Office Use Only Rebate:

Commercial Product Month/Year: Rebate Application Complete application and sign/date. All information is required to process rebate(s).

CUSTOMER INFORMATION

Utility Account # Date Phone

Contact Company Name Name Installation Email Address (optional)

City State Zip

Mailing Address (if different)

City State Zip

QUALIFYING PRODUCTS TYPE TOTAL BRAND MODEL NUMBER REBATE Requirement(s) AMOUNT INSULATED HOT FOOD CABINET ® $375 ENERGY STAR Qualified $ Listed on Food Service Technology per Unit Center's Qualifying Appliance List ELECTRIC COMBINATION ENERGY STAR Qualified $1,250 $ Listed on Food Service Technology per Unit Center's Qualifying Appliance List ELECTRIC STEAM COOKER $1,575 ENERGY STAR Qualified $ Listed on Food Service Technology per Unit Center's Qualifying Appliance List ELECTRIC CONVECTION OVEN ENERGY STAR Qualified $450 $ Listed on Food Service Technology per Unit Center's Qualifying Appliance List ELECTRIC FRYER $250 ENERGY STAR Qualified $ Listed on Food Service Technology per Unit Center's Qualifying Appliance List ELECTRIC GRIDDLE $375 ENERGY STAR Qualified $ Listed on Food Service Technology per Unit Center's Qualifying Appliance List , Under-Counter ENERGY STAR 2.0 Qualified $1,000 (Electric water heat is required) $ Water heat: Electric Gas per Unit

Gas water heat is not eligible. DISHWASHER, Door-Type ENERGY STAR 2.0 Qualified (Electric water heat is required) $2,500 $ Water heat: Electric Gas per Unit

Gas water heat is not eligible.

© Efficiency Services Group, LLC. All Rights Reserved. V_07/19 QUALIFYING PRODUCTS (continued) TYPE TOTAL BRAND MODEL NUMBER REBATE Requirement(s) AMOUNT DISHWASHER, Single-Tank ENERGY STAR Qualified $2,000 (Electric water heat is required) $ Water heat: Electric Gas per Unit

Gas water heat is not eligible. DISHWASHER, Multi-Tank ENERGY STAR 2.0 Qualified $5,000 (Electric water heat is required) $ Water heat: Electric Gas per Unit

Gas water heat is not eligible. MULTI-FAMILY CLOTHES WASHER, In-Unit MEF 2.40 or Greater, WF 4.0 or Less $75 $ (Electric water heat is required) per Unit Water heat: Electric Gas

Gas water heat is not eligible. MULTI-FAMILY CLOTHES WASHER, Coin-Operated $250 MEF 2.40 or Greater, WF 4.0 or Less $ (Electric water heat is required) per Unit Water heat: Electric Gas Gas water heat is not eligible. ICE MACHINE, Air-Cooled $500 ENERGY STAR 2.0 Qualified $ Listed on Food Service Technology per Unit Center's Qualifying Appliance List REACH-IN , Solid Door $150 $ ENERGY STAR 2.0 Qualified per Unit Listed on Food Service Technology Center's Qualifying Appliance List REACH-IN REFRIGERATOR, Glass Door $250 $ ENERGY STAR 2.0 Qualified per Unit Listed on Food Service Technology Center's Qualifying Appliance List REACH-IN FREEZER, Solid Door $300 ENERGY STAR 2.0 Qualified $ Listed on Food Service Technology per Unit Center's Qualifying Appliance List REACH-IN FREEZER, Glass Door $500 ENERGY STAR 2.0 Qualified $ Listed on Food Service Technology per Unit Center's Qualifying Appliance List NEW REFRIGERATED CASE $75 New Display Case with Doors, EC per $ Motors and T8 Lamps with Electronic Lin/Ft Ballast Case SMART POWER STRIP $25 $ Smart-Control Unit per Unit TOTAL REBATE REQUESTED $

Rebate(s) will not exceed 100% of installed cost.

© Efficiency Services Group, LLC. All Rights Reserved. V_07/19 Upon signing this agreement, customer acknowledges the following: City of Lompoc (City) reserves the right to inspect completed work and installed product(s). Rebate(s) will be paid only on work that meets City specifications. Customer certifies that they are familiar with, and agree to, the standards regarding this program. City disclaims any warranty, whether expressed or implied, for any materials or labor associated with installation, maintenance, repair, or any energy savings associated with use. City will not accept any liability resulting from participation in this program. This rebate offer may be changed or discontinued at any time by City. Rebate(s) less than $750 will be applied as a credit to the customer’s City of Lompoc utility account. Rebate amounts over $750 will first be applied to any past due balance on the customer’s account. A check will be issued for the remaining rebate balance and will be mailed to the account mailing address on record. I understand the above and certify that I am a customer of City, that the product(s) are installed and operating at the location indicated and that this address is within City service territory.

CUSTOMER SIGNATURE DATE

Submit completed rebate application, copies of all invoices/receipts, and additional qualification information (if applicable) to:

[email protected] City of Lompoc Attn: Customer Rebates PO Box 13742 Sacramento, CA 95853

Rebate applications must be submitted within six (6) months of purchase to qualify.

Allow 8–10 weeks for processing. Call 805-875-8018 to learn about additional energy efficiency and water conservation programs.

© Efficiency Services Group, LLC. All Rights Reserved. V_07/19