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PSO HPH Single Upgrade Homeowner Participation Agreement ... · PSO Home Rebates – Single Upgrade Homeowner Participation Agreement . This Homeowner Participation Agreement is only

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Page 1: PSO HPH Single Upgrade Homeowner Participation Agreement ... · PSO Home Rebates – Single Upgrade Homeowner Participation Agreement . This Homeowner Participation Agreement is only

PSO Home Rebates – Single Upgrade Homeowner Participation Agreement

This Homeowner Participation Agreement is only valid for installation or service(s) completed on or after January 18, 2016. Only participating Service Providers may submit rebate applications for consideration. Rebate requests cannot be processed unless all fields on this form are complete.

Homeowner Name: Email:

Address: City: State: ZIP: County:

Phone: PSO Account Number:

House Type: Single Family Townhouse Condo Rental Other___________________

Approximate House Age: 1979 or Older 1980-2004 2005 to Present

Approximate Square Footage: Basement: Yes No

Primary Heating & Cooling Systems: AC/Gas Heat AC/Electric Resistance Gas Heat (no AC) Heat Pump

Existing Windows: Single Pane Double Pane

Approved Energy Efficiency Upgrades Attic/Ceiling Insulation $400 $ High Efficiency Electric Water Heater Replacement – Qty _____ $80 $ ENERGY STAR® Windows and Doors ($500 max) – Qty _____ $30 per window/door $ Solar Screens ($200 max) – Qty _____ $20 per window $ Air Conditioner/Heat Pump Replacement $ SEER 16-16.99 – Qty _____ $500 $ SEER 17-17.99 – Qty _____ $550 $ SEER 18+ – Qty _____ $600 $ Ground Source Heat Pump Bonus – Tons _____ $350 per ton $ Furnace Electronically Commutated Motor (ECM) – Qty _____ $100 $

Total Installation Cost $ PSO Rebate $

Net Installation Cost $

Homeowner and Service Provider Acceptance Homeowner: I have read and understand the Terms and Conditions attached. I certify that the information I have provided is true and correct and the product(s) and/or equipment for which I am requesting a rebate meets the requirements in this application. I acknowledge that all rebate payments will be made directly from AEP/PSO to the Service Provider. Service Provider: I verify that I have or will follow all applicable rules and standards for PSO's Home Rebates while evaluating the above homeowner’s home, formulating comprehensive recommendations and proposals, and conducting any work resulting from those recommendations. I also certify that the information contained in this form, in the Service software record, and in any contract material submitted for review, is true and complete to the best of my knowledge.

Homeowner Signature

Date

Service Provider Signature Date

Page 1 of 2 2016-2018 Single Upgrade Homeowner Participation Agreement v1 – 1/14/16

Page 2: PSO HPH Single Upgrade Homeowner Participation Agreement ... · PSO Home Rebates – Single Upgrade Homeowner Participation Agreement . This Homeowner Participation Agreement is only

Public Service Company of Oklahoma Home Rebates – Single Upgrade Terms and Conditions Incomplete applications will not be accepted for payment. Your participating Service Provider must provide all supporting documentation. This includes a completed and signed copy of this form, along with a copy of the Service Provider’s invoice, including installation date, equipment type, make, model and serial numbers. All supporting documentation will be submitted by the participating Service Provider via the online application system. PAYMENT: ALL REBATE PAYMENTS WILL BE MADE DIRECTLY TO THE SERVICE PROVIDER. CUSTOMER WILL RECIVE REBATE IN THE FORM OF AN UPFRONT DEDUCTION ON THE SERVICE PROVIDER’S SALES/INSTALLATION INVOICE. Please call us toll free at 888.776.1366 or email [email protected] if you have any questions about your rebate. APPLICATION: The application and any required additional documentation, including the invoice and permit information must be filled out completely, truthfully and accurately and must be submitted electronically by the Service Provider. Customers are advised to get and retain a copy of the application from their Service Provider and any accompanying documentation submitted to Public Service Company of Oklahoma (PSO) under this service. PSO will not be responsible for lost documentation pertaining to an application request. Home Rebates covers products purchased and installed on or after January 18, 2016. Please check our website for updates. Details of this service, including rebate levels, are subject to change or cancellation without prior notice. The application, with required documentation, must be received within 30 days of the installation’s completion or service performed. Only one rebate is available for each qualifying upgrade purchased or service received. Funds for rebates are limited and available on a first-come, first-served basis. Rebate amounts are valid through December 31, 2018, but can change without notice. Please call us toll free at 888.776.1366, email [email protected] or visit PowerForwardWithPSO.com for the most up-to-date details. ELIGIBILITY: This offer is valid for PSO residential electric customers applying through PSO Home Rebates only. In order to qualify for a rebate, all equipment must be installed by a participating Service Provider listed on the PSO website. The application must be submitted by a participating Service Provider via the online application located at https://psohvac.icfwebservices.com/ or via the Power Rebate app. Equipment must be installed in the PSO service territory. Participating Service Providers and eligible upgrades are listed at PowerForwardWithPSO.com. APPROVAL, VERIFICATION AND INSPECTION: Prior to any payment of rebates, PSO reserves the right to verify sales transactions. Customer’s Service Provider will verify that the installed energy-saving upgrades meet all applicable building codes; zoning laws; local, state and federal requirements; and other relevant requirements. The Service Provider is responsible for any applicable permits as required by aforementioned code/law. Outdoor temperatures may affect this verification process. Customer’s home may also be selected for a quality control post-installation inspection by PSO. No warranty is implied by this inspection. REQUIRED DOCUMENTATION: A Service Provider’s invoice itemizing the purchased equipment or service performed must accompany each PSO Home Rebates rebate request. The invoice copy must indicate the equipment type, make, model, serial numbers (coil and condenser model/serial numbers listed separately) for HVAC equipment; beginning and ending insulation depth for attic insulation; U-Value and Solar Heat Gain Coefficient (SHGC) for windows and doors, Water Heater Replacement type, Efficiency Factor, and volume, square feet of Solar Screens installed, and date of purchase or service performed. Invoice

must include PSO rebates provided to the customer. Applications must also include the mechanical permit number or a copy of the submitted permit application. TAX LIABILITY: PSO will not be responsible for any tax liability that may be imposed on the customer as a result of the payment of rebates. Please contact your tax advisor for more information. NO ENDORSEMENT: PSO does not endorse any particular manufacturer, product, system design, claim or Service Provider in promoting Home Rebates. INFORMATION RELEASE: By signing and dating this document I hereby grant American Electric Power (AEP), its affiliated companies, successors, and assigns the unqualified and unconditional right and permission to reproduce, copyright, publish, circulate, edit or otherwise use audio and video/film/still photo productions, project information and/or quotes of me and/or my organization for any purpose relating to the following project. This authorization and release covers the use of said audio and video/film/still photo productions, project information and/or quotes in any published form and in any media in any part of the world at any time during the next five years. I also assign and transfer to AEP, its successors and assigns, all my rights, title and interests in and to all audio and video/film/still photos/project information and/or quotes made or taken regarding the organization by said company or in its behalf by any other person for any purpose related to the above-named project. By signing this document I am aware that I give up and release all rights to such images and/or audio in any form. I grant these rights to my images, project information and/or audio to AEP. LIMITATION OF LIABILITY: PSO’S LIABILITY IS LIMITED TO PAYING THE REBATE SPECIFIED. IN NO EVENT WILL PSO BE LIABLE WHETHER IN CONTRACT, TORT (INCLUDING NEGLIGENCE), STRICT LIABILITY, WARRANTY OR OTHERWISE FOR SPECIAL, INCIDENTAL OR CONSEQUENTIAL DAMAGES CONNECTED WITH OR RESULTING FROM PARTICIPATION IN HOME REBATES. PSO RESERVES THE RIGHT TO NOT PAY THIS REBATE IF THE APPLICATION FORM AND ALL REQUIRED ADDITIONAL INFORMATION ARE NOT COMPLETE AND ACCURATE. WARRANTIES: PSO DOES NOT WARRANT THE PERFORMANCE OF INSTALLED EQUIPMENT, EXPRESSLY OR IMPLICITLY. PSO MAKES NO WARRANTIES OR REPRESENTATIONS OF ANY KIND, WHETHER STATUTORY, EXPRESSED OR IMPLIED, INCLUDING WITHOUT LIMITATIONS, WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE REGARDING THE CENTRAL AIR CONDITIONING, INSULATION, WINDOW/DOOR, WATER HEATER, OR SOLAR SCREEN EQUIPMENT PROVIDED BY A MANUFACTURER OR VENDOR. CONTACT YOUR SERVICE PROVIDER FOR DETAILS REGARDING EQUIPMENT PERFORMANCE AND WARRANTIES. PROPERTY RIGHTS: Customer represents that he/she has the right to complete and/or install the energy-saving upgrades on the property on which those upgrades are completed and/or installed, using a participating Service Provider, and that any necessary landlord’s consent has been obtained. CUSTOMER’S CERTIFICATION: Customer certifies that he/she has purchased and has installed the equipment listed on the application at the defined location through a participating Service Provider. Customer agrees that all information is true and that he/she has conformed to all requirements listed.

Page 2 of 2 2016-2018 Single Upgrade Homeowner Participation Agreement v1 – 1/14/16