APPLICATION
MINNESOTA
Lighting Efficiency
LED TRAFFIC SIGNAL RETROFIT REBATE
Business Customer Information
Company name________________________________________________________________________________ Date submitted_____________
Billing address___________________________________________________City__________________________ State_______ ZIP__________
Installation address (IF DIFFERENT)_____________________________________City__________________________ State_______ ZIP__________
Contact name (PRINT)___________________________________________ Phone______________________________________________________
Fax_________________________________________________________ Contact email*_______________________________________________
*By providing your email address, you are granting Xcel Energy permission to send further emails regarding our programs and services.
Xcel Energy electric premises number______________________________________________________________
I verify the information on this application is correct and request consideration for participation in this program.
Customer signature_____________________________________________________________________________ Date______________________
Customer hereby certifies that: 1. the customer, and not Xcel Energy is solely responsible for the accuracy of the information contained in this
application; 2. all installation is complete and operational prior to submitting rebate; and 3. all rules of this Xcel Energy program have been followed.
Further, the customer acknowledges that participation in this rebate program shall impose no liability on Xcel Energy. In particular, Xcel Energy shall
not be liable for the work performed by the customer’s engineer, contractor, or vendor.
Xcel Energy account manager____________________________________________________________________ Date______________________
Email_____________________________________________________________________________________________________ @xcelenergy.com
Alternate Rebate Recipient
Note: Complete this section only if customer wants rebate check to go to someone other than the company tied to the account number.
Company name___________________________________________________________________________________________________________ Contact name________________________________________________ Phone______________________________________________________
Address________________________________________________________City__________________________ State_______ ZIP__________
I authorize the above company to receive the rebate check for this project.
Customer signature_____________________________________________________________________________ Date______________________
Contractor Information
Contractor name______________________________________________ Contractor contact name_______________________________________
Contractor address_______________________________________________City__________________________ State_______ ZIP__________
Phone______________________________________________________ Fax________________________________________________________
Email*__________________________________________________________________________________________________________________
*By providing your email address, you are granting Xcel Energy permission to send further emails regarding our programs and services.
How to Apply for Rebates
1. Fill out the rebate application. (All information needs to be supplied before a rebate check can be issued.)
2.Mail or fax completed and signed rebate form along with paid invoices to:
Energy Efficiency Specialist, Business Solutions Center, P.O. Box 8, Eau Claire, WI 54702-0008, or Fax 1-800-311-0050.
INTERNAL USE ONLY – PLEASE DO NOT WRITE IN THIS SPACE
Rebate Operations_____________________________________________________Date_____________________ Check request_____________
Customer______________ Send to rep_________________ Authorization________________________________Date_____________________
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14-03-504 | 03/2014 | CRS 1541
APPLICATION
LIGHTING EFFICIENCY
MINNESOTA
LED TRAFFIC SIGNAL RETROFIT REBATE
Lighting Replacement Options
Existing Equipment (What was removed?)
Incandescent
Pedestrian Signals
(Walk/Don’t Walk)
Qty
9" signals
12" or larger signals
Proposed Equipment (What was installed?)
LED Pedestrian
Signals
(Walk/Don't Walk)
8" red balls
Incandescent Traffic
Balls and Arrows
8" green balls
12" red balls
12" green balls
LED Traffic Balls and
Arrows
12" red arrows
Qty x
Rebate =
9" signals
$30
12" or larger signals
$40
8" red balls
$25
8" green balls
$25
12" red balls
$32
12" green balls
$32
12" red arrows
Total Rebate
$50
Total Rebate $
Rules and Requirements
Customer Qualifications
• LED Traffic Signal rebates apply to customers with a valid Xcel Energy commercial account in our Minnesota electric service territory.
•Customers that retrofit their existing incandescent traffic signals to new LED traffic signals.
• Retrofits that result in load reduction.
Equipment Requirements
• Equipment must be purchased, installed and fully operational before submitting rebate application.
•Xcel Energy will issue rebates in the form of a check, not utility bill credits. The minimum rebate is $5. The maximum rebate is 60 percent of the total
project cost.
• Rebates will not be given for equipment that does not comply with Xcel Energy rebate rules; or local, state or federal regulations.
• Rebates are not available for amber LED traffic balls/arrows or green LED traffic arrows.
• Xcel Energy reserves the right to limit any rebate.
• Xcel Energy will reject incomplete rebate application forms. Xcel Energy is not liable for rebates promised to customers as a result of a contractor
misrepresenting the program.
• Customers and vendors must submit itemized equipment invoices along with the rebate applications. To ensure that the equipment installed meets
Xcel Energy’s performance standards, these invoices must itemize labor charges, quantity and price of the equipment installed.
• Customers must apply for rebates within one year of the purchase date shown on the equipment invoice.
• A signed application and detailed installation invoice(s) must be completed and submitted to Xcel Energy within 12 months of the invoice date.
• Xcel Energy reserves the right to conduct random inspections of installations. If Xcel Energy finds that you don’t comply with the Xcel Energy rules
and standards, any rebate you have received must be returned to Xcel Energy.
• Xcel Energy’s Conservation Rebate programs are subject to 60 days notice of cancellation. The customer and contractor are responsible for
checking with the Business Solutions Center at 1-800-481-4700 or bsc@xcelenergy.com to ask whether or not the program is still in effect and to
verify program parameters.
Warranty Information
Warranties are between the customer and equipment manufacturer(s). Xcel Energy makes no warranties, expressed or implied, with respect to
equipment operation, material, workmanship or manufacture. Xcel Energy does not guarantee that a specific level of energy or cost savings will
result from the implementation of energy conservation measures or the use of products funded under this program. In no event shall Xcel Energy
be liable for any incidental or consequential damages.
PLEASE ALLOW SIX TO EIGHT WEEKS FOR THE REBATE CHECK TO ARRIVE.
xcelenergy.com | © 2014 Xcel Energy Inc. | Xcel Energy is a registered trademark of Xcel Energy Inc. |
Northern States Power Company – Minnesota, an Xcel Energy Company. | 14-03-504 | 03/2014 | CRS 1541