2018 Rebate Application for Commercial & Multifamily Thermostat, Air Conditioner, Boiler and Furnace for Existing Buildings

Step #2) Complete Customer & Facility Information

Company (Check will be payable to this name):

Installation Address:

Contact Person: Phone:

Mailing Address (if different): City/State:

Contact Email: Mailing Zip:

Website: Fax No:

Facility InformationConvenience/Grocery/Restaurant Church/Warehouse Industrial/Manufacturing

Multifamily (4+ Units)/Lodging Education/Office/Retail Agriculture/Farm Building

Approx. year built: Building Sq. Ft. Owner-occupied Rental Property

Step #3) Complete Project & Dealer Information Replacement/Retrofit (existing) New Construction (not eligible) New Installation

Dealer Installed Customer Installed

Installing Dealer Information

Dealer/Company:

Mailing Address: City/State:

Contact Person: Mailing Zip:

Phone: Contact Email:

Dealer Agreement

I certify that all equipment and installation information provided on this application is correct and accurate.

Installer/Dealer Signature: Date:

Step #4) Read Terms & Conditions and Sign ReleaseThe undersigned agrees that the stated energy efficiency measure(s) was (were) installed and in operation at the job site address listed above as part of the CFU Program and that the information contained in this application is accurate and complete. I have read and agree to the Terms & Conditions within this application. The undersigned agrees to indemnify, defend, and hold harmless and release CFU from any claims, damages, liabilities, costs and expenses (including reasonable attorneys' fees) arising from or relating to the removal, disposal, installation or operation of any equipment or related materials in connection with the programs described in this application, including any incidental, special or consequential damages.

Customer Signature: Date:

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Is a newly constructed facility (built in 2017) or

is this a large multifamily property?

No. Go to Step 2.

Yes. Contact CFU at 319-268-5355. May qualify for Custom

rebates.

Is the furnace, central air conditioner, or boiler larger

than the limits on page 4 of this form?

No. Go to Step 2.

Yes. Contact CFU at 319-268-5355. May qualify for

Custom rebates.

Step #1) Make sure this is right application form for your project.

CFU 2018 COMMERCIAL/LARGE MULTIFAMILY THERMOSTAT, AIR CONDITIONER, BOILER AND FURNACE REBATES, TERMS & CONDITIONS:

n Applicant must be a current Cedar Falls Utilities (CFU) customer and CFU must supply electricity to the equipment for which the cash rebate is being paid. This program is intended as an option for multifamily complexes with more than 4 units per building that are using residential-style, forced-air HVAC systems. These complexes are also eligible to participate in CFU's Residential HVAC rebate programs instead of this rebate application (the residential rebates are larger in value but require SAVE tests and units must follow CFU's Manual J based load calculation). This CFU Commercial rebate application is the only rebate option for nonresidential facilities with small, residential-style forced-air HVAC systems. Payments will be made to property owners or account holders, not to builders, energy service companies, or contractors. n All HVAC equipment must serve as a primary source of heating or cooling for the facility or control the primary equipment. Units installed as backup or redundant systems or in control of backup or redundant systems are not eligible. n Incentives are available on a first-come, first-served basis. CFU may modify or end any cash rebate program at any time without notice. Neither pre-approval of a project, nor any other action by CFU, entitles applicant to a rebate payment until and unless this application is approved by CFU. The most current rules of this program are on the application forms posted at www.cfu.net. To evaluate your application, CFU will use the rules listed on the application form that was posted on the day CFU receives your application. n Purchase and installation must be completed between January 1, 2018 and December 31, 2018. Equipment or improvements must be installed and operating on the premises before you apply for a rebate. Submit your application no later than March 31, 2019. Allow 2-8 weeks for application review and rebate funding. Incomplete applications may be delayed or rejected. CFU reserves the right to award rebates in the form of utility bill credits or directly mailed checks. In no event will the rebate award from CFU exceed 50% of the total eligible, reasonable project costs or reduce the simple payback of a project to less than 12 months. n CFU may inspect and verify the installation; ask you to complete a customer survey; and/or meter the specified equipment or process, at no cost to the customer, to determine the actual energy saved for up to 12 months after the installation. CFU may publicize your participation in this program unless you request otherwise in writing. Rebate application may be shared with state agencies or departments. n Projects must comply with all applicable federal, state, and local codes, standards, and regulatory requirements. Limit one rebate payment per piece of qualifying equipment or project expense. All equipment must be new; used or rebuilt equipment is not eligible. Existing equipment must be removed and may not be resold. n Cedar Falls Utilities: 1) does not endorse any provider, manufacturer, product, labor or system design by offering this program; 2) is not responsible for any tax liability arising from customer's receipt of a rebate payment; 3) does not expressly or implicitly warrant the performance of installed equipment or contractor's quality of work (contact your contractor or vendor for warranty information); 4) is not responsible for the proper disposal/recycling of any waste generated by this project; 5) is not liable for any incidental or consequential damages caused by the installation of the equipment or for any damage caused by the malfunction of the installed equipment; 6) does not guarantee that a specific level of energy or cost savings will result from the implementation of energy efficiency measures or the use of products funded under this program. n DIRECTIONS: For each project, submit a completed and signed rebate application with receipts and documentation as described below to either energyservices@cfu.net or Cedar Falls Utilities, Attn: Energy Services, P.O. Box 769, Cedar Falls, IA 50613. Steps: 1) Apply for the correct program: If the central air conditioner(s), furnace(s), or boiler(s) exceed the maximum MBtuh size parameters in this application (65 MBtuh for central air conditioners, 225 MBtuh for natural gas furnaces, and 300 MBtuh for natural gas boilers), the rebate is a custom rebate that must be pre-approved by CFU instead of using this application. Contact CFU at 319-268-5355 for more information or use the CFU Custom Rebate form to apply for your rebate. Otherwise, use this application form to apply for your rebate. 2) Complete application after project completion and attach supporting documentation: Provide an invoice for each each unit, including: n Total project costs n Date of purchase n Vendor name & address n Customer name & address of facility at which the new equipment is installed n Make, model, quantity, and pre-tax purchase price of each type of unit installed.

Page 2 of 5 (2018)

Step #5) Complete applicable information below AND attach copies of all sales invoices and or receipts.

Packaged Terminal Air Conditioners (PTAC) - $50 for units with a minimum efficiency of 10.9 EER. No pre-approval or sizing calculation from CFU required.AHRI Reference

Number Brand Model EER Size (Btuh) Incentive Quantity Total

Incentive Date Installed

$50/unit x

Project Type (select one):

New Construction Replaces working PTAC Replaces

broken PTACNew installation - no prior PTAC at existing property

Equipment Cost:

If replacing working PTAC: estimate prior PTAC size (Btuh):

If replacing working PTAC, estimate prior EER :

Is this unit equipped or paired with electric resistance heating? Yes No If yes, size of resistance system (kW):

Programmable Thermostats - $25 for programmable thermostats - must be 7-day, 5 +2 day, 5 -1 -1 day, or Wi-Fi programmable units. No pre-approval or sizing calculation from CFU required; existing construction only.

Brand Model Incentive Quantity Total Incentive Date Installed

$25/unit x

Primary Heating Source: Natural Gas Furnace/Boiler Heat Pump Electric Resistance Heat

Primary Cooling Source: Central AC

Room AC/PTAC Heat Pump None Purchase

Price:

Residential-Style Central Air Conditioners (up to 65 MBtuh) - $200 plus additional $100 per each 1 SEER above 14, up to $400 maximum. 14 SEER minimum. For minimum rebate, no pre-approval or sizing calculation from CFU required for this rebate; existing construction only. Multifamily properties may have additional options - call 319-266-1761 for details. BONUS OPTION: Additional $400 per kW saved with optional CFU sizing. Contact CFU for pre-approval at 266-1761.

Residential-Style Central Air Conditioner Type 1 (< 65 MBtuh)

AHRI Reference Number Coil Make/Model Condenser Make/Model SEER Quantity

Purchased Date Installed

Project Type (select one):

Replaces broken central AC

New construction

Replaces working central AC

New installation - no prior central AC system in existing building.

Single stage Two stage Total Cooling Btuh: Partial Cooling Btuh (if two stage):

Equipment Cost: Approximate Btuh

of system removed:

Make and model of cooling system removed OR estimated SEER:

Which Rebate are You Applying For (select all that apply):

Basic Rebate (no sizing or pre-

approval required):

Bonus Option (must follow CFU's sizing

requirement):

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Natural Gas Furnaces (up to 225 MBtuh) - $200 for 95% AFUE system or higher. No pre-approval or sizing calculation from CFU required; existing construction only. Multifamily properties may have additional options - call 319-266-1761 for details.

Natural Gas Furnace Type 1

AHRI Reference Number Manufacturer Model AFUE Quantity Date Installed

Project Type (select one):

Replaces broken gas furnace

New construction

Replaces working gas furnace

New installation - no prior natural gas furnace in existing building.

ECM efficient fan motor

No ECM efficient fan motor

Input heating capacity (Btuh):

Output Heating Capacity (Btuh):

Equipment Cost: Approximate Btuh of system removed:

Type of fuel used by old heating system:

Make and model of heating system removed or approximate efficiency:

Natural Gas Furnace Type 2

AHRI Reference Number Manufacturer Model AFUE Quantity Date Installed

Project Type (select one):

Replaces broken gas furnace

New construction

Replaces working gas furnace

New installation - no prior natural gas furnace in existing building.

ECM efficient fan motor

No ECM efficient fan motor

Input heating capacity (Btuh):

Output heating capacity (Btuh):

Equipment Cost: Approximate Btuh of system removed:

Type of fuel used by old heating system:

Make and model of heating system removed or approximate efficiency:

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Residential-Style Central Air Conditioner Type 2 (< 65 MBtuh)

AHRI Reference Number Coil Make/Model Condenser Make/Model SEER Quantity Date Installed

Project Type (select one):

Replaces broken central AC

New construction

Replaces working central AC

New installation - no prior central AC system in existing building.

Single stage Two stage Total Cooling Btuh: Partial Cooling Btuh (if two stage):

Equipment Cost: Approximate Btuh of system removed:

Make and model of cooling system removed OR estimated SEER:

Which Rebate Are You Applying For (Select All That Apply):

Basic Rebate (no sizing or pre-

approval required):

Bonus Option (must follow CFU's sizing

requirement):

Chillers, Larger Furnaces, Rooftop Units, and Boilers: Furnaces, chillers, rooftop units or boilers the size limits in the application form above may still qualify for incentives through CFU's Custom Incentives program. Below are minimum efficiency guidelines. Contact 319-268-5355 for more information. Furnace Size: Above 225 MBtuh Minimum Efficiency: Contact CFU for information. Boiler Size: Above 300 MBtuh Minimum Efficiency: Contact CFU for information. Central Air Conditioner (Rooftop Unit): > 65 MBtuh and Minimum Efficiency: 12.0 EER < 240 MBtuh Central Air Conditioner Size: >240 MBtuh Minimum Efficiency: Contact CFU for information. Chillers: Any size, any type Minimum Efficiency: Contact CFU for information.

Natural Gas Boilers (up to 300 MBtuh) - $400 for 92% AFUE system or higher. No pre-approval or sizing calculation from CFU required; existing construction only.

Manufacturer Model AFUE Incentive Quantity Total Incentive

Date Installed

$400/unit x

Project Type (select one): Replaces broken boiler

New construction

Replaces working natural gas boiler

New installation - no prior natural gas boiler in existing building

Input heating capacity (Btuh):

Output heating capacity (Btuh):

Does the system provide water heating energy?

Equipment Cost: Approximate Btuh of system removed:

Type of fuel used by old heating system:

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