2015 Rebate Application for Commercial & Large Multifamily Fluorescent Lighting & Occupancy Sensors

Step #2) Complete Customer & Facility Information

Property Owner or Account Holder (Check will be payable to this name):

Installation Address:

Contact Person: Phone:

Mailing Address (if different): City/State:

Contact Email: Mailing Zip:

Website: Fax No:

Facility InformationConvenience/Grocery/Restaurant Church/Warehouse Industrial/Manufacturing

Multifamily (4+ Units)/Lodging Education/Office/Retail Agriculture/Farm Building

Approx. year built: Building Sq. Ft. Owner-occupied Rental Property

Step #3) Complete Project & Dealer Information Replacement/Retrofit (existing) New Construction New Installation

Dealer Installed Customer Installed

Installing Dealer Information

Dealer/Company:

Mailing Address: City/State:

Contact Person: Mailing Zip:

Phone: Contact Email:

Dealer Agreement

I certify that all equipment and installation information provided on this application is correct and accurate.

Installer/Dealer Signature: Date:

Step #4) Read Terms & Conditions and Sign ReleaseThe undersigned agrees that the stated energy efficiency measure(s) was (were) installed and in operation at the job site address listed above as part of the CFU Program and that the information contained in this application is accurate and complete. I have read and agree to the Terms & Conditions within this application. The undersigned agrees to indemnify, defend, and hold harmless and release CFU from any claims, damages, liabilities, costs and expenses (including reasonable attorneys' fees) arising from or relating to the removal, disposal, installation or operation of any equipment or related materials in connection with the programs described in this application, including any incidental, special or consequential damages.

Customer Signature: Date:

Page 1 of 4 (2015)

Step #1) Contact CFU if pre-approval is needed.

Does rebate exceed $5,000?

No. Go to Step 2.

Yes. Contact CFU at 319-268-5355.

Is the project or technology listed in the "Custom Rebate" table on p. 4?

No. Go to Step 2.

Yes. Contact CFU at 319-268-5355.

CFU 2015 FLUORESCENT LIGHTING & OCCUPANCY SENSOR REBATES TERMS & CONDITIONS: n Applicant must be a current Cedar Falls Utilities (CFU) customer and CFU must supply electricity to the equipment for which the cash rebate is being paid. This program is intended for multifamily units with more than 4 units per building & nonresidential facilities. Payments will be made to property owners or account holders, not to builders, energy service companies, or contractors. n Incentives are available on a first-come, first-served basis. CFU may modify or end any cash rebate program at any time without notice. Neither pre-approval of a project, nor any other action by CFU, entitles applicant to a rebate payment until and unless this application is approved by CFU. The most current rules of this program are on the application forms posted at www.cfu.net. To evaluate your application, CFU will use the rules listed on the application form that was posted on the day CFU receives your application. n Purchase and installation must be completed between January 1, 2015 and January 31, 2015. Equipment or improvements must be installed and operating on the premises before you apply for a rebate. Submit your application no later than March 31, 2016. Allow two to eight weeks for application review and funding of approved rebates. Incomplete applications may be delayed or rejected. CFU reserves the right to award rebates in the form of utility bill credits or directly mailed checks. In no event will the rebate award from CFU exceed 50% of the total eligible, reasonable project costs or reduce the simple payback of a project to less than 12 months. Reasonableness determined by CFU. n CFU reserves the right to inspect and verify the installation through an on-site inspection; ask you to complete a customer survey; and/or meter the specified equipment or process, at no cost to the customer, in order to determine the actual energy saved for up to 12 months after the installation. CFU may publicize your participation in this program unless you request otherwise in writing. Rebate application information may be shared with state agencies or departments. Projects must comply with all applicable federal, state, and local codes, standards, and regulatory requirements. Limit one rebate payment per piece of qualifying equipment or project expense. All equipment must be new; used or rebuilt equipment is not eligible. Existing equipment must be removed and may not be resold. n Cedar Falls Utilities: 1) does not endorse any provider, manufacturer, product, labor or system design by offering this program; 2) is not responsible for any tax liability arising from customer's receipt of a rebate payment; 3) does not expressly or implicitly warrant the performance of installed equipment or contractor's quality of work (contact your contractor or vendor for warranty information); 4) is not responsible for the proper disposal/recycling of any waste generated by this project; 5) is not liable for any incidental or consequential damages caused by the installation of the equipment or for any damage caused by the malfunction of the installed equipment; 6) does not guarantee that a specific level of energy or cost savings will result from the implementation of energy efficiency measures or the use of products funded under this program. n All projects exceeding $10,000 in CFU Commercial/Multifamily Lighting Rebates will qualify for CFU's Custom Program and specified incentives instead of the CFU Commercial/Large Multifamily Lighting Rebates prescriptive program. n DIRECTIONS: For each project, submit a completed and signed rebate application with invoices and documentation as described below to either energyservices@cfu.net or Cedar Falls Utilities, Attn: Energy Services, P.O. Box 769, Cedar Falls, IA 50613. Steps: 1) Apply for the correct program: if rebate amount exceeds $5,000 or the project uses technologies listed in the "Custom Rebates" table on page 4, then contact CFU for pre-approval before submitting this application. 2) Complete application after project completion and attach supporting documentation: You must provide an invoice for each type of lighting fixture, lamp, or occupancy sensor purchased. Each invoice must show: n Date of purchase n Vendor name & address n Customer name & address n Total Amount Due n Itemized quantity and pre-tax purchase price of each type of fixture, lamp, or sensor purchased n If invoice is from a vendor to a contractor: invoice must show the customer name or installation address. 3) Comply with additional requirements. For Linear Fluorescent or High Bay Fluorescent Lighting Projects: You must provide an invoice or receipt documenting proof of disposal of old HID or fluorescent tube lighting. Each receipt or invoice must show: n Customer (your company) name & address n Date of Transaction n Name of landfill, contractor, or waste management provider n Types & amounts of lighting products recycled

Page 2 of 4 (2015)

Additional Comment Regarding Disposal for HID and Fluorescent Fixtures As of July 1, 2010, CFU requires that all old lighting replaced through its Commercial Lighting and Custom Incentives programs is properly recycled, and is not used at another location or sold to another party. This policy applies to all old fluorescent tubes (including low-mercury brands) and high-intensity discharge (HID) lamps replaced, as these lighting products and many others used by businesses contain a small amount of mercury. Disposing of these lighting products in trash is prohibited by federal regulations; by recycling them you prevent mercury contamination and allow the glass and metals they contain to be recycled. A list of local and state recyclers is available upon request from CFU; you are also welcome to use another organization of your choice. See Terms & Conditions for instructions on how to submit proof of recycling or disposal with your application.

Linear Fluorescents - For Existing Construction ONLY (must replace T-12 lamp and magnetic ballast systems)

Type Install Date

Annual Hours of

Operation

Fixture Model Number

Fixture Brand/Manufacturer

Total watts of old fixture

Total Cost (Labor +

Equipment)Incentives

T-8: U-Bend 2' x 2, (electronic ballasts, 800-series lamps)

$15/fixture

T-8: 2' x 1 or 2' x 2, (electronic ballasts, 800-series lamps)

$15/fixture

T-8: 4' x 1 (electronic ballasts, 800-series lamps)

$18/fixture

T-8: 4' x 2 (electronic ballasts, 800-series lamps)

$35/fixture

T-8: 4' x 3 (electronic ballasts,

800-series lamps) $50/fixture

T-8: 4' x 4 (electronic ballasts, 800-series lamps)

$15 per tandem

T-8: 8' x 1 or 8' x 2 (electronic ballasts, 800-series lamps)

$50 per 4' tandem

T-8HO: 8' x 1, 8' x 2, (electronic ballasts, 800-

series lamps)

$70 per 4' tandem

T-5: 2' x 1 or 2' x 2, (electronic ballasts, 800-series lamps)

$15/fixture

T-5: 4' x 1 (electronic ballasts, 800-series lamps)

$21/fixture

T-5: 4' x 2 (electronic ballasts, 800-series lamps)

$52.50/fixture

T-5: 4' x 3 (electronic ballasts,

800-series lamps) $75/fixture

Page 3 of 4 (2015)

Step #5) Complete application below and attach all invoices or receipts.

Occupancy Sensors - For Existing Construction Only

Sensor Type Total Watts Controlled

How many hours per year do the controlled lights operate? Rebate Quantity Total

RebateEquipment

Cost

Wall-mounted occupancy sensor

Ceiling-mounted occupancy sensor

Fixture-mounted occupancy sensor

$20 per sensor x =

Page 4 of 4 (2015)

High Bay Fluorescents - For Existing Construction Only - (15 feet minimum mounting height; must replace HID fixtures)

For indoor projects only. Complete both grey sections below. Don't forget to include proof of disposal of previous lighting types (see page 2).

Brand/Manufacturer of Light Type 1 Model of Light Type 1 Brand/Manufacturer of Light

Type 2 (if applicable) Model of Light Type 2 (if

applicable)

Wattage of Indoor HID Replaced

Type of Replacement Fluorescent Fixture (check one)

Must be 800-series lamps.Incentive Quantity Total Rebate Date Installed

250 W - 399 W

HID Fixture Wattage: :

4 lamp T8 2 lamp T5HO

3 lamp T5HO

Other T8 or T5HO less than 155 W (List wattage) :

$40/HID fixture replaced (or

minimum of $300/kW of reduction)

x

400 W - 649 W

HID Fixture Wattage: :

6 lamp T8

4 lamp T5HO

Other T8 or T5HO less than 250 W (List wattage) :

$50/HID fixture replaced (or

minimum of $300/kW of reduction)

x

650 W - 999 W

HID Fixture Wattage: :

6 lamp T5HO

8 lamp T8

Other T8 or T5HO less than 365 W (List wattage) :

$90/HID fixture replaced (or

minimum of $300/kW of reduction)

x

1000 W (option 1: ≤ 800 total fixture watts)

HID Fixture

Wattage: :

(two) 6 lamp T5HOs per HID replaced

Other T8 or T5HO, 500- 800 W (list type & wattage): :

$80/HID fixture replaced (or

minimum of $300/kW of reduction)

x

1000 W (option 2: ≤ 500 total fixture watts). If replacing 1 HID

with 2 high bay fluorescent fixtures, total wattage must be

within specified range.

HID Fixture Wattage: :

6 lamp T5HO

(two) 4 lamp T5HO fixtures/HID replaced

8 lamp T8

Other T8 or T5HO less than 500 W (list type & wattage): :

(two) 6 lamp T8 fixtures/HID replaced

8 lamp T5HO

10 lamp T8$150/HID fixture

replaced (or minimum of $300/kW of reduction)

x

Custom Fluorescent and Metal Halide Rebates Table

If your fluorescent project does not appear on this application, contact CFU at 319-268-5355 for more information about CFU's Custom Rebate Program. Below are just a few of the fluorescent and metal halide lighting projects that can potentially qualify for custom rebates:

Pulse start metal halide lighting All prescriptive rebates costing more than $10,000 in CFU rebates Lighting controls, clocks or timers Exterior lighting (i.e., parking lot/garage fixtures) Reduced wattage (25 & 28 watt) T-8 lamps/systems Delamping measures in comprehensive lighting upgrades High Performance (HP) T-8 systems New construction projects