Fillable HP Res Reb Form Instructions.pmd (City Water, Light, and Power)

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HP Res Reb Form Instructions.pmd (City Water, Light, and Power)

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CWLP RESIDENTIAL HEAT PUMP
REBATE APPLICATION
The online Residential Heat Pump Rebate Application can either be (a) filled in online then printed
out or (b) printed out and then filled in by hand. The application cannot be submitted electronically.
Both you and your HVAC contractor must sign the document.
The application must be accompanied by a detailed proof of purchase (preferably a sales receipt)
that includes the equipment model numbers and total project cost.
Return the completed application by mail or in person to:
CWLP Energy Services Office
1008 E. Miller Street
Springfield, IL 62702
FOR OFFICE
USE ONLY
HP Rebate Amt: WH Rebate Amt :
CWLP Acct/Cust #:
Rate :
Notes:
Please complete this form and return it to CWLP’s Energy Services O ce, 1008 E. Miller Street, Spring eld, IL 62702 within one year of your equipment’s
installation date. The form must be signed both by you and your contractor and be accompanied by a detailed sales receipt containing model numbers for
equipment installed and total cost of project. Call Energy Services at 789-2070 for help completing this form.
CUSTOMER INFORMATION: (Please type or print clearly.)
Name:
Day Phone:
Installation Address (Include Zip Code):
Mailing Address (If di erent from above):
REQUIRED: CWLP ELECTRIC ACCOUNT #
INSTALLER INFORMATION and EQUIPMENT DETAILS (to be completed by HVAC contractor):
Phone:HVAC Contractor:
Contact:
Purchase Date:
Equipment installed: Air Source Heat Pump Geothermal Heat Pump Hybrid Geothermal Heat Pump
Condensing Unit Manufacturer: Model #:
Inside (“A”) Coil Manufacturer: Model #:
Date Installed:
Number of like units:
EER: SEER: HSPF: COP:
AHRI Reference #:
Rebate credit will be
applied to this account.
Cooling
Capacity:
Heating
Capacity:
Replaced Systems (check all that apply):
Heating: Natural Gas Electric Capacity in KBTUh________
Cooling: Central Air Other _______Capacity in KBTUh________
BUILDING INFORMATION:
 New Construction Existing
Approx. SQ. FT.
Signature of account holder is veri cation that you have read and agree to the Terms & Conditions on the back of this application. If you have
applied for CWLP’s Electric Heat Rate by checking the box above, your signature a rms that you are the account holder and the information
provided is correct. This application must be accompanied by a detailed sales receipt identifying newly installed equipment model numbers.
Customer Signature Date:
Contractor Signature Date:
Were you planning to purchase a new heat pump prior to learning about CWLP’s Heat Pump Rebate Program?
Yes No
If you answered yes to the previous question, did the rebate encourage you to invest in a more e cient unit?
Yes No
PLEASE COMPLETE THE FOLLOWING QUESTIONS:
What gas appliances do you currently have in your home (check all that apply)?
Water Heater Stove Oven Clothes Dryer Fireplace
Whole House Generator Other
CWLP residential customers who install heat pumps as their primary* heating source are eligible to receive the utility’s Electric Heat
Rate (providing you are not already on CWLP’s Electric Rates 34-37), which is a 9% discount on CWLP’s Regular Residential Electric
Rate during the months you heat your home.
*
CWLP will determine if the unit quali es as “primary” by using a formula that factors in your home’s square footage and the heat pump’s capacity.
Customers who replace a gas water heater with a new electric water heater may qualify for an additional rebate.
Did this project include replacement of a gas water heater with an electric model? Yes No
Water heater equipment installed: Manufacturer: Model#:
Tank Size (gallons): Wattage: Energy Factor: Quantity:
Old/replaced water heater: Natural Gas/Propane Electric Model #:
If your rebate exceeds $1,000, you may request payment in the form of a check by indicating below and providing
your Social Security number. No checks will be issued for rebate amounts less than $1,000. If you do not provide your
social security number for check processing, your rebate will be applied as a credit to your CWLP account.
,
Social Security #
- -
(Only required for check processing.)
I request a check
Did your HVAC contractor discuss CWLP’s ELECTRIC HEAT RATE with you?
Yes No
Would you like to apply for the Electric Heat Rate? Yes
No
DLR Rebate Amt :
AHRI# :
DB/ID# :
Signature as contractor is veri cation that you included all required model numbers for newly installed equipment and provided necessary
documentation to the customer.
(New water heater must be itemized on sales receipt and submitted with this rebate application to be considered.)
■
■
,
CWLP’s
CWLP’s
RESIDENTIAL HEAT PUMP
RESIDENTIAL HEAT PUMP
Rebate Program
Rebate Program
Terms & Conditions (Effective November 1, 2012)
Terms & Conditions (Effective November 1, 2012)
1. ELIGIBILITY: CWLP will provide rebates in the
form of bill credits (checks may be requested for
rebate amounts over $1,000) to eligible customers
(de ned below) for the purchase and installation
of qualifying heat pump and electric water heater
products, subject to these Terms and Conditions.
a) Qualifying heat pump products are de ned as
any Air-Conditioning, Heating, and Refrigeration
Institute (AHRI) rated air source or geothermal
heat pump system installed as a central heating and
cooling system. Heat pump system installations
must include a new A-coil. b) Qaulifying electric
water heaters must have a tank size between 30 to
80 gallons and: 1) conventional electric resistance
heating elements installed to replace an existing gas
or propane water heater or as  rst unit in a newly
constructed home. Conventional electric water
heaters must meet minimum Federal E ciency
standards; or 2)electric hybrid water heater with an
Energy Factor (EF) of 2.0 or higher. All installations
of heat pump hybrid water heaters qualify for a
rebate regardless of the model it is replacing (i.e.
natural gas, propane or electric.)
c)All products installed must be new with warranty
and installed in accordance with City building
codes. d) Ineligible heat pump products include
portable or window mounted heat pump units, and
units that do not meet minimum federal e ciency
standards. e) Ineligible water heater products
include, but are not limited to electric tankless
models and all natural gas or propane fueled water
heaters.
f) CWLP reserves the right to determine  nal
eligibility for rebate of any and all products installed.
2. ELIGIBLE CUSTOMERS are directly metered
residential electric customers of CWLP who fall
under Rate 30, 31, 32, 33, 34, 35, 36, or 37, with
no accounts past due more than 30 days. CWLP
Rebates are awarded to eligible customers only
for qualifying heat pumps and water heaters that
are installed in new or existing residences at the
location identi ed on this application. Applicants
are ultimately responsible for compliance with all
Terms and Conditions.
3. POST-INSTALLATION VERIFICATION:
CWLP reserves the right to perform a post-
installation veri cation visit to ensure that a
qualifying heat pump system or water heater unit
was installed and that the installation is consistent
with City building codes before obligating any rebate
payments. If CWLP determines that the qualifying
product was not installed in a manner consistent
with City building codes, or an unapproved product
was installed, it may deny payment or require
modi cations before making payment.
4. INDEPENDENT TESTING: CWLP reserves the
right to deny a rebate payment for any heat pump
or water heater that has not been favorably assessed
or approved by recognized, independent public
authorities, such as the AHRI. CWLP may, at its
discretion, require the customer to undertake, at
their own expense, testing of any installed unit that
has not been approved by AHRI, or an equivalent
independent testing facility approved in advance by
CWLP, in order to be considered a qualifying unit.
5. REBATE AMOUNTS:
a) Heat Pump rebate amounts are calculated
by the cooling capacity in tons. Air source heat
pump unit(s) can qualify for a onetime $300
per ton rebate for both new and replacement
heat pumps. Geothermal heat pumps units can
qualify for a onetime $500 per ton rebate for new
initial installations which require a new well  eld.
Replacement geothermal heat pumps are not
eligible for a rebate.
b) Water Heater rebate amounts are determined as
follows: For conventional electric resistance models,
the rebate amount is $200 per water heater installed
with a maximum rebate allowed of $400 per account
number. For electric hybrid heat pump water heaters, the
rebate amount is $400 per water heater installed with a
maximum rebate allowed of $800 per account number.
c) CWLP reserves the right to adjust and/or negotiate the
rebate amount based upon its independent assessment of
appropriate cost estimates.
6. INSTALLATION COST: e customer must
provide copies of all invoices or other reasonable
documentation providing veri cation of the
quantities and costs of purchasing and installing
qualifying equipment. Invoices must indicate
veri able brand and model numbers of all
equipment installed under this rebate application
and the location(s) of the installation.
7. REBATE PAYMENT: a) CWLP will process
completed rebate applications only a er 1)
submission of all veri cation documentation to
CWLP within one year of installation date; 2)
completed installation of approved qualifying
equipment (i.e., heat pump system or electric water
heater); and 3) a satisfactory post-installation
veri cation performed by CWLP, all in accordance
with the speci cations outlined elsewhere in these
Terms and Conditions.
b) If it is determined applicant’s electric account
is more than 30 days past due, CWLP reserves the
right to delay or deny payment until account is
brought to a current status.
c) Rebate amounts less than $1,000 will be applied
as a credit to applicant’s CWLP electric bill. For
rebate amounts greater than or equal to $1,000,
the customer may choose to receive their rebate in
the form of a check sent by U.S. Mail. If applicant
chooses to receive a check, applicant’s social
security number must be provided. CWLP will
provide applicant with a Statement of Purpose in
accordance with  e Identity Protection Act, 5 ILCS
179/1et seq. Requests for check payment for which
applicant does not provide a social security number
will be processed as a bill credit.
8. PROGRAM CHANGES/ CANCELLATION:
a) CWLP may change the program requirements,
rebates, or Terms & Conditions at any time without
notice, including suspending acceptance of rebate
applications or terminating the program entirely.
CWLP is not obligated to approve any submitted
rebate application that may result in exceeding the
allocated program budget.
b) Submission of a completed rebate application
does not guarantee the customer a rebate.
c) Rebates under this CWLP program are o ered
on a  rst-come,  rst-served basis and are subject to
project and customer eligibility as outlined in these
terms and conditions, and the availability of funds.
9. PUBLICITY OF CUSTOMER
PARTICIPATION: CWLP may wish to publicize
information relating to customer participation
in this program, including such data as projected
energy savings and rebate amount. CWLP will
make all e orts to obtain customer permission
before making such information public.
10. LIMITATION OF LIABILITY AND
INDEMNIFICATION:
a) CWLP liability under this rebate application will
be limited to the rebate amounts speci ed on this
rebate application. CWLP and any of its a liates or
contractors shall not be liable to the customer for
any special, indirect, consequential or incidental
damages or for any damages in tort (including
negligence) caused by any activities associated
with this rebate application. By participating in this
program, customer agrees to waive any claims and
fully releases CWLP from any damages of any kind.
b) Customer hereby irrevocably and
unconditionally waives any right such party may
have to a trial by jury or to initiate or become a
party to any class action claims in respect of any
action, suit or proceeding directly or indirectly
arising out of or relating to this application or the
transactions contemplated by this application.
c) e customer shall protect, indemnify, and hold
harmless CWLP from and against all liabilities,
losses, claims, damages, judgments, penalties,
causes of action, costs and expenses (including,
without limitation, attorney’s fees and expenses)
incurred by or assessed against CWLP arising out
of or relating to the performance of this rebate
application.
11. NO WARRANTIES:
a) CWLP does not endorse, guarantee, or warrant
any particular manufacturer or product, and it
provides no warranties, expressed or implied,
including any implied warranty of merchantability
or implied warranty of  tness for any product or
services. CWLP is not liable or responsible for any
act or omission of any contractor.  e customer’s
reliance on warranties is limited to any warranties
that may be provided by contractors, vendors, etc.
b) CWLP is not responsible for verifying the
equipment installation is proper or complies with
any particular laws, codes, or industry standards.
CWLP does not make any representations of any
kind regarding the results to be achieved by the
installed qualifying equipment or the adequacy or
safety of such measures.
12. CUSTOMER MUST PAY ALL TAXES:
Rebates received by the customer under this rebate
program may be taxable by federal, state, and local
governments.  e customer is responsible for
declaring and paying all such taxes.
13. MISCELLANEOUS:
a) e entire agreement between the customer and
CWLP is composed of a signed rebate application
and these Terms and Conditions.
b) Paragraph headings are for the convenience of
the parties only and are not to be construed as part
of these Terms and Conditions.
c) e Customer acknowledges that the only
individuals authorized to bind CWLP under this
rebate program are CWLP sta .
d) If any provision of the Terms and Conditions
is deemed invalid by any court or administrative
body having jurisdiction, such ruling shall not
invalidate any other provision, and the remaining
Terms and Conditions shall remain in full force
and e ect in accordance with their terms.
e) If a dispute arises out of, or relates to this
application, or the breach thereof, the dispute
will be settled through negotiation. Otherwise,
resolution of disputes concerning these Terms
and Conditions, or any other requirement of this
application or condition of rebate, resolution will
be governed in all respects by the laws, statutes, and
regulations of the State of Illinois.
f) Customer shall not assign any rights it may
have under this rebate application without the
prior written consent of CWLP. Any assignment in
violation hereof shall be deemed null and void.
City Water, Light & Power - Energy Services O ce
1008 E. Miller Street, Spring eld, IL 62702
Phone: (217)789-2070 Fax:(217)789-2210
Web: www.cwlp.com
Rev. 10/2012
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HP Res Reb Form Instructions.pmd (City Water, Light, and Power)

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Completed 22 July 2021

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