Rhode Island Rhode Island Residential Heating Program from National Grid Save money, improve comfort and ensure a cleaner environment with energy savings offers for residential customers. For Natural Gas Heating Customers: High-Efficiency Heating Equipment High-Efficiency Water Heaters Programmable Thermostats Weather-Sensitive Outdoor Boiler Reset Controls For Electric Customers Heating with Oil or Propane: High-Efficiency Oil or Propane Heating Systems 1.800.292.2032 www.nationalgrid.com Use this form to apply for any of the equipment rebates listed below. Follow these steps to receive a rebate for the equipment listed on this page: 1) Consult a licensed contractor to determine what equipment will be installed and that the new equipment will qualify for the listed rebates. 2) National Grid requires rebate funding be reserved prior to equipment installation. To confirm funds are available and to make your reservation, please visit www.smartenergy-zone.com/nationalgrid. Rebate funding is reserved for 60 days from the date of the reservation. Receive confirmation on your reservation via a web submission ID. Once your new high-efficiency equipment is installed, review, complete and return this rebate application within 60 days of rebate reservation with a dated contractor invoice. Please make sure your invoice includes: a) The type of equipment installed with the complete equipment manufacturer and model number(s) b) AFUE for heating equipment, Energy Factor or Thermal Efficiency for water heating equipment c) Contractor’s name and address d) Contractor’s license number If you opt to self-install a thermostat, please include your store receipt and the original UPC code from the product package. 3) 4) Mail application and documentation to: National Grid High-Efficiency Residential Equipment Rebate (RI) • Offer # H243804 • PO Box 130013 • El Paso, TX 88513-0013 Please call 1-800-292-2032, e-mail ngridinfo@smartenergy-zone.com or visit www1.nationalgridus.com/ EnergyEfficiencyPrograms if you have any questions. You may track the status of your rebate by visiting www.smartenergy-zone.com/nationalgrid. 2012 Residential Energy Efficiency Rebates for Rhode Island Customers PRODUCT REBATE REPLACEMENT THERMOSTATS 7-day programmable thermostats $18.75/ea. Limit of two thermostats per account. May be self-installed or contractor installed. Rebate cannot exceed purchase price. Must submit a dated receipt and original UPC code from the package. Wi-Fi Enabled thermostat 50% of cost up to $100 (equipment cost only) Limit of two thermostats per account. May be self-installed or contractor installed. Rebate cannot exceed purchase price. Must submit a dated receipt and original UPC code from the package. AFTER MARKET OUTDOOR BOILER RESET CONTROLS — for gas heating customers Add on unit attached to a natural gas forced hot water boiler $150 HIGH-EFFICIENCY NATURAL GAS WARM AIR FURNACE — for gas heating customers AFUE* Rating 96% or greater with Electronic Commutated Motor or listed on www.cee1.org/gas/gs-ht/gs-ht-main.php3 as electrically efficient. Click on qualifying furnaces at that site. $450 AFUE* Rating 95% or greater with Electronic Commutated Motor or listed on www.cee1.org/gas/gs-ht/gs-ht-main.php3 as electrically efficient. Click on qualifying furnaces at that site. $300 HIGH-EFFICIENCY NATURAL GAS BOILER — for gas heating customers Hot water boiler with an AFUE* Rating of 96% or greater Hot water boiler with an AFUE* Rating of 90% or greater $1,125 $750 HEAT RECOVERY VENTILATOR — for gas heating customers A factory-assembled, packaged unit including fans or blowers that transfer heat between two isolated air streams. Must be a natural gas heating customer; excludes portable unit $375 GFN 2012 Residential Energy Efficiency Rebates for Rhode Island Customers cont. PRODUCT REBATE HIGH-EFFICIENCY WATER HEATERS — for gas water heating customers On-demand tankless water heater with an Energy Factor of .95 or higher and electronic ignition $600 Condensing gas water heater with 95% Thermal Efficiency or greater $500 On-demand tankless water heater with an Energy Factor of .82 or higher and electronic ignition $375 Indirect water heater connected to a natural gas forced hot water boiler $300 Tank type gas hot water heater with an Energy Factor of .67 or greater $75 COMBINED HIGH-EFFICIENCY NATURAL GAS BOILER AND WATER HEATING UNIT — for gas heating customers Combined condensing boiler and on-demand water heating unit with an AFUE* Rating of 90% or greater; must be considered one unit by manufacturer $1,200 OIL OR PROPANE HEATING EQUIPMENT — for electric customers heating with oil or propane Forced hot air furnace with Electronic Commutated Motor and AFUE* Rating of 92% or greater $400 Forced hot air furnace with Electronic Commutated Motor and AFUE* Rating of 85% or greater $200 Forced hot water boiler with AFUE* Rating of 85% or greater $200 Steam boiler with AFUE* Rating of 82% or greater $200 HIGH-EFFICIENCY ELECTRIC WATER HEATERS — for electric customers Heat Pump Water Heater** $1,000 * AFUE = Annual Fuel Utilization Efficiency ** Eligible for rebate only when replacing an existing electric hot water heater or installed in a new home, go to www1.nationalgridus.com/EnergyEfficiencyPrograms for more information. Requirements include: >= 2.3 Energy Factor, 50 - 80 gallons, and ten year warranty. Rhode Island Residential Heating Program Please review terms and conditions. Form must be completed entirely. If eligible, you are entitled to only one rebate per category listed in bold below. You are not entitled to an additional GasNetworks rebate. CUSTOMER INFORMATION (all information required) Account Holder’s Name: ________________________________________________________________________________________ — National Grid Electric Account Number: — National Grid Gas Account Number: Rebate Reservation Number (Web Submission ID Number): Installation Address: _______________________________________City: _____________________State:_____ Zip: _____________ (where equipment was installed) Mailing Address: __________________________________________City: _____________________State:_____ Zip: _____________ (If different from installation address listed above) Name of person to whom rebate should be made payable:________________________________Phone: ____________________ E-mail:_________________________________________________________________________________________________________ (Customers will receive status updates via e-mail.) CONTRACTOR INFORMATION (all information required) Heating Contractor Name: __________________________________________ Contact Person: _____________________________ Gas Permit Number: __________________________Gas Fitter/Plumber License Number: __________________________________ (For High-Efficiency Heating/Water Heating Equipment Rebate) Street: ____________________________________ City: ______________________ State: __________ Zip: ____________________ Business Phone: ____________________________________________________ Is technician NATE certified? r Yes (not required for rebate eligibility) r No REBATES FOR GAS HEATING CUSTOMERS HIGH-EFFICIENCY NATURAL GAS FURNACE REBATE ENERGY EFFICIENCY MEASURE (Information required if this equipment is installed) MODEL NUMBER MANUFACTURER AFUE INSTALLED DATE REBATE AMOUNT Natural Gas Furnace with Electronic Commutated Motor > 96% AFUE $450 Natural Gas Furnace with Electronic Commutated Motor > 95% AFUE $300 Prior Unit’s Fuel Type: ❐ Gas ❐ Oil ❐ Electric ❐ Propane ❐ New Construction ANTICIPATED REBATE AMOUNT TOTAL REBATE HIGH-EFFICIENCY NATURAL GAS BOILER AND COMBINED BOILER/WATER HEATING UNIT REBATE (Information required if this equipment is installed) ENERGY EFFICIENCY MEASURE MANUFACTURER MODEL NUMBER AFUE INSTALLED DATE REBATE AMOUNT Natural Gas Hot Water Boiler > 96% AFUE $1,125 Natural Gas Hot Water Boiler > 90% AFUE $750 Combined Condensing Boiler with On-Demand Water Heater > 90% AFUE Prior Unit’s Fuel Type: EE4587 (3/12) RI ❐ Gas ANTICIPATED REBATE AMOUNT $1,200 ❐ Oil ❐ Electric ❐ Propane ❐ New Construction TOTAL INCENTIVE GFN Rhode Island Residential Heating Program cont. Please review terms and conditions. Form must be completed entirely. HIGH-EFFICENCY NATURAL GAS WATER HEATER REBATE ENERGY EFFICIENCY MEASURE MANUFACTURER MODEL NUMBER (Information required if this equipment is installed) ENERGY FACTOR OR THERMAL EFFICIENCY INSTALLED COST REBATE AMOUNT INSTALLED DATE On-Demand Tankless Water Heater > .95 Energy Factor with Electronic Ignition $600 On-Demand Tankless Water Heater > .82 Energy Factor with Electronic Ignition $375 Condensing Gas Water Heater > 95% Thermal Efficiency $500 Indirect Water Heater $300 High-Efficiency Storage Water Heater > .67 Energy Factor $75 Prior Unit’s Fuel Type: ❐ Gas ❐ Oil ❐ Electric HEAT RECOVERY VENTILATOR REBATE ENERGY EFFICIENCY MEASURE MANUFACTURER ❐ Propane ❐ New Construction TOTAL REBATE (Information required if this equipment is installed) MODEL NUMBER QUANTITY INSTALLED DATE REBATE AMOUNT ANTICIPATED REBATE AMOUNT $375 Heat Recovery Ventilator TOTAL REBATE Installed By (Contractor’s Name):__________________________________________________ AFTER-MARKET BOILER RESET CONTROL REBATE ENERGY EFFICIENCY MEASURE MANUFACTURER (Information required if this equipment is installed) MODEL NUMBER INSTALLED DATE PURCHASE PRICE QUANTITY After Market Boiler Reset Control REBATE AMOUNT ANTICIPATED REBATE AMOUNT $150 Installed By (Contractor’s Name):__________________________________________________ THERMOSTAT REBATE ANTICIPATED REBATE AMOUNT TOTAL REBATE (Information required if this equipment is installed) ENERGY EFFICIENCY MEASURE MANUFACTURER MODEL NUMBER INSTALLED PURCHASE QUANTITY DATE PRICE 7-Day Programmable Thermostat Limit two thermostats per account. Rebate not to exceed the purchase price. Wi-Fi Enabled Thermostat Limit two thermostats per account. Wi-Fi connections must be enabled. Please submit store receipt (if self-installed) and UPC code from thermostat package. Installation of Thermostat: ❐ Self-installed ❐ Contractor-installed, installed by (Contractor’s Name):__________________________________ REBATE AMOUNT ANTICIPATED REBATE AMOUNT $18.75/each 50% of equipment cost up to $100/unit TOTAL REBATE GFN Rhode Island Residential Heating Program cont. Please review terms and conditions. Form must be completed entirely. REBATES FOR CUSTOMERS HEATING WITH OIL OR PROPANE OIL/PROPANE HEATING SYSTEM REBATE ENERGY EFFICIENCY MEASURE (Information required if this equipment is installed) MODEL NUMBER MANUFACTURER AFUE INSTALLED COST INSTALLED DATE REBATE AMOUNT Forced Hot Air Furnace with Electronic Commutated Motor > 92% AFUE $400 Forced Hot Air Furnace with Electronic Commutated Motor > 85% AFUE $200 Forced Hot Water Boiler > 85% AFUE $200 Steam Boiler > 82% AFUE $200 ANTICIPATED REBATE AMOUNT TOTAL REBATE REBATES FOR ELECTRIC WATER HEATING CUSTOMERS ELECTRIC WATER HEATER REBATE ENERGY EFFICIENCY MEASURE MANUFACTURER MODEL NUMBER ENERGY FACTOR QUANTITY Heat Pump Water Heater > 2.3 Energy Factor REBATE AMOUNT ANTICIPATED REBATE AMOUNT $1,000 Requirements: 50 - 80 gallons and ten year warranty Eligible for rebate only when replacing an existing electric water heater or installed in a new home. Where did you hear about this program? INSTALLED PURCHASE PRICE DATE TOTAL REBATE r Sales Rep/Account Executive r Heating Contractor r Energy Auditor r Equipment Supplier r Trade Show r Print Advertising r Internet r Radio/TV r Direct Mail r E-Mail r Other _____________________________ Work Completion and Rebate Validation. I hereby affirm the Energy Efficiency Equipment has been installed by a licensed contractor. I acknowledge that all work is subject to on-site work verification and inspection as may be required by state and local law and by National Grid. I am aware of and agree to the Terms & Conditions stated on the last page of this application and am attaching copies of (1) itemized proof of purchase for programmable thermostats and (2) contractor invoices for the installation of all other high-efficiency equipment. Customer Signature: ____________________________________________________ Date: ________________________________ Qualifying equipment installed between 1/1/12 and 12/31/12 is eligible. Rebate form and required documentation must be postmarked within 60 days of the rebate reservation date, but no later than 1/31/2013. One account number per form. Some restrictions may apply. Rebate offers are subject to change or cancellation without notice. For rebates for natural gas heating customers, projects greater than ten (10) units of equipment require pre-approval. Pre-approval can be obtained by contacting ngridinfo@smartenergy-zone.com. EE4587 (3/12) RI GFN National Grid Rhode Island Residential Heating Program Terms & Conditions 1. Rebates - Subject to these Terms and Conditions, this program is offered by Narragansett Electric d/b/a National Grid (“the Company” or “National Grid”). The Company, through its contractual Vendor, Helgeson Enterprises, will pay rebates to eligible customers in the Company’s Service Territory, for the purchase and installation of the equipment/products described in this literature and within this application. 2. Customer Eligibility - Equipment installed from 1/1/12 to 12/31/12 is eligible. It must have been installed at the installation address listed on this application and the required documentation must be postmarked within 60 days of the rebate reservation date, but no later than 1/31/2013. Must be a National Grid residential gas heating customer to be eligible for the high-efficiency natural gas heating, programmable thermostat and outdoor boiler reset control rebates specified in this form. Must be a National Grid residential gas or residential electric customer to qualify for the high-efficiency water heating rebates specified in this form. Must be a National Grid residential electric customer heating with oil or propane to qualify for the oil/propane heating rebates specified in this form. Some restrictions may apply. Rebate offers are subject to change or cancellation without notice. Check www.powerofaction.com/efficiency frequently for program updates. 3. Post-Installation Work Verification - The Company reserves the right to perform a verification of the specified installation; this right to access extends up to one year after date of application, even if rebates have been paid. If the Company and/or Vendor determines that the equipment was not installed in a manner that is consistent with program guidelines, the Company and/or Vendor may require that the installation be modified before making any rebate payments. The cost of such modifications is the responsibility of the customer. I hereby authorize the Company to release my energy use information to Energy Efficiency Program Sponsors (EEPS) and System Benefit Charge (SBC) program administrators and/or their designee. I understand that such information will be kept confidential and used only for the purpose of determining program eligibility and energy savings. 4. Installation Requirements - All installations must be completed in conformance with state and local code requirements and by properly licensed contractors. 5. Proof of Proper Installation - As part of his/her application, the Customer is required to submit dated copies of all paid invoices documenting the installation (including all materials, labor and equipment invoices) which reflect the actual cost of purchasing and installing the equipment. 6. Indemnification - Customer shall defend, indemnify and hold harmless the Company and its officers, directors, employees, agents, servants and assigns from and against any and all losses, claims, demands and/or liability for damage to property, injury or death of any person, or any other liability incurred by the Company, including all expenses, legal or otherwise, arising out of or related to the equipment or installation, except to the extent attributable to the negligence of Company. In no event shall Company’s liability to Customer exceed the rebate amounts. 7. Limited Scope Review - The scope of review by the Company, Vendor and their Inspector of the installation of the equipment is limited solely to determine whether rebates are payable. It does not include any kind of safety or code review and should not be relied upon as one. 8. Rebate Amounts - The Company will provide rebates for approved equipment, up to rebate amount indicated in the program literature and within this application. 9. Pre-Approval - For rebates for natural gas heating customers (high-efficiency natural gas heating or water heating equipment, boiler reset controls and/or programmable thermostats), projects greater than ten (10) units of equipment require pre-approval from the Company. Pre-approval can be obtained by contacting ngridinfo@smartenergy-zone.com. 10. Payment - The Company, through the Vendor, expects to make rebate payments to eligible customers within 45 days of a satisfactory work verification. Payment processing may take longer if information or documentation are missing from the application. The customer must refund any rebate made to the extent the contractor or equipment does not satisfy program requirements. The Company reserves the right to change or terminate rebate offers without notice. 11. No Warranties - The Company and the Vendor do not endorse, guarantee or warrant any particular contractor, manufacturer or product installation. The Company and the Vendor do not make any representation of any kind regarding the results to be achieved by the equipment or the adequacy or safety of such equipment. 12. Changes in the Program - Equipment Incentive Program/Tax Liability Conditions and details of the Incentive Program are subject to change without prior notice and rebate offers may increase or decrease over time. The Company reserves the right to modify or terminate the Incentive Program without notice. Participants of the program may be subject to tax liability for the value of goods and services received through the program pursuant to state or federal income tax codes. The Company is not responsible for any tax liability which may be imposed as a result of receipt of the rebate by the Customer. 13. Contractor Insurance - The Company is not responsible for any damage that may be caused by or arise out of an installation of any equipment. The customer is responsible for selecting contractors who are qualified and carry adequate insurance coverage.
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