COMMERCIAL KITCHEN EQUIPMENT

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1 CMMERCIAL KITCHEN EQUIPMENT 2018 ILLINIS FR YUR BUSINESS REBATE APPLICATIN Instructions: Fill out form completely and sign. Attach itemized invoices and supporting documentation, if applicable. Failure to complete the required sections and provide documentation will result in denial of claim. must be purchased between Jan. 1, 2018, and Dec. 31, must be installed and operating prior to submission of final rebate application. Rebates cannot exceed 50 percent of the installed (materials and reasonable labor). You will receive the lesser of the rebate amount listed or 50 percent of installed. Installed includes contractor labor only and does not include internal labor. Rebate application must be submitted within six months of dealer invoice, or by Dec. 31, 2018, whichever comes first, for the equipment/ material purchased. The rebate will be based on the rebate schedule in effect on the date of dealer invoice for the equipment/material purchased. Rebate applications received after Dec. 31, 2018, are not eligible for rebates. Custom : If specific equipment you intend to purchase and install is not listed, it may qualify under Nonresidential Custom Systems. However, custom projects must be preapproved by MidAmerican Energy prior to purchase and installation of equipment or system. Projects must be completed within six months of preapproval. See the Nonresidential Custom Systems application for details. SECTIN 1 (REQUIR) Name on account Customer Information Self-installed q Yes q No Installation address City State ZIP Phone MidAmerican Energy Company account number (found on bill; first seven digits only) Mailing address (if different than installation address) City State ZIP Contact name Title address* *This address only will be used for communication regarding this rebate application. Your address never will be shared and you can unsubscribe at anytime. SECTIN 2 (REQUIR) Year building was constructed Building size [sq. ft. (area)] Do you: q wn q Rent this building The new equipment is for: q Replacement of existing equipment q New installation (new to facility) q New construction Page 1 of 5

2 SECTIN 2 CNT. (REQUIR) installed in what type of facility? (check one) Industrial Commercial q Apparel manufacturing q Apartment, halfway house q Chemical manufacturing q Condo q Computer/electronic product manufacturing q Convenience store/gasoline station CV q Electrical equipment, appliance/component manufacturing q Food/beverage/tobacco product manufacturing q Furniture and related product manufacturing q Leather and allied product manufacturing q Machinery manufacturing q Nonmetallic mineral product manufacturing q il and gas extraction; mining q Paper manufacturing; printing and related support activities q Personal and laundry services q Dealership small <30k q Dealership large >30k q Financial institution small <30k q Financial institution large >30k q Grocery store and supermarket q Healthcare (outpatient) q Healthcare (inpatient, including hospital, nursing home, senior care facility) q Healthcare senior housing - individual apartment q Health club/exercise facility small <30k GR HC HS q Petroleum and coal products manufacturing q Health club/exercise facility large >30k q Plastics and rubber products manufacturing q Library q Primary metal/fabricated metal product manufacturing q Textile mill and textile product mill q Transportation equipment manufacturing q Utility q Warehouse and storage q Warehouse large refrigerated q Wood product manufacturing q Miscellaneous manufacturing q ther industrial q Lodging hotel q Lodging motel q Mixed use q ther - commercial q ffice small 4 floors q ffice large > 4 floors q ffice government small 4 floors q ffice government large > 4 floors q ffice public order and safety small 4 floors q ffice public order and safety large > 4 floors L L Agriculture q Corn farming q Dairy cattle and milk production q Hog facility q Soybean farming q All other animal production q All other miscellaneous crop farming DF HF q Pharmacy and drug store small <30k q Pharmacy and drug store large >30k q Public assembly events/conventions/casinos small <30k q Public assembly events/conventions/casinos large >30k q Religious worship/church q Restaurant fast food q Restaurant full service HY HY RE T T q Retail small <30k q Retail large >30k q Retail department store small <30k q Retail department store large >30k q School elementary q School jr. high q School high school q School college, university and professional school q School lodging (school/dorm) q Service small <30k q Service large >30k q Truck stop CV q Warehouse and storage WH-C q Warehouse large refrigerated WH-C Page 2 of 5

3 SECTIN 3 Complete all fields for each type of equipment purchased and installed. Commercial Refrigeration q Refrigerator transparent door cabinet (ENERGY STAR ): $500/unit q Freezer solid door cabinet (ENERGY STAR): $75/unit q Refrigerator solid door cabinet (ENERGY STAR); 10 cubic feet or q Anti-sweat heater controls for refrigerator/freezer transparent door cabinets: $50/door larger: $35/unit Number refrigeration/freezer doors for anti-sweat rebate Size (cubic feet) Total calculation labor Refrigerated L Case Lighting 5- and 6-Foot Doors (DLC QPL required) Eligible DLC primary use designations: Rebates are based on replacement of T12 or T8 linear 5- to 6-foot fluorescent refrigerated case door lighting with 5- to 6-foot L refrigerated case door strip lighting. Rebates are per door, not per lamp. Linear L tube lights do not qualify for this rebate. With preapproval before purchase or installation, they may qualify through the Nonresidential Custom Systems program. The program adopts the DLC definition: Strip lights in refrigerator cases vertically mounted along refrigerator case door mullions. Category only covers complete luminaires with all necessary components. Replacement lamps currently are not eligible under this category. Annual operating hours of equipment Date of installation nhorizontal refrigerated case luminaires nvertical refrigerated case luminaires nrefrigerated case luminaires Is facility where equipment will be installed conditioned? (check one) q Cooled only q Heated only q Not cooled or heated q Both heated and cooled q ther If facility is heated, what fuel type is used? (check one) q Natural gas (furnace) q Natural gas (boiler) q Electric (resistance heating) q Electric (heat pump) q Propane Cooler Case q 5-foot door q 6-foot door Replace fluorescent T12 or T8 systems with L case lighting New brand/ manufacturer New model number DLC product ID New wattage Watts replaced Rebate calculation X $45/door = Qty Rebate Total Total calculation labor Freezer Case q 5-foot door q 6-foot door Replace fluorescent T12 or T8 systems with L case lighting New brand/ manufacturer New model number DLC product ID New wattage Watts replaced Rebate calculation X $45/door = Qty Rebate Total Total calculation labor Ice Makers Air-Cooled Remote Condensing or Ice- Making Head (ENERGY STAR) Manufacturer/brand name Install date Quantity Installed Rebate Total Rebate x = Total calculation labor Page 3 of 5

4 Commercial Cooking Hot Food Holding Cabinet q Hot food holding cabinet electric (ENERGY STAR); full-size only: $400/cabinet Install date Manufacturer/brand name Cooking efficiency rating (watts/cu. ft.) Volume (cu. ft.) Annual operating hours Total calculation labor Commercial Cooking ther q Convection oven natural gas (ENERGY STAR): $100/unit q Conveyor oven natural gas with thermostatic control and a cooking efficiency rating 42%: $675/unit q Infrared upright broiler natural gas with a cooking efficiency rating of 34%: $1,350/unit q Salamander broiler natural gas with a cooking efficiency rating 34%: $125/unit q Steam cooker natural gas (ENERGY STAR): $650/unit Install date Manufacturer/brand name Total calculation labor Cooking efficiency rating Motors Motor No. 1 Total calculation labor Motor No. 2 Total calculation labor Motor No. 3 Total calculation labor REMEMBER T SIGN THE NEXT PE Page 4 of 5

5 Disclaimer MidAmerican Energy Company does not guarantee that installation and operation of high-efficiency equipment will result in reduced usage or in savings. MidAmerican Energy Company makes no warranties, expressed or implied, with respect to any equipment purchased or installed, including, but not limited to, any warranty of merchantability or fitness for a particular purpose. In no event shall MidAmerican Energy Company be held liable for any incidental or consequential damages or injuries resulting from defective equipment or installation. MidAmerican Energy Company reserves the right to cancel or change these programs at any time. MidAmerican Energy Company s acceptance of this application does not guarantee payment of rebate. Specific Terms and Conditions nparticipants must be commercial or industrial customers with facilities located in MidAmerican Energy Company s Illinois service territory. nmidamerican Energy Company must deliver the electricity and/or natural gas to the equipment at the facility for which the rebate is being paid. nfor prescriptive rebates, the rebate payment cannot exceed 50 percent of the installed (reasonable labor and material/equipment - reasonableness to be determined by MidAmerican Energy Company). Installed includes contractor labor only and does not include internal labor. nfor equipment that requires ENERGY STAR certification, visit and for information on qualifying commercial kitchen equipment. A manufacturer s specification sheet with efficiency ratings of the product(s) installed must accompany the application. n installed as a replacement unit, retrofit or in new construction is eligible. n must be purchased between Jan. 1, 2018, and Dec. 31, must be installed and operating prior to submission of final rebate application. nrebate application must be submitted within six months of dealer invoice, or by Dec. 31, 2018, whichever comes first, for the equipment/material purchased. The rebate will be based on the rebate schedule in effect on the date of dealer invoice for the equipment/material purchased. Rebate applications received after Dec. 31, 2018, will not be eligible for rebates. nallow 4 6 weeks for rebate processing, excluding on-site verification time, if needed. General Terms and Conditions Important: Before completing and signing this form, please read the General Terms and Conditions located in the 2018 Illinois For Your Business rebate booklet or at Customer Agreement My signature indicates consent to and agreement with all program terms and conditions. It certifies that all information in this application is correct and equipment installed at the indicated location. I understand that MidAmerican Energy Company reserves the right to inspect and verify installation before issuing payment. Customer signature Date Dealer name Installer/Dealer Information Phone Address Fax City State ZIP Contact name address Installer/Dealer Agreement I certify that all equipment and installation information provided on this application is correct and accurate. Installer/dealer signature Date Before you submit your form: oofill out this form completely. ooattach a copy of the itemized sales receipt or invoice. ooinclude documentation listed in the instructions. oosign the Customer Agreement section. Send completed forms to: Mail: MidAmerican Energy Company P.. Box 4628 Des Moines, IA Fax: For MidAmerican Energy Use Project # Project # Received date Method: E M F I Assessment # Assessment date KAM-BAM Sector type Rebate total amount $ For more information call or go to Page 5 of 5

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