Participation in this program requires pre-approval. Complete this application and return to CWLP Energy Services O ffi ce, 1008 E. Miller St,
Springfi eld, IL 62702 prior to purchasing any HVAC equipment. The form must be signed by the customer and be accompanied by a
signed project proposal containing model numbers for each heat pump unit(s) proposed and total cost of project.
You will receive email con rmation of CWLP’s receipt of this application. Following review, CWLP will provide a pre-installation approval
letter documenting preliminary approval of the project. You will have one year from the date on the approval letter to complete your project
and submit an Equipment Summary Sheet and  nal documentation for rebate payment. Call Energy Services at 789-2070 if you have any
questions or for help completing this application.
CUSTOMER INFORMATION: (Please type or print clearly.)
Business Name:
Installation Address (Include Zip Code):
Mailing Address (If di erent from above):
REQUIRED: CWLP ELECTRIC ACCOUNT #
INSTALLER INFORMATION:
Phone:HVAC Contractor:
System Design or
Engineering Firm:
Phone:
SUMMARY OF PROPOSED EQUIPMENT TO BE INSTALLED:
Air Source Heat Pump Geothermal Heat Pump Hybrid Geothermal Heat Pump
Rebate credit will be applied to
this account.
Replaced Equipment (check all that apply).
Heating: Gas Boiler Gas Forced Air Electric Capacity in KBTUh_______
Cooling: Cooling Tower Chiller Capacity in KBTUh_______
BUILDING INFORMATION:
New Construction Existing
O ce Building Retail Medical Warehouse High-Rise Apartments
Restaurant School Hotel Other ______________________________
Building
Type:
Approx. SQ. FT.
How many weeks per year
does your building operate?
How many days
per week?
How many
hours per day?
Your signature is veri cation that you have read and agree to the Terms & Conditions on the back of this
application and a rm that the information provided is correct. This application is for pre-approval of a
commercial heat pump project. Additional documentation is required to receive rebate payment.
Day Phone:
Contact Person:
Equipment Type :
Did CWLPs rebate a ect your decision to install a heat pump?
YES NO
If your rebate exceeds $1,000, you may request payment in the form of a check by indicating below and providing
your W9 form. No checks will be issued for rebate amounts less than $1,000. If you do not provide your W9 form for
check processing, your rebate will be applied as a credit to your CWLP account.
Did you plan to purchase a heat pump prior to
learning about CWLPs Heat Pump Rebate Program?
YES NO
Customer Signature Date:
This application must be accompanied by a detailed project proposal indicating proposed equipment model numbers.
FOR OFFICE
USE ONLY
HP Rebate Amt:
CWLP Acct/Cust #:
Notes:
DLR Rebate Amt :
AHRI# :
DB/ID# :
I request a check
(MUST ATTACH W9 FORM for check processing)
Project Start Date: Projected Completion Date:
Total number of heat pumps proposed : Total combined cooling capacity proposed :
CWLP’s
CWLP’s
COMMERCIAL HEAT PUMP
COMMERCIAL HEAT PUMP
Rebate Program
Rebate Program
Terms & Conditions
Terms & Conditions
(Effective November 1, 2012)
(Effective November 1, 2012)
1. ELIGIBILITY: CWLP will provide rebates
in the form of bill credits or checks to eligible
customers (de ned below) for the purchase and
installation of qualifying heat pump products,
subject to these Terms and Conditions.
a) Qualifying Heat Pump Systems: Air Source:
De ned as any air source heat pump installed
as the primary source of heat within a de ned
space. Geothermal: De ned as an all-electric
geothermal heat pump installed as the primary
source of heat for a de ned space. Hybrid:
De ned as a geothermal heat pump that uses
an alternative source for heat rejection limited
to the use of a cooling tower. Cooling towers
cannot provide more than 25% of the required
heat rejection capacity. b)Heat pump systems
must be assigned an e ciency rating from the
Air-Conditioning, Heating, and Refrigeration
Institute (AHRI) to qualify. All heat pump
systems must be complete new systems with
warranty and installed in accordance with City
of Spring eld building codes. c) Ineligible
pr
oducts include portable or window mounted
heat pump units, replacement heat pumps that
do not include replacement of the “A-coil”
and units that do not meet minimum federal
e ciency standards. CWLP reserves the right
to determine  nal eligibility of any heat pump
system(s) installed. d) Eligible customers are
directly metered commercial electric customers
of CWLP who fall under Rate 40, 41, 42, 44, 46,
47 or 48, with no accounts past due more than
30 days. Rebates for accounts more than 30 days
past due will not be processed or approved until
outstanding balance(s) are paid. CWLP Rebates
are awarded to eligible customers only for
qualifying heat pump systems that are installed
in new or existing commercial buildings at
the location identi ed on this application.
Customers are ultimately responsible for
compliance with these Terms and Conditions.
2. PRE-APPROVAL & POST-
INSTALLATION VERIFICATION: a)
Pre-approval is REQUIRED. Before you
purchase any HVAC equipment, you must
provide to CWLP a completed, signed Rebate
Application and detailed vendor proposal for
new equipment including model numbers for
each heat pump system to be installed. You will
receive an e-mail con rming CWLP’s receipt
of your application. Following its review,
CWLP will provide you with a pre-installation
approval letter specifying the projected rebate.
You will have one year from the date on the
approval letter to complete your project and
submit a supplemental Equipment Summary
Sheet and  nal purchase documentation to
request payment of your rebate. Extensions
may be granted if CWLP approves the progress
being made on the project.
b) A er the installation of the heat pump
system(s) is complete, submit an Equipment
Summary Sheet and a detailed equipment
invoice showing the manufacturer, model
number, date purchased, and itemized cost for
heat pump system(s) installed. Upon receipt of
the detailed invoice CWLP sta may conduct a
post-installation inspection for
veri cation purposes unless it has waived
this requirement. c)If CWLP determines
that a qualifying heat pump system(s) was
not installed in a manner consistent with city
building codes, or an unapproved heat pump
system(s) was installed, it may deny rebate
payment or require modi cations before
processing the rebate payment.
3. INDEPENDENT TESTING: CWLP reserves
the right to deny rebates for any heat pump
system(s) that has not been favorably assessed
or approved by recognized, independent public
authorities, such as the AHRI. CWLP may, at
its discretion, require customers to undertake,
at their own expense, testing of a heat pump
system that has not been approved by AHRI,
or an equivalent independent testing facility
approved in advance by CWLP, in order to
consider a heat pump system as quali ed.
4. REBATE AMOUNTS: a) Rebate amounts
are calculated by the combined cooling capacity
of the heat pump system(s) being considered
for rebate in tons. Air source heat pump unit(s)
can qualify for a onetime $200 per ton rebate
for both new and complete replacement heat
pumps. Geothermal heat pump system(s)
installed in an existing commercial building
can qualify for a onetime $300 per ton rebate
for new, rst time installations (i.e. systems
requiring installation of a new well  eld). For
a geothermal heat pump system(s) installed
in a newly constructed commercial building
the rebate will be calculated at $800 per ton of
cooling capacity for new,  rst time installations
(i.e. systems requiring installation of a new well
eld). Replacement geothermal heat pumps
are ineligible for a rebate. New additions to an
existing commercial building, will be treated
as new construction providing a stand alone
geothermal system is installed for the addition
only.
b) CWLP reserves the right to adjust the
rebate amount based upon its independent
assessment of appropriate cost estimates.
5. HEAT PUMP 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 the
qualifying heat pump system(s). Invoices
must indicate a veri able brand and model
number of each qualifying heat pump system
installed and being applied for rebate under
this application.  e receipt must also detail
the location(s) of the installed heat pump(s).
6. REBATE PAYMENT: a) CWLP will process
rebate applications on a  rst-come, rst-served
basis. To qualify for processing the application
must be accompanied by: (1) submission of
Equipment Summary Sheet and all veri cation
documentation to CWLP within 1 year of the
installation date; (2) completed installation of
approved qualifying heat pump system; 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 customer
account(s) shows a balance more than 30
days past due, CWLP reserves the right to
delay rebate processing until past due amount
is paid, bringing account current. c) For
rebate amounts exceeding $1,000, applicant
may request a check in lieu of a CWLP
account credit. Customer will be required to
furnish W-9 form prior to check processing.
d) Applicants applying for a commercial
heat pump rebate should allow up
to 90-days for payment processing.
7
. 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. CWLP is not obligated to approve
any submitted rebate application that may
result in CWLP exceeding its program budget.
b) Rebates under this CWLP program are
o ered on a  rst-come, rst-served basis and
are subject to product and customer eligibility
as outlined in these terms and conditions, and
the availability of funds.
8. PUBLICITY OF CUSTOMER
PARTICIPATION: CWLP may wish to publicize
information relating to customer participation
in the 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.
9. 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.
10. NO WARRANTIES: a) CWLP does not
endorse, guarantee, or warrant any particular
manufacturer or product, and 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 customers reliance on warranties
is limited to any warranties that may be
provided by contractors, vendors, etc. b)
CWLP is not responsible for verifying that
the installation of the heat pump system(s)
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 heat pump system
or the adequacy or safety of such measures.
11. CUSTOMER MUST PAY ALL
TAXES: Rebates received by the
customer under this rebate program may
be taxable by the federal, state, and local
government.  e customer is responsible
for declaring and paying all such taxes.
12. MISCELLANEOUS: a)  e entire
agreement between the customer and CWLP
is composed of a signed rebate application,
equipment summary sheet 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
the only individuals authorized to bind CWLP
under this heat pump rebate program are
CWLP sta . d) If any provision of the Ter ms
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.
rev. 11/2012
City Water, Light & Power - Energy Services Offi ce
1008 E. Miller St, Springfield, IL 62702
Phone: (217)789-2070 Fax:(217)789-2210
Web: www.cwlp.com