Home Rewards Application Fy 0708 Final Web3

HOME REWARDS REBATE APPLICATION BWP Account # _________________________________

Phone #____________________________________________

Name: _____________________________________________________________________________________________ (As it appears on your account)

Service Address: ____________________________________________________________________________________ City:

Burbank___________________State___________________________________Zip Code_____________________

Mailing Address

(If different from above)

Please fill out entire application. Attach an 8 ½ x 11 copy of your sales receipt or invoice and copies of manufacturer label, if applicable, showing energy efficiency information. Incomplete and/or unclear applications will be returned to you by U.S. Mail. Please allow 6-8 weeks for processing. Applications must be submitted no later than four months from date of purchase.

Product Eligibility Requirements

Attic Insulation The final insulation level must be R-30 or R-19 if there is less than 24” of attic clearance. Please submit invoice (proof of purchase) showing total square footage and finished level of insulation. Contracts, quotes, work orders and proposals do not qualify as an invoice. New construction is not eligible for this rebate.

PURCHASED

Required Information

OUT OF BURBANK

IN BURBANK

Total Sq. Ft. _________________ $ 0.15 sq ft.

$ 0.10 sq ft.

Manufacturer ______________________ Finished Insulation Level___________ Purchase Date ____________________

Central Air Conditioning Minimum 14 SEER rating for packaged and split systems. Please submit invoice (proof of purchase) showing Seasonal Energy Efficiency Ratio (SEER) rating and tonnage. Contracts, quotes, work orders and proposals do not qualify as an invoice.

Tonnage_____________________ Manufacturer ______________________

SEER 14 - 14.9

$100.00/ton

$ 80.00/ton

SEER 15 - 15.9

$120.00 /ton

$100.00/ton

SEER 16+

$140.00/ton

$120.00/ton

Purchase Date _____________________

Manufacturer ______________________

Ceiling Fans (Up to 3) Energy Star ® rated

$ 25.00

$ 15.00

Model #_________________________ Purchase Date _____________________

Clothes Washer Energy Star ® rated You may also be eligible to receive a separate rebate of $135.00 From Metropolitan Water District if the clothes washer purchased has a qualifying water factor of 5.0 or less.

Manufacturer ______________________ $100.00

$

75.00

To apply for additional rebate go to: BeWaterWise.com and link to SoCalWaterSmart or call 1-888-376-3314

Dishwasher Energy Star ® rated

Model #__________________________ Purchase Date _____________________

Manufacturer ______________________ $ 75.00

$ 50.00

Model #_________________________ Purchase Date ____________________

PLEASE NOTE: Signature and date is required on reverse side

Product Eligibility Requirements Low-E Windows/Doors Energy Star ® labeled for southern climates. Both the U-Factor and Solar Heat Gain Coefficient (SHGC) must be 0.40 or lower. Please submit a copy of your invoice (proof of purchase) and window sticker(s) showing U-factor and SHGC. Contracts, quotes, work orders and proposals do not qualify as an invoice. For existing window replacement only.

Pool Pump Multiple Speed High Efficiency Replacement Pool Pumps only (spa pumps not eligible)

PURCHASED IN BURBANK

Required Information

OUT OF BURBANK

Total Square Footage_______________________ $2.00 sq ft.

$1.00 sq ft.

Manufacturer ______________________ Purchase Date ____________________

$100.00

$ 50.00

Manufacturer ______________________ Purchase Date ____________________

Refrigerator Energy Star ® rated AND you must have an existing refrigerator. Your existing refrigerator must be recycled by: Calling the City’s Public Works Department at 818 238-3800 to schedule a pick-up appointment. Please note that this phone number is different from the Bulky Item pick up number. OR Your retailer (place of purchase) may haul away. If using your retailer make sure it states “haul away” on your original sales receipt.

Manufacturer ______________________ Model #__________________________ $150.00

$100.00

Purchase Date _____________________ Public Works P/U Date ______________ OR Retailer Haul Away Date _____________

Manufacturer ______________________ Room Air Conditioner Energy Star ® rated

$ 75.00

Model #_________________________

$ 50.00

Qty_____________________________ Purchase Date _____________________

Solar Attic Fan All solar attic fans are eligible

Manufacturer ______________________ $200.00

$200.00

Model # _________________________ Purchase Date _____________________

Wall Insulation Existing walls must be un-insulated and the installed insulation must achieve a minimum of R-13. Please submit invoice (proof of purchase) showing finished level of insulation and total square footage. Contracts, quotes, work orders and proposals do not qualify as invoice. New construction is not eligible for this rebate.

Whole House Fan All whole house fans are eligible

Total Square Footage________________ $0.15 sq ft

$0.10 sq ft

Manufacturer ______________________ Finished Insulation Level____________ Purchase Date ________________ Manufacturer ______________________

$100.00

$ 50.00

Model ____________________________ Purchase Date _____________________

Participant Agreement: The energy-efficient product(s) marked above have been installed at the Burbank location indicated. I have attached a copy of the itemized proof of purchase (sales slip or invoice) and copies of manufacturer labels showing energy efficiency information or other required documentation. I understand that falsifying information may lead to my disqualification from this incentive program and that BWP will take appropriate action to recover the rebate amount. This program is subject to change without prior notice. I have read and agree to these terms and to verification of installation by a BWP representative, as necessary. Customer Signature: _________________________________________________

Date: _______________________

If you have any questions, call us at 818 238-3730 or check our website at BurbankWaterandPower.com for up-to-date rebate requirements and qualifications. MAIL APPLICATION TO: Burbank Water and Power, 164 W Magnolia Boulevard, Burbank, CA 91502 Attention: Rebates Note: Per the City of Burbank’s Municipal Code, Sec 14-804, permit(s) may be required for a new or replacement work done in/or for the City of Burbank. Permit(s) maybe obtained from the Building Division. You may contact them at (818) 2385220 for related questions.