Snohomish County PUD offers rebates on many energy-efficient improvements for your home. When you purchase and install energy-efficient products, you can save energy and money while reducing your impact on the environment.

Thank you for participating!

EligibilityTo qualify for a PUD weatherization or heating rebate, your home must have permanently installed electric heat as the primary heating system. Other requirements apply. Rebates are subject to change. Visit our website at snopud.com/weatherization or snopud.com/heating for program details, or contact the PUD Energy Hotline (see Need Help? section below).

Purchase & InstallationInstallation must be completed by a PUD Registered Trade Ally. PUD Registered Trade Allies provide a PUD Instant Rebate, agree to meet PUD installation speci-fications, and provide a two-year equipment and workmanship warranty. Find a PUD Registered Trade Ally at snopud.com/weatherization or snopud.com/heating.

How to Apply

1. Complete this application. Your PUD Registered Trade Ally can help ensure your application is complete. Incomplete applications cannot be processed.

2. Review this checklist before submitting. Have you… o Included a copy of the itemized invoice? (Retain original for your records.) o Included required supporting documents? See detailed instructions on the

application. (Retain originals for your records.) o Completed the PUD Registered Trade Ally section? o Signed the application? o Made a copy of the application for your records?

3. Email or mail your completed application with all supporting documents, within 90 days of installation, to:

ce@snopud.com OR

Residential Energy Services (E2), Snohomish County PUD, PO Box 1107, Everett, WA 98206-1107

4. Your PUD Registered Trade Ally will deduct the amount of your PUD Instant Rebate from your invoice before this application is submitted. The PUD Registered Trade Ally will then collect the rebate payment from Snohomish PUD on your behalf after this application has been processed and the work has passed any required inspections.

Need Help?Call the Energy Hotline at 425-783-1700, Monday to Friday, 8AM to 5PM (toll-free in Western Washington and outside the local Everett calling area 1-877-783-1000).

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EXISTING SINGLE FAMILY HOMESR E B A T E A P P L I C A T I O N

ENERGY-EFFICIENCY REBATE AGREEMENTPAYMENT FOR INSTALLATION: The Homeowner is responsible for paying for the installation of the Measure(s).

MEASURE(S) SELECTION, INSTALLATION, OPERATION, AND MAINTENANCE: The selection, purchase, and installation of the Measure(s) shall be the sole responsibility of the Homeowner. Installation must be done in accordance with all applicable federal, state and local laws, codes and ordi-nances, including all building energy codes, manufacturer specifications and in compliance with the procedures specified by the PUD. The Home-owner must rely upon the PUD Registered Trade Ally, if applicable, regarding any representation or promise about the materials or labor required for installation of the Measure(s), the cost of such Measure(s), including materials and labor, and any energy savings that may accrue for the installation of the Measure(s). THE PUD MAKES NO WARRANTY WITH RESPECT TO THE MEASURE(S), EXPRESSED OR IMPLIED, AND SPECIFICALLY DISCLAIMS ANY WARRANTY OF MERCHANTABILITY AND OF FITNESS FOR A PARTICULAR PURPOSE AND ANY LIABILITY FOR CONSEQUENTIAL DAMAGES ARISING OUT OF THE USE OF, OR THE INABILITY TO USE THE MEASURE(S). Any required maintenance, repair, or replacement of the Measure(s) shall be the sole responsibility of, and at the expense of the Homeowner.

VERIFICATION, INSPECTION, EVALUATION AND ACCESS: Participating homes are subject to random on-site inspections in order to verify that installation meets program eligibility guidelines. No warranty is implied by this inspection. The Homeowner agrees to provide reasonable access to the property for the purposes described herein if contacted to schedule an inspection. The PUD may contact the Homeowner for survey participation and program feedback. In addition, Homeowner expressly agrees that the PUD may release the Homeowner’s account information, including billing and energy usage information, to an independent third-party evaluator solely for the purposes of evaluating this program, confirming energy savings, and for other quality assurance purposes.

TAX LIABILITY: The Homeowner (and not the PUD) is responsible for any taxes (federal, state, and/or local) that may be imposed on the Homeowner because of the receipt of rebate funds. For homes owned by a LLC or Trust, the tax form W-9 is required.

FACSIMILE/SCANNED: Facsimile transmission of any signed original document, and the retransmission of any signed facsimile transmission, shall be the same as delivery of the original signed document. Scanned original documents transmitted to the PUD as an attachment via electronic mail shall be the same as delivery of the original signed document. At the request of the PUD, the Homeowner shall confirm documents with a facsimile trans-mitted signature or a scanned signature by providing the original document.

COMPLIANCE WITH LAWS: The Homeowner represents and warrants that the Homeowner, its agents and employees, and any PUD Registered Trade Ally or sub-contractor it may retain to install or maintain the Measure(s) are, or will become, familiar with and will at all times comply with all applicable equipment manufacturer’s instructions, federal, state, and local laws, codes, ordinances, rules and regulations pertaining to the installation, maintenance, operation, and use of the Measure(s).

DISCLAIMER AND INDEMNITY: Homeowner understands that the PUD is providing funding for kilowatt-hour savings only; and that the PUD as-sumes no liability for Homeowner’s voluntary decision to participate in the program, for the Measure(s) selected by the Homeowner, for the actions or omissions of any third parties selected by the Homeowner to install such Measure(s), or for any disputes arising out of the installation, repair or replacement of the Measure(s) installed. Furthermore, in consideration of the PUD providing a rebate for the installation of the Measure(s), the Homeowner agrees to hold harmless, indemnify and defend the PUD, its officers, employees, and agents, from any and all claims, losses, actions, suits, liabilities, damages, judgments and expenses (including costs and attorney’s fees) of any nature whatsoever, or allegations thereof, arising directly or indirectly out of or in any way connected with any act, omission, fault or negligence of the Homeowner or any third party selected by Homeowner to install the Measure(s).

ADDITIONAL CONDITIONSw Qualifying equipment must be installed in Snohomish

County PUD’s service area.w Available for existing single family residences. This includes

manufactured and modular homes individual condomini-ums, and townhouses.

w Residence must have permanently installed electric heat as the primary heat source.

w Weatherization rebates are available for existing single-family residences up to three (3) stories in height.

w Heating rebates are available for existing single-family residences up to four (4) attached dwellings. Townhouses and condos that do not vertically overlap are exempt from the number of attached dwellings.

w Multifamily and condominium properties with more than four (4) attached dwellings do not qualify but may be eligible for weatherization under the PUD Multifamily Program.

w Rebate(s) will not exceed purchase price of any rebated product.

Proof of Purchase Requirement:Itemized Invoice

Invoices must be legible and include the following information. Photocopies are acceptable. Please retain the original for your records.

w PUD Registered Trade Ally name, address and phone number.

w Itemized listing of each product, including quantity, product description, manufacturer, model number, or other identifying informa-tion. This must match the information listed on your application.

w Installed cost.

w PUD Instant Rebate deducted.

CUSTOMER INFORMATION

1099 11/19

o HOME o WORK o CELL o PHONE o EMAIL o U.S. MAIL

SIGNATURE I, the homeowner, request one or more rebates for measure(s) installed in the home located at the address above. Attached are legible copies of the itemized invoice(s) and other required documentation. I understand and agree to the terms of the Energy Efficiency Rebate Agreement, the Additional Conditions, and the conditions for participation in Residential Energy Efficiency Programs (“Programs”). I also understand that: (i) the Public Utility District No. 1 of Snohomish County (“PUD”) will make the final determination of any rebate I may be eligible to receive; (ii) Program(s) are subject to change without notice; and (iii) rebate applications must be submitted within 90 days of installation of the energy-efficiency measure(s). I agree to receive my rebate via (check one):

Instant Rebate (provided on the PUD Registered Trade Ally’s invoice) and authorize the PUD to pay the PUD Registered Trade Ally, in my name, the rebate(s) due to me; OR

Credit to my PUD utility account, which may take up to six (6) weeks for processing.

Homeowner Signature: Date:SIGNATURE

Weatherization Rebate Total: Heating Rebate Total:

TOTAL REBATE APPLIED FOR: $

EXISTING SINGLE FAMILY HOMESR E B A T E A P P L I C A T I O N

PROMO CODE:

Electronic Signature: By checking the Signature box, inserting my name on the signature line, and submitting the form electronically to the PUD, I certify that I understand and agree to the above terms.

Please submit this completed, signed application with accompanying paperwork to:ce@snopud.com OR

Residential Energy Services (E2), Snohomish County PUD, PO Box 1107, Everett WA 98206-1107

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ENERGY HOTLINE: 425-783-1700, Monday - Friday, 8 AM to 5 PM (toll-free in Western Washington and outside the local Everett calling area at 1-877-783-1000)

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$$

HOMEOWNER NAME EMAIL ADDRESS

DAYTIME PHONE NUMBER (WITH AREA CODE) PREFERRED CONTACT METHOD FOR THIS PROJECT

HOME INFORMATION (ALL FIELDS ARE REQUIRED) INSTALLATION ADDRESS CITY / STATE / ZIP CODE

MAILING ADDRESS o SAME AS ADDRESS ABOVE CITY / STATE / ZIP CODE

REBATE IS FOR (choose one): o PRIMARY RESIDENCE o RENTAL TYPE OF HOME (choose one): o SINGLE-FAMILY o MANUFACTURED HOME o CONDOMINIUM

SQ FT # OF DWELLINGS YEAR BUILT ELECTRIC HEAT SOURCE TYPE: o Ductless Heat Pump WATER HEATER

o Zonal (baseboard, wall unit) o Furnace o Heat Pump (with electric furnace) o Electric o Non-Electric

CONTACT PERSON (if not homeowner) Contact Person Daytime Phone No. (with area code)

PUD REGISTERED TRADE ALLY INFORMATION TRADE ALLY COMPANY NAME REPRESENTATIVE NAME

DAYTIME PHONE NUMBER (WITH AREA CODE) EMAIL ADDRESS

Weatherization RebatesRebates are available to PUD customers with electric heat for the addition of new insulation, windows, and duct seal-ing. For more information on this program: snopud.com/weatherization

INSULATIONInsulation must be installed only in cavities that separate conditioned (heated) from unconditioned areas of the residence (livable space). Homes built prior to 1976 and have no existing insulation are eligible for an additional $0.50/s.f.

Please complete all applicable fields and provide: 1) PUD Insulation Certificate and 2) an itemized invoice.

o ATTIC INSULATION - $0.50 per sq. ft. Rebate available if existing insulation is R-19 or less (under 6”)

SQUARE FOOTAGE OLD R-VALUE NEW R-VALUE INSTALL DATE INSTALLED COST REBATE AMT

SQUARE FOOTAGE OLD R-VALUE NEW R-VALUE INSTALL DATE INSTALLED COST REBATE AMT

o WALL INSULATION - $0.50 per sq. ft. Rebate available if there is no existing insulation.

SQUARE FOOTAGE OLD R-VALUE NEW R-VALUE INSTALL DATE INSTALLED COST REBATE AMT

SQUARE FOOTAGE OLD R-VALUE NEW R-VALUE INSTALL DATE INSTALLED COST REBATE AMT

o FLOOR INSULATION - $0.50 per sq. ft. Rebate available if existing insulation is R-11 or less (3.5” of insulation)

SQUARE FOOTAGE OLD R-VALUE NEW R-VALUE INSTALL DATE INSTALLED COST REBATE AMT

SQUARE FOOTAGE OLD R-VALUE NEW R-VALUE INSTALL DATE INSTALLED COST REBATE AMT

WINDOWSNew windows must have a U-Value of .30 or lower.

Please complete all applicable fields and provide: 1) NFRC stickers or manufacturer packing slip with U-Value for each window and 2) an itemized invoice. *Round-up square footage to nearest half-foot.

o INSULATED WINDOWS / SINGLE-PANE TO DOUBLE-PANE - $100 per window # OF WINDOWS SQUARE FOOTAGE* INSTALL DATE INSTALLED COST REBATE AMT

o INSULATED WINDOWS / DOUBLE-PANE (METAL FRAME) TO DOUBLE-PANE - $50 per window # OF WINDOWS SQUARE FOOTAGE* INSTALL DATE INSTALLED COST REBATE AMT

DUCT SEALING AND INSULATIONMust be sealed with mastic and insulated to a minimum of R-8.

Please complete all applicable fields and provide an itemized invoice. Linear feet required only for Standard Construc-tion homes.

o STANDARD CONSTRUCTION HOME - $5 per Linear Foot (up to $450) o MANUFACTURED HOME: SINGLE-WIDE - $200 o MANUFACTURED HOME: DOUBLE/TRIPLE-WIDE - $400 LINEAR FEET OLD R-VALUE NEW R-VALUE INSTALL DATE INSTALLED COST REBATE AMT

ENERGY HOTLINE: 425-783-1700, Monday - Friday, 8 AM to 5 PM (toll-free in Western Washington and outside the local Everett calling area at 1-877-783-1000)

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(PUD REGISTERED TRADE ALLY TO COMPLETE THIS PAGE)

DUCTLESS HEAT PUMP

Must have a minimum 9.0 HSPF and SEER 14, be inverter-driven and use 410A refrigerant. Must install one head in the main living area, and main living area must have existing permanently installed electric heat. Please complete all fields and provide an itemized invoice.

OUTDOOR MODEL # INDOOR MODEL # INDOOR MODEL # INDOOR MODEL # AHRI # (if applicable) (if applicable)

Heating RebatesRebates are available to PUD customers who replace their primary electric resistance heating system (e.g., baseboard, wall heaters, electric furnace) with an efficient electric heat pump. Customers living in a condominium building with five (5) or more attached dwellings (see Additional Conditions section) or have an existing gas, oil or propane furnace or boiler are not eligible. Only one (1) heating rebate per home. For more information on this program: snopud.com/heating.

Duct sealing and insulation are recommended when installing a ducted heat pump system.

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ENERGY HOTLINE: 425-783-1700, Monday - Friday, 8 AM to 5 PM (toll-free in Western Washington and outside the local Everett calling area at 1-877-783-1000)

oINSTALL DATE INSTALLED COST

$800REBATE AMT

oINSTALL DATE INSTALLED COST

$1,500REBATE AMT

oINSTALL DATE INSTALLED COST

$600REBATE AMT

oINSTALL DATE INSTALLED COST

$2,500REBATE AMT

oAHRI # INSTALL DATE INSTALLED COST

$1,000REBATE AMT

oINSTALL DATE INSTALLED COST

$200REBATE AMT

COMMISSIONING, CONTROLS, AND SIZING

For heat pumps not meeting PUD HSPF program efficiency requirements. Must meet all other eligibility require-ments. Please provide: 1) a PUD Startup Checklist, 2) a PUD Sizing Calculator with balance point, and 3) an item-ized invoice.

DUCTED HEAT PUMP / UPGRADE – SIZED

For customers replacing an existing heat pump. Back-up heating must be electric. Must have a minimum 9.0 HSPF and SEER 14. Please provide: 1) a PUD Startup Checklist, 2) a PUD Sizing Calculator with balance point, 3) a Duct Testing Affidavit, and 4) an itemized invoice.

DUCTED HEAT PUMP / CONVERSION – SIZED

Must have a minimum 9.0 HSPF and SEER 14. Please provide: 1) a PUD Startup Checklist, 2) a PUD Sizing Calcu-lator with balance point, 3) a Duct Testing Affidavit, and 4) an itemized invoice.

INVERTER-DRIVEN DUCTED HEAT PUMP / CONVERSION – SIZED

Must have a minimum 10.0 HSPF and SEER 14. Please provide: 1) a PUD Startup Checklist, 2) a PUD Sizing Calcu-lator with balance point, 3) a Duct Testing Affidavit, and 4) an itemized invoice. Geothermal heat pumps with a mini-mum COP of 3.2 and EER 12 can be submitted here.

DUCTED HEAT PUMP / CONVERSION – NOT SIZED

Must have a minimum 9.0 HSPF and SEER 14. Please complete all fields and provide: 1) a Duct Testing Affidavit and 2) an itemized invoice. For inverter-driven systems: supply manufacturer documentation that the compressor is either inverter or variable speed.

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