Commercial Rebate Lighting Program Application/Confirmation

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2 A B Fixtures Rebate per Fixture Estimate Qty BUILDING NAME: Actual Qty Existing Lamp/Fixture Wattage (Actual Draw) Commercial Rebate Lighting Program Application/Confirmation Installed Lamp/Fixture Wattage (Actual Draw) Estimated Annual Oper Hrs (min hrs.) Actual Equipment Cost per each fixture Actual Date Installed & Operable (mm/dd/yy) Total Requested Rebate T5 with Electronic Ballast plus lamp(s) T5 1 lamp replacing T12 $3.00 W W hrs $ - T5 2 lamp replacing T12 $6.00 W W hrs $ - T5 3 lamp replacing T12 $8.00 W W hrs $ - T5 4 lamp replacing T12 $11.00 W W hrs $ - T5 HO 1 lamp replacing T12 $3.00 W W hrs $ - T5 HO 2 lamp replacing T12 $6.00 W W hrs $ - T5 HO 3 lamp replacing T12 $9.00 W W hrs $ - T5 HO 4 lamp replacing T12 $12.00 W W hrs $ - T5 HO High-Bay 2 lamp $15.00 W W hrs $ - T5 HO High-Bay 3 lamp $23.00 W W hrs $ - T5 HO High-Bay 4 lamp $30.00 W W hrs $ - T5 HO High-Bay 6 lamp $45.00 W W hrs $ - T5 HO High-Bay 8 lamp $59.00 W W hrs $ - T5 HO High-Bay 10 lamp $74.00 W W hrs $ - T8 with Electronic Ballast plus lamp(s) T8 2 ft 1 lamp $1.00 W W hrs $ - T8 2 ft 2 lamp $2.00 W W hrs $ - T8 2 ft 3 lamp $3.00 W W hrs $ - T8 2 ft 4 lamp $4.00 W W hrs $ - T8 3 ft 1 lamp $2.00 W W hrs $ - T8 3 ft 2 lamp $3.00 W W hrs $ - T8 3 ft 3 lamp $4.00 W W hrs $ - T8 3 ft 4 lamp $5.00 W W hrs $ - T8 4 ft 1 lamp $2.00 W W hrs $ - T8 4 ft 2 lamp $4.00 W W hrs $ - T8 4 ft 3 lamp $6.00 W W hrs $ - T8 4 ft 4 lamp $8.00 W W hrs $ - T8 8 ft 1 lamp $4.00 W W hrs $ - T8 8 ft 2 lamp $8.00 W W hrs $ - T8 HO 8 ft 1 lamp $3.00 W W hrs $ - T8 HO 8 ft 2 lamp $6.00 W W hrs $ - T8 High-Bay 4 ft 3 lamp $21.00 W W hrs $ - T8 High-Bay 4 ft 4 lamp $ W 146 W 2080 hrs 58 11/10/12 $ 1, T8 High-Bay 4 ft 6 lamp $ W 168 W 2080 hrs 69 11/10/12 $ T8 High-Bay 4 ft 8 lamp $34.00 W W hrs $ - Rev. 03/2012 Lighting - 1

3 Fixtures Rebate per Fixture Estimated Qty Actual Qty Commercial Rebate Lighting Program Application/Confirmation High Performance T8 Lighting Replace standard T8 systems with high performance T8 systems containing high lumen, long life F32T8 lamps (min. >3100 initial lumens, 24,000 hour rated life at 3 hour start) from CEE High Performance T8 qualified product list & either of the following: A low ballast factor electronic ballast (<.78 ballast factor), or approved ballast from the CEE High Performance T8 qualified product list (or equivalent performance standard.) Both ballast & lamp must meet these guidelines to qualify for rebates. To view the CEE High Performance T8 qualified products, go to Actual Equipment Costs per each fixture Actual Date Installed & Operable (mm/dd/yy) Total Requested Rebate HPT8 4 ft 1 lamp $2.00 W W hrs $ - HPT8 4 ft 2 lamp $3.00 W W hrs $ - HPT8 4 ft 3 lamp $5.00 W W hrs $ - HPT8 4 ft 4 lamp $6.00 W W hrs $ - Low Watt HPT8 Lighting Low Watt HPT8 4 ft 1 lamp of 28 W or less & approved ballast bulb $2.00 W W hrs $ - Low Watt HPT8 4 ft 2 lamp of 28 W or less & approved ballast bulb $4.00 W W hrs $ - Low Watt HPT8 4 ft 3 lamp of 28 W or less & approved ballast bulb $5.00 W W hrs $ - Low Watt HPT8 4 ft 4 lamp of 28 W or less & approved ballast bulb $7.00 W W hrs $ - T12 8 ft Fixture Replaced by T8 High Performance Lighting Replace T12 & T12 HO 8' fixtures with High Performance T8 4 ft. lamps & ballasts. Approved lamps & ballasts must be listed on the CEE High Performance T8 qualified product list at Relamp T8 fixtures with low watt T8 lamps 28 W or less T12 8 ft 1 lamp replaced with T8 4 ft High Performance 2 lamp & ballast (same lumen output) T12 8 ft 2 lamp replaced with T8 4 ft High Performance 4 lamp & ballast (same lumen output) T12HO 8 ft 1 lamp replaced with T8 4 ft High Performance 2 lamp & ballast (same lumen output) T12HO 8 ft 2 lamp replaced with T8 4 ft High Performance 4 lamp & ballast (same lumen output) Existing Lamp Wattage (Required) Installed Lamp Wattage (Required) avg or each Estimated Annual Oper Hrs (min hrs.) Replace standard T8 systems with high performance 4' 25W, 28W or 30W T8 U lamps & approved ballast OR relamp existing T8 fixtures with low Watt T8 lamps 28W or less. To view the CEE High Performance T8 qualified products, go to In order to qualify for rebates, ballasts must be from the CEE approved list. NOTE: Low Watt T8 compatibility varies. Consult manufacturer's literature before specifying products. $0.40 W W hrs $ - $5.00 W W hrs $ - $9.00 W W hrs $ - $8.00 W W hrs $ - $16.00 W W hrs $ - Rev. 03/2012 Lighting - 2

4 Compact Fluorescents (CFL) Fixtures Rebate per Fixture Estimated Qty Actual Qty Commercial Rebate Lighting Program Application/Confirmation Actual Equipment Costs per each fixture Actual Date Installed & Operable (mm/dd/yy) Total Requested Rebate CFL - Screw In Bulb Only $2.00 W W hrs $ - CFL - Hardwired Fixture & Bulb $4.00 W W hrs $ - CFL - High Bay 42 W 8 lamp $35.00 W W hrs $ - LED Lights LED Screw-In Bulb $2.00 W W hrs $ - LED Refrigerated Display Light $6.00 W W hrs $ - LED Floodlight $4.00 W W hrs $ - LED Exit Signs (replacement) $7.00 W W hrs $ - Interior < 50W $5.00 W W hrs $ - Interior > = 50W $10.00 W W hrs $ - Exterior < 100W $10.00 W W hrs $ - Exterior > = 100W $30.00 W W hrs $ - Pole Light:Replaced Light > 300W and < 750 W $30.00 W W hrs $ - Pole Light: Replaced Light > = 750W $88.00 W W hrs $ - Metal Halide - Pulse Start 320 W MH PS $12.00 W W hrs $ - Replace W with W $12.00 W W hrs $ - Replace 400w MH with 200w MH or less $24.00 W W hrs $ - Other Efficient Lighting Technologies Tubular Skylight (18" or larger) $ W W hrs $ - Occupancy Sensor ** $0.04 per controlled W W hrs $ - watt **Calculation for Sensor Rebate:.04 cents * total qty installed * installed lamp wattage per romm/area being controlled. Existing Lamp Wattage (Required) Installed Lamp Wattage (Required) Estimated Annual Oper Hrs (min hrs.) Total Rebate: $ 2, Rev. 03/2012 Lighting - 3

5 Commercial Rebate Lighting Program Application/Confirmation Lighting Rebate Eligibility: All fluorescent fixtures must utilize electronic ballast and T8 lamps and T5 lamps. Ballasts must have a power factor greater than 90%. Ballasts, harmonic distortion shall not exceed 20%. For 8 fluorescent ballasts, the total harmonic distortion must not exceed 30%. Lighting circuits must be installed with a neutral wire that has the same size conductor as the line load. All fixtures, lamps and ballasts must be UL-certified and meet all applicable codes and regulations. LED exit signs must use 8 watts or less, including the battery charger, when active. They must meet State Fire Marshal code and be UL-rated. All fixtures must be scheduled to operate a minimum of 1,800 hours annually to be eligible. Rebates for pulse start metal halide fixtures are for 320W pulse start metal halide lamp/ballast combinations. In a retrofit application, the fixture must be hard-wired ballast retrofit or new fixture. Screw in retrofit lamps do not qualify. Pulse start lamp wattage must be lower than existing probe start lamp wattage. Tubular skylight requires at least one light fixture per light tube that must be controlled by a daylight sensor. Eligible T8 and T5 High Bays must have specular/mirror-like reflectors, high-power factor ballasts, fixture efficiency greater than 90%, and the manufacturer spec sheet must indicate that it is a High Bay Fixture. Must replace existing HID fixture to qualify. Low watt T8 lamps should not be used in dimming applications unless the lamp and ballast manufacturers have approved a specific application for dimming or frequent switching. May demonstrate dim light, spiraling, pulsing and other undesirable behavior in cooler temperature rooms and while warming up. System performance varies, based on lamp or ballast components. Please state installed lamp/fixture wattage per each sensor. Rev. 03/2012 Lighting - 4

6 Mark s Lighting 5678 Donahue St. Louisville, KY INVOICE Invoice Number: Invoice Date: 11/10/2012 Customer Information: Billing Address: Shipping Address: Company: John s Foodmart Company: same Name: John Richardson Name: Address: 1234 Sunny Drive Address: City/State/Zip Louisville, KY City/State/Zip Order Information: B A Qty Product Description Amount Each Amount 25 MG4RA632UNIH10CSPF $1, F32T8/850 B LAMPS 1.40 $ MG4RA432UNIH10CSPF $ F32T8/741 A LAMPS 1.40 $ TOTAL: $4, Tax: $0.00 Payments/Credits -$4, BALANCE DUE $0.00

7 PROOF OF PAYMENT

8 A, B Modified Green Hi-Bay T8/T5 Quick Ship Catalog Number Notes Type Application The Modified Green Hi-Bay s superior lumen package is ideal for replacing traditional metal halide high bay systems. Benefits include high efficiency, 95% lumen maintenance, improved color rendering, extended lamp life, instant on, and improved uniformity. Suggested mounting heights from with primary applications including warehousing, commercial facilities, manufacturing facilities, open and stack aisle applications. Description The fixture was designed for optimum performance utilizing either T5 or T8 lamps. A more efficient alternative to 400 watt metal halide lamps. The Modified Green Hi- Bay s heavy duty frame is composed of a 20 gauge steel back bone and end caps that are post painted with a glossy, high reflectance white paint. Sockets include secure positioning rotating collars. Green Hi-Bay T5 and T8 Series Maintenance No tools required for lamp and ballast access. Installation Suspension by chain, cable, or hook with appropriate accessories. SKU s Available Warranty One year warranty against defect in manufacturing. Listing UL/CUL Listed - Suitable for damp locations. Reflector Optics The superior beam spread optic covers from narrow aisle lighting to open area general lighting. The Modified Green Hi-Bay is available using a 92% reflective aluminum (RA). Electrical All ballasts are class P rated, UL/CUL listed, and CEE approved. Our ballasts are also thermally protected, sound rated and tightly secured by mounting bolts. Finish The baked white enamel finish is electrostatically applied and post-painted with a glossy, highly reflective and durable paint. PART # A MG4RA432UNIH10CSPF MG4RA454UNIV10CSPF B MG4RA632UNIH10CSPF MG4RA654UNIV10CSPF MG4RA832UNIH10CSPF MG4RA854UNIV10CSPF TCPYHOOKX10FT TCPYHOOKX20FT Dimensions & Construction top view 48 DESCRIPTION Modified Green Hi Bay 4 32w T8 4-Lamp HBF with 10 cord only and single packed Modified Green Hi Bay 4 54w T5HO 4-Lamp with 10 cord only and single packed Modified Green Hi Bay 4 32w T8 6-Lamp HBF with 10 cord only and single packed Modified Green Hi Bay 4 54w T5HO 6-Lamp with 10 cord only and single packed Modified Green Hi Bay 4 32w T8 8-Lamp HBF with 10 cord only and single packed Modified Green Hi Bay 4 54w T5HO 8-Lamp with 10 cord only and single packed Y-Hook 10 Hanging Kit (optional, order separately) Y-Hook 20 Hanging Kit (optional, order separately) Ballasts operate at lower temperatures resulting in lower heat output Quarter turn locks allow access to the ballasts without the use of tools See back for side views and dimensions. Hurry! While supplies last! TCP, Inc. 325 Campus Dr. Aurora, Ohio P: tcpi.com TCP, Inc. 2011/45875 Computer designed, CNC formed.020 aluminum reflectors Heavy Duty steel housing TCP is proud to have been awarded ENERGY STAR Partner of the Year Quality, cam-lock lampholders

9 Photometric Report Modified Green Hi-Bay T8/T5 Quick Ship MG4RA432UNIH10CSPF Modified Green Hi Bay 4 32w T8 4-Lamp HBF with 10 cord only and single packed Zonal Lumen Summary Zone Lumens % Lamp Total Luminaire Efficiency = 90% % Fixt Photometric Report Plane 0-Deg 90-Deg Spacing Criterion Shielding Angles 1 0 Luminous Length Side View Dimensions 7/16 7-1/2 10 3/4 2-7/16 MG4RA454UNIV10CSPF Modified Green Hi Bay 4 54w T5HO 4-Lamp with 10 cord only and single packed Zonal Lumen Summary Zone Lumens % Lamp Total Luminaire Efficiency = 91% % Fixt Photometric Report Plane 0-Deg 90-Deg Spacing Criterion Shielding Angles 1 0 Luminous Length Side View Dimensions 7/16 MG4RA632UNIH10CSPF Modified Green Hi Bay 4 32w T8 6-Lamp HBF with 10 cord only and single packed 4-1/2 6 7/8 2-9/16 Zonal Lumen Summary Zone Lumens % Lamp Total Luminaire Efficiency = 92% % Fixt Photometric Report Plane 0-Deg 90-Deg Spacing Criterion Shielding Angles 1 0 Luminous Length Side View Dimensions 7/ /2 15 3/4 2-7/16 MG4RA654UNIV10CSPF Modified Green Hi Bay 4 54w T5HO 6-Lamp with 10 cord only and single packed Zonal Lumen Summary Zone Lumens % Lamp Total Luminaire Efficiency = 90% % Fixt TCP, Inc. 325 Campus Dr. Aurora, Ohio P: tcpi.com TCP, Inc. 2011/45875 Photometric Report Plane 0-Deg 90-Deg Spacing Criterion Shielding Angles 1 0 Luminous Length Side View Dimensions 7/16 7-1/2 9 7/8 2-9/16 Photometric Data by Independent Testing Lab. ITL Boulder. TCP is proud to have been awarded ENERGY STAR Partner of the Year 2010.

10 B T8 LAMPS Lamp Specifications F32T8/850 TCP Item Number: Lamp code: F32T8/850 D B C Cathode Guarded Average Rated Life (hours) 3 hours per start ,000 TCLP Compliant Yes Low Mercury Yes Physical Characteristics Lamp type T8 Base type BiPin (G13) Lamp Material Soda Lime Phosphor Tri-Phosphor Lamp Diameter (inches) Nominal (D) Maximum (D) Minimum (D) Overall Length (inches) Nominal (C) Maximum (C) Minimum (C) Face to End of opposing pin (inches) Maximum (B) Minimum (B) Photometric Characteristics Normalized Spectral Power - W/ nm per 1000 lm % Initial Light Output Spectral Power Distribution WAVELENGTH (nm) Lamp Lumen Maintenance % Rated Life Initial Lumens Mean Lumens (40% of rated life) Correlated Color Temperature (Kelvin) Color Rendering Index (CRI) Normal Efficacy (Lumens/Watts) Electrical Characteristics Lamp Watts Nominal Lamp Volts Nominal Lamp Operating Frequency (Hz) Hz Min. Starting Lamp Voltage at 10?C Min. Cathode Resistance (Rh/Rc) Max. Cathode Resistance (Rh/Rc) MONTH STANDARD WARRANTY PERCENT SURVIVING Typical Lamp Mortality PERCENT RATED LIFE TCP, Inc. 325 Campus Drive Aurora, Ohio P: F: TCP, Inc. 2007/01848

11 A T8 LAMPS Lamp Specifications F32T8/741 TCP Item Number: Lamp code: F32T8/741 D B C Cathode Guarded Average Rated Life (hours) 3 hours per start ,000 TCLP Compliant Yes Low Mercury Yes Physical Characteristics Lamp type T8 Base type BiPin (G13) Lamp Material Soda Lime Phosphor Tri-Phosphor Lamp Diameter (inches) Nominal (D) Maximum (D) Minimum (D) Overall Length (inches) Nominal (C) Maximum (C) Minimum (C) Face to End of opposing pin (inches) Maximum (B) Minimum (B) Photometric Characteristics Normalized Spectral Power - W/ nm per 1000 lm % Initial Light Output Spectral Power Distribution WAVELENGTH (nm) Lamp Lumen Maintenance % Rated Life Initial Lumens Mean Lumens (40% of rated life) Correlated Color Temperature (Kelvin) Color Rendering Index (CRI) Normal Efficacy (Lumens/Watts) Electrical Characteristics Lamp Watts Nominal Lamp Volts Nominal Lamp Operating Frequency (Hz) Hz Min. Starting Lamp Voltage at 10?C Min. Cathode Resistance (Rh/Rc) Max. Cathode Resistance (Rh/Rc) PERCENT SURVIVING Typical Lamp Mortality PERCENT RATED LIFE 24 MONTH STANDARD WARRANTY TCP, Inc. 325 Campus Drive Aurora, Ohio P: F: TCP, Inc. 2007/01831

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