Broward County
BUSINESS APPLIANCE REBATE
APPLICATION
START HERE – PLEASE READ THIS FIRST
How to Apply
1) Review Program Eligibility on page 3. See www.energystar.gov for list of eligible ENERGY STAR commercial-
grade refrigerator and freezer models.
2) Contact vendors for price quotes on the appliance you intend to purchase. You will need to provide the
purchase price of the appliance during pre-registration.
3) Pre-register at www.broward.org/gogreen or call 954-357-REB8 (954-357-7328), Monday through Friday,
between 8:30 am to 5:00 pm, from September 7 to October 10, 2011, to obtain a Reservation Number.
Reservations and rebates will be dispersed on a first-come, first-served basis.
4) Complete a free Florida Power & Light (FPL) Business Energy Evaluation or call 1-877-748-4233 to schedule an
evaluation with a FPL representative or online at www.FPL.com. You may need to register with FPL for online
access.
5) Purchase an eligible ENERGY STAR commercial-grade refrigerator or freezer on/after September 7, 2011.
Then, recycle/ dispose of the old appliance according to federal/state/local laws and regulations; make sure
the old appliance is not resold or put back into service.
6) Complete and sign the application form and gather the required documentation to include in your application
packet.
7) Mail the application packet to the address below. The application packet must be postmarked no later than
Friday, November 4, 2011 or your rebate reservation will be forfeited and made available to waiting list
applicants.
Please allow 6-8 weeks after application deadline for the delivery of your
rebate check from Broward County.
ONLY COMPLETE AND ACCURATE APPLICATIONS WILL BE PROCESSED
Natural Resources Planning and Management Division
ATTN: Energy Sense Appliance Rebate Program
115 S. Andrews Ave., Suite 329H
Fort Lauderdale, FL 33301
Call 954-357-REB8 (954-357-7328) with questions or inquires.
SEND FORMS TO
1. APPLICANT INFORMATION (Must match information on pre-registration form)
Business Name
Owner/Principal First Name
Last Name
Business Mailing Address
City
Zip Code
Business Phone #
Cell Phone #
Email Address
Reservation/Waiting List #
NAICS Code OR Type of Business (describe)
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Broward County
BUSINESS APPLIANCE REBATE
APPLICATION
2. APPLIANCE INFORMATION
Eligible Appliance
Rebate Amount
ENERGY STAR commercial-grade Refrigerator*
ENERGY STAR commercial-grade Freezer*
Check ONE box
20% of appliance cost up to a maximum of $1,000
20% of appliance cost up to a maximum of $1,000
Serial # (of new Appliance)
Manufacturer/Brand
Model Number
Purchase Price (without sales tax):
Age of OLD Appliance
years
*A list of eligible USEPA ENERGY STAR Qualified Products may be found at www.energystar.gov. Purchase of an ineligible product will
result in disqualification for a rebate.
3. Additional Information (Please Check One)
A. My old appliance was disposed or recycled by/at:
Retailer
Landfill
Other, please describe _____________
B. Did the Rebate Program influence your decision to purchase an Energy Star appliance?
C. My NEW refrigerator/freezer has a:
Solid Door
No
Yes
Glass Door
4. APPLICATION CHECK LIST (Include ALL items below with your COMPLETED application packet)
Completed Application
Original Purchase Receipt
Photocopy of most recent FPL utility bill
Photocopy of FPL Business Energy Evaluation (completed after April 30, 2011)
5. BUYER’S SIGNATURE
By signing this form, I certify that the information provided on this rebate application and in its supporting documents
is accurate, that I meet the eligibility requirements of the Broward County Business Appliance Rebate Program, and
that I have read, understand, and agree to comply with the program terms and conditions. I affirm that the new
appliance replaced an existing appliance which has been permanently taken out of service and been properly disposed.
Required Signature
Date
Please retain a copy of the application packet for your records
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BROWARD COUNTY
BUSINESS APPLIANCE REBATE
TERMS AND CONDITION
1. Program Eligibility
requested on the rebate application form,
including supporting documents. The purchaser
must sign and date the application form.
 Must pay sales tax on appliance purchased.
To qualify for a rebate, the applicant must meet the
following criteria:
 Must be a legitimate small to medium- sized business
physically located in Broward County with a valid
Broward County address. Qualifying appliances must 2. Rebate Restrictions
 Limit one rebate per person and business.
be purchased and installed for business use in
 Rebates are limited to one appliance per rebate.
Broward County. Small to medium sized businesses
 Rebates are awarded on a first-come, first-served
are defined as using less than 500 KWD as displayed
basis.
on Florida Power & Light utility bill, with one of the

By pre-registering for a rebate and receiving a
following allowable rate code classifications
reservation confirmation, rebate funds are
designations: General Service Non-Demand (GS-1),
reserved for the applicant.
General Service Demand (GSD-1), General Service
 Rebates are not guaranteed and require full
Non-Demand Time of Use (GST-1), or General Service
compliance of the governing rules to be issued. If
Demand Time of Use (GSDT-1). Applicant must
each of the program requirements are not
provide proof of business location to include a copy of
satisfied, the applicant gives up rights to the rebate
the business’ most recent Florida Power & Light utility
and those rebate funds will no longer be available
bill with the same business name and address as on
to the applicant. The rights to a rebate or a rebate
the application. Post Office Boxes are ineligible.
application may not be transferred or sold.
 Must purchase a new ENERGY STAR commercial

Reservation Numbers expire if a valid and
refrigerator or freezer based on the current list of
complete submission of application packet is not
eligible USEPA ENERGY STAR Qualified Products found
postmarked by November 4, 2011.
at www.energystar.gov.
 Waiting list applicants will only receive rebates if
 Must replace an existing appliance of the same type.
funds become available from unused reserved
 Must dispose/recycle the existing appliance according
rebates or disqualified rebate applications.
to federal/state/local laws and regulations. The
 Purchase of ineligible product will result in
existing appliance must not be resold or put back into
disqualification for a rebate.
service. Recycling methods for existing appliance is
 Original purchase receipt submitted with the
available at www.broward.org/gogreen and click
application must include: make and model of
REBATE PROGRAMS.
appliance; amount paid for appliance; date of
 Must be approved through a preregistration program,
purchase; and retailer name where purchase was
which opens September 7, and closes October 10,
made.
2011 or until all rebate funds are reserved.
 Original purchase receipt must include a valid
 Must make the purchase of eligible products during
model number for the applicable ENERGY STAR
the rebate offer period on or after September 7,
Product.
2011.
 Based on purchase receipt, a maximum rebate will
 Must install the appliance at the business listed on
be awarded equal to but not greater than the
the rebate application form, prior to submittal of the
amount requested on reservation form.
rebate application.
 Rebates will not be awarded for appliances
 Must mail a complete rebate application to the
purchased before the rebate offer period,
address specified on the rebate application form by
September 7, 2011.
November 4, 2011 (postmarked) in one mailing.
Application packets must include all information
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BROWARD COUNTY
BUSINESS
APPLIANCE REBATE
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TERMS & CONDITIONS


 Rebates are subject to available funding. Due to
grant requirements, all rebate monies and issues
must be expended/resolved by February 29, 2012.
Any unresolved issues after this date will be
ineligible for rebates.
 Purchase of products that are used, rebuilt, rented,
leased, exchanged, won as a prize or purchased at
auction or online auction are ineligible.
 Rebate values vary based on price paid for product
less discounts, and does not include: sales tax;
auxiliary equipment purchases; or installation and
delivery/freight charges.
3.
4.
5.
6.
7.
appliance offered for sale or purchased, (2) services
provided by a retailer, installer, contractor, hauler, or
recycler.
 This program was prepared as an account of work
sponsored by an agency of the United States
Government. Neither the United States Government
nor any agency thereof, nor any of their employees,
nor any of their contractors, subcontractors or their
employess, makes any warranty, express or implied,
or assumes any legal liability or responsibilty for the
accuracy, completeness, or third party’s use or the
results of such of any information, apparatus,
product, or process disclosed, or represents that its
Public Records
use would not infringe privately owned rights.
Under Florida law, information/documents submitted
Reference herein to any specific commerical product,
by applicant will become public record and may be
process, or serivce by trade name, trademark,
subject to public disclosure.
manufacturer, or otherwise, does not necessarily
constitute or imply its endorsement,
Verification of Installation
recommendation, or favoring by the United States
Application/purchase may be subject to visual
Government or any agency thereof or its contractors
inspection/verification of installation by Broward
or subcontractors. The views and opinions of authors
County. The applicant must provide Broward County, or
expressed herein do not necessarily state or reflect
agents of, with access to the business listed on rebate
those of the United States Government or any
application form based upon reasonable written
agency thereof.
notification. The County may deny or seek the return of

Broward County is not responsible for: lost, late,
payment to an applicant that refuses to provide the
incomplete, damaged, misdirected, or postage due
County with access to the business to verify appliance
requests/mail; electronic transmission errors;
installation.
technical, network, telephone equipment, electronic,
Purchaser Compliance Responsibilities
computer, hardware or software malfunctions;
The applicant is responsible for compliance with all
limitations of any kind; inaccurate transmissions of
requirements of federal, state, county, and city
or failure to receive rebate submission on account of
governments. Tenants are responsible for obtaining the
technical problems or traffic congestion on the
property owner’s permission to install the purchased
internet or at any website; or any combination
appliance, if needed. Any fraudulent activities are a
thereof.
violation of criminal and civil laws; Broward County
8. Acknowledgement
reserves the right to seek damages from rebate
Funding for the Energy Sense program is made
applicant to the fullest extent of the law.
possible by an Energy Efficiency and Conservation
Endorsement
Block Grant through the American Recovery and
Broward County does not endorse any particular
Reinvestment Act.This material is based upon work
appliance, retailer, manufacturer, installer, contractor,
supported by the U.S. Department of Energy, Office
hauler, or recycler that provides products or services
of Energy Efficiency and Renewable Energy grant
related to the Broward County Appliance Rebate
agreement # DE-E000800 and the Florida Energy and
Program.
Climate Commission grant agreement # ARE010.
Disclaimer of Warranty & Limitation of Liability
 Broward County makes no warranties, nor shall be
liable for damages regarding/related to: (1) the
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