Vectren Indiana 2016 Residential Rebate Application

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1 Residential Rebate Application Thank you for participating in Vectren s Indiana Residential Rebate Program! Refer to the information below to ensure you are eligible for program rebates and your application is complete. Please retain a copy of your completed application and all invoices for your records. Visit Vectren.com/saveenergy to apply online, view complete terms and conditions and find lists of qualifying equipment. Need Help? For assistance completing this application, call to speak with a Vectren Energy Efficiency Advisor. What You Will Need A copy of your itemized invoice that contains all equipment and installation information (please keep the original for your records) Your Vectren account number from your most recent bill Installing contractor information (if applicable) AHRI Certificate for the appropriate equipment For self-installation, please provide a purchase receipt for equipment installed HOW TO APPLY FOR A REBATE Step 1: Determine Eligibility Step 2: Complete Application & Attach Invoices Step 3: Submit Paperwork Applicant The property must be serviced by Vectren Energy Delivery of Indiana, Inc. ( Vectren ) under an active residential account. Application and Installation The application must be postmarked within 60 days of equipment installation to be eligible for a rebate. For new construction projects, builders must submit applications and supporting documentation within 60 days after buildilng inspection and approval and/or issuance of a certificate of occupancy.) Equipment & Service The installed equipment must be new; no refurbished equipment will be accepted. Equipment must be purchased and installed between January 1, 2016 and December 31, Read all individual rebate qualifications carefully to ensure your product qualifies. Complete Application Unless noted otherwise, all fields must be completed on the application to receive a rebate. Incomplete applications will not be processed. Sign Application The application must be signed in the space provided on page 2 of the application receive a rebate. Attach Invoice(s) Ensure that you have attached a copy of all equipment invoices, spec sheets and the AHRI Certificate of Product Ratings for the applicable equipment to the rebate application. The invoice should include: Equipment make, model and serial number of installation Total number of units installed Total project cost of the equipment Instant rebate amount (if applicable) Double-check Information Make sure the information listed on the application is correct and that you have provided all required information, invoices, spec sheets, and certificates. Submit Application Submit your completed application along with required documentation within 60 calendar days of equipment installation in one of the following ways: Mail your application to: Vectren Energy Delivery of Indiana ATTN: Rebates, PO Box 3552, Evansville, IN your application to: INrebates@vectren.com If you choose to your application, be sure to include all invoices as attachments. Fax* your application to: *You will receive an confirmation once your application has been received via FAX. If you do not receive confirmation within 3 business days call VECTREN.COM/SAVEENERGY IN RESIDENTIAL REBATE APPLICATION 2016

2 CUSTOMER AND CONTRACTOR INFORMATION Customer / Account Holder Information Who should we contact with questions? How did you hear about the program? Who will receive the rebate? Total Rebate Requested Customer/Account Holder Contractor Property Owner/Landlord Contractor Direct Mail Family/Friend Bill Insert Vectren Website Trade Ally Rep Customer/Account Holder Contractor (see signature section) Property Owner/Landlord (if not account holder) First Name of Account Holder (or Tenant Name if completed by Landlord) Last Name of Account Holder (or Tenant Name if completed by Landlord) Address Phone Number Alternate Phone Number Vectren Account Number (REQUIRED as shown on your Vectren bill) Service Type (REQUIRED please type of service utilized by your home) Vectren Natural Gas Service + Vectren Electric Service Vectren Electric Service Only Vectren Natural Gas Service Only Installation Address Address Location Description Existing Home City State ZIP Code Installing Contractor Information Company Name Address Equipment was self-installed Contact Person Phone Number Alternate Phone Number Address City State ZIP Code Federal Tax ID Number (TIN/EIN) or SSN (complete if receiving the rebate) Federal Tax Classification Individual/Sole Proprietor Corporation Partnership Limited Liability Exempt Other Mailing Information for Rebate Check Check Payable to: Customer/Account Holder Contractor Property Owner/Landlord (if not account holder) Payable to: Address City State ZIP Code Signatures I hereby certify that: 1) The information contained in this application is accurate and complete. 2) All rules of this incentive application have been followed. 3) I have read and understand the Terms and Conditions found at Vectren.com/SaveEnergy. I agree to verification of equipment installation which may include a site inspection by a program or utility representative. I understand that I am not allowed to receive more than one incentive from this program on any one piece of equipment. I hereby agree to indemnify, hold harmless and release the utility and program administrator from any actions or claims in regard to the installation, operation and disposal of equipment (and related materials) covered herein, including liability from any incidental or consequential damages. If, as the Installing Contractor, I am submitting an Instant Discount application, I certify that I have provided the full rebate as an instant discount to the account customer listed on this application. I have explained to the customer that the rebate he/she qualifies for has been applied as a discount off the purchase price, and he/she will not be eligible to receive a rebate for the same product(s) being submitted in the application. Submitted with this application, is the required invoice clearly itemizing the amount of the rebate provided as a discount to the customer. Customer / Account Holder Signature Contractor Signature Customer / Account Holder signature is required For the Instant Discount Option, the Contractor s signature is required VECTREN.COM/SAVEENERGY 2 OF 6

3 Only one installation address and account number can be submitted on an application. For additional account numbers, please complete separate applications. Home must utilize the Vectren fuel source specified (Natural Gas, Electric) for all space heating needs. Please the requested rebate. This page may be copied for multiple units. Please print legibly. PROGRAMMABLE THERMOSTAT Vectren Natural Gas or Vectren Electric Service # Unit Controlled (Please ) Rebate Homes using Vectren natural gas or Vectren electric as the primary heat source are eligible for this rebate. Dual fuel systems are not eligible. Rebate available for existing homes only; new construction is not eligible. If a Programmable Thermostat was purchased at the time of a 2016 Vectren Home Energy Assessment, you are not eligible for this rebate. Must be digital and have the following features: wake, day, evening, and sleep daily settings, weekday vs. weekend setting (5-2, 5-1-1), override or hold setting. Serial number is preferred, but not required. SMART Wi-Fi ENABLED THERMOSTAT Vectren Natural Gas or Vectren Electric Service # Unit Controlled (Please ) Rebate Homes using Vectren natural gas or Vectren electric as the primary heat source are eligible for this rebate. Dual fuel systems are not eligible. Rebate available for existing homes only; new construction is not eligible. Must be Wi-Fi capable and connected to the internet for programming and adjusting remotely. Serial number is preferred, but not required. Limit of three Wi-Fi enabled thermostats per home. BOILER Vectren Natural Gas Service Equipment Specification AFUE Input Capacity (MBtuh) Heating Capacity (MBtuh) AHRI Reference Number Rebate % AFUE Homes using Vectren natural gas as the primary heat source are eligible for this rebate. Input capacity must be < 300 MBTUH AFUE = Annual Fuel Utilization Efficiency; MBTUh = British Thermal Units per hour performance for HVAC equipment. To obtain a copy of the AHRI certificate and certificate reference number, please visit: FURNACE Vectren Natural Gas Service Equipment Specifications (Please ) AFUE Heating Capacity (BTUh) AHRI Reference Number 95% AFUE 250 Rebate 97% AFUE 300 Rebate Homes using Vectren natural gas as the primary heat source are eligible for this rebate. AFUE = Annual Fuel Utilization Efficiency; BTUh = British Thermal Units per hour Furnace must be primary heat source for home s living space and be a sealed combustion unit. Systems supplementing gas space heating with an air source or geothermal heat pump are not eligible. performance for HVAC equipment. To obtain a copy of the AHRI certificate and certificate reference number, please visit: VECTREN.COM/SAVEENERGY 3 OF 6

4 CENTRAL AIR CONDITIONING UNIT Vectren Electric Service Equipment Specifications (Please ) SEER Btuh SEER 16 SEER Rebate 500 Rebate AHRI Reference Number Homes with Vectren electric service are eligible for this rebate. SEER = Seasonal Energy Efficiency Ratio; Btuh = British Thermal Units per Hour Purchase must be a high-efficiency electric central air conditioner as part of an AHRI rated qualifying system. performance for HVAC equipment. To obtain a copy of the AHRI certificate and certificate reference number, please visit: ECM (Electronically Commutated Motor) Vectren Electric Service Equipment Specifications (Please ) AHRI Reference Number if new furnace with ECM Rebate New Furnace with ECM New ECM Only (in existing furnace ): Replaces standard motor Replaces defective ECM Homes with Vectren electric service are eligible for this rebate. ECM can be a retrofit or part of a new HVAC system. If the ECM is part of a new furnace, an AHRI certificate must be submitted. The Air-Conditioning, Heating and Refrigeration Institute (AHRI) maintain a directory of certified product performance for HVAC equipment. To obtain a copy of the AHRI certificate and certificate reference number, please visit: Geothermal heat pump system ECMs do not qualify. 100 HEAT PUMPS Vectren Electric Service Equipment Specifications (Please ) SEER 16 SEER 18 Is natural gas service on or adjacent to property? Yes-300 Rebate No--400 Rebate Yes-500 Rebate No--600 Rebate SEER Btuh HSPF AHRI Reference Number Homes using Vectren electric service as the primary heat source are eligible for this rebate. SEER = Seasonal Energy Efficiency Ratio; HSPF = Heating Seasonal Performance Factor; Btuh = British Thermal Units per Hour Purchase must be a high-efficiency electric air source heat pump. Geothermal heat pumps do not qualify. Both the condenser and indoor unit must be replaced as part of an AHRI rated qualifying system. performance for HVAC equipment. To obtain a copy of the AHRI certificate and certificate reference number please visit: If you do not know if natural gas is on or adjacent to the property, please contact Vectren customer service at VECTREN.COM/SAVEENERGY 4 OF 6

5 DUAL-FUEL HEAT PUMP Vectren Natural Gas + Vectren Electric Service Equipment Specifications (Please ) SEER Btuh HSPF SEER 16 SEER Rebate 500 Rebate AHRI Reference Number Homes using dual-fuel (Vectren natural gas + Vectren electric service) as the primary heat source are eligible for this rebate. SEER = Seasonal Energy Efficiency Ratio; HSPF = Heating Seasonal Performance Factor; Btuh = British Thermal Units per Hour Purchase must be a high-efficiency dual-fuel air source heat pump. Geothermal heat pumps do not qualify. Both the condenser and indoor unit must be replaced as part of an AHRI rated qualifying system. performance for HVAC equipment. To obtain a copy of the AHRI certificate and certificate reference number, please visit: DUCTLESS HEAT PUMP Vectren Electric Service Equipment Specifications (Please ) SEER Btuh HSPF AHRI Reference Number Rebate SEER 17, 9.5 HSPF New room addition to home 500 SEER 19, 9.5 HSPF New room addition to home 700 SEER 21, 10 HSPF New addition to home 850 SEER 23, 10 HSPF New room addition to home 1,000 Homes using Vectren electric service as the primary heat source are eligible for this rebate. If natural gas is used as the primary heat source, then rebates are only available for installations in a new room addition, or previously unconditioned space. SEER = Seasonal Energy Efficiency Ratio; HSPF = Heating Seasonal Performance Factor; Btuh = British Thermal Units per Hour performance for HVAC equipment. To obtain a copy of the AHRI certificate and certificate reference number, please visit: HEAT PUMP WATER HEATER Vectren Electric Service Equipment Specifications EF Rating Gallons Installation Rebate Energy Factor (EF) Homes with Vectren electric service are eligible for this rebate. Heat pump water heaters must have an Energy Factor (EF) of 2.0 or greater to qualify. Look for the EF rating on the water heater specification sheet or on the packing box. It may or may not be listed on the water heater label VECTREN.COM/SAVEENERGY 5 OF 6

6 POOL HEATER Vectren Electric Service Equipment Specifications Capacity (BTUh) COP Rating Installation Rebate Coefficient of Performance (COP) 5 1,000 Homes must have Vectren electric service to be eligible for this rebate. VARIABLE SPEED POOL PUMP Vectren Electric Service Equipment Specification Manufacturer/Make Installation Rebate 300 Variable-Speed Pool Pump Model Number Serial Number Homes must have Vectren electric service to be eligible for this rebate. Single and two speed pool pumps do not qualify for a rebate. EXISTING EQUIPMENT (if applicable) Complete the applicable fields below if replacing existing equipment Type of Equipment Being Replaced (Please ) Old Unit Condition Nonprogrammable Thermostat Central Air Conditioner Unit Electronically Commutated Motor (ECM) Heat Pump Electric Service/Dual-Fuel Water Heater Pool Heater Pool Pump Inoperable, but repairable Operable, upgrading equipment Inoperable, not repairable Other Old Unit Manufacturer/Make/Brand Old Unit Model Age of Old Unit Old Unit Tons Old Unit SEER Old Unit AFUE Old Unit Gallons Type of Equipment Being Replaced (Please ) Old Unit Condition Nonprogrammable Thermostat Central Air Conditioner Unit Electronically Commutated Motor (ECM) Heat Pump Electric Service/Dual-Fuel Water Heater Pool Heater Pool Pump Inoperable, but repairable Operable, upgrading equipment Inoperable, not repairable Other Old Unit Manufacturer/Make/Brand Old Unit Model Age of Old Unit Old Unit Tons Old Unit SEER Old Unit AFUE Old Unit Gallons VECTREN.COM/SAVEENERGY 6 OF 6