new nicor res rebate application

5
Get Started: 1. Verify Customer and Product Eligibility Before Installing: • Read complete list of requirements on Pages 3-4 • View a list of qualifying products online 2. Collect Nicor Gas Account Number and Contractor Invoice 3. Complete this application in full, or apply online at NicorGasRebates.com/home Read the complete list of requirements on Pages 3 and 4 to ensure that your installation is eligible for Program rebates. If you meet the requirements, please complete Steps 2 and 3 (Pages 1 and 2) using the tips and guidance provided on the left, and mail all required documentation to the address listed in the bottom left corner. Step 2: Enter Your Information and Sign Below Step 1: Verify Eligibility Page 1 of 4 NOTE: Incentives are taxable and if greater than $600 in a calendar year will be reported to the IRS unless you are exempt. If you have exceeded a total of $600 in rebates, a W-9 form will be requested if applicable. * Payee: The Program allows the check to be made out to any one of the following: Account Holder, Contractor or Landlord. Please review all requirements listed on Page 4. If you are the Account Holder and wish the rebate check to be made out to you, please complete all of the required fields in the rebate application, provide the required supporting documentation listed on Pages 3 and 4 of this rebate application, and have the Nicor Gas account holder sign on Page 1 as the “Applicant”. The check may also be made out to the Landlord (who is not the account holder) or the installing Contractor (offering an Instant Discount). Please review all requirements outlined on Page 4 for applications submitted by a Landlord or Contractor. The Nicor Gas account holder must sign the applicable Customer Release Form if the check is being made payable to the Landlord or Contractor. Thank you for your interest in the Nicor Gas Energy Efficiency Program! Please follow the steps outlined below to ensure that your application is eligible for submission. Make a copy of your completed application and supporting documentation to retain for your records. 06012012ResApplication 2011 - 2014 Home Energy Efficiency Rebate Program Application The Nicor Gas Energy Efficiency Program is a multi-year program funded by Nicor Gas ratepayers in compliance with state law through a small charge identified on customer bills as “Energy Program.” Account Holder Information Nicor Gas Account Number Prefix (Mr., Mrs., Ms.) First Name Last Name Installation Information Installation Address City State Zip Code Application Contact Information Contact First Name Contact Last Name Contact Email Contact Phone Contractor Information Contractor Business Name Phone Email Address City State Zip Code Mailing Address for Rebate Check Make Check Payable To* Mailing Address City State Zip Code q Account Holder q Contractor q Landlord I certify that the participant has not received/will not receive a rebate for the same product or equipment from more than one Illinois investor owned utility or third-party energy efficiency program offering rebates or financing funded with ratepayer funds. I certify that the energy-efficient product or service was paid for as reflected on the receipt and described in this rebate application. I certify that all information is true and correct, and that I have met all Program requirements as outlined in the General Program Qualifications section. I understand and agree to the terms and requirements for which I am submitting this rebate application, as outlined on Pages 1 through 4. This is q an existing home q new construction Applicant Signature Print Applicant Name Date Promo Code (if applicable) Ready to Submit? n Page 1 is complete with the Account Holder’s signature n Page 2 is complete with all product/equipment information n Contractor Invoice is attached and contains all requirements: - Equipment Make, Model & Serial Number - Total Installed Cost (itemized by qualifying equipment) - Installation & Purchase Dates (if different) - Payment Terms, Balance Due of Zero, or Paid in Full Stamp - Professional Contractor Information (if applicable) - Any rebate-specific invoice requirements listed on Page 3 Submit your completed application and invoice: Nicor Gas Energy Efficiency Program 3800 Watt Avenue, Suite 105 Sacramento, CA 95821-2672 Need help? Contact us at 877.886.4239 Monday through Friday 7:00 a.m. – 7:00 p.m.

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NICOR REBATE

TRANSCRIPT

Page 1: New Nicor Res Rebate Application

Get Started:

1. Verify Customer and Product Eligibility Before Installing:• ReadcompletelistofrequirementsonPages3-4

• Viewalistofqualifyingproductsonline

2. Collect Nicor Gas Account Number and Contractor Invoice

3. Complete this application in full, or apply online at NicorGasRebates.com/home

ReadthecompletelistofrequirementsonPages3and4toensurethatyourinstallationiseligibleforProgramrebates. Ifyoumeettherequirements,pleasecomplete Steps 2 and 3 (Pages 1 and 2) using the tips and guidance provided on the left, and mail all required documentation to the address listed in the bottom left corner.

Step 2: Enter Your Information and Sign Below

Step 1: Verify Eligibility

Page 1 of 4

NOTE: Incentives are taxable and if greater than $600 in a calendar year will be reported to the IRS unless you are exempt. If you have exceeded a total of $600 in rebates, a W-9 form will be requested if applicable.

* Payee: TheProgramallowsthechecktobemadeouttoanyoneofthefollowing:AccountHolder,ContractororLandlord.PleasereviewallrequirementslistedonPage4.IfyouaretheAccountHolderandwishtherebatechecktobemadeouttoyou,pleasecompletealloftherequiredfieldsintherebateapplication,providetherequiredsupportingdocumentationlistedonPages3and4ofthisrebateapplication,andhavetheNicorGasaccountholdersignonPage1asthe“Applicant”.ThecheckmayalsobemadeouttotheLandlord(whoisnottheaccountholder)ortheinstallingContractor(offeringanInstantDiscount).PleasereviewallrequirementsoutlinedonPage4forapplicationssubmittedbyaLandlordorContractor.TheNicorGasaccountholdermustsigntheapplicableCustomerReleaseFormifthecheckisbeingmadepayabletotheLandlordorContractor.

Thank you for your interest in the Nicor Gas Energy Efficiency Program!

Pleasefollowthestepsoutlinedbelowtoensurethatyourapplicationiseligibleforsubmission.Makeacopyofyourcompletedapplicationandsupportingdocumentationtoretainforyourrecords.

06012012ResApplication

2011 - 2014Home Energy Efficiency Rebate Program Application

The Nicor Gas Energy Efficiency Program is a multi-year program funded by Nicor Gas ratepayers in compliance with state law through a small charge identified on customer bills as “Energy Program.”

Account Holder Information

Nicor Gas Account Number Prefix (Mr., Mrs., Ms.) First Name Last Name

Installation Information

Installation Address City State Zip Code

Application Contact Information

Contact First Name Contact Last Name Contact Email Contact Phone

Contractor Information

Contractor Business Name Phone Email

Address City State Zip Code

Mailing Address for Rebate Check

Make Check Payable To* Mailing Address City State Zip Code

q Account Holder q Contractor q Landlord

Icertifythattheparticipanthasnotreceived/willnotreceivearebateforthesameproductorequipmentfrommorethanoneIllinoisinvestorownedutilityorthird-partyenergyefficiencyprogramofferingrebatesorfinancingfundedwithratepayerfunds.Icertifythattheenergy-efficientproductorservicewaspaidforasreflectedonthereceiptanddescribedinthisrebateapplication.Icertifythatallinformationistrueandcorrect,andthatIhavemetallProgramrequirementsasoutlinedintheGeneralProgramQualificationssection.IunderstandandagreetothetermsandrequirementsforwhichIamsubmittingthisrebateapplication,asoutlinedonPages1through4.

This is q an existing home q new construction

Applicant Signature Print Applicant Name Date

Promo Code (if applicable)

Ready to Submit?

nPage 1 is complete with the Account Holder’s signature

nPage 2 is complete with all product/equipment information

n Contractor Invoice is attached and contains all requirements:-EquipmentMake,Model&SerialNumber

-TotalInstalledCost(itemizedbyqualifyingequipment)

-Installation&PurchaseDates(ifdifferent)

-PaymentTerms,BalanceDueofZero,orPaidinFullStamp

-ProfessionalContractorInformation(ifapplicable)

-Anyrebate-specificinvoicerequirementslistedonPage3

Submit your completed application and invoice:

Nicor Gas Energy Efficiency Program3800 Watt Avenue, Suite 105Sacramento, CA 95821-2672

Need help? Contactusat877.886.4239MondaythroughFriday7:00a.m.–7:00p.m.

Page 2: New Nicor Res Rebate Application

Step 3: Enter Product Information

Equipment/Product Rebate Amount

Installed Date

Total Installed Cost* Make Model Serial Number

High-Efficiency FurnaceAFUE** > 95%

$250

High-Efficiency FurnaceAFUE** > 92%

$200

High-Efficiency BoilerAFUE** > 95%

$450

High-Efficiency BoilerAFUE** > 90%

$350

Indirect Water Heater Must be combined with

a qualifying high-efficiency boiler$100

Storage Water Heater Energy Factor > 0.67

$200

Hot Water Pipe InsulationMinimum 6 feet

Must be submitted with another rebate

$10Insulation Type Insulation Thickness Linear Feet Installed

q Fiberglass q Foam q Calcium Silicate

Programmable Thermostat

$20

Manufacturer/Make Model Self-Installers: Certify Installation

q Thermostat is installed per Program requirements on residential-sized natural gas equipment and is currently operational.

High Performance Windows

$1.50 per square

foot

Manufacturer Total Square Footage Installed Quantity of Windows Installed

RE

SID

EN

TIA

L E

QU

IPM

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Reminders:

Page 2 of 4

*The“TotalInstalledCost,”isthetotalpurchasepriceofanindividualpieceofequipment/product,includingthecostoftheequipment/product,materialsandexternallabor.“TotalInstalledCost”mustbeitemizedbyeachequipment/productinstalledandenteredinthechartsaboveforeachrebateyouareapplyingfor.TheItemizedContractorInvoicemustincludethe“TotalInstalledCost,“itemizedbyeachqualifyingequipment/productontheinvoice.**AFUE=AnnualFuelUtilizationEfficiency+TheevaporatorandcondensercoilcombinationmustbeAHRICertified,withtheAHRICertifiedReferenceNumberenteredaboveasshownintheAHRIDatabase,availableatwww.ahridirectory.org.TheComEdSmartIdeasCentralAirConditioningrebateisfundedbyComEdcustomersincompliancewithILPublicAct95-0481.

Please use an additional copy of Page 2 if applying for more than one rebate of the same type.

Complete System Replacement Rebates - Available to Customers of Nicor Gas and ComEd

New High-Efficiency Equipment

EquipmentRebate

AmountPurchase

DateInstalled

DateTotal Installed

Cost*Make Model AHRI Certified

Ref. # + Serial Number

Central AC (CAC):Evaporator Coil

(Indoor Unit) $250(for complete CAC system)Central AC (CAC):

Condenser Unit(Outdoor Unit)

High-Efficiency Furnace

$200 or $250 (based on efficiency)

n/a

Old/Existing Furnace and CAC Condenser Unit

The “Condition” and “Estimated Age” fields are

required for this application. Please enter the make, model, size

and efficiency if available.

Equipment Condition Estimated Age (Yrs) Make Model Capacity (Btuh) Efficiency

CAC - Condenser q Operableq Inoperable

SEER

Furnace q Operableq Inoperable

AFUE

ComEd Account Number:

Dwelling Type: q Single-Family Attached q Single-Family Detached q Multi-Family q Manufactured Home

• Complete all fieldsfortherebateyouareapplyingfor.Unlessnoted,all fields are required.

• Verifythemake,modelandserialnumberenteredarecorrect, complete and legible.

• Pipe Insulation:Mustbecombinedwithanotherqualifyingequipment/product(cannotbesubmittedalone).

• Indirect Water Heater:Mustbeinstalledon(addedonorintegratedinto)aqualifyingHighEfficiencyBoiler.

• Programmable Thermostat: Ifself-installed,certifyyouhaveinstalledthethermostatperallrequirementsonPage3and4anditiscurrentlyoperational.

• CompleteSystemReplacementrebatesareavailabletocurrentresidentialdeliverycustomersofboth Nicor Gas and ComEd(CommonwealthEdison).

• CompleteallfieldsinthesecondtableifyouareapplyingforaCompleteSystemReplacementRebate.Do not enter furnace information in the first table.

• Include the AHRI Certified Reference Number-Askyourinstallingcontractorforassistance,orvisitNicorGasRebates.com/csr.

Complete System Replacement Rebates:

Rebate-Specific Requirements:

abrahmstedt
Text Box
New rebate offerings available for qualifying purchases and installations completed November 19, 2012 through May 31, 2013. Refer to the last page of this application for more information.
Page 3: New Nicor Res Rebate Application

Page 3 of 4

General Rebate Requirements

Equipmentandproductsmustbenewandinstalledbyaprofessionalcontractor(unlessotherwisenoted)accordingtoallapplicablebuilding,localandstatecodes,andmanufacturerspecifications.EquipmentandproductsmustbeinstalledandoperationalpriortosubmittalofthisapplicationattheaddresslistedonPage1.EquipmentmustbepurchasedandinstalledJune1,2011-May31,2014,unlessotherwisenoted.

CompleteSystemReplacementRequirementsCombinedRebatesfromComEd&NicorGasforCentralAirConditioning(CAC)&FurnaceReplacementsParticipationintheCompleteSystemReplacementrequiresthatallGeneralProgramQualificationslistedonPage4ofthisapplicationbemet,unlessotherwisenotedbelow,inadditiontothefollowingrequirements:

• ParticipantmustbeacurrentresidentialdeliveryservicecustomerofCommonwealthEdison(ComEd).• Applicationmustbepostmarked(orsubmittedonline)nolaterthan90daysaftertheinitialinstallationdate,orbyJune15,2013,whichevercomesfirst.

• Allequipment,includingthefurnace,evaporatorcoilandcondenserunit,mustbeincludedonthesameinvoice.• OfferisvalidforqualifyingequipmentpurchasedandinstalledJune1,2012-May31,2013,oruntilfundsaredepleted.

• Installationofaqualifyinghigh-efficiencyfurnaceandCACunitmustbecompletedatthesametimebythesameinstallingcontractor.Thefurnacemustbefullyinstalledandoperationalpriortosubmittalofthisapplication.Ifinstallationiscompletedinthewintermonths(NovemberthroughApril)andthecondenserunitcannotbeplaced,thefurnaceandevaporatorcoilmustbeinstalledatthesametime.Thecondenserunitmusthaveinstallationplannedforthespring.

Equipment-Specific Requirements Required Documentation

High-Efficiency Furnace

AqualifyingfurnacethatmeetsallrequirementslistedabovemustbeincludedonPage2tobeeligiblefortheCompleteSystemReplacementrebate.

ItemizedContractorInvoice(s)orProofofPurchaseReceipt(s)forthefurnaceandCACinstallationconsistingof:• Equipmentmake,modelandserialnumberforthefurnace,condenserandevaporator

• Totalinstalledcost(itemizedbythefurnacecostandcompleteCACcost)

• Totalnumberofunitsinstalled• Purchasedateandinstallationdate(includingestimatedcompletiondateifCondensercannotbeplaceduntilspring)

• AllotherrequirementslistedonPage3

Central Air Conditioning Unit

NewequipmentmusthaveaSeasonalEnergyEfficiencyRatio(SEER)of14.5orgreater.TheevaporatorcoilandcondenserunitcombinationmustbeAHRICertified(Visitwww.ahridirectory.orgtoverifycertification).Equipmentmustbereplacingexisting,CACequipmentusedforthesamepurposes,oneforone.Equipmentadditionstoaresidentialdwelling,whicharenotreplacingexistingCACequipment,arenoteligibleforrebates.Newconstructionisnoteligible.CACmustbepurchasedandinstalledduringtheProgramofferingperiod,June1,2012-May31,2013.Therebateamountof$250isforthecompleteCACunit,includingboththeevaporatorcoilandcondenserunit.

Rebate-Specific RequirementsHigh-Efficiency Furnaces

AFUE>95%AFUE>92%

NewequipmentmusthaveanAFUE>92%or>95%.FurnaceswithanAFUE>95%mustbeENERGYSTAR®qualified.Therebateamountisdeterminedbytheefficiency(AFUE)ratingofthequalifyingfurnace.

High-Efficiency Boilers AFUE>95%AFUE>90%

NewequipmentmustmeetENERGYSTARstandardswithanAFUE>90%or>95%.Onlyresidential-sizedboilerswithaninputcapacity<300MBTUHareeligible.Boilersmustincludeanoutdoor-airresetcontrol(integratedoraddedtothesystem),unlessthesupplytemperaturedoesnotexceed140oF.Therebateamountisdeterminedbytheefficiency(AFUE)ratingofthequalifyingboiler.

Indirect Water Heaters

Newindirectwaterheatermustbeaddedonorintegratedintoanewhigh-efficiencyboilerthatqualifiesforaHigh-EfficiencyBoilerRebate(above).Indirectwaterheaterandspaceheatingboilermustbeinstalledatthesametime,andbeincludedonthesameinvoice.AdditionofanIndirectWaterHeaterontoanexistingboilerdoesnotqualify.Indirectwaterheatermustbeusedforalldomesticwaterheatingforthewholehome(point-of-useunitsarenoteligible).IndirectwaterheatermustbepurchasedandinstalledJune1,2012-May31,2014.

Storage Water HeatersEnergyFactor>0.67 NewequipmentmustmeetENERGYSTARstandardswithanEnergyFactor>0.67.Instantaneous(tankless)waterheatersarenoteligible.

Hot Water Pipe Insulation (Mustbeincludedon

anapplicationwithanotherqualifyingproduct)

Insulationthicknessmustbe0.75inchesorgreater.Fiberglass,foamorcalciumsilicateinsulationtypesqualify.Mustbeaddedtoun-insulatedpipesofanaturalgasdomestichotwatersystem.Electricandpropanewaterheaterpipesystemsarenoteligible.Minimumof6linearfeetmustbeinstalled.Minimumqualifyingpipediameteris0.75inches.Rebateapplicationmustcontainanotherqualifyingproduct.Newconstructionisnoteligible.PipeinsulationmustbepurchasedandinstalledJune1,2012-May31,2014.

Programmable Thermostats

Newthermostatmustbecapableofmaintainingseparateprogramsforweekdaysandweekends,withatleasttwotemperaturesettingsforeachprogram.Thermostatmustbeinstalledonsystemwithresidential-sizednaturalgasspaceheatingequipmentwithInputCapacity<300MBTUH.Thermostatmustbeinstalledaccordingtomanufacturerspecifications.Professionalinstallationisnotrequired,butisstronglyencouraged.Newconstructionisnoteligible.ThermostatmustbepurchasedandinstalledJune1,2012-May31,2014.

High Performance Windows

MusthaveU-Value<0.20andberatedbytheNationalFenestrationRatingCouncil(NFRC).Replacementglass(addingglasstoanexistingframe)andwindowfilmsdonotqualify.Newconstructionisnoteligible.WindowsmustbepurchasedandinstalledJune1,2012-May31,2014.

Rebate Requirements and Qualifications:

Required Documentation

1. Itemized Contractor Invoice/Proof of Payment Receipt which includes: • Equipmentmake,modelandserialnumber• Totalinstalledcost(itemizedbyqualifying

equipment)• Purchasedateandinstallationdate(ifpurchased

andinstalledondifferentdates)• Totalnumberofunitsinstalled• Professionalcontractor’sbusiness/company

name,addressandphonenumber(ifinstalledbyaprofessionalcontractor)

• Balancedueofzero,paidinfullstamp,orpaymentterms

• Anyrebate-specificinvoicerequirements:• Furnaces: Includethedischargeair

configuration(either“Upflow,”“Downflow,”or“Horizontal”).

• Pipe Insulation:Includetheinsulationtype,thicknessandtotallinearfeetinstalled.

• Windows:Includethewindowdimensions,quantityofeachandtotalsquarefootageofqualifyingwindowsinstalled.

2. Completed and signed rebate application

3. Additional Supporting Documentation:• Windows:NFRC“Label”orManufacturer

SpecificationSheetforeachwindowtypeinstalled• Pipe Insulation:ManufacturerSpecificationSheet

Page 4: New Nicor Res Rebate Application

General Program Qualifications:

Page 4 of 4

Participant Eligibility

YouareonlyeligibletoparticipateintheHomeEnergyEfficiencyRebateProgram(“Program”)ifyouare:• AcurrentresidentialcustomerofNicorGas.• Installingqualifyingenergy-efficientproductsorequipmentinaresidentialdwellingusedastheoccupants’primaryresidence.

Installation Requirements

Yourinstallationofhigh-efficiencynaturalgasequipmentorproductsiseligibleforarebateif:• Itmeetsallequipment-specific,energyefficiency,andProgramrequirementsoutlinedintheapplicationform.• Itispurchasednew.Resaleequipment,newpartsinstalledinexistingequipment,orequipmentthatisleased,rebuilt,rented,receivedfrominsurance

claims,receivedfromawarrantyorwonasaprizedonotqualify.• Itisreplacingexisting,naturalgasequipmentusedforthesamepurposes(applicableonlytoinstallationscompletedinexistingfacilities;doesnotapply

topipeinsulation,programmablethermostatsorhighperformancewindows).Equipmentadditionstoaresidentialspace,whereequipmentdidnotpreviouslyexist,orinstallationofqualifyingequipmentinanewfacility,areeligibleforProgramrebatesifallotherProgramqualificationsaremet,unlessotherwisenoted(newconstructionisnoteligibleforHighPerformanceWindow,PipeInsulation,ProgrammableThermostatandCompleteSystemReplacementrebates).Naturalgasequipmentreplacingelectricequipment,andelectricequipmentreplacingnaturalgasequipment,arenoteligible.

• Equipmentisinstalledbyaprofessionalcontractorconformingtoallapplicablebuilding,localandstatecodes,andmanufacturerspecifications(ProgrammableThermostatsdonotrequireprofessionalinstallation).Equipmentisinstalledandoperationalpriortosubmittalofthisapplicationattheaddresslistedontheapplication.

• Itisinstalledinasingle-familydwelling,oramulti-familydwellingofthreeunitsorless.• Itisinstalledinapropertyownedbytheapplicant,ortheapplicanthasreceivedpermissionfromthepropertyownertoinstalltheequipment.• ItispurchasedandinstalledduringtheProgramofferingperiod:June1,2011-May31,2014(withtheexceptionofindirectwaterheaters,hotwaterpipe

insulation,highperformancewindowsandprogrammablethermostats,whichmustbepurchasedandinstalledJune1,2012orlater).

Application Requirements

Tobeconsideredcompleteandeligibleforrebates,allapplicationsmust:• Bepostmarked(orsubmittedonline)nolaterthan90daysaftertheinstallationdate,orbyJune30,2014,whichevercomesfirst.• IncludeItemizedContractorInvoice(s)orProofofPurchaseReceipt(s)consistingof:

• Equipment/productmake,modelandserialnumber(ifequipment/producthasaserialnumber)• Totalinstalledcost(itemizedbyqualifyingequipment)• Purchasedateandinstallationdate(ifpurchasedandinstalledonseparatedates)• Professionalcontractor’sbusiness/companyname,addressandphonenumber(ifinstalledbyaprofessionalcontractor)• Balancedueofzero,paidinfullstamp,orpaymentterm• Anyotherrebate-specificrequirements,asnotedonPage3

• BesignedbytheNicorGasaccountholder,orincludeaCustomerReleaseFormsignedbytheaccountholder.• Please Note: Ifrebateistobepaiddirectlytotheinstallingcontractor(foranInstantDiscount)oralandlord(whoisnottheaccountholder)application

submissionsmustmeetallrequirementslistedintheInstantDiscountRequirementsandLandlordApplicantRequirementssections,below.Useseparateapplicationsifapplyingformultipleequipmentorproductsinstalledbydifferentcontractors.Onlineapplicationsmust:• Besubmittedonlineat:NicorGasRebates.com(donotmailthisform).• BeaccompaniedbyacopyofItemizedContractorInvoice/ProofofPurchaseReceiptandallrebate-specificrequireddocumentation.

Program Terms and Conditions

• Fundsarelimitedandapplicationsareprocessedonafirst-come,first-servedbasis.Programissubjecttochangeandmayendwithoutpriornotice.

• Pleaseallowapproximately2weeksforyourcompletedapplicationtobeprocessed.Incompleteapplicationscannotbeprocessed.

• Failuretocompletetherebateapplicationinfullandprovidetherequiredsupportingdocumentationwilleitherdelaythepaymentprocessorresultinyourapplicationbeingdenied.

• Maintainacopyofyourrebateapplicationandallsupportingdocumentation.TheProgramisnotresponsibleforitems(i.e.,rebateapplications,supportingdocumentation,and/orrebatechecks)lostordamagedinthemail.

• Contractorsareeligibletohavetherebatesignedovertothem.Contractorsreceivingrebatesarenoteligibleforanyotherincentivesforthesameproducts.Contractorsmustsubmitthehardcopyapplication(withtheexceptionofeligibleContractorCircleMembers).

• Ifyoudonotownthepropertywherethisequipmentisinstalled,asatenantyouareresponsibleforobtainingthepropertyowner’spermissiontoinstalltheequipmentforwhichyouareapplyingforarebate.Yoursubmissionofthisapplicationindicatesthatyouhaveobtainedthispermission.

• Rebateincentivesmaynotexceedthetotalpurchasepriceoftheenergyefficientequipment.Theonlycostseligibleforincentivesare:materials,equipment,andexternallabor.

• AllequipmentinstallationsaresubjecttoverificationinspectionbytheProgramAdministratortoensurethattheequipmentisproperlyinstalledandoperating.

• Participantsmustallow,ifrequested,theNicorGasEnergyEfficiencyProgramoraProgramrepresentativereasonableaccesstotheirhometoverifytheinstalledequipment.

• NicorGas,ContractandProgramAdministratorsdisclaimanyandallliability,lossordamage,andmakenoguaranteesrelatedto:

• ParticipationintheProgram,includinguseorinstallationoftheequipment;• Lossordelayofrebatecheckinthemail;and• AnytaxesthatmaybeimposedasaresultofparticipationintheProgram.

Landlord Participant Requirements

Ifyouareapplyingforarebateforapropertyyouown,butthegasaccountnumberisinyourtenant’sname,providethefollowing:• Page1:Includeyourtenant’saccountnumber,nameandinformation.Select“Landlord”under

“MakeCheckPayable.”Includeyournameunder“ApplicationContactInformation.”• CopyoftheItemizedContractorInvoice/ProofofPurchaseReceipt,signedbythepurchaser.• Allapplicablepurchaseinvoicesandrequireddocumentation,aslistedonthisapplication.• Completedrebateapplication,signedbytheapplicantandaCustomerReleaseForm-Landlord

ApplicantssignedbytheNicorGasaccountholder.CustomerReleaseFormscanbefoundonthe“ApplyNow”pageatNicorGasRebates.com/home.

Instant Discount Requirements

Ifrebateisbeingpaiddirectlytotheinstallingcontractor,contractormustsubmit:• Copyofcustomerjoborder/invoiceshowingtherebateamountdeductedfromthetotalpurchaseprice,signedbycustomer.• Completedandcontractor-signedrebateapplication,withaccountholder-signedCustomerReleaseFormverifyingproduct(s)installedandreleasing

paymenttothecontractor.(Accountholder-signedrebateapplicationwillbeacceptedinplaceofaCustomerReleaseForm.)InstantDiscountRequirements:• TheNicorGasaccountholdermustsigntheItemizedContractorInvoiceandeithertherebateapplicationoraCustomerReleaseForm.• CustomerReleaseFormsareavailablefordownloadatNicorGasRebates.com/contractor-circle.• Thecontractorinvoicemustclearlyshowthefullrebateamountasadeductionoffthecustomer’spurchaseprice.• Itistheinstallingcontractor’ssoleresponsibilitytoverifycustomer,productandinstallationeligibilitypriortoprovidinganInstantDiscount.Contractor

assumesallliabilitybyprovidingtherebateasanInstantDiscount.• TheonlineapplicationsystemforInstantDiscountsislimitedtoContractorCircleMembers.VisitNicorGasRebates.com/contractor-circleformore

informationortoenrollintheContractorCircle.

Complete System Replacement Terms and Conditions• BysigningonPage1andcompletingPage2foraCompleteSystemReplacementrebate,

theApplicantisagreeingtoalltermsandconditionsandcertifiesthathe/shehasmetallqualificationslistedonthisrebateapplication.

• TheProgramreservestherighttorequestasignedreleaseformfromtheComEdaccountholder,agreeingtoallProgramrequirementsandtermsandconditions,iftheapplicantisnottheComEdaccountholder.

• Ifyouareapplyingforarebateforapropertyyouown,buttheelectricaccountnumberisinyourtenant’sname,includeyourtenant’sComEdaccountnumberonPage2.

• Bysigningandsubmittingthisapplication,asaComEdcustomeryouareagreeingtoallowcontractorsandvendorsaccesstoyourinstallationdata(excludingsensitivecustomerinformation).

• Therebatesforthehigh-efficiencyfurnaceandtheCACunitwillbepaidonseparatechecks.

Page 5: New Nicor Res Rebate Application

HOME ENERGY EFFICIENCY REBATE PROGRAM

Additional offers to save more at home

Choose the rebate that’s right for your home today. Visit NicorGasRebates.com/home or call 877.886.4239 to learn more.

Now there are even more ways to save money and energy with the Nicor Gas Energy Efficiency Rebate Program! Enjoy the benefits of natural gas efficiency in your home. You may experience increased comfort, lower utility bills and the peace of mind knowing you are using less energy.

LOOK FOR THE BEST VALUE BADGEThe Home Energy Efficiency Rebate Program now offers new ways to save energy in your home—including more efficient products and value packages. Look for this badge on the rebate information page at NicorGasRebates.com/home to find offers that can bring you the best rebate, energy savings and utility bill savings!

For complete program rules, dates, and eligibility, visit NicorGasRebates.com/home. Offers are limited and subject to change. The Nicor Gas Energy Efficiency Program is a multi-year program funded by Nicor Gas ratepayers in compliance with state law through a small charge identified on bills as “Energy Program.”

112512_HEERNewOffers

EQUIPMENT TYPE EFFICIENCY REQUIREMENT REBATE AMOUNT

NATURAL GAS EQUIPMENT AND IMPROVEMENTS

High-Efficiency Furnace ≥ 92% Annual Fuel Utilization Efficiency (AFUE) $200/unit

High-Efficiency Furnace ≥ 95% AFUE $250/unit

High-Efficiency Furnace ≥ 97% AFUE; ENERGY STAR® Most Efficient List $500/unit

High-Efficiency Boiler ≥ 90% AFUE, ENERGY STAR qualified $350/unit

High-Efficiency Boiler ≥ 95% AFUE, ENERGY STAR qualified $450/unit

Indirect Water Heater Installed on or integrated into a qualifying high-efficiency boiler $100/unit

Storage Water Heater ENERGY STAR qualified with Energy Factor ≥ 0.67 $300/unit

High-Performance Windows U-Value ≤ 0.20, rated by the National Fenestration Rating Council (NFRC) $1.50/square foot installed

Hot Water Pipe Insulation 6 linear feet of 0.75 inch thick insulation installed on natural gas hot water pipes $10/installation

Programmable Thermostats Must be installed on residential natural gas space heating equipment $20/unit

COMPLETE SYSTEM REPLACEMENT PROGRAM (for joint customers of Nicor Gas and qualified electric distributors only)

High-Efficiency Furnace and High-Efficiency Central Air Conditioner ≥ 92% AFUE AND ≥ 14.5 Seasonal Energy Efficiency Ratio (SEER) $600

High-Efficiency Furnace and High-Efficiency Central Air Conditioner ≥ 95% AFUE AND ≥ 14.5 SEER $650

High-Efficiency Furnace and High-Efficiency Central Air Conditioner

≥ 97% AFUE; ENERGY STAR Most Efficient List AND ≥ 14.5 SEER $750

VALUE PACKAGES—Save even more with these bundles!

Efficient Equipment Bundle (Furnace, Central Air Conditioner, Storage Water Heater, Pipe Insulation and Programmable Thermostat)

≥ 92% AFUE; ≥ 14.5 SEER; ≥ 0.67 Energy Factor; ≥ 6' pipe insulation; Eligible Programmable Thermostat

$1,000

Efficient Equipment Bundle (Furnace, Central Air Conditioner, Storage Water Heater, Pipe Insulation and Programmable Thermostat)

≥ 95% AFUE; ≥ 14.5 SEER; ≥ 0.67 Energy Factor; ≥ 6' pipe insulation; Eligible Programmable Thermostat

$1,250

Efficient Equipment Bundle (Furnace, Central Air Conditioner, Storage Water Heater, Pipe Insulation and Programmable Thermostat)

≥97% AFUE/ENERGY STAR Most Efficient List; ≥16 SEER; ≥0.67 Energy Factor; ≥ 6' pipe insulation; Eligible Programmable Thermostat

$1,500

Equipment must be purchased and installed November 19, 2012 through May 31, 2013.