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Residential Rebate Application

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  2. Description of Program

    Residential Rebate Program:

    1. MAKE SURE YOUR PROJECT IS ELIGIBLE
      1. Check the specifications listed in this application and/or speak with a CBPU advisor by calling (517) 279-9531 to make sure your project is eligible for CBPU incentives. All equipment must be new and installed or operated in a residential dwelling, whose electric service is provided by the Coldwater Board of Public Utilities.
    2. COMPLETE YOUR PROJECT
      1. Install your new, energy-efficient equipment and remove your old equipment, following the specifications listed in this application.
    3. APPLY FOR YOUR CASH INCENTIVE 
      1. Once your project is complete, it’s time to request your cash incentive. Within 30 days of project completion, you must submit:
        1. A completed and signed application (which you can fill out here or by requesting a paper copy)
        2. Itemized invoice(s) for contractor-installed equipment, including installation date, costs for equipment installed and installation labor
        3. For furnace and central air conditioning units, the AHRI certificate
        4. For ENERGY STAR® products/equipment, the ENERGY STAR® logo and copy of invoice/receipt
  21. How did you hear about this program?

    Select all that apply.

  25. APPLIANCES & OTHER EQUIPMENT REBATES

    Please select the quantity for each of the following appliances or other equipment purchased. Please be sure to read through the specifications under each drop-down box. 

    If you have purchased 10+ of a single item in this category, please place the specific number in parentheses next to the category in the text box at the bottom of this section. 

    Ex. AIR PURIFIERS (13): Make&Model, Make&Model, etc.

  27. Must be ENERGY STAR Qualified

    Incentive: $15.00 per unit

  28. Must be ENERGY STAR Qualified

    Incentive: $3.50 per unit

  29. Must be ENERGY STAR Qualified

    Incentive: $5.50 per unit

  30. Must be ENERGY STAR Qualified

    Incentive: $7.50 per unit

  32. In the text box at the bottom of this section, please include the make and model numbers for each ENERGY STAR Air Purifier purchased. Place commas between each item in a category.

    Formatting for this should be as follows: 

    • AIR PURIFIER(s): Make-Model, Make-Model, etc.

    Incentive: $40.00 per unit

  33. Must be Wifi Enabled with Occupancy Sensor 

    Incentive: $50.00 per unit

  34. In the text box at the bottom of this section, please include the make and model numbers for each ENERGY STAR TV 31"-40" purchased. Place commas between each item in a category.

    Formatting for this should be as follows: 

    • TV 31"-40"(s): Make-Model, Make-Model

    Incentive: $25.00 per unit

  35. In the text box at the bottom of this section, please include the make and model numbers for each ENERGY STAR TV 41"+ purchased. Place commas between each item in a category.

    Formatting for this should be as follows: 

    • TV 41"+(s): Make-Model, Make-Model

    Incentive: $50.00 per unit

  37. In the text box at the bottom of this section, please include the make and model numbers for each ENERGY STAR Freezer purchased. Place commas between each item in a category.

    Formatting for this should be as follows: 

    • FREEZER(s): Make-Model, Make-Model

    Incentive: $35.00 per unit

  38. In the text box at the bottom of this section, please include the make and model numbers for each ENERGY STAR Dishwasher purchased. Place commas between each item in a category.

    Formatting for this should be as follows: 

    • DISHWASHER(s): Make-Model, Make-Model

    Incentive: $25.00 per unit

  39. In the text box at the bottom of this section, please include the make and model numbers for each ENERGY STAR Ceiling Fan purchased. Place commas between each item in a category.

    Formatting for this should be as follows: 

    • CEILING FAN(s): Make-Model, Make-Model

    Incentive: $25.00 per unit

  40. In the text box at the bottom of this section, please include the make and model numbers for each ENERGY STAR Dehumidifier purchased. Place commas between each item in a category.

    Formatting for this should be as follows: 

    • DEHUMIDIFIER(s): Make-Model, Make-Model

    Incentive: $15.00 per unit

  42. In the text box at the bottom of this section, please include the make and model numbers for each ENERGY STAR Refrigerator purchased. Place commas between each item in a category.

    Formatting for this should be as follows: 

    • REFRIGERATOR(s): Make-Model, Make-Model

    Incentive: $50.00 per unit

  43. In the text box at the bottom of this section, please include the make and model numbers for each ENERGY STAR Room AC purchased. Place commas between each item in a category.

    Formatting for this should be as follows: 

    • ROOM AC(s): Make-Model, Make-Model

    Incentive: $15.00 per unit

  44. In the text box at the bottom of this section, please include the make and model numbers for each ENERGY STAR Electric Clothes Dryer purchased. Place commas between each item in a category.

    Formatting for this should be as follows: 

    • ELECTRIC CLOTHES DRYER(s): Make-Model, Make-Model

    Incentive: $50.00 per unit

  45. In the text box at the bottom of this section, please include the make and model numbers for each ENERGY STAR Clothes Washer purchased. Place commas between each item in a category.

    Formatting for this should be as follows: 

    • CLOTHES WASHER(s): Make-Model, Make-Model

    Incentive: $50.00 per unit

  47. Please tell us the specific quantity (if 10+ items are purchased), make, and model number for the rebates that require it. You can determine which of the above rebates require it by looking under each item. Be sure to place commas between items in the list.

    Items should be written as follows:

    • CATEGORY (QUANTITY 10+): Make-Model, Make-Model, etc. 

    Ex. 

    • AIR PURIFIER(13): Powermatic-PM1250,JET-JAFS-1250, etc.

  49. Please submit a scan or clear photo of the receipt or invoice for the rebates you are applying for.

  50. Please submit a scan or clear photo of the receipt or invoice for the rebates you are applying for. 

  51. Please submit a scan or clear photo of the receipt or invoice for the rebates you are applying for.

  52. Please submit a scan or clear photo of the receipt or invoice for the rebates you are applying for. 

  54. How many items did you purchase that are eligible for a rebate? Please total the quantities of your items above in the APPLIANCES & OTHER EQUIPMENT REBATES section.

  55. How much of a rebate are you expecting from this section? 

    Calculate this number by taking the quantities of each item above multiplied by the incentive amount. Then add together. 

    Ex. LED FIXTURES (2 Units x $15.00 per Unit) + PROGRAMMABLE THERMOSTAT (2 Units x $50.00 per Unit) = $130.00 in rebates.

  59. CENTRAL AIR CONDITIONING REBATES

    Please select the quantity for each of the following systems purchased. Please be sure to read through the specifications under each drop-down box. 

    If you have purchased 10+ of a single item in this category, please place the specific number in parentheses next to the category in the text box at the bottom of this section. 

    Ex. CENTRAL AC - 15 SEERS (13): Make&Model, Make&Model, etc. 

  61. The indoor coil & outdoor condenser must be a matched set and installed on the same date to be eligible. 

    Please provide the Central AC Manufacturer, Central AC Model Number, and Central AC Serial Number for your new, installed equipment

    Incentive: $75.00 per unit

  62. The indoor coil & outdoor condenser must be a matched set and installed on the same date to be eligible. 

    Please provide the Central AC Manufacturer, Central AC Model Number, and Central AC Serial Number for your new, installed equipment

    Incentive: $100.00 per unit

  63. The indoor coil & outdoor condenser must be a matched set and installed on the same date to be eligible. 

    Please provide the Central AC Manufacturer, Central AC Model Number, and Central AC Serial Number for your new, installed equipment

    Incentive: $150.00 per unit

  65. Please tell us the specific quantity (if 10+ items are purchased), the Central AC Manufacturer, Central AC Model Number, and Central AC Serial Number. Be sure to place commas between items in the list.

    Items should be written as follows:

    • CATEGORY (QUANTITY 10+): Make-Model, Make-Model, etc. 

  67. Please submit a scan or clear photo of the receipt or invoice for the rebates you are applying for.

  68. Please submit a scan or clear photo of the receipt or invoice for the rebates you are applying for.

  69. Please submit a scan or clear photo of the receipt or invoice for the rebates you are applying for.

  70. Please submit a scan or clear photo of the receipt or invoice for the rebates you are applying for.

  72. How many items did you purchase that are eligible for a rebate? Please total the quantities of your items above in the CENTRAL AIR CONDITIONING REBATES section.

  73. How much of a rebate are you expecting from this section? 

    Calculate this number by taking the quantities of each item above multiplied by the incentive amount. Then add together. 

    Ex. LED FIXTURES (2 Units x $15.00 per Unit) + PROGRAMMABLE THERMOSTAT (2 Units x $50.00 per Unit) = $130.00 in rebates.

  77. MINI/MULTI-SPLIT DUCTLESS AIR-SOURCE HEAT PUMP REBATES

    Please select the quantity for each of the following systems purchased. Please be sure to read through the specifications under each drop-down box. 

    If you have purchased 10+ of a single item in this category, please place the specific number in parentheses next to the category in the text box at the bottom of this section. 

    Ex. MINI/MULTI-SPLIT DUCTLESS AIR-SOURCE HEAT PUMP REBATES (13): Make&Model, Make&Model, etc. 

  79. Minimum SEER Rating of 18 for Indoor and Outdoor components

    Please provide the Manufacturer, Model Number, and Serial Number for your new, installed equipment

  81. Please tell us the specific quantity (if 10+ items are purchased), the Manufacturer, Model Number, and  Serial Number. Be sure to place commas between items in the list.

    Items should be written as follows:

    • CATEGORY (QUANTITY 10+): Make-Model, Make-Model, etc. 

  83. Please submit a scan or clear photo of the receipt or invoice for the rebates you are applying for.

  84. Please submit a scan or clear photo of the receipt or invoice for the rebates you are applying for.

  85. Please submit a scan or clear photo of the receipt or invoice for the rebates you are applying for.

  86. Please submit a scan or clear photo of the receipt or invoice for the rebates you are applying for.

  88. How many items did you purchase that are eligible for a rebate? Please total the quantities of your items above in the MINI/MULTI-SPLIT DUCTLESS AIR-SOURCE HEAT PUMP REBATES section.

  89. How much of a rebate are you expecting from this section? 

    Calculate this number by taking the quantities of each item above multiplied by the incentive amount. Then add together. 

    Ex. LED FIXTURES (2 Units x $15.00 per Unit) + PROGRAMMABLE THERMOSTAT (2 Units x $50.00 per Unit) = $130.00 in rebates.

  93. WATER HEATER REBATES

    Please select the quantity for each of the following systems purchased. Please be sure to read through the specifications under each drop-down box. 

    If you have purchased 10+ of a single item in this category, please place the specific number in parentheses next to the category in the text box at the bottom of this section. 

    Ex. WATER HEATER REBATES (13): Make&Model, Make&Model, etc. 

  95. Must be ENERGY STAR qualified and be replacing an Electric Water Heater

    Please provide the Manufacturer, Model Number, and Serial Number for your new, installed equipment

  97. Please tell us the specific quantity (if 10+ items are purchased), the Manufacturer, Model Number, and  Serial Number. Be sure to place commas between items in the list.

    Items should be written as follows:

    • CATEGORY (QUANTITY 10+): Make-Model, Make-Model, etc. 

  99. Please submit a scan or clear photo of the receipt or invoice for the rebates you are applying for.

  100. Please submit a scan or clear photo of the receipt or invoice for the rebates you are applying for.

  101. Please submit a scan or clear photo of the receipt or invoice for the rebates you are applying for.

  102. Please submit a scan or clear photo of the receipt or invoice for the rebates you are applying for.

  104. How many items did you purchase that are eligible for a rebate? Please total the quantities of your items above in the WATER HEATER REBATES section.

  105. How much of a rebate are you expecting from this section? 

    Calculate this number by taking the quantities of each item above multiplied by the incentive amount. Then add together. 

    Ex. LED FIXTURES (2 Units x $15.00 per Unit) + PROGRAMMABLE THERMOSTAT (2 Units x $50.00 per Unit) = $130.00 in rebates.

  109. POOL PUMP REBATES

    Please select the quantity for each of the following systems purchased. Please be sure to read through the specifications under each drop-down box. 

    If you have purchased 10+ of a single item in this category, please place the specific number in parentheses next to the category in the text box at the bottom of this section. 

    Ex. POOL PUMP REBATES (13): Make&Model, Make&Model, etc. 

  111. Must be ENERGY STAR Qualified.

    Must provide variable speed below in Specifications field. 

  113. Please tell us the specific quantity (if 10+ items are purchased) and the variable speed for each in the space below. Be sure to place commas between items in the list.

    Items should be written as follows:

    • CATEGORY (QUANTITY 10+): Variable Speed, Variable Speed, etc. 

  115. Please submit a scan or clear photo of the receipt or invoice for the rebates you are applying for.

  116. Please submit a scan or clear photo of the receipt or invoice for the rebates you are applying for.

  117. Please submit a scan or clear photo of the receipt or invoice for the rebates you are applying for.

  118. Please submit a scan or clear photo of the receipt or invoice for the rebates you are applying for.

  120. How many items did you purchase that are eligible for a rebate? Please total the quantities of your items above in the POOL PUMP REBATES section.

  121. How much of a rebate are you expecting from this section? 

    Calculate this number by taking the quantities of each item above multiplied by the incentive amount. Then add together. 

    Ex. LED FIXTURES (2 Units x $15.00 per Unit) + PROGRAMMABLE THERMOSTAT (2 Units x $50.00 per Unit) = $130.00 in rebates.

  125. How many items did you purchase that are eligible for a rebate? Please total the quantities of your items from the above sections. 

  126. Please total the rebate amounts from the above sections. 

  128. Certifications*

    I hereby certify that: 

    1. The information contained in this application is accurate and complete. 

    2. All rules of this incentive program have been followed. 

    3. I have read and understand the Terms and Conditions included with this document.

    I agree to verification of equipment installation which may include a site inspection by a Coldwater Board of Public Utilities representative. I understand that I am not allowed to receive more than one incentive from this program for any one piece of equipment. I hereby agree to indemnify, hold harmless and release the utility from any actions or claims in regard to the installation, operation and disposal of equipment (and related materials) covered herein, including liability from any incidental or consequential damages.

    I understand that my submittal of the requested information is for the sole purpose of my program participation. I further understand that this information will be treated as confidential to the extent permitted by law. *Limited funds are available. Please allow 6-8 weeks to receive your Simply Efficient incentive. Check from the time your complete application is received by CBPU.

  130. Leave This Blank:

  133. This field is not part of the form submission.