Wallingford Electric Division Residential COOL CHOICE
MAIL-IN REBATE
RESIDENTIAL CENTRAL AIR
CONDITIONING OR HEAT
PUMP REBATE
CUSTOMER INFORMATION
Name
Phone
Installation Address
City
State
Zip
Mailing Address
City
State
Zip
(If different from installation address)
Email
WED Account number
Type of installation (Check one):
New installation (New Home)
How did you hear about this program? (Check one):
Bill insert
New Installation (existing home)
Print Ad
Website
Replacement (for Existing Home)
Manufacturer Ad
Other ____________________________
Customer Signature ________________________________________________________________________________ Date __________________________________________
CONTRACTOR INFORMATION
Company Name
Contractor License Number
Address
City
State
Zip
Mailing Address
City
State
Zip
FAX
Email
Federal ID Number
Phone
.
By signing below, contractor agrees to the conditions as stated on the back of this application and to any special conditions.
Contractor Signature ________________________________________________________________________________ Date ___________________________________________
APPLICATION INSTRUCTIONS
Valid for customers who purchase a qualifying high efficiency heating and/or cooling system installed January 1, 2014 through December 31, 2015. All rebate requests must be
postmarked no later than January 31, 2016. Total incentive cannot be more than 50% of the total installation cost of the qualifying high efficiency heating and/or cooling system.
TO RECEIVE YOUR REBATE, READ THE PROGRAM REQUIREMENTS ON THE REVERSE SIDE OF THIS FORM BEFORE PROCEEDING. INSTRUCTIONS: Please fill out
this form completely and mail it to the address below. You must include a copy of the contractor’s invoice, listing the condenser, coil and fan model and serial numbers, the
purchased equipment type, the AHRI certificate for your system as MATCHED ASSEMBLY and a copy of your recent electric bill. A matched assembly is a model combination that
is listed in the AHRI Directory of Certified Equipment. ANSI/AHRI STANDARD 210/240-2008. These items must accompany each incentive Application.
Mail to: Energy Efficiency Programs, Wallingford Electric Division, 100 John Street, Wallingford, CT 06492
.
NEW EQUIPMENT INFORMATION (TO BE COMPLETED BY CONTRACTOR)
Type
C=Central Air
H=Heat
Pump
Install Date
Manufacturer/Brand
Model Numbers
(Condenser Model, Coil Model, Fan
Model)
Unit Size
(Tons)
SEER
Sq Ft of Heated Space:
EER
Number
of units
HSPF
.
Measure Information: Please review Eligibility Requirements on reverse. Include invoices, product specification sheets and other documents.
For administrative use only:
Project ID:
Required
Inspections
Approvals
Approved Rebate Amount:
AHRI Reference
Number
Total
Incentive
Rebate Total: $ ______________
Approving Program Manager:
Pre-Installation Date:
Inspector:
Post-Installation Date:
Inspector:
Pre-Installation Approval Date:
Program Manager:
Pre-approved Rebate: $
Post-Installation Date:
Program Manager:
Final Rebate: $
REBATE REQUIREMENTS
Application Offer: This Rebate covers products purchased and installed in 2014
through 2015. Details of this Rebate are subject to change or cancellation without
prior notice. This application form with required documentation must be postmarked
by January 31, 2016.
Warranties: WED DOES NOT WARRANT THE PERFORMANCE OF INSTALLED
MEASURES, EXPRESSLY OR IMPLICITLY. WED makes no warranties or
representation of any kind, whether statutory, expressed or implied, including, without
limitations, warranties of merchantability or fitness for particular purpose regarding the
material or services provided by a contractor or vendor. Consult your contractor or
vendor for details regarding performance and warranties.
Completed and signed applications must be submitted within 30 days of the equipment
installation to be eligible foR rebate(s).
Limitations of Liability: The liability of WED is limited to paying the Rebate specified.
WED is not liable for any consequential or incidental damages or for any damages in
tort connected with or resulting from participation in this Rebate program.
Eligibility: Rebates are available only to residential customers of the Wallingford
Electric Division (WED). Materials must be installed in the WED service territory.
Mail-in attic insulation rebates must have an existing R-value of R-19 or less in order to
be eligible for insulation rebate. In addition, the R-value of the completed attic space,
once installed, must be R-38 or greater in order to be eligible for rebate.
Assignment: The customer may assign the Rebate payment to a qualified contractor.
Owner’s Certification: Owner certifies that he/she purchased and had installed by a
licensed contractor the equipment listed on this form at the defined location. Owner
agrees that all information is true and that he/she conformed to all requirements listed.
Owner has verified that the equipment listed on this form has been installed correctly.
There are no unusual noises or vibrations and all controls have been calibrated.
Owner or owner’s representative has been instructed on how to operate and maintain
this equipment and has received all the necessary operation and maintenance
manuals. Owner has verified that any applicable air-system and water balancing has
been performed.
Proof of Purchase: An itemized invoice must accompany each Rebate application
form. The invoice must indicate the equipment type, size, make and model, serial
number of the system and date of installation.
Application Form: This application must be filled out completely, truthfully and
accurately. An authorized representative of the customer must sign, date and submit
the application along with the invoice, and manufacturer’s equipment performance
sheet stating the ARI certified efficiency rating and nominal capacity.
Payment: Please allow six to eight weeks for payment. Payment process may take
longer if information is missing on application. Call (203) 294-2280 with questions.
ISO-NE Capacity Payments: Customer agrees and acknowledges that this
installation of energy efficiency measures by Contractor may result in financial
incentives or environmental attributes related to Customer’s participation in the Rebate
program which may benefit WED. Customer hereby agrees to assign to WED any and
all right, title and interest in Customer’s portion, if any, of such financial incentives
and/or environmental attributes. By signing this document, and as a condition for
receiving a Rebate pursuant to this program, Customer hereby assigns to WED,
whichever the case may be, all of its rights, title and interest in and to any and all
LICAP, ICAP, or any and all other capacity-related credits or payments for which
Customer may be eligible from ISO-NE or such value associated with the settlement of
such LICAP, ICAP or capacity payments as determined through the ISO-NE LICAP,
ICAP or other such like capacity supply auction or market (or its successors or
replacements) for any capacity enrolled with ISO-NE.
Approval and Verification: WED reserves the right to verify sales transactions and
to have reasonable access to your property to inspect the HVAC system installed
under this initiative, prior to issuing rebate(s), or at a later time.
Tax Liability: Customer may be subject to tax liability for the value of the Rebate
received through the program pursuant to state and/or federal income tax codes.
WED will not be responsible for any tax liability that may be imposed on the customer
as a result of the payment of rebate(s). Please consult with a tax advisor on whether
to include the amount of the Rebate on your income tax filing.
Endorsement: WED does not endorse any particular manufacturer, product or
system design in promoting this Rebate.
Minimum Efficiency Levels / Incentive Schedules
Central Air Conditioning
Incentive Per Unit*
AHRI1 Rated Unitary Air Conditioning and Split Systems
AHRI Rated Central Air Conditioning Packaged Systems
AHRI Rated Air Source Heat Pump Split Systems
AHRI Rated Air Source Heat Pump Packaged Systems
14.5 SEER2 / 12 EER3
14.0 SEER / 11 EER
14.5 SEER / 12 EER / 8.2 HSPF4
14.0 SEER / 11 EER / 8.0 HSPF
$250
$250
$250
$250
Eligibility Requirements (Requires Pre-Approval)
Water Source Heat Pump Equipment
Tons
BTUs
Minimum Qualifying EER
Rebate / Ton
14.0
$300
AHRI – Air Conditioning, Heating and Refrigeration Institute. All equipment must be rated in the AHRI Air Conditioner Coils or Heat Pump directories. Both can be found online at
www.AHRIdirectory.org.
2 SEER – Seasonal Energy Efficiency Ratio.
3 EER – Energy Efficiency Ratio.
4 HSPF – Heating and Seasonal Performance Factor.
1
* Total incentive payment not to exceed 50% of the total installation cost of the qualifying high efficiency heating and/or cooling system. Funding for this rebate program is limited to the
period indicated or while funds last.