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Appliance & Windows Rebate Application QUALIFICATION: • All energy efficient products must be installed in a residential dwelling receiving electricity from MID and must be purchased new at the retail price. • Offer is valid for purchases made on or after November 1, 2008 or until funds are depleted. • All applications and supporting material(s) must be postmarked no later than 90 days from date of purchase or by December 18, 2009 whichever comes first. In case of delayed installation, applicant may request an extension in writing, which is subject to MID approval. • A copy of your sales receipt and supporting documentation including purchase date, installation date, purchase price, brand and model number must be submitted with this application form.
• Owners of rental units should submit a separate application for each service address. Clothes Washer ENERGY STAR® qualified clothes washer must be used in combination with an electric dryer.
Windows Product can receive only one rebate from MID during its useful life period of 20 years
Sun Screen / Window Film Product can receive only one rebate from MID during its useful life period of 10 years.
Limit one (1) rebate per household within an eight (8) year period.
Rebate given for replacement of existing windows with new high performance dual pane ENERGY STAR qualified windows.
Must be installed per the manufacturer’s instructions on south, east or west facing windows: (any direction except 45 degrees of true north).
Room Air Conditioner Limit two (2) ENERGY STAR qualified Room Air Conditioner rebate per household within an eight (8) year period. Electric Water Heater Electric Water Heater must have storage capacity of 40 gallons or greater and must have an energy factor (EF) of .93 or greater. Tankless water heaters and instantaneous heaters do not qualify. Limit one (1) rebate per household within a fifteen (15) year period.
Windows must have a Ufactor of 0.4 or less, and a Solar Heat Gain Coefficient (SHGC) of 0.4 or less. Must be installed in an air conditioned area (central, window or wall unit). A copy of the NFRC sticker from the window for each window type must be included with the application.
Sunscreens should have (SHGC) of .35 or less and cover the entire window aperture and window film should have (SHGC) of .39 or less and cover the entire window aperture. Shading coefficient (SC) to SHGC conversion: SHGC = SC X 0.87. Windows must not be shaded by existing awnings, exterior curtains or blinds or any other shading device. Sun Screens must have a rigid frame and be attached to the window perimeter. Must be installed in an air conditioned area (central, window or wall unit).
MID Appliance Application
web 04/08/2009
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Appliance & Windows Rebate Application Purchaser Information (please print) Customer/Tenant Name (as it will appear or presently appears on MID bill)
MID Account Number
Installation Address
City, Zip Code
Contact Person / Title
Phone
Retailer Information Store Name
Phone
Store Address
City , State Zip Code
Appliances ENERGY STAR Qualified Room Air Conditioner ($50.00) Date Purchased
Date Installed
Brand
Model
Required Efficiency
ENERGY STAR® 2009 ENERGY STAR Qualified Clothes Washer ($35.00) Date Purchased
Date Installed
Brand
Model
Required Efficiency
ENERGY STAR® 2009 Electric Hot Water Heater – Tank ($25.00) Date Purchased
Date Installed
Brand
Model
Required Factor
Sq Ft
Required Efficiency
ENERGY STAR Qualified Windows – ($1.00 per Sq Ft) Date Purchased
Date Installed
Brand
ENERGY STAR® 2009
Window Film or Sun Screen – ($0.75 per Sq Ft) Date Purchased
Date Installed
Brand
Sq Ft
Check One
□ Window Film □ Sun Screen I certify that this qualified product was purchased at retail price for personal use, not for resale. All product installations that receive a rebate are subject to MID inspection. I also certify that this product will be installed in the MID service territory. I have read and understand the “Qualifications” section of this rebate application. Purchaser Signature
Date
PLEASE NOTE: • For questions regarding the program or for rebate status, please contact MID at (209) 526-7339. • Your rebate will be credited to your MID account. Incomplete applications will be returned. • Do not include rebate application with your MID electric bill. • MID reserves the right to verify both the efficiency and installation of products before rebate is issued. • MID is not responsible for items lost or delayed in the mail. • MID disclaims any and all liability, loss or damage that may arise as a result of the applicant’s or contractor’s participation in this program. • MID is not responsible for any taxes that may be imposed as a result of receipt of any financial rebates from MID. • Rebate incentives may not exceed the cost of the energy efficient products. • This program is subject to change or may end without prior notice. MID reserves the right to determine final program eligibility. Mail completed application and supporting documents to: MID Energy Services Department P.O. Box 4060, Modesto, CA 95352-4060
MID Appliance Application
web 04/08/2009