Up to $125 Rebates forHigh-E�ciency Toilets

For the fastest rebate, apply online at www.BayAreaConservation.org

E�ective July 1, 2016 Through June 30, 2017

For the fastest rebate, apply online at www.BayAreaConservation.org

650-349-3000 www.BayAreaConservation.org

650-349-3000 www.BayAreaConservation.org

High-E�ciency ToiletRebate ApplicationSave Water Save Money

Up to

$125Rebates for

High-E�ciency Toilets

Get Up to $125 for Replacing Your OldToilet With a High-E�ciency Toilet 650-349-3000

www.BayAreaConservaton.org

Participating BAWSCA Agencies are o�ering up to a $125 rebate when you replace your old toilet with anEPA WaterSense Labeled High-E�ciency Toilet (HET).

A toilet that uses 3.5 gallons per �ush (GPF) or more accounts for about 26% of your home’s indoor water use.One of the easiest ways to lower your indoor water use is to install a HET, which uses 1.3 GPF or less.

Although HETs use approximately 62% less water, they remove waste e�ectively and perform well.

HIGH-EFFICIENCY TOILET REBATE PROGRAM ELIGIBILITY RULES• Rebates are $75 per high-e�ciency toilet (HET) or $125 per MaP Premium high-e�ciency toilet (Premium HET), up to the total cost of toilet, not including sales tax, whichever is less.• To receive the $125 rebate, you must purchase a MaP Premium qualifying HET. MaP Premium HETs use 1.06 gallons per �ush or less, and meet a minimum MaP threshold of 600 grams of waste removed from the toilet �xture in a single �ush. A link to the list of MaP Premium HETs can be found at www.bawsca.org.• To receive the $75 rebate, you must purchase an EPA WaterSense Labeled HET. A link to the list of EPA WaterSense Labeled HETs can be found at www.bawsca.org.• HETs must be purchased between July 1, 2016 and June 30, 2017. The HET installation must be complete, and the rebate application postmarked, within 90 days of the HET purchase date.• A separate and complete HET rebate application must be submitted for each metered address. • Original HET receipt(s) must be included with the HET rebate application. If you need the receipt(s) returned, please enclose a self-addressed, stamped envelope with your application. • The HET must be installed within the service area of the water agency that is paying the rebate.• Pre-Quali�cation Requirements: Applicant must contact their local water agency to pre-qualify if Applicant is: (1) not listed on the water service account, (2) a customer of Daly City or Estero Municipal Improvement District, or (3) a commercial customer of Coastside County Water District.• Customers of Alameda County Water District: Alameda County Water District does not provide HET rebates for homes built after 1994.

• Customers of Estero Municipal Improvement District: Commercial accounts are eligible for MaP Premium HET rebates only.• Customers of Redwood City: Rebates are provided for MaP Premium HETs only. • Toilets purchased for new construction do not qualify for a rebate.• All sites are subject to post-installation inspections. Pre-purchase and post-installation inspections are required at any sites where seven (7) or more rebates are issued.• Rebates are $75 - $125 per HET, or up to the total cost of the HET (not including sales tax), whichever is less.• All rebates are subject to availability of funds. Rebates may take up to eight (8) weeks to process.• Rebates are issued as checks or as credits on water service accounts.• Limit: Three (3) rebates per living unit, not per account. Ten (10) rebates per commercial account. For questions regarding rebates in excess of these limits, contact your water agency.• Mid-Peninsula Water District o�ers a total of six (6) rebates per commercial account.• Applicant must be a water customer in good standing with a participating BAWSCA Agency. If Applicant is not the property owner and/or is not listed on the water service account, Applicant must submit documentation that includes the property owner/account holder’s contact information.• Accounts that have reached the limits speci�ed above for prior toilet rebates, or that have previously received toilets through a water agency direct installation or distribution program, are not eligible for rebates.• BAWSCA and the local water agencies reserve the right to deny a rebate to any Applicant that does not meet the program requirements.

For the fastest rebate, apply online at www.BayAreaConservation.org

Participating BAWSCA AgenciesTo be eligible for a rebate you must be a customerof one of these BAWSCA water agencies: • Alameda County Water District 510-668-4299 www.acwd.org• City of Brisbane/Guadalupe Valley Municipal Improvement District 415-508-2130 www.ci.brisbane.ca.us• City of Burlingame 650-558-7230 www.burlingame.org• Coastside County Water District* 650-726-4405 ext. 7210 www.coastsidewater.org• Daly City 650-991-8203 www.dalycity.org• Foster City/Estero Municipal Improvement District** 650-286-8140 www.fostercity.org• City of Hayward 510-583-4700 www.hayward-ca.gov• Town of Hillsborough 650-375-7444 www.hillsborough.net• City of Menlo Park/Menlo Park Municipal Water District 650-330-6720 www.menlopark.org• Mid-Peninsula Water District 650-591-8941 www.midpeninsulawater.org• City of Millbrae 650-259-2348 www.ci.millbrae.ca.us/waterconservation• Redwood City 650-780-7436 www.redwoodcity.org/conservation• City of San Bruno 650-616-7162 www.sanbruno.ca.gov• Westborough Water District 650-589-1435 www.westboroughwater.com* Coastside rebates are $100 for Standard and MaP Premium HETs

Get up to $125 for Replacing Your OldToilet With a High-E�ciency Toilet

❑ I called my local water agency to pre-qualify, if required.

❑ The toilet I purchased is an EPA WaterSense Labeled HET.

❑ I included my water service account number on the application.

❑ I completely �lled out and signed the application.

❑ I enclosed the original HET receipt with my rebate application.

❑ I installed my HET and mailed in the application within 90 days of purchase.

HET Rebate Application Checklist

Mail application and receipt(s) to: BAWSCA155 Bovet Road, Suite 650, San Mateo, CA 94402

Or, for the fastest rebate, apply online at:www.BayAreaConservation.org

Shop for theWaterSense Logo

• Shoreway Environmental Center 650-802-8355 www.rethinkwaste.org• Zanker Recycling 408-263-2384 www.zankerrecycling.com• Davis Street Transfer Station 510-613-8710 www.dsgardencenter.com

• Recology of the Coast 650-355-9000 www.recologyofthecoast.com• Green Waste Recovery 408-283-4800 www.greenwaste.com

Toilet Recycling and Disposal Sites

650-349-3000 www.BayAreaConservation.org

Check # Check date

Amount of actual rebate Date check mailed

Signature of Rep. Approving

Date

HIGH-EFFICIENCY TOILET REBATE APPLICATIONComplete application, detach, and mail with original receipt(s) to: BAWSCA 155 Bovet Road, Suite 650, San Mateo, CA 94402Or, for the fastest rebate, apply online at www.BayAreaConservation.org

650-349-3000www.BayAreaConservation.org

CHECK PAYEE INFORMATION (check one) NAME ON WATER ACCOUNT APPLICANT NAME (pre-approval from water agency required if Applicant is not named on water account)

ADDRESS: CITY ZIP

I HAVE READ, UNDERSTAND, AND AGREE TO THE TERMS AND CONDITIONS OF THIS REBATE PROGRAM.

SIGNATURE OF APPLICANT DATE

PLEASE PRINT:

APARTMENT NUMBER FOR EACH MULTI-UNIT RESIDENTIAL AND NUMBER OF

TOILETS INSTALLED IN EACH UNIT (attach additional sheet of paper, if necessary):

TOILET INFORMATION (if the information does not �t below, please attach a separate sheet of paper with the requested information):

INSTALLATION ADDRESS CITY ZIP

NUMBER OF REBATES REQUESTEDNUMBER OF TOILETS AT INSTALLATION ADDRESS AGE OF THE TOILET BEING REPLACED

INSTALLATION DATE APPLICANT PHONE

PURCHASE DATEPURCHASE LOCATION (store name and city)

APT. QTY. APT. QTY. APT. QTY.

DISCLAIMER:The undersigned expressly agrees that BAWSCA and its participating member agencies: 1) may inspect all properties participating in the High-Efficiency Toilet Rebate Program, 2) do not guarantee the performance of any toilet, 3) do not warrant any toilet or installation to be free of defects, and 4) do not warrant the quality of workmanship, or the suitability of the premises or the toilet for the installation. The undersigned further agrees to defend, indemnify and hold harmless BAWSCA and its participating member agencies including their directors, officers, agents, and employees,from and against any and all loss, damage, expense, claims suits and liability, including attorneys fees arising out of or in any way connected with the toilet(s) and its (their) installation.Applicant has read, understands and agrees to the terms and conditions listed on the High-Efficiency Toilet Rebate Program application. Applicant understands that installation of a qualifying high-efficiency toilet may not result in lower water bills. BAWSCA and its participating member agencies reserve the right to add or remove eligible high-efficiency toilets from the list or changethe terms of the incentive offer at any time.

O�er good for purchases made between July 1, 2016 and June 30, 2017.Application must be postmarked within 90 days of purchase.A separate application must be submitted for each metered address.

AGENCY WATER SERVICE ACCOUNT NUMBERNAME OF WATER AGENCY

APPLICANT FIRST NAME LAST NAME

MANUFACTURER MODEL NAME MODEL NUMBER

AGENCY USE ONLY

BUSINESS OR HOA NAME (if applicable)

NAME ON WATER ACCOUNT (if di�erent from Applicant name)