So Cal Gas Company 2012 Rebate List
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ENERGY EFFICIENCY REBATES FOR BUSINESHelping You Save Money And Energ
Effective January 20
Rebate Guide aNd applicatioN
2010–2012
IntrdutInThe Southern Caliornia Gas Company (SoCalGas®)
oers an array o Energy Efciency Programs as
part o our commitment to exceptional customer
service. While this guide oers inormation on
several ways SoCalGas can save you money and
energy, it is ocused on the Energy Efciency
Rebates or Business (EERB) program.
The EERB program oers rebates on qualiying
energy-efcient products and improvements or
your business. It is just one o the energy-efciency
programs and services at SoCalGas designed to
help businesses like yours save money and energy.
This document will guide you through the easy
application process. Careully read the program
requirements, qualifed equipment requirements,
and Terms and Conditions beore purchase to
determine eligibility requirements.
Wh n ppy?Any commercial, industrial, or agricultural customer with an active, valid, and non-delinquent account can
apply or a rebate under the EERB program. Whether you’re a small business or a large industrial customer,
we have rebates or you.
Fr re InFrtInVisit ocalga.com (search “REBATES”).
You are encouraged to reserve unds by calling (800) 508-2348 beore you purchase and install equipment.
Questions? Call us toll-ree at (800) GAS-2000 or email us at [email protected] .
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tbe F ntents
Program Requirements ..............................................................3
Using a Licensed Contractor .....................................................3
Energy Efciency Benchmarking .............................................3
Rebate Payment ...........................................................................3
Disclaimer ......................................................................................3
Qualifed Equipment .................................................................. 4
• Boilers....................................................................................... 4
– Commercial (Non-Space Heating) Boiler ....................... 4
– Space Heating Boiler .......................................................... 4
– Process Heating Boiler or Manuacturing....................4
• Storage Water Heater ........................................................... 5
• Instantaneous/Tankless Water Heater ............................. 5
• Direct Contact Water Heater or Manuacturing ............ 5
• Pool/Spa Heater ..................................................................... 5
• Steam Trap .............................................................................. 5
• Pipe Insulation ........................................................................6
• Tank Insulation .......................................................................6
• Residential High Efciency Clothes Washers
or Businesses ........................................................................6
• Greenhouse Curtain ...............................................................7
• Inrared Film or Greenhouses.............................................7
• Commercial Cooking Equipment ........................................ 8
Customer Checklist .................................................................... 9
Glossary .......................................................................................10
Rebate Application ..................................................................... 11
Terms and Conditions ............................................................... 12
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pRoGRam RequiRemeNts
Gener• Customers eligible or the Energy Efciency Rebates or
Business (EERB) program are defned as active, valid, and
non-delinquent commercial, industrial, and agricultural accounts.
• The total rebate limit or the EERB program is $200,000 per
customer, per year, including corporate (multiple) accounts.
equIpent requIreents• Equipment must meet the requirements as outlined in the
ollowing rebate guide. SoCalGas reserves the right to
veriy installation and deny payment or products that do
not meet the requirements.
• All equipment must be new and within the same rating
capacity o the equipment that was replaced. Used or
rebuilt equipment is not eligible. Fuel switching (changing
rom electricity to gas) does not qualiy.
• New equipment must replace older, less efcient equipment,
with the exception o commercial cooking equipment.
• Commercial cooking equipment that does not replace old
equipment may be eligible or either the EERB program
or the Energy Efciency Calculated Incentive Program
(EECIP). For more inormation, visit ocalga.com (search
“INCENTIVES”).
• Qualifed equipment must be installed at the acility served
by the SoCalGas account listed on the application and
must be operational according to local building codes,
ordinances, and/or manuacturer’s requirements.
• I you are not sure whether the equipment qualifes,please contact a SoCalGas representative at
• Equipment efciency listed ratings rom the Caliornia
Energy Commission (CEC) and/or Gas Appliance Manuacturers
Association (GAMA) prevail over all submitted technical
documentation, unless otherwise approved.
prGr IIttIns• No rebates will be paid on new equipment that replaces
equipment or which the customer has received a rebate
rom SoCalGas within the last fve (5) years.
• Customers who have received rebates, incentives, orservices or the same equipment rom other utilities, states,
or local programs unded by the Public Purpose Program
Surcharge (PPPS) are not eligible. However, customers can
apply or rebates rom water agencies i the equipment
qualifes or one.
• Residential dwellings such as single-amily attached and
detached homes, condominiums, or apartments do not qualiy
or rebates under this program but may under the Home
Energy Efciency Rebates Program. Some common areas
o multi-amily residential properties that are served under
the GN-10 rate schedule may qualiy or the EERB program.
For more inormation, visit ocalga.com (search
“CONSERVE ENERGY”).
eNeRGy efficieNcy beNchmaRkiNGSoCalGas encourages customers to benchmark their acility’s
energy usage by using the complimentary online ENERGY
STAR® Portolio Manager benchmarking tool. Energy efciency
benchmarking is a method o comparing a acility’s level o
energy efciency with that o similar acilities nationwide.
It allows building owners and managers to track and assess
the energy perormance o their buildings over time.
Benchmarking is a key step in identiying opportunities to
increase proftability by lowering energy and operating costs.
For more inormation, visit ocalga.com (search
“BENCHMARKING”).
Rebate paymeNtQualifed customers with complete applications will receive
their rebate payment within our to six (4-6) weeks
(i verifcation is not necessary), provided that unding
is still available or you have reserved unds. The precise
rebate amount may be subject to subsequent adjustments
by SoCalGas.
disclaimeRThe selection, purchase, and ownership o equipment are
the sole responsibility o the customer. SoCalGas makes no
representation as to the saety, reliability, and/or efciencyo the equipment. SoCalGas makes no warranty, whether
expressed or implied, including warranty o merchantability
or ftness or any particular purpose, use, or application o
the equipment.
The 2010-2012 EERB program may be modifed or terminated
without prior notice. Visit the SoCalGas website at ocalga.com
or program modifcations and updates. Please see the EERB
Policies and Procedures Customer Handbook or complete
inormation and other applicable restrictions.
For more inormation, visit ocalga.com
(search “BUSINESS REBATES CUSTOMER HANDBOOK”).
usiNG a liceNsed coNtRactoRHow well your Heating, Ventilating, and Air Conditioning
(HVAC) system perorms, and how much it costs to
operate, depend in part on the proper installation o
the system. Hiring a licensed contractor who obtainsthe required building permit and has knowledge o,
and complies with, local codes, ordinances and the
requirements o the Building Energy-Efciency Standards
(State Administrative Code, Title 24, Part 6) increases the
likelihood that your system will be properly installed and
will work efciently, quietly, and saely.
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qualified equipmeNtBeore you buy product(s), careully read the specifcations below.
bIers:Boiler rebates cannot exceed $25,000 per unit.
ommcial (no-sac haig) boil
Equipment Input Rating Required Efciency Rebate Amount
Non-Space Heating Boiler ≥75 MBtuh ≥84% $0.50/MBtuh
sac haig boil• Equipment must be used or space heating to provide human comort (as defned by CEC Titles 20 and 24 Standards).
• om m vif, cckig ox o iga ag, a av a lic coaco.
Type o Boiler Input Rating Required Efciency Rebate AmountLarge Steam >300 MBtuh Annual Fuel Utilization Efciency
(AFUE)≥77%$0.25/MButh
Small Water <300 MBtuh AFUE ≥82% $0.25/MButh
Large Water ≥300 MBtuh – <2,000 MBtuh Thermal Efciency ≥84% $0.25/MButh
poc haig boil fo afacig (nIs co 31-33)• Manuacturing involves the mechanical or chemical transormation o materials or substances into a new product that
is neither a structure nor any other fxed improvement.
• A ue gas analysis (FGA) measured under ull load conditions is required to document combustion efciency under ull
load conditions ater the installation is complete. SoCalGas oers ree FGAs; please call (800) GAS-2000 to set up an
appointment.• Process Boilers >2,000 MBtuh may participate in either the Energy Efciency Rebates or Business program or the
Energy Efciency Calculated Incentive Program (EECIP).
Equipment Combustion Efciency Rebate Amount
Boiler ≥82% $0.50/MBtuh
strGe Wter heter:
Storage Water Heater Size Input Rating Required Efciency Rebate Amount
Small ≤75 MBtuh Energy Factor ≥0.62 $2/MBtuh
Large >75 MBtuh Thermal Efciency ≥82% $2/MBtuh
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Instntneus/tness Wter heters:• Large tankless water heater rebates cannot exceed $25,000 per unit.
• Water heaters must meet efciency requirements based on size, as shown below.• Large water heaters >2,000 Btuh are eligible or either the Energy Efciency Rebates or Business program
or the Energy Efciency Calculated Incentive Program (EECIP).
Tankless Water Heater Size Input Rating Required Efciency Rebate Amount
Small <200MBtuh Energy Factor ≥0.63 $2/MBtuh
Large ≥200 MBtuh Thermal Efciency ≥82% $0.50/MBtuh
dIret ntt Wter heter Fr nuFturInG (nIs des 31-33):In direct contact water heater systems design, heat rom a ame comes into direct contact with small droplets o cold water
that run through a stainless steel heat exchange media. Droplets composed rom this process come into direct contact with
rising heat rom the ame and as a result the water is heated directly.
Equipment Input Rating Required Efciency Rebate Amount
Direct ContactWater Heater
≤300 MBtuh Annual Fuel Utilization Efciency(AFUE)≥88%
$2/MBtuh
Direct ContactWater Heater
>300 MBtuh Thermal Efciency >90% $2/MButh
p/sp heter:Must have an “on/o” switch and have no pilot light.
Equipment Efciency Requirement Rebate Amount
Pool/Spa Heater Thermal Efciency ≥84% $2/MBtuh
ste trp:• Customer may be asked to veriy the location o the replaced steam trap(s) in steam loop.
• Equipment in service or a minimum o fve (5) years is eligible.
• Must replace one-or one, existing-ailed-open steam traps.
• Drycleaning businesses are not eligible or commercial steam trap rebates.
• Steam trap replacements or industrial customers (NAICS codes 31-33) do not qualiy or a rebate under this program,
but may qualiy under SoCalGas’ Energy Efciency Calculated Incentive Program (EECIP).
Equipment Facility Hours o Operation Rebate Amount
Steam Trap >12 hours $100/unit
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pIpe InsutIn:• Minimum qualiying pipe diameter is 1/2”.
• A minimum o 1” o pipe insulation must be added to existing a commercial or industrial steel or copper pipe.Replacing existing insulation is not eligible.
• The pipes must transer hot water, low-pressure or high-pressure steam directly rom gas-fred equipment.
• Acceptable types o insulation or hot water pipes include elastomeric oam rubber, polyethylene oam, UV-resistant
polyethylene oam, and rigid polyurethane oam.
• Acceptable types o insulation or steam pipes include silicone oam rubber, melamine oam, rigid urethane-based oam,
cellular glass, rigid fberglass, and rigid mineral wool.
• Insulation required by Title 24 and OSHA or the replacement o damaged (existing) insulation is not eligible or a rebate.
• The manuacturer’s specifcation sheet must be submitted with the application.
• Insulation or straight pipes are eligible: insulation or elbows and valves between pipes is not eligible.
Type o Pipe Pipe Size Rebate Amount
Hot Water <1" $2/linear t.
Hot Water ≥1" $2/linear t.
Steam <15 psig <1" $3/linear t.
Steam <15 psig ≥1" $3/linear t.
Steam ≥15 psig <1" $3/linear t.
Steam ≥15 psig ≥1" $3/linear t.
tn InsutIn:• 1” or 2” o fber glass or oam insulation must be added to existing a liquid storage or transer tanks that are coupled
to gas-fred commercial or industrial equipment that transers heat to the liquid or solution. Replacing existing insulationis not eligible.
• Insulation required by Title 24 and OSHA or the replacement o damaged (existing) insulation is not eligible or a rebate.
• The manuacturer’s specifcation sheet must be submitted with the application.
Insulation Thickness Tank Temperature Requirement Rebate Amount
1" Low temperature application: 120-170 degrees F solution $2/square t.
1" High temperature application: 170-200 degrees F solution $3/square t.
2" Low temperature application: 120-170 degrees F solution $3/square t.
2" High temperature application: 170-200 degrees F solution $4/square t.
resIdentI hIGh eFFIIeny thes Wshers Fr busInesses:• Must be used in a business and not be coin operated.
• Must be Tier 2 or 3 and listed on Consortium or Energy Efciency (CEE) website: c1.og/com/cw/cwc.f.
Equipment Efciency Requirement Rebate Amount
CEE Tier 2 Modifed Energy Factor ≥ 2.2Water Factor ≥ 4.5
$35/unit
CEE Tier 3 Modifed Energy Factor ≥ 2.4Water Factor ≥ 4.0
$75/unit
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Greenhuse urtIn:• Curtain must be new or replace curtains that are at least fve (5) years old.
• Curtain must be located so that the gas heat source provides hot air to a conditioned spacebounded by the curtain.
• Must be designed by the manuacturer to be a heat curtain and the installation must have the ability to move the curtain
automatically or manually into place.
• The total rebate cannot be more than the lesser o:
– $50,000 per account per year, or
– 50 percent o the account’s preceding 12-month gas consumption (therms) X $0.80 (average prorated i less than
12 months usage is available).
• Rebate amount cannot exceed the cost o purchasing and proessionally installing curtains or the square ootage o the
greenhouse. Overhang and overlap curtain material cannot be included in the square ootage calculation.
• All greenhouse curtain installations are inspected beore the rebate application is approved.
• The manuacturer’s specifcation sheet must be submitted with the application.
Equipment Energy Efciency Requirement Rebate
Greenhouse Curtain ≥40% $0.20/square t.
InFrred FI (Fr Greenhuses):• Film must be a single sheet o inrared anti-condensate polyethylene plastic or heat retention in an existing, heated greenhouse.
• The manuacturer’s specifcation sheet must be submitted with the application.
Equipment Energy Efciency Requirement Rebate
Inrared Film (or Greenhouses) Single sheet,minimum thickness o six mil
$0.05/square t.
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erI InG equIpentAll cooking equipment eligible or the EERB program is based on the American Society or Testing and Materials (ASTM)
standards listed on the Fishnick website: ick.com/avg/a/. The Fishnick website is subject to change, please
check or updates on eligible equipment. All gas equipment listed on the Fishnick website is qualifed or the EERB program.
Equipment Required Efciency Idle Energy Rate Rebate Amount
Combination Oven Steam mode ≥38% andconvection mode ≥44%
Diers based on model,see Fishnick website
$750/oven
Commercial Fryer ≥50% Diers based on model,see Fishnick website
$500/vat
Commercial Griddle Heavy load cookingenergy efciency ≥38%
≤2,650 Btuh per t2 o cooking surace
$125/unit
Convection Oven ≥44% ≤13,000 Btuh $500/oven
Double-Rack Oven ≥50% Diers based on model,
see Fishnick website
$2,000/oven
Large Conveyor Oven(≥25” wide)
≥42% ≤57,000 Btuh $750/oven deck
Large Vat Fryer ≥50% Diers based on model,see Fishnick website
$500/vat
Pressureless Steamer ≥38% Diers based on model,see Fishnick website
$2,000/unit
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customeR checklistYou are encouraged to reserve unds by calling (800) 508-2348 beore you purchase and install equipment. Payment will
be delayed i applications are incomplete. Beore submitting your application, make sure you have completed the ollowing:
scio 1cco IfomaioDid you provide the ollowing?
q SoCalGas account number
q Taxpayer ID or Social Security Number
q Customer name, as it appears on your SoCalGas bill
q Installation and mailing address
q Contact inormation
q Checks marks on the boxes that apply
scio 2ra eim IfomaioDid you provide the ollowing?
q Installation date (must be beore application is signed)
q Manuacturer name, model number, and serial number
(i applicable)
q Equipment type, quantity, input rating (i applicable),
rebate per unit, and rebate total. Please use pages 4-8
o this rebate guide or the correct rebate amount.
q For insulation, note whether you purchased it or pipesor tanks, hot water or steam, and size.
scio 3po & plac o rciv ckDid you provide the ollowing?
q Person authorizing payment.
q Signature o person authorizing payment.
q Payee’s name and address.
q Payee tax status & ID number
I you are releasing your rebate check to a vendor,they must have a signed agreement with SoCalGas.
scio 4om sigaq Checked box confrming the use o a licensed contractor
or space heating boiler rebates.
q Accepted the “Terms and Conditions”
by dating and signing.
ac docmDid you provide/attach the ollowing?
q Copy o paid itemized invoice that clearly indicates zero
balance or that it has been paid in ull. Invoices should
clearly state the cost o the equipment, installation, and
tax. I your invoice is not itemized, please contact your
vendor or the breakdown.
q Product manuacturer specifcation sheet, or a print out
rom the Fishnick website veriying that the oodservice
equipment qualifes or a rebate.Submit the completed application orm and other
required documentation with proo o purchase(s)
by mail, ax, or email:
so alifoia Ga oma
: /I eg efcic ra
fo bi
bX 513249 28h2
o gl, 90051
Fax: 213-244-8252
email: [email protected]
q Kept a copy o the completed application orm
and all required documentation, such as receipts,
and invoices or my records.
For more inormation, visit ocalga.com (search “REBATES”)
or email us at [email protected] .
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eeRb Guide GlossaRy• Fue - al Fl uilizaio efcic- The AFUE is a measure o annual efciency o boilers and urnaces.
It takes into account the cyclic on/o operation and associated energy losses o the heating unit as it responds to
changes in the load.
• alifoia eg ommiio (e)- The CEC is the state’s primary energy policy and planning agency.
• alifoia plic uilii ommiio (pu)- The CPUC regulates privately owned electric, natural gas,
telecommunications, water, railroad, rail transit, and passenger transportation companies.
• eg efcic bcmakig- Benchmarking is a method o comparing a acility’s level o energy efciency with
that o similar acilities nationwide.
• eg efcic alcla Iciv pogam (eeIp)- EECIP is a SoCalGas program or business customers that oers
fnancial incentives and recognition awards or a variety o qualiying energy-efciency improvements not covered
by the Energy Efciency Rebates or Business (EERB) Program. The incentive payment or qualiying projects amounts
to the ollowing (whichever is less), subject to caps o $1 million per project and $2 million per premise per year:
• $1.00 per therm saved annually, or
• 50 percent o the project cost (excluding taxes and internal labor).
• eg efcic ra fo bi (eerb) pogam- EERB is a SoCalGas program that gives rebates to business
customers who buy qualiying energy-efcient gas equipment and improvements.
• eg Faco- The energy actor is an efciency rating or water heaters. It is the ratio o useul energy output to the
total amount o energy used.
• Fl Ga ali (FG)- FGA measures the uel/air ratio and combustion pollutants in the ue gases o combustion
equipment. It is used or optimizing combustion efciency.
• Il eg ra- An appliance’s idle energy rate is its rate o energy consumption while it is holding or maintaining
a stabilized operating condition or temperature.
• I raig- The input rating measures the gas-burning capacity o an appliance in Btu per hour as specifed
by the manuacturer.
• b- Thousand British thermal units
• b- Thousand British thermal units per hour
• ig- Pounds per square inch, a unit o measure or pressure
• tmal efcic- Thermal efciency is an energy-efciency measure o combustion equipment. For boilers
it is the percentage o energy consumed that converts to heat or the water or steam.
© 2011 Southern Caliornia Gas Company. All copyright and trademark rights reserved. N1140016 1111
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2010-2012 ENERGY EFFICIENCY REBATE APPLICATIONHelping You Save Money And Energy
Effective January 2012
sectioN 1 accouNt iNfoRmatioN
x____x____x____x____x____x____x____x____x____x____x ____________________________________
SoCalGas® Account Number Facility Square Footage
Tx Stts: q Corporation q Partnershipq Individual/Sole Proprietor q Exempt (Tax exempt, non-prot)
Tx ID Nm: q EIN q Federal Tax ID q SSN_________________________
x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x
Name as it Appears on Your SoCalGas Bill
x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x
Address Where Item(s) Installed Unit/Suite Number
x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x
City State Zip
x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x
Mailing Address (If different from installation address)
x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x
City State Zip
x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x
Contact Name Contact Title
x____x____x____x - x____x____x____x - x____x____x____x____x x____x____x____x - x____x____x____x - x____x____x____x____x
Contact Telephone Number Fax Number
x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____xE-Mail Address
x____x____x____x____x____x____x____x____x____x____xReservation Number (optional)
sectioN 2 Rebate equipmeNt iNfoRmatioN
Not all equipment qualies. Please refer to the requirements listed on pages 4-8.
pleaSe ceck all TaT apply
q Primary language spoken is other than English q Lease building
q Less than 10 employees q Received a SoCalGas Energy Analysis
Submit the completed application form and other required documentation with proof of purchase(s) by mail, fax, or email:
IInstall Date Equipment Type Manufacturer Model # Serial # Input Rating Quantity Rebate/Unit Rebate To (mm/day/yr) (if applicable) (if applicable)
5/27/11 WaterHeater SmithsCo. L-K4-OS 6300056 190MBtuh 1 $2/MBtuh $380
6/1/11 PipeInsulation<1" JonesCo. N/A N/A N/A 3,238ft. $2/ln.ft. $6476 hotwater
TTal rebaTe Due:
1.
2.
3.
4.
5.
Sothn cioni Gs comnattn: c/I eng efin rts o bsinssbX 513249 Ml 282
los angs, ca 90051
Fx: 213-244-8252emi: [email protected]
Commercial
Industrial
Agricultural
AE Name: ____________________Employee ID: _________________
CST/IST Name: ________________
Employee ID: _________________
Assistance Provided: ___________
_____________________________
_____________________________
NAICS Code: __________________
Rate Schedule: ________________
Fr cuSTMer prGraMS:
Customer BP#: ________________
Date Received: ________________Total Cost o Equipment
(w/o labor, tax, or shipping):
_____________________________
Product Code Quantity
1.
2.
3.
4.
5.
Fr uTIlITy uSe Nly
**
*
=
=
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sectioN 4 customeR siGNatuRe
teRms aNd coNditioNs
• As a qualied SoCalGas customer, I certify that I purchased andinstalled the indicated energy saving products between January 1,
2010 and December 31, 2012 for use in my business facility and not forresale. I have attached documents establishing paid proof of purchasefor the items applied for on this rebate form.
• I will allow, if requested, a representative from SoCalGas, theCalifornia Public Utilities Commission (CPUC), or any authorized thirdparty reasonable access to my property to verify the installed productbefore a rebate is paid. I understand that a rebate will not be paid ifI refuse to participate in any required verication. I understand thatSoCalGas may contact the qualifying product vendor and/or installerto verify purchase and/or installation and may provide my name and/or address to complete this verication.
• Additionally, I understand that this project may be selected forevaluation studies and/or program measurement by externalcontractors appointed by the CPUC. These studies are used to
analyze and improve program performance. I agree to participate byresponding to inquiries from these external contractors.• I certify that the information on this rebate form is true and correct,
and that the tax ID provided is accurate. I understand that rebatepayments are based on related energy benets over the life of theproduct. I agree to:
n Provide SoCalGas with 100% of the related energy benetsspecied in the rebate form for the life of the product orfor a period of ve (5) years from receipt of rebate, whicheveris less, and
n Continue to be a customer of SoCalGas during said time period.• I th ov ss to th s, I sh nd otd
mont o t dos to SocGs sd on th t iodo tim o whih I ovidd th td ng nfts s
stom o SocGs. I ndstnd tht this ogm m modifd o tmintd withot io noti.
• I understand that this rebate form and the paid itemized invoice must bereceived at SoCalGas’s Central Processing Center or postmarked no later
than December 31, 2012. I acknowledge that I would not have undertakenan energy-efciency equipment upgrade at this time if SoCalGas had notoffered a monetary rebate.
• In the event that I choose to participate in the On-Bill Financing Program(OBF) offered by SoCalGas to obtain nancing for the products listed onthis form, I understand that the OBF terms and conditions will control(including, without limitation, the rebate amount for the products listedhere) if there is any conict between the EERB terms and conditions and OBF.
• In no s wi th tiit mo thn 100% o th ths i o th itms to td o th mximmown nit. phs i inds mtis ost sinsttion o o i instion, tn instion, gnhosht tin, gnhos ind fm, nd stm ts. lohgs to vndos on. cstoms who s-inst m
not hg insttion o. Ss txs nd ight (shiing) not indd in th itm’s hs is.• This program has a limited budget. If no reservation has been made,
rebate forms will be accepted on a rst-come, rst-served basis, untilallocated funds are no longer available, or by December 31, 2012.
• I agree that I have not received rebates, incentives, or services for thesame equipment from other utilities, states, or local programs funded bythe Public Purpose Program Surcharge (PPPS). However, I understand thatwater utilities are not funded by the PPPS and I may apply for their rebates.
• I understand rebates are taxable, if greater than $600 for businesscustomers, and will be reported to the IRS on Form 1099 unless I haveidentied myself as a corporation or exempt. I am urged to consult my taxadvisor concerning the taxability of rebates. SoCalGas is not responsiblefor any taxes that may be imposed on me or my business as a result of
receipt of this rebate.
sectioN 3 peRsoN & place to Receive check
THE REBATE CHECK SHOULD GO TO THE PARTY NAMED BELOW. I UNDERSTAND THAT I WILL NOT BE RECEIVING THE REBATE CHECK FROM SOCALGAS, IF MY BUSINESS
IS NOT NAMED BELOW. I ALSO UNDERSTAND THAT MY RELEASE OF THE PAYMENT TO ANOTHER PARTY DOES NOT EXEMPT ME FROM PROGRAM REQUIREMENTS.
Authorized By (please print) Signature of Authorized Date
Checks should be made payable and sent to:
x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x x____x____x____x - x____x____x____x - x____x____x____x____xPayee Business Name/Individual Telephone Number
x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____xPayee Mailing Address City State Zip
p Tx Stts: q Corporation q Partnership q Individual/Sole Proprietor q Exempt (Tax exempt, non-prot)
p Tx ID Nm: q EIN q Federal Tax ID q SSN _________________________________________________________
IrS Tx roting: SoCalGas will report this payment made to another party on IRS form 1099 as “Other Income” to you (the customer receiving the benet of the EERB rebate payment)unless the payment is less than $600, or you have identied yourself as a corporation or exempt. SoCalGas is not responsible for any taxes that may be imposed on you as a result of thisincentive/rebate.
/ /x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x
I have read and understand the program requirements and terms and conditions set forth in this rebate form and I agree to abide by those requirements.Furthermore, I concur that I must meet all eligibility criteria in order to be paid under this program.
For more information, visit sogs.om (search “REBATES” ).
This program is unded by Caliornia utility customers and administered by the state’s
investor-owned utilities, under the auspices o the Caliornia Public Utilities Commission.
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Customer Signature (s sign in o in) Customer Name (s int) Date
pleaSe Make a cpy F TIS DcuMeNT Fr yur recrDS