Office Use Only Rebate: Commercial Appliance Rebate Application Month/Year: Complete application and sign/date. All information, including Utility Account #, is required to process rebate(s). CUSTOMER INFORMATION Utility Account # Date Phone (REQUIRED)
Company Name Contact Name
Installation Email Address (optional)
City State Zip
Mailing Address (if different)
City State Zip
REBATE REQUIREMENTS AND AMOUNTS Type Existing Condition Final Condition Rebate ENERGY STAR® Qualified Unit Listed Standard Efficiency Insulated Hot Food Cabinet on Food Service Technology Center’s $375 per Unit Unit Qualifying Appliance List ENERGY STAR Qualified Unit Listed Standard Efficiency Electric Combination Oven on Food Service Technology Center’s $1,250 per Unit Unit Qualifying Appliance List ENERGY STAR Qualified Unit Listed Standard Efficiency Electric Steam Cooker on Food Service Technology Center’s $1,575 per Unit Unit Qualifying Appliance List ENERGY STAR Qualified Unit Listed Standard Efficiency Electric Convection Oven on Food Service Technology Center’s $450 per Unit Unit Qualifying Appliance List ENERGY STAR Qualified Unit Listed Standard Efficiency Electric Fryer on Food Service Technology Center’s $250 per Unit Unit Qualifying Appliance List ENERGY STAR Qualified Unit Listed Standard Efficiency Electric Griddle on Food Service Technology Center’s $375 per Unit Unit Qualifying Appliance List Dishwasher, Under-Counter $2,000 per Unit Electric Water Heat Dishwasher, Door-Type $5,000 per Unit with Electric Water Heat with Dishwasher, Single-Tank Standard Efficiency ENERGY STAR 2.0 Qualified Unit $4,000 per Unit Unit Dishwasher, Multi-Tank $10,000 per Unit Multi-family Clothes Washer, Electric Water Heat with Electric Water Heat $100 per Unit In Tenant Unit High-Efficiency Unit with Multi-family Clothes Washer, [MEF 2.40 or Greater] Standard Unit $300 per Unit In Common Area [WF 4.0 or Less] $450 per Kitchen Demand Ventilation Type 1 Standard Unit Type 1 Unit with Exhaust Fan Control with No Control Variable Frequency Drive Control Horsepower Rebate(s) will not exceed 75% of installed cost. © Efficiency Services Group, LLC. All Rights Reserved. V_11/15 To learn more about energy efficient food service equipment, explore the FOOD SERVICE TECHNOLOGY CENTER at http://www.fishnick.com/.
NEW EQUIPMENT INFORMATION BRAND MODEL NUMBER QTY
INSULATED HOT FOOD CABINET
ELECTRIC COMBINATION OVEN
ELECTRIC STEAM COOKER
ELECTRIC CONVECTION OVEN
ELECTRIC FRYER
ELECTRIC GRIDDLE DISHWASHER Type:
Under-Counter Door-Type
Single-Tank Multi-Tank
Water heat: Electric Gas
Water heat must be electric to qualify.
Temp: Medium Low
Booster (high temp only): Electric Gas
MULTI-FAMILY CLOTHES WASHER
Appliance Type:
In Tenant Unit In Common Area
Water heat: Electric Gas
Water heat must be electric to qualify. KITCHEN DEMAND VENTILATION
CONTROL
Upon signing this agreement, customer acknowledges the following:
City of Shasta Lake Municipal Utilities (SLU) reserves the right to inspect completed work and installed product(s). Rebate(s) will be paid only on work that meets SLU specifications. Customer certifies that they are familiar with, and agree to, the standards regarding this program. SLU disclaims any warranty, whether expressed or implied, for any materials or labor associated with installation, maintenance, repair, or any energy savings associated with use. SLU will not accept any liability resulting from participation in this program. This rebate offer may be changed or discontinued at any time by SLU.
I understand the above and certify that I am a customer of SLU, that the product(s) are installed and operating at the location indicated and that this address is within SLU service territory.
CUSTOMER SIGNATURE DATE
Submit completed rebate application, copies of all invoices/receipts, and additional qualification information (if applicable) to:
City of Shasta Lake Municipal Utilities Attn: Energy Efficiency Rebates 5605 NE Elam Young Parkway Hillsboro, OR 97124
Rebate applications must be submitted within six (6) months of purchase to qualify. Allow 8–10 weeks for processing.
Call 1-855-516-2105 to learn about additional energy efficiency programs.
© Efficiency Services Group, LLC. All Rights Reserved. V_11/15