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Residential Electric Rebate Application

High efciency heating, ventilation and cooling (HVAC) equipment can save up to 30% more energy than older inefcient models.* Con Edison residential customers can receive rebates of up to $1,000 for installing qualied equipment. Purchase and install qualied equipment between January 1, 2012 and December 31, 2015. Refer to the program eligibility requirements and other terms and conditions below. Complete and sign this rebate application. First and last name must match the name on your Con Edison account. Mail this application with a copy of manufacturers specication sheet and a paid invoice from your contractor that indicates the equipment type, make, model, price and serial number and the date of purchase, to: Con Edison Residential Energy Efciency Program - HVAC c/o Honeywell 145 Route 46 West Wayne, NJ 07470
Eligibility Requirements and Other Terms and Conditions
1. Rebates are offered to Con Edison residential electric customers with service addresses that have one-to-four dwelling units regardless of their energy supplier. 2. Eligible equipment must be installed by a licensed contractor meeting all New York State and local municipality requirements and such equipment must meet the efciency level set forth within the rebate application. The eligible high-efciency equipment must be installed in accordance with applicable codes and standards, including the proper sizing of high-efciency equipment. 3. Electric equipment must be purchased and installed between January 1, 2012 and December 31, 2015 to be eligible. 4. Customer is not eligible to receive nancial incentives and/or rebates for the same eligible measure from NYSERDA and/or another electric or gas utility company. 5. Rebate applications must be completed, signed and mailed to Honeywell, together with a copy of manufacturers specication sheet and a paid invoice from your contractor that indicates the equipment type, make, model, price and serial number and the date of purchase. Applications must be postmarked by January 16, 2016. Neither Con Edison, Honeywell, nor their designee shall be responsible for lost, late, illegible or misdirected mail. 6. All work to be performed by or on behalf of a customer applying for the rebate must be in compliance with all applicable federal, state and local laws, rules and regulations (including laws requiring the employment of licensed persons to perform such work) and all Con Edison requirements for electric and gas service, where applicable. 7. Con Edison, Honeywell, or their designee may conduct a nal inspection after all work has been completed and all necessary documentation has been received. If it is determined that you are eligible for the rebate, please allow six (6) to eight (8) weeks after inspection or receipt of documentation for payment of the rebate. Rebate will be paid directly to the Con Edison account holder. 8. Customer agrees that Con Edison may provide customer information including customer name, account number, electric consumption data and electric energy savings to its evaluation contractor for program evaluation purposes. The evaluation contractor is obligated to Con Edison to keep the customer information condential. This information may also be provided to the New York State Public Service Commission aggregated with information about other customers. 9. Customer shall be responsible for all taxes that may be imposed with respect to the rebate offer. Customer may want to consult a tax adviser about any tax consequences of this offer. 10. Customer will be eligible for the rebate when, in the sole discretion of Con Edison, Honeywell, or their designee, you have complied with the requirements and terms and conditions hereof. 11. Con Edison reserves the right to amend or terminate this rebate offer.

CUSTOMER INFORMATION
Name (Rebate will only be paid to current and valid Con Edison account holder. Please refer to your utility bill for account name and number.) Con Edison Electric Account Number

Installed Address

City

State

Zip Code

Home Phone

Work Phone

Email Address (to receive updates on your application)

Date Installed

Optional: How did you nd out about this program?

CONTRACTOR INFORMATION
Contractor Name Contact Name Contractor License # (as applicable)

Address

City

State

Zip Code

Work Phone

Cell Phone

Fax #

Email Address

Con Edison, Honeywell, or their designee makes no promise, warranty or representation regarding any work performed by a contractor. Con Edison shall not be responsible for the work or for the failure by a contractor to perform any work.

Account Holder Signature


*Source: energystar.gov

Date

Con Edison Electric Account Number

Failure to submit required documentation including itemized paid invoice and manufacturers specication sheet may delay or disqualify your rebate. If you have any questions, please call 1-800-430-9505.

HVAC SYSTEMS
Measure Rebate Amount Minimum Efciency Rating
(must meet all)

Required Documentation

Manufacturer

Condenser Model #
(Outside Unit)

Condenser Serial #
(Outside Unit)

Coil Model #

Certied Reference #
(See Below)*

Central Air Conditioner Central Air Conditioner Central Air Source Heat Pump Central Air Source Heat Pump Measure

$400

SEER 15 EER 12.5 SEER 16 EER 13.0 SEER 15 EER 12.0 Plus HSPF 8.5 SEER 16 Itemized paid invoice or payment terms. Manufacturers specication sheet.

$600

$400

$600

EER 13.0 Plus HSPF 9.0 Installed on (check all that apply) Required Documentation Certied Reference #
(See Below)*

Rebate Amount

Manufacturer

Model #

Serial #

ECM Furnace Fan**

$200

Itemized paid invoice or Heat pump payment terms. Central air conditioner Manufacturers Furnace specication sheet.

* **

To identify the Certied Reference number, go to www.ahridirectory.org, ask your contractor or call 1-800-430-9505 for assistance. An ECM fan installed as a factory component of a central air conditioning system is not eligible for an additional $200 rebate. A new ECM furnace fan is eligible for a $200 rebate if installed on a furnace. The same ECM fan will not receive an incentive under both the natural gas and electric rebates.

OTHER MEASURES
Electric Heat Pump Water Heater Rebate Amount Minimum Efciency Rating Required Documentation Itemized paid invoice or payment terms. Manufacturers specication sheet. Natural Gas Propane Oil Unit in Heated Space? Yes No Manufacturer Model # Serial # Energy Factor Heat Pump Hot Water Volume Old Hot Water Volume

$400

Energy Factor > 2.0

Old Fuel:
CENY-HVACER-R5-042012

Electricity

Programmable Thermostat Rebate Amount $25 Required Documentation Itemized paid invoice or payment terms. Manufacturers specication sheet for programmed equipment. Manufacturer Model #

10% post-consumer waste

Residential Electric Rebate Application