30

n Brushless DC

n Synchronous$30



Temperature Code Designation Refrigerated Space Temperature

LT Low Temperature < 25° F

MT Medium Temperature 25° - 40° F

HT High Temperature 41° - 65° F

Product and Rebate InformationStep 3

Floating Head Pressure Controls3Eligibility Requirements ∞ Rebate is for floating head pressure controls for compressors < 10HP.

∞ High temperature applications (> 41°F) are not eligible.

∞ Condensing temperature should be set to 70°F.

∞ Cannot be used in conjunction with any instant off rebates.

∞ Rebate only applicable for retrofitting existing equipment. Not valid for inclusion in new condensers.

Fill Out Below

Equipment Temperature

(check one)

Equipment Configuration

(check one)

Compressor Horsepower

Condenser Manufacturer

Condenser Model Number

A = Quantity of Floating

Head Pressure Controls

B = Rebate/ Floating Head

Pressure Controller

A x B = Rebate

Amount

n Refrigerator n Freezer

n Self-Contained (Packaged) n Split

$300



Refrigerator & Freezer Case Light Sensors4Eligibility Requirements ∞ For use on interior LED or fluorescent equipment.

∞ Minimum of 3 doors per sensor.

∞ Companion switches for wireless sensors are not eligible for rebates.

Fill Out Below

Application# of Hours Lights

are on/Week(before controls)

Installation Date

A = Quantity of Controls

B = Rebate/Control


Refrigerator or Freezer Case Sensors $40


Refrigerator & Freezer LED Case Light Fixtures5Eligibility Requirements ∞ Product must be qualified by DesignLights Consortium® for rebates. To verify a product is qualified, visit www.efficiencyvermont.com/qualified-lighting. Please make sure your product is qualified by DLC by clicking on the Details button located next to the products listed in the link above.

∞ Horizontal and vertical doors are eligible.

Fill Out Below

Installation Date

Manufacturer Model ## of Hours Lights are on/Week

A = Quantity

of Fixtures

B = Rebate/Fixture


$40

$40

$40



ENERGY STAR® Ice Machines6Eligibility Requirements ∞ Units must be listed on the ENERGY STAR certified products list, available at www.energystar.gov/productfinder/product/certified-commercial-ice-machines/results.

Fill Out Below

Equipment Code

(from table above)

Installation Date

Ice Machine Type

Make Model # Serial #A =

Quantity

B = Rebate/Ice

Machine


n Batch n Continuous

n Batch n Continuous


Ice Machine Type(batch or continuous)

Harvest Rate(lbs ice/day)

Equipment Code Rebate

Ice Making Head (IMH)< 450 7.1 $50

≥ 450 7.2 $75

Remote Condensing Unit (RCU)< 1,000 7.3 $50

≥ 1,000 7.4 $75

Self-Contained Unit (SCU)< 175 7.5 $50

≥ 175 7.6 $75

Display Case Strip-Curtains & Continuous Covers7Eligibility Requirements ∞ Eligible covers are PVC, metal, or equivalent curtains.

∞ Installed on open, multi-deck (merchandise) coolers.

∞ Rebate is based on length (in feet) of case covered.

Fill Out Below

Temperature Code(from table on page 3)

MT & HT only

Application(check one)

Installation DateA =

Length(linear feet)

B = Rebate/Foot


n Strip Curtain n Continuous

$6

n Strip Curtain n Continuous

$6


Capacity

Appliance CodesSolid DoorFreezer and

Refrigerator Rebate

Transparent Glass Door Freezer and

Refrigerator RebateSolid Door

FreezerSolid Door

Refrigerator

Transparent Glass Door Refrigerator

Transparent Glass Door

Freezer

< 15 cu. ft. SFA SRA GRA GFA $200 $250

15 - < 30 cu. ft. SFB SRB GRB GFB $200 $250

30 - < 50 cu. ft. SFC SRC GRC GFC $250 $300

50 - < 80 cu. ft. SFD SRD GRD GFD $300 $400

Reach-In Refrigerators & Freezers8Eligibility Requirements ∞ Eligible units are high-efficiency, ENERGY STAR certified commercial reach-in units that meet the ENERGY STAR V4.0 specification.

∞ Units must be listed on the ENERGY STAR certified products list, available at www.energystar.gov/productfinder/product/certified-commercial-refrigerators-and-freezers/results.

∞ Additional rebate bonus of $100 available for refrigerators or freezers utilizing natural refrigerants: propane or butane (R-290/R-600a).

Fill Out Below

Appliance Code

(from table above)

Model #Installation

Date

A = Quantity of

Refrigerators or Freezers

B = Rebate/

Refrigerator or Freezer

C = $100/Unit for

Natural Refrigerant (R-290, R-600a)

A x B + C = Rebate Amount



Submit Form and InvoiceStep 4

Mail to:Mail: Efficiency Vermont c/o Rebate Coordinator 128 Lakeside Ave., Suite 401 Burlington, VT 05401

Fax: 802-658-1643

E-mail: [email protected]

Burlington projects, submit form to:

Mail: Burlington Electric Department c/o Energy Services Area 585 Pine Street Burlington, VT 05401

Fax: 802-865-7500

E-mail: [email protected]

Burlington Electric Department (BED) administers efficiency programs for the City of Burlington, including the rebates listed on this form. For more information, call 802-865-7342.

Need help?For more information or to confirm eligibility, visit

www.efficiencyvermont.com or call 888-921-5990.

Prefer to submit online?

Visit https://rebates.efficiencyvermont.com/refrigeration

Instant Rebate ProductsSpecial pricing is now available at participating distributors for the following products. Call 888-921-5990 or visit https://contractors.efficiencyvermont.com/programs//refrigeration for more information. For Burlington projects, call Burlington Electric Department for pre-approval.

∞ Efficient Evaporator Fan Motors

∞ High Efficiency Condensing Units


1. REBATE is for new equipment purchased and installed between January 1, 2018 and June 30, 2018 by commercial, industrial and agricultural customers of Vermont electric utilities, except that rebates are not available to the following customers: IBM, GlobalFoundries, Omya, and electric utility companies. Equipment must be installed within the state of Vermont in a commercial, industrial or agricultural facility. Rebate forms must be postmarked or received by July 31, 2018. Rebate offer is subject to change without notice and may not be combined with any other offer.

2. LIMITATIONS: This form cannot be used for any project involving more than 250 individual items subject to rebate, or for any project involving new construction. For information on such projects, please call Efficiency Vermont (or Burlington Electric Department for projects within the City of Burlington).

3. PROOF OF PURCHASE: Invoice(s) must include the quantity, size, type, manufacturer, model or part number, purchase date, and vendor of the efficient equipment. All sales transactions and installations are subject to verification and inspection. By signing this form, the customer consents to allow Efficiency Vermont (or, within the City of Burlington, Burlington Electric Department) 1.) to access the equipment for purposes of verification and inspection, and 2.) to disclose the customer’s information (including but not limited to the customer’s information included on this form and information on the invoices(s)) to the vendor and/or contractor who sold or installed the equipment to verify equipment purchase/installation and to collect additional information about the equipment and its installation.

4. LIMITATION OF LIABILITY: Performance of installed equipment is not guaranteed expressly or implicitly.

5. ENDORSEMENT: No particular manufacturers, products, or system designs are endorsed through this program.

6. PAYMENT: Allow 60 calendar days for delivery of payment. Incomplete or missing information will delay processing of rebate form and payment.

7. MAXIMUM PAYMENT Maximum payment will not exceed 100% of the equipment purchase price and installation cost. Customer is responsible for all other costs including sales tax, disposal/recycling, and any tax liability associated with rebate payment.

8. CAPACITY CREDITS/ENVIRONMENTAL CREDITS: In accepting these financial incentives, the customer agrees that Efficiency Vermont (or, for customers within its service territory, Burlington Electric Department) holds the sole rights to any electric system capacity credits and environmental credits associated with the energy efficiency measures for which incentives have been received.

Terms & Conditions

www.efficiencyvermont.com128 Lakeside Avenue, Suite 401Burlington, VT 05401888-921-5990 © 2018 Efficiency Vermont

EV

-473

4-0

118

-RN

AX

commercial refrigeration rebate form - efficiency …€™t forget to include a copy of your...

Documents