Commercial/Industrial Lighting Rebate Program
[Enter you utility’s information here]
APPLICATION DIRECTIONS:
1. Lighting equipment must be installed in a facility located in [Municipal Utility’s] service territory. Equipment
must be purchased and installed between January 1, 2013 and December 31, 2013 to qualify for the 2013
rebate program.
2. After equipment is installed and operating, complete this application, including the signature.
3. Attach original sales receipt(s)/invoice(s) to the rebate application. The receipt(s) must indicate the purchase
date, quantity, and price.
4. Mail or bring the completed application and receipts/invoices to: [Municipal Utility Address]. Please allow 4 to 5
weeks for payment.
TERMS AND CONDITIONS
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No customer shall receive more than [X] lighting rebates or [X] worth of rebates from [Municipal Utility] during any period of 12
consecutive months.
[Municipal Utility] does not guarantee that the installation and operation of energy efficiency equipment will result in reduced usage or
demand or in cost savings. [Municipal Utility] makes no warranties, expressed or implied, with respect to any equipment purchased
and/or installed, including, but not limited to, any warranty or merchantability or fitness for a particular purpose. In no event shall
[Municipal Utility] be liable for any incidental or consequential damages or injuries resulting from defective equipment or installation.
[Municipal Utility] reserves the right to cancel or change these programs at any time.
[Municipal Utility’s] acceptance of this application does not guarantee payment of the incentive.
Prior to any payment of rebates, [Municipal Utility] reserves the right to verify sales transactions and installation.
[Municipal Utility] will not be responsible for any tax liability that may be imposed on the customer as a result of the payment of
rebates.
[Municipal Utility] does not endorse any particular manufacturer, product, system design, claim, or retailer in promoting this program.
CUSTOMER INFORMATION (Please Print)
Business Name
Phone
Installation Date
Mailing Address
City
State
ZIP Code
Installation Address
City
State
ZIP Code
Utility Account Number (Found on Utility Bill)
Email Address (By providing your email address, you are granting The Utility permission to send emails regarding this project or updates on our incentive programs.)
Building Use
 Office  Retail  24-hour Facility  Warehouse  Restaurant  Lodging  Grocery  Manufacturing  K-12 School  College
 Healthcare Clinic  Hospital  Other/Miscellaneous_______________________________________________________________________________________
Customer Agreement:
My signature indicates consent to and agreement with all program terms and conditions. It certifies that all information in this application is correct and that all of the listed
new equipment has been purchased, installed, and is operating at the indicated location. I understand that my utility company reserves the right to inspect and verify
installation before and after issuing payment.
Customer Signature
Printed Name
Date
Thank You for participating in the eco@work program.
Commercial/Industrial Lighting Program
COMMERCIAL AND INDUSTRIAL LIGHTING
Equipment
Fixture
Size
# Of
Lamps
Lamp Type
Incentive for
Building
Retrofit
Incentive for
New
Construction
u-bend
2
T8 U-Bend
$10/fixture
N/A
$
1
T8 or T5
$10/fixture
N/A
$
2
T8 or T5
$10/fixture
N/A
$
1
T8
$5/fixture
N/A
$
2
T8
$10/fixture
N/A
$
3
T8
$15/fixture
N/A
$
4
T8
$20/fixture
N/A
$
1
T8 or T5
$8/fixture
N/A
$
2
T8 or T5
$14/fixture
N/A
$
Any
T8 or T5 HO
$15/lamp
$8/lamp
$
320 W Replace 400 W or larger lamp
$20/fixture
N/A
$
750 W Replace 1,000 W or larger lamp
$30/fixture
N/A
$
$10/fixture
$10/fixture
$
50% of
purchase cost
up to $2
50% of
purchase cost
up to $10
$30% of
installed cost
2 Foot
Replace T12
lamps with T8 or
T5 lamps
Low-Bay
(Mounting Height
<15 feet)
4 Foot
8 Foot
T8 or T5 HO
High Bay
(Mounting Height
≥ 15 feet)
4 Foot
Pulse Start Metal
Halide Fixtures
Compact
Fluorescent
Fixture (Hard
Wired Pin Base)
Compact
Fluorescent
Lamps (screw-in)
N/A
1
ENERGY STAR
rated
N/A
1
ENERGY STAR
rated
LED Screw-In
Lamp
N/A
1
ENERGY STAR
rated
LED Fixture
(Hard Wired)
N/A
1
Design Lights
Qualified
50% of
purchase cost
up to $2
50% of
purchase cost
up to $10
30% of installed
cost
N/A
N/A
Vertical Lighting
$20 per door
$20 per door
N/A
N/A
$5 per foot
$5 per foot
N/A
N/A
Horizontal
Lighting
Light Emitting
Diode
$5 each
N/A
N/A
N/A
Must control >
400 Watts
$20 each
$20 each
N/A
Must control >
150 Watts
LED Strip/
Refrigerated
Case Lighting
LED Exit Sign
Occupancy
Sensors (Wall or
Ceiling)
Occupancy
Sensors (Fixture
Mount)
N/A
$10 each
$10 each
TOTALS:
Thank You for participating in the eco@work program.
Quantity
Total Incentive
$
$
$
$
$
$
$
$
Commercial/Industrial Lighting Program
Thank You for participating in the eco@work program.
Commercial/Industrial Lighting Program