Rebate
This document was uploaded by user and they confirmed that they have the permission to share it. If you are author or own the copyright of this book, please report to us by using this DMCA report form. Report DMCA
Overview
Download & View Rebate as PDF for free.
More details
- Words: 405
- Pages: 1
Energy Efficient Electric Equipment
$$ REBATES $$ CUSTOMER INFORMATION Name: _________________________________ Service Address: _________________________ Account #: ______________________________ Mailing Address: _________________________ City: ________________________ State: _____ Zip: _________ Phone: ( ) _____-________ E-mail: _________________________________ Type of Building: ___ Residential ___ Existing ___ Multi-Unit ___ New Construction ___ Commercial ___ Primary Electric Heat ___ Total Electric (Rate 12) ___ Demand Service (Rate 14 or 16)
To apply for your rebate - Please complete and submit this form to your local Black Hills Power office, along with “PROOF OF PURCHASE” to begin processing your rebate. Please provide all pertinent information on this form so it can be processed immediately. All Water Heaters, Demand Controllers, Heat Pumps, and Geothermal systems are subject to inspection by a BHP Service Technician prior to rebate approval. Rebate applications must be submitted within 12 months from date of purchase. Trade Ally Incentive (Paid to Sales Person) To be completed by Trade Ally Contractor only. Dealer: __________________________________ Sales Person (req’d): _________________________
Heat Pump & Geothermal Systems:
Address: _________________________________
Make: ___________________________ SEER: _______ Model #: _________________________ Tons: _______ Type: ____ Air to Air Heat Pump - kW of resistance: _________ ____ Geothermal - kW of resistance: _________ ____ Water Source HP kW of resistance: ____________ (Commercial Use)
(When purchased at same time as demand controller)
Work Order # _____/65/11406/15 (air to air heat pump) Work Order # _____/65/10085/15 (geothermal) Work Order # _____/65/11406/15 (water heat pump)
Total Rebate: $___________ Work Order # _____/65/10071/15
Demand Controller Installation:
____
Electric Water Heater Rebate Make: ___________________________________ Model #: ____________________ Gallons: _____ ____ Demand Controller Bonus $100
Total Rebate: $___________
____
City: _______________ State: _____ Zip: ______
Electric Resistance Heat Rebate (Demand Controller Required)
Free standard installation in existing home by certified licensed contractor . $200 Rebate - Certified Licensed Installer in new construction home.
Make: _____________________ Total kW: _____ Type: ____ Cove _____ Baseboard ____ Ceiling Radiant _____ Furnace
Installed by (Individual’s name)______________________ Date: _________ WO# for Free Installation: _____/65/10075/06 WO# for Cash Rebate or Credit: _____/65/10075/15
Total Rebate: $_________ Work Order # _____/65/11838/15 (cove only) Work Order # _____/65/10080/15 (all other)
Office Use Only: Sales Person: ________________________________ Heat Pump Inspection: _________________________ District Manager Approval: ______________________ Energy Services Approval: _______________________
Date: ________ Date: ________ Date: ________ Date: ________
Rebate Total: ________________ _____ Apply to MAR (attach form) _____ Apply to Electric Account (attach form) _____ Issue check to customer Rev. 1/2008
White - Accounting Department
Yellow - Energy Services
$$ REBATES $$ CUSTOMER INFORMATION Name: _________________________________ Service Address: _________________________ Account #: ______________________________ Mailing Address: _________________________ City: ________________________ State: _____ Zip: _________ Phone: ( ) _____-________ E-mail: _________________________________ Type of Building: ___ Residential ___ Existing ___ Multi-Unit ___ New Construction ___ Commercial ___ Primary Electric Heat ___ Total Electric (Rate 12) ___ Demand Service (Rate 14 or 16)
To apply for your rebate - Please complete and submit this form to your local Black Hills Power office, along with “PROOF OF PURCHASE” to begin processing your rebate. Please provide all pertinent information on this form so it can be processed immediately. All Water Heaters, Demand Controllers, Heat Pumps, and Geothermal systems are subject to inspection by a BHP Service Technician prior to rebate approval. Rebate applications must be submitted within 12 months from date of purchase. Trade Ally Incentive (Paid to Sales Person) To be completed by Trade Ally Contractor only. Dealer: __________________________________ Sales Person (req’d): _________________________
Heat Pump & Geothermal Systems:
Address: _________________________________
Make: ___________________________ SEER: _______ Model #: _________________________ Tons: _______ Type: ____ Air to Air Heat Pump - kW of resistance: _________ ____ Geothermal - kW of resistance: _________ ____ Water Source HP kW of resistance: ____________ (Commercial Use)
(When purchased at same time as demand controller)
Work Order # _____/65/11406/15 (air to air heat pump) Work Order # _____/65/10085/15 (geothermal) Work Order # _____/65/11406/15 (water heat pump)
Total Rebate: $___________ Work Order # _____/65/10071/15
Demand Controller Installation:
____
Electric Water Heater Rebate Make: ___________________________________ Model #: ____________________ Gallons: _____ ____ Demand Controller Bonus $100
Total Rebate: $___________
____
City: _______________ State: _____ Zip: ______
Electric Resistance Heat Rebate (Demand Controller Required)
Free standard installation in existing home by certified licensed contractor . $200 Rebate - Certified Licensed Installer in new construction home.
Make: _____________________ Total kW: _____ Type: ____ Cove _____ Baseboard ____ Ceiling Radiant _____ Furnace
Installed by (Individual’s name)______________________ Date: _________ WO# for Free Installation: _____/65/10075/06 WO# for Cash Rebate or Credit: _____/65/10075/15
Total Rebate: $_________ Work Order # _____/65/11838/15 (cove only) Work Order # _____/65/10080/15 (all other)
Office Use Only: Sales Person: ________________________________ Heat Pump Inspection: _________________________ District Manager Approval: ______________________ Energy Services Approval: _______________________
Date: ________ Date: ________ Date: ________ Date: ________
Rebate Total: ________________ _____ Apply to MAR (attach form) _____ Apply to Electric Account (attach form) _____ Issue check to customer Rev. 1/2008
White - Accounting Department
Yellow - Energy Services
Related Documents
Rebate
May 2020 21
Rebate
May 2020 18
Rebate Brochure
May 2020 2
Rebate Dehumid
May 2020 2
Rebate Application
May 2020 5