HEATING AND COOLING EQUIPMENT 2017 SOUTH DAKOTA NONRESIDENTIAL PROGRAM AND APPLICATION MidAmerican Energy Company s EnergyAdvantage Heating and Cooling program offers financial incentives to all nonresidential customers in South Dakota who purchase electricity and/or natural gas from MidAmerican Energy. MidAmerican Energy offers rebates to reduce your out-of-pocket s. Your installation of new energy-efficient equipment saves you money over the life of your equipment on monthly energy bills and makes your business environment more comfortable. Instructions: Complete the application in full and return it to MidAmerican Energy along with product specifications, dated itemized invoices and installation date(s). Incomplete information will delay rebate processing. Equipment must be purchased between Jan. 1, 2017, and Dec. 31, 2017. Equipment must be installed and operating prior to submission of final rebate application. s cannot exceed 70 percent of the installed (materials and reasonable labor). You will receive the lesser of the rebate amount listed or 70 percent of installed. Installed includes contractor labor only and does not include internal labor. application must be submitted within six months of dealer invoice for the equipment/material purchased. The rebate will be based on the rebate schedule in effect on the date of dealer invoice for the equipment/material purchased. applications received after six months of dealer invoice are not eligible for rebates. Custom Equipment: If specific equipment you intend to purchase and install is not listed, it may qualify under the Nonresidential Custom Systems program. However, Custom projects must be preapproved by MidAmerican Energy prior to purchase and installation of equipment or system. See the Nonresidential Custom Systems application for details. SECTION 1 (REQUIRED) Name on account Customer Information Self-installed q Yes q No Installation address City State ZIP Phone MidAmerican Energy Company account number (found on bill; first seven digits only) Mailing address (if different than installation address) City State ZIP Contact name Title Email address This email address only will be used for communication regarding this rebate application. Your email address will never be shared and you can unsubscribe at anytime. SECTION 2 (REQUIRED) My facility had an energy assessment in the following program (check if applicable): q Small Commercial Assessment: Date assessment completed / (month/year) q No assessment has been completed Building size [sq. ft. (area)] Year building was constructed Do you: q Own q Rent this building The new equipment is for: Is space where equipment will be installed conditioned? If space is heated, what fuel type is used? q Replacement of existing equipment (check one) (check one) q New installation (new to facility) q Cooled only q Natural gas q New construction q Heated only q Electric q Not cooled or heated q Other q Both heated and cooled q Other Questions about the forms or need assistance with the forms? Call our energy efficiency representatives at 800-894-9599. Page 1 of 6
SECTION 2 CONT. (REQUIRED) Equipment installed in what type of facility? (check one) Industrial MEC Use Only Commercial MEC Use Only q Apparel manufacturing q Apartment, halfway house q Chemical manufacturing q Condo q Computer/electronic product manufacturing q Convenience store/gasoline station CN q Electrical equipment, appliance/component manufacturing q Dealership RS q Food/beverage/tobacco product manufacturing q Financial institution OF q Furniture and related product manufacturing q Grocery store and supermarket GR q Large refrigerated warehouse q Healthcare (outpatient) HC q Leather and allied product manufacturing q Healthcare (inpatient) HS q Machinery manufacturing q Health club/exercise facility FC q Nonmetallic mineral product manufacturing q Library ED q Oil and gas extraction; mining q Lodging - hotel HO q Paper manufacturing; printing and related support activities q Lodging - motel MO q Personal and laundry services q Mixed use O q Petroleum and coal products manufacturing q Office small OS q Plastics and rubber products manufacturing q Office - government - small OS q Primary metal/fabricated metal product manufacturing q Office public order and safety small OS q Textile mill and textile product mill q Office large OL q Transportation equipment manufacturing q Office government - large OL q Utility q Office - public order and safety - large OL q Warehouse and storage WH q Pharmacy and drug store RT q Warehouse - large refrigerated q Public assembly HY q Wood product manufacturing q Religious worship/church RL q Miscellaneous manufacturing q Restaurant - fast food RSF q Other O q Restaurant full service RSS q Retail - small RS Agriculture MEC Use Only q Retail - large RL q Corn farming AG q Retail department store RL q Dairy cattle and milk production DF q Retirement home, nursing home, assisted living q Hog facility HF q School - elementary SE q Soybean farming AG q School - jr. high SJH q All other animal production AF q School - high school SJH q All other miscellaneous crop farming AG q School - college, university and professional school ED q School - lodging (school/dorm) q Service RS q Truck stop CV Page 2 of 6
SECTION 3 Complete all fields for each piece of equipment purchased and installed New Equipment Information: Identify each individual piece of equipment; use additional sheets if necessary. MidAmerican Energy will verify unit efficiencies as listed in the current and applicable Air Conditioning, Heating and Refrigeration Institute Directory or ENERGY STAR list. View the AHRI directory at www.ahridirectory.org. Equipment installed as replacement units, retrofits or in new construction is eligible. ENERGY STAR Room Air Conditioners Unit 1 $40 Install date CEER Total calculation Capacity (Btuh) Equipment Unit 2 $40 Install date CEER Total calculation Capacity (Btuh) Equipment Central Air Conditioners s cannot exceed 70 percent of the installed (materials and reasonable labor). You will receive the lesser of the rebate amount or 70 percent of installed. Unit 1 Size category Qualifying Efficiency (per unit installed) Outdoor unit manufacturer Indoor unit manufacturer 14-14.9 SEER $150 per ton Outdoor unit model number Indoor unit model number Small < 65 MBtuh 15-15.9 SEER $225 per ton 16 + SEER $300 per ton 11.2-11.9 EER $20 per ton Outdoor unit serial number Indoor unit serial number Large > 65 MBtuh 12-12.9 EER $40 per ton 13 + EER $60 per ton Install date AHRI reference number Total rebate Total calculation $ Equipment Unit 2 Size category Qualifying Efficiency (per unit installed) Outdoor unit manufacturer Indoor unit manufacturer 14-14.9 SEER $150 per ton Outdoor unit model number Indoor unit model number Small < 65 MBtuh 15-15.9 SEER $225 per ton 16 + SEER $300 per ton 11.2-11.9 EER $20 per ton Outdoor unit serial number Indoor unit serial number Large > 65 MBtuh 12-12.9 EER $40 per ton 13 + EER $60 per ton Install date AHRI reference number Total rebate Total calculation $ Equipment 12,000 Btu=1 ton cooling capacity Page 3 of 6
HEATING - Natural Gas Boilers AHRI Certified s cannot exceed 70 percent of the installed (materials and reasonable labor). You will receive the lesser of the rebate amount or 70 percent of installed. Qualifying Efficiency Capacity of Equipment (check one) (per new equipment) New Unit in MBtuh Total q 0.85-0.899 AFUE $3.00 x = Natural gas boiler < 300 MBtuh q 0.900-0.949 AFUE $5.00 x = q 0.95 AFUE and above $7.00 x = With preapproval before purchase or installation, boilers 300 MBtu may qualify under Nonresidential Equipment Custom Systems. AHRI reference number Install date AFUE Total calculation HEATING - Natural Gas Furnace AHRI Certified s cannot exceed 70 percent of the installed (materials and reasonable labor). You will receive the lesser of the rebate amount or 70 percent of installed. Qualifying Efficiency Capacity of Equipment (check one) (per new equipment) New Unit in MBtuh Total q 0.92-0.939 AFUE $5.00 x = Natural gas Furnace < 250 MBtuh q 0.94-0.959 AFUE $7.50 x = q 0.96 AFUE and above $10.00 x = AHRI reference number Install date AFUE Total calculation : $15 Natural Gas Storage Water Heater - AHRI Certified AHRI reference number - AHRI reference sheet required Qualifying Efficiency: 0.65 EF Size Category: > 30 gallons Water heater capacity (gallons) Energy factor Total calculation Invoice date Installed date For more details, view the AHRI directory at www.ahridirectory.org. Page 4 of 6
Programmable Thermostat (For gas heat/electric cooling or gas heat only. MidAmerican Energy must provide energy source controlled by the programmable thermostat for which the rebate is being paid.) Unit 1 Number of Units Total Installed Install date X $25 = Programmable thermostat controls (select all that apply): q Furnace q Boiler qcentral air conditioner qheat pump Total calculation Unit 2 Number of Units Total Installed Install date X $25 = Programmable thermostat controls (select all that apply): q Furnace q Boiler qcentral air conditioner qheat pump Total calculation Terms and Conditions Participants must be nonresidential customers (commercial or industrial) with facilities located in MidAmerican Energy Company s South Dakota service territory. MidAmerican Energy Company must directly provide the primary electricity or natural gas to the equipment at the facility for which the rebate is being paid. Transportation gas customers with daily metering are ineligible for natural gas incentives. However, customers with monthly metering under the Monthly Metered Transportation Service natural gas tariff are eligible for energy efficiency incentives. Qualifying equipment must be new, installed on the premises and must not be purchased for resale. Participants are responsible for ensuring that the equipment installed for this program meets all applicable codes, standards and regulatory requirements. Equipment must be installed and operating prior to submission of final rebate application. Installations must meet the standards referenced in the individual program guidelines. s will be based on the rebate schedule in effect on the invoice date. checks will be issued to the building owner or account holder. s may be subject to income tax. Consult your tax advisor for more information. s for all South Dakota energy efficiency programs are issued on a first come, first served basis. s may not be available if 2017 program funding is depleted prior to the end of the year. Itemized and dated invoices from the contractor must accompany equipment applications. Specification sheets also are required for all equipment. Applications must be completed in full; incomplete applications will delay processing and may be returned. Applications for equipment must include the equipment manufacturer s name, model/serial number, efficiency rating and the quantity of high-efficiency equipment installed. All project installations with rebates exceeding $20,000 will be reviewed for on-site verification of installation by MidAmerican Energy Company or its agent prior to issuance of rebate. Allow 4-6 weeks for rebate processing. MidAmerican Energy Company reserves the right to conduct onsite verification of equipment installation, install metering devices on new equipment, and to verify sales receipts and other project documentation at any time before or after issuing a rebate. MidAmerican Energy Company does not endorse any particular manufacturer, product or system design in promoting this incentive program. Listing a product does not constitute an endorsement, nor does it imply that unlisted products are defective in any way. This program is effective Jan.1, 2017, through Dec. 31, 2017, and is subject to periodic review by MidAmerican Energy Company, and MidAmerican Energy Company reserves the right to modify or end these programs at any time. Disclaimer MidAmerican Energy Company does not guarantee that installation and operation of energy-efficient equipment will result in reduced usage or in savings. The manner in which a customer uses and maintains energy-efficient equipment affects potential savings. MidAmerican Energy Company makes no warranties, expressed or implied, with respect to any equipment purchased or installed, including, but not limited to, any warranty of merchantability or fitness for a particular purpose. In no event shall MidAmerican Energy Company be held liable for any incidental or consequential damages or injuries resulting from defective equipment or installation. MidAmerican Energy Company reserves the right to cancel or change these programs at any time. REMEMBER TO SIGN THE NEXT PAGE Page 5 of 6
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 equipment installed at the indicated location. I understand that MidAmerican Energy Company reserves the right to inspect and verify installation before issuing payment. Customer signature Date Dealer name Installer/Dealer Information Phone Address Fax City State ZIP Contact name Email address Installer/Dealer Agreement I certify that all equipment and installation information provided on this application is correct and accurate. Installer/dealer signature Date Before you submit your form: o Fill out this form completely. o Attach a copy of the itemized sales receipt or invoice. o Include documentation listed in the instructions. o Sign the Customer Agreement section. Send completed forms to: Mail: MidAmerican Energy Company P.O. Box 4628 Des Moines, IA 50305-4628 Fax: 515-244-8825 Email: rebateapplications@midamerican.com For more information call 800-894-9599 or go to www.midamericanenergy.com/ee. Page 6 of 6