Residential Builders & Developers New Construction Energy...

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Builder/Owner Phone Number Social Security/Tax ID Mailing Address City State Zip Code Signature (Builder/Owner) Date Builder Rebate Program Service Address City State Zip Code Service Subdivision Lot Number Block Qty. Gas Appliance Allowance Total Allowance $550 $350 High Efficiency Water Heater Furnace $500 Dryer $100 Range $150 Additional Incentives For Office Use Only Approval Signature Date Rebate Number Residential Builders & Developers New Construction Energy Conservation Program B u i l d e r I n f o r m a t i o n This energy conservation program is designed to encourage builders to install natural gas appliances in their new construction projects. Builders must provide reasonable verification and there must be an active gas account to qualify for the residential new construction energy conservation program. Acceptable verification of new appliance includes the following: appliance make, model and serial number, authorized field employee verification or purchase and installation receipts. Please note ONLY connected appliance are eligible. If you have any questions, call 888.CITY.GAS. Email this form to: [email protected] A p p l i a n c e C o u n t Water Heater Tankless Water Heater Make/Model Number Serial Number $400 Total:

Transcript of Residential Builders & Developers New Construction Energy...

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Builder/Owner Phone Number Social Security/Tax ID

Mailing Address City State Zip Code

Signature (Builder/Owner) Date

B u i l d e r R e b a t e P r o g r a m

Service Address City State Zip Code

Service Subdivision Lot Number Block

Qty. Gas Appliance Allowance Total Allowance

$550

$350

High Efficiency Water Heater

Furnace $500

Dryer $100

Range $150

Additional Incentives

F o r O f f i c e U s e O n l y

Approval Signature Date Rebate Number

Residential Builders & DevelopersNew Construction Energy Conservation Program

B u i l d e r I n f o r m a t i o n

This energy conservation program is designed to encourage builders to install natural gas appliances in their new construction projects. Builders must provide reasonable verification and there must be an active gas account to qualify for the residential new construction energy conservation program. Acceptable verification of new appliance includes the following: appliance make, model and serial number, authorized field employee verification or purchase and installation receipts. Please note ONLY connected appliance are eligible. If you have any questions, call 888.CITY.GAS.

Email this form to: [email protected]

A p p l i a n c e C o u n t

Water Heater

Tankless Water Heater

Make/Model Number Serial Number

$400

Total: