Consumer Rebate Program

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1 Consumer Rebate Program Residential Application Qualifying Product Categories: Refrigerators, Room Air Conditioners, Windows, Pool Pumps and Motors, Central Air Conditioning Systems, Cool Roofs and Whole House Fans. CONFIRM REBATE ELIGIBILITY BEFORE MAKING YOUR PURCHASE. Complete this application after both purchasing and installing your high efficiency product or recycling your refrigerator/freezer and receive a rebate. All applications must be postmarked within 12 months of purchase or recycling date. See inside for details, or visit our website at

2 Consumer Rebate Program (CRP) Application HOW TO APPLY 1. Read 2. Purchase and Install 3. Mail the Terms and Conditions and Qualifying Products and Requirements section of this application. If you have any questions or if you don't see the rebate you are applying for listed below, please contact the Consumer Rebate Program before purchasing and installing your efficiency measure/product. your qualifying energy efficient product(s). All applications will require specific documentation depending on the energy efficient measure or product. Please verify that your documents have all of the required information at the time of purchase. Complete CRP Application A copy of your LADWP Bill (page 1) Proof of purchase (invoice or receipt) Additional documentation (see Part B) Mail To: LADWP Rebate Processing Center P.O. Box 51111, Room 1019 Los Angeles, CA All applications must be postmarked within 12 months of purchase or recycling date. For your records, please make a copy of all documents (including your application) before mailing. Energy Star Qualified Refrigerator 65 Minimum 15 cubic foot Energy Star qualifying model. For a list of qualifying products visit Limit 1 per household Refrigerator/Freezer Recycling Program QUALIFYING PRODUCTS AND REQUIREMENTS 50 per unit Minimum 10 cubic foot/maximum 27 cubic foot. The recycled unit must be in working condition and picked up by Appliance Recycling Center of America (ARCA). To schedule an appointment, call Limit 2 units per year - per residence Energy Star Qualified Room Air Conditioner For a list of qualifying products go to 50 per unit Variable Speed or Variable Flow Pool Pump and Motor 500 For a list of qualifying models, go to For information on the limited time 1,000 Certified Pool Pump Replacement (CPPR) Program, go to (CPPR Program expires 12/31/16 or when funds are exhausted) Above ground pools, pool cleaners, boosters, spas, ponds, and decorative fountains do not qualify. Limit 1 per household Heating Ventilation and Air Conditioning (HVAC) System per ton Heating, Ventilation and Air Conditioning system (split or packaged) must meet the following criteria: System Type Rebate Amount Central Air Conditioner 15 SEER 100 per ton 16 SEER 120 per ton Central Heat Pump 8.5 HSPF, 15 SEER 100 per ton SEER-Seasonal Energy Efficiency Ratio HSPF-Heating Seasonal Performance Factor Whole House Fan 200 per unit Whole house fans must be permanently installed (connected to the framing) and must move at least 1,000 cubic feet of air per minute (CFM) full house ventilation/exhaust. Cool Roof per square foot Roofs must meet the three-year Solar Reflectance Index (SRI) according to CAL Green Tier 2 standards. SRI is rated by the Cool Roof Rating Council. (See Roof Slope 3 Year SRI 0.20 per sq. ft per sq. ft. Low ( 2:12) 75 SRI 85 SRI Steep (>2:12) 16 SRI 35 SRI Square footage is subject to verification by LADWP. The parapet is not included in the rebate. Energy Star Qualified Residential Window Windows must meet the following criteria: Based on purchase date: On or before 06/30/14 On or after 07/01/14 2 per square foot On or after 01/01/15 If you have any questions, you may contact LADWP's Rebate Processing Center. Send your inquiry to or call Office hours: Monday-Friday, 7:00 AM-4:00 PM Rev. 01/2016 Window Type U-Factor SHGC U-Factor SHGC U-Factor SHGC Windows/glass doors Skylights U-Factor: measure of heat flow through the window SHGC: measure of a window's ability to absorb or reflect heat from You should receive your rebate check within six months. Expect further delays for incomplete applications and/or if an inspection is required. Page 2

3 Consumer Rebate Program (CRP) Application TERMS AND CONDITIONS 1. Funds are limited and rebates are not guaranteed. Completed applications are accepted on a first-come, first-served basis. This program may be modified or terminated without prior notice. LADWP Consumer Rebate Program (CRP) participants cannot receive more than one rebate for any qualifying product(s) and/or equipment from more than one California electric or gas utility including but not limited to payment received through participation in the Energy Upgrade California Home Upgrade incentive program. 2. CRP application must be completed and signed by the LADWP customer of record hereinafter referred to as Applicant. Applicant must have an active residential electric meter serviced by LADWP. Dwelling or property type must be one of the following: (a.) detached single family home, (b.) multi-residential or attached home such as a duplex, (c.) condo/townhome, or (d.) apartment unit. 3. Products and equipment installed at the LADWP residence must replace inefficient products. Item(s) must be new and installed in the LADWP customer residence prior to submittal of this application. Resale units, units leased, rebuilt, rented, received from warranty insurance claims, won as a prize, or new parts installed in existing units do not qualify. Products must meet or exceed energy efficiency required by laws and standards (depending on the product). 4. Verification Inspection may be requested before the rebate is paid. Applicant agrees to provide, if requested, reasonable access to the LADWP residence so that an LADWP representative can verify the item(s) installed. Refusal of verification inspection will result in rebate payment denial. 5. Documentation required to process the rebate application may differ depending on the energy efficiency measure, whether it is self installed, contractor installed, and/or if measure was purchased online. Applicant may need to request additional information from the retailer, contractor, and/or government permitting agency as required to participate in the CRP. Copies of receipt(s), invoice(s), Home Improvement Contract, and other required documentation must be sent to the LADWP CRP Processing Center along with this completed application within 12 months of the purchase date printed on the sales receipt to be eligible for payment of a rebate. Altered and illegible documents will not be accepted. LADWP reserves the right to request original documentation. If original documents are requested, the Applicant may submit a self-addressed stamped envelope and upon application process completion, the original documents will be returned. LADWP is not responsible for items and documents lost, late, incomplete, misdirected or destroyed in the mail or via electronic transit. Applicant should keep copies of all material sent/submitted. 6. Invoice/Receipt - An itemized paid invoice or receipt is required for all measures. Invoice or receipt must include retailer name, business address, and phone number, itemized description of each product including manufacturer, product make and model number, measure cost and purchase date. The rebate amount cannot exceed the purchase/paid price. 7. Online Purchases must include a copy of the order confirmation notification that lists the purchase date, product make and model number, payment type (paid), shipping date, and a copy of the signed and dated delivery confirmation sheet or a print out of the shipment tracking record. 8. Refrigerators and Room Air Conditioners must be Energy Star qualified and listed on the Energy Star approved product list at 9. Proof of Recycling Certificate issued by Appliance Recycling Centers of America, Inc. - California (ARCA) must be included for all recycled refrigerators and freezers. Certificate must be signed by ARCA representative and include Applicant pickup address and signature, pick up date, appliance type and quantity. 10. Air-Conditioning, Heating & Refrigeration Institute (AHRI) Certificate must correspond with the HVAC system(s) installed. If the HVAC system manufacturer ceased production of the equipment, a confirmation letter from AHRI on letterhead listing all the system components, SEER, and cooling capacity can be submitted. Rebates are paid according to the nearest half ton (rounded). 11. Variable Speed/Flow Pool Pump and Motor must have a CA Title 20 qualifying programmable controller unit (built-in or stand-alone) to be eligible for rebate. Only pumps used for in-ground pools qualify. Pumps used for above ground pools, pool cleaners, boosters, spas, ponds, and decorative fountains do not qualify. Additional terms and conditions apply under the limited time Certified Pool Pump Replacement (CPPR) Program. 12. Energy Efficient Window dimensions must be listed in the order confirmation sheet and/or Home Improvement Contract. Only actual/final installed dimensions for each window will be accepted. Estimated window dimensions do not qualify. Gable, top arch, pentagon, and trapezoid windows must include width, short and long length. Circle window(s) must include the radius. Octagon window(s) must include each side length in addition to total window dimension. Only windows installed to replace inefficient windows qualify. New construction and additions do not qualify. National Fenestration Rating Council (NFRC) label verifying the U-Factor and Solar Heat Gain Coefficient (SHGC) for each window is required for window rebates. If the NFRC label is not available, Applicant may submit the specific U-factor and SHGC for each window by sending the Manufacturer's Order Confirmation sheet on the manufacturer's letterhead. 13. Home Improvement Contract (HIC) is required if a contractor is hired. The HIC must include contractor name, business address, phone number, installation date, and installation address. HIC must be signed by Applicant and licensed contractor. Windows HIC must include the dimensions for each window. HVAC HIC must include the complete condenser, evaporative coil and furnace model number(s). Cool Roof HIC must include roof square feet, slope, cool roof manufacturer, brand, and model number. Documentation for self-installed measures will be evaluated on a case by case basis if a contractor was not hired. 14. Permits for central air/heating systems (HVAC), whole house fans, cool roofs (except liquid applied coating), windows and new pools are required. A copy of the FINAL APPROVED permit issued by the L.A. Dept. of Building and Safety must be submitted to participate in the program. Permit must include the installation address, final approved date, and the permit description must correspond with the rebate measure listed in this application. Cool roof permits must list the number of squares permitted. It is the Applicant s responsibility to be aware of and in compliance with any restrictions, codes, ordinances, rules and regulations including but not limited to Historic Preservation Overlay Zones (HPOZ). Applicant is responsible for obtaining the permits and permissions necessary including state/county/city government, property owner, and/or homeowner association. 15. Rebate Check will be issued in the Applicant s name unless an alternate payee authorization is given in Part A - Section 2 of this application. The check will be mailed to the installation address unless an alternate mailing address is listed in Part A - Section 1 of this application. Rebate check discrepancies, lost, stolen, or misplaced check(s) must be reported to the CRP in writing within six months of the rebate application submission date. Upon notification, CRP management will investigate and may replace the check if the circumstances were beyond the Applicant s control. Under certain conditions incentives may be taxable and, if greater than 600, may be reported to the IRS (IRS Form 1099) unless payee is exempt from reporting. Applicant and Payee should consult a tax advisor concerning the taxability of rebates. LADWP is not responsible for any taxes that may be imposed as a result of receipt of this rebate. 16. LADWP makes no warranty whether expressed or implied, including warranty of merchantability or fitness for any particular purpose, use, or application of the item(s) or measure(s). LADWP has no liability whatsoever concerning (a.) the quality, safety and/or installation of the item(s) or measure(s), including their fitness for any purpose, (b.) the estimated savings of the item(s) or measure(s), (c.) the workmanship of any third parties, (d.) the installation or use of the item(s) or measure(s) including, but not limited to, effects on indoor pollutants, or any other matter with respect to the CRP. In no event shall LADWP s liability for property loss or damage resulting from its activities under this application exceed the total rebate amount paid to me under this application. The selection, purchase, installation and ownership/maintenance of the item(s) and measure(s) listed in this application are my sole responsibility. The supplier or installer of these item(s) and measure(s) is not an agent or representative of LADWP. 17. Implementation and interpretation of the terms and conditions of the CRP are at the sole discretion of LADWP. Rev. 01/2016 Page 3

4 Keep Your Home Energy Efficient A F Cool Roof How cool is your roof? That depends on how much light is reflected (solar reflectance - SR) and the portion of absorbed heat (thermal emittance TE). Learn more: Central HVAC System Look for higher Seasonal Energy Efficiency Ratio (SEER) ratings for the most efficient HVAC system. Proper insulation of your house, HVAC maintenance and temperature settings also affect its efficiency. F B Energy Star Refrigerator Keep it dust-free and airtight; set the fresh food compartment temp at and freezer at 0-5. A B C C Whole House Fan A great way to keep the house cool and costs about 1/10th of a central air conditioner to operate. D D Energy Star Room Air Conditioner Make sure you get a room air conditioner with the right capacity for the size of the room. Otherwise you could be wasting energy. E G I E Energy Efficient Windows Windows with the lowest U-Factor and SHGC are the most efficient. Ratings can be found on the affixed NFRC label(s). Learn more: G Skylights Install energy efficient skylights to add more natural light to your home and save energy. Learn more: H H Pool Pump Make sure it s properly calibrated to reduce the flow rate and save up to 80% of energy costs. I Refrigerator Recycling Program LADWP pays you to recycle old refrigerators and freezers that guzzle energy. Call ARCA to learn more and make an appointment. Energy Upgrade California Home Upgrade may be an option for homeowners making multiple improvements at the same time through a "whole house" approach. LADWP has partnered with Southern California Gas Company (SoCalGas ) to offer incentives of up to * Learn more about Home Upgrade at or call *Customers may also be eligible for incentives exceeding 6,500 based on their calculated energy savings. Work with your Home Upgrade Participating Contractor or rater to calculate your upgrade s incentive. Energy Upgrade California Home Upgrade participants will not be eligible to apply for additional rebates for the same measure(s) through another LADWP program including but not limited to the LADWP Consumer Rebate Program. Page 4

5 Consumer Rebate Program (CRP) Application PART A: APPLICANT AND INSTALLATION INFORMATION SECTION 1: LADWP ACCOUNT AND PROPERTY INFORMATION LADWP Account Holder Name APP# (office use only) LADWP Account Number Own Rent LADWP Installation Address (or ARCA Pick-up Address) City Zip Property Type (check one): Single Family Residence Apartment Condominium/Townhome Mobile Home Duplex Other: Daytime Telephone Number ( ) - Alternate Phone Number ( ) - Address Where would you like us to mail the rebate check? LADWP Installation/ARCA Pick-up Address Other (complete Alternative Mailing Address below) Alternative Mailing Address: City State Is the rebate Payee the LADWP account holder? Yes No- Complete Section 2. If Payee is a business, complete Section 2 and Section 3. SECTION 2: PAYMENT ASSIGNMENT Please complete this section only if the payee is different than the LADWP Account Holder. I am authorizing this rebate payment to the third party Payee named below. I understand that I will not be receiving the rebate check from LADWP and that my release of this rebate payment to the Payee does not exempt me from the rebate requirements outlined in this application. Payee Name Payee Phone Number Payee Address ( ) - Payment Assignment Authorized by (Please Print LADWP account holder name as it appears on the LADWP First Name Last Name Signature SECTION 3: BUSINESS TAX INFORMATION Complete this section if Payee is a business. Please include a W-9 with the application. Business Tax Status (Check one): Corporation Tax Exempt/Non Profit Partnership LLC Other: California Business Entity ID Number C Payee Business Federal Tax ID SECTION 4: CUSTOMER AGREEMENT By submitting this application, I (Applicant) agree to the Terms and Conditions. I certify that the information I have provided is true and correct. I further certify that the item(s) and/or equipment for which I am requesting a rebate meets the requirements listed on the rebate forms. I am aware of restrictions, codes, ordinances, rules and regulations of which I am in compliance and have obtained the permits necessary with my state/county/city government, property owner, and/or homeowner association. I will provide, if requested, an LADWP representative reasonable access to my residence to verify the installation of item(s) I have purchased before a rebate is paid. I understand that a rebate will not be paid if I refuse a verification inspection. Print LADWP Account Holder (Applicant) Name LADWP Account Holder (Applicant) Signature Date Rev. 01/2016 Page 5

6 Rev.01/2016 PART B: PRODUCT AND REBATE AMOUNT Proof of purchase is required for all products and must be submitted with the Additional Documentation listed below 1 Energy Star Qualified Refrigerator 65 Limit 1 per household Total Rebate 2 Refrigerator/Freezer Recycling Program 50 per unit Limit 2 units per year - per residence Total Rebate Recycled Appliance(s) Qty. Pick Up Date Additional Documentation Refrigerator Recycling Certificate Freezer (given by ARCA representative) 3 Whole House Fan 200 per unit Total Rebate Additional Documentation Home Improvement Contract Final Approved Permit 4 Heating Ventilation and Air Conditioning (HVAC) System per ton Total Rebate System Type Rebate Amount Additional Documentation Central Air Conditioner 15 SEER 100/Ton AHRI Certificate Central Air Conditioner 16 SEER 120/Ton Home Improvement Contact Central Heat Pump 8.5 HSPF, 15 SEER 100/Ton Final Approved Permit Condenser Evaporative Coil#: Furnace System Tons: AHRI Cert. #: SEER: 5 Energy Star Qualified Room Air Conditioner 50 per unit Total Rebate Qty. 6 Variable Speed or Variable Flow Pool Pump and Motor 500 Limit 1 per household Total Rebate Additional Documentation Proof of installation New Pool Final Approved Permit For required documentation under the 1,000 CPPR Program visit 7 Cool Roof per square foot Total Rebate 3 Year SRI Additional Documentation Roof Slope 0.20 per sq. ft per sq. ft. Home Improvement Contract Low ( 2:12) 75 SRI 85 SRI Final Approved Permit Steep (>2:12) 16 SRI 35 SRI (except liquid applied coating) Cool Roof Rating Council Product ID#: Total sq. feet: 8 Energy Star Qualified Residential Window 2 per square foot Total Rebate # Windows Installed: Additional Documentation # Glass Doors Installed: Home Improvement Contract Total window sq. feet: Final Approved Permit NFRC Label for each window and/or Manufacturer Order Confirmation Sheet Total Rebate Amount Page 6

7 Certified Pool Pump Replacement Program (CPPR) Single to Variable Speed (up to 1,000) Rebate Consumer Rebate Program Addendum The Certified Pool Pump Replacement Program (CPPR) offers, for a limited time, up to a 1,000 rebate to LADWP residential customers who have inground swimming pools filtered with a single-speed pool pump. This retrofit installation program is intended to retire older, inefficient single-speed pool pumps and motors with qualifying energy-efficient variable-speed pool pumps. Program Requirements: Residence must have an existing in-ground swimming pool (new pool construction, ponds, decorative fountains, and spas do not qualify) Swimming pool must be primarily filtered with a single-speed pool pump that is replaced with a qualifying variable speed pool pump and motor. See the LADWP qualified variable-speed Pool Pump and Motor list The qualifying pool pump must be installed and calibrated by a certified aquatic equipment installer between 02/15/2015 through 12/31/2016 Pool pump must be programed to: Run only during 8:00 PM - 9:59 AM (off-peak electric demand hours) Run for the minimum time necessary to maintain the water in the condition required by applicable public health standards and comply with California Energy Code calibration, low-speed default and maximum flow rate requirements. Required Documentation: This completed Addendum Part "A" of the Consumer Rebate Program (CRP) Application Paid invoice/receipt for the qualifying variable-speed pool pump and motor (purchased on or after 02/15/2015 and on or before 12/31/2016) that lists the purchase date, retailer name, address, phone number, pool pump make and model number Proof of installation that includes the business name, address, telephone number, the certified installer's name, and pool pump controller settings that include pool volume, high and low speed run times and GPM for each setting A copy of the aquatic equipment installer certificate or aquatic energy auditor certificate that corresponds to the installer listed in the proof of installation. Acceptable certification must be issued by a recognized pool industry, governmental, or a utility-sponsored agency upon course completion. The certified course training must include optimizing energy efficiency when calibrating, installing and programming a variablespeed pool pump. Pictures Required: In-ground swimming pool INSTALLED single-speed pool pump (prior to removal) NOTE: The removed single-speed pool pump must remain onsite to be verified during LADWP variable-speed installation inspection. Single-speed pool pump specification label that lists the make, model, and serial number. Variable-speed pool pump specification label that lists the make, model, and serial number INSTALLED variable-speed pool pump and motor (after installation) LADWP Service and Installation Address City Zip LADWP Account Holder Name LADWP Account Number Telephone Number Single-Speed Pump and Motor Information Serial #: Variable-Speed or Variable Flow Pool Pump and Motor Information (Limit 1 per household) Installation Date: Variable Speed Pump Controller Settings Pool Volume High Speed Run Time: GPM: to Low Speed Run Time: GPM: to Gallons By submitting this Addendum along with Part A of the CRP application, I certify that I am in compliance with the terms and conditions listed in the LADWP CRP application and I meet all of the requirements to participate in the CPPR program. LADWP Account Holder s Initials Page 7

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