Business Customer Information. Account Number (9 digits) Account Holder Name Phone (As shown on your utility bill) Service Street Address

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1 Commercial Lighting Rebate Application Please complete the application including existing and installed information. Application will be returned without valid purchase receipt/invoice or if equipment requirements are not met. Submit application and invoices to or fax to WE CARE Program at or mail to Holy Cross Energy, Attn: WE CARE Program, PO Box 2150, Glenwood Springs, CO Business Customer Information Account Number (9 digits) Account Holder Name Phone (As shown on your utility bill) Service Street Address Account holder hereby certifies that 1. The account holder is solely responsible for the accuracy of the application information; 2. All installation is complete and operational prior to submitting this application; 3. All rules of Holy Cross energy efficiency program have been followed; 4. Holy Cross is not liable for any work performed; 5. Account is in good standing (no more than 2 delinquent payments in 12 months); 6. Business agrees to have project written up as a case study. By typing in your name below, you are agreeing to all terms of this rebate application. Account Holder Signature Date Rebate Check Issued to Another Party Note: Complete this section only if the rebate should be issued to someone other than the account holder named above. Name Phone Address City State Zip I authorize the above party to receive the rebate check. Account Holder Signature Date Contractor Information Contractor Company Contact Person Phone 1

2 Lighting Rebates Read All Rebate Requirements at Holycross.com/rebates New Equipment Specifications All LEDs must be DLC or Energy Star Certified Rebate/Unit x Minimum 30% wattage reduction Limited to 50% of required for rebate Project Cost Interior Lighting Rebates LED Fixtures or Retrofit Kits; troffer, suspended, pendant, or surface-mounted fixtures LED Fixture or Retrofit Kit T5 or T12 fixture T8 fixture Rebates are based on one-for-one replacement of fluorescent fixtures with new LED fixtures. 1x4, 2x2, or 2x4 fixtures Qty = Rebate LED Linear ment Lamps, 2 or 4-foot replacement LED Linear Tube LED Linear Tube Exit Sign LED or LEC Exit Sign T8 fluorescent T5 or T12 fluorescent incandescent LED Screw-in Lamps; A-bulbs, Candelabra, MR16, BR, PAR, etc LED Screw-in incandescent or halogen LED Downlight Luminaires UL Type A, B, or C LED tube $5 UL Type A, B, or C LED tube $10 Must replace entire exit sign; does not include emergency only fixtures No rebate for replacing CFL with LED $5 $15 LED hard-wired downlight incandescent, fluorescent, or HID systems LED Screw-in or Pin-Based Lamps and LED Retrofit Kits for Downlights Rebates based on one-for-one new full fixture replacements with commercial hardwired downlight luminaires. Certified Energy Star Downlight (recessed, surface mount or pendant) LED screw-in or pinbased 2 or 4- pin CFL or screw-in Rebates are based on one-for-one replacement of downlight. Wattage must be reduced at least 50% $10 2

3 LED Mogul Screw Base ments for HID Lamps 100 $30 LED mogul screw-base lamps 125 to Rebates based on one-for-one replacement of HID mogul-based screw-in lamps with new LED mogul screw base lamps $40 $60 > 400 LED High or Low Bay Fixtures and Retrofit Kits LED high or low bay fixture or retrofit kit Exterior Lighting Rebates 150 to 750 to 1,000 fixtures with new LED fixtures Includes horticultural LEDs (LM test results required) DLC category: High/low-bay luminaries or high/low-bay aisle luminaries for commercial and industrial buildings; Retrofit kits for same category $150 $225 LED Wall Pack Fixtures, Walkway or Security Lights Affixed to Building Wall LED Wall Pack Fixture to Rebates based on one-for-one replacement of HID wall packs with new hard-wired LED fixtures rated for exterior use 400 $125 LED Parking Garage Fixtures, Parking Structures Underground or Semi-enclosed Above Ground Lighting must operate 24 hours a day 70 watt or less HID LED Parking Garage Fixture to parking garage fixtures with new LED parking garage fixtures rated for exterior use. $135 $175 Canopy or Soffit Fixtures; Fuel Station Canopies, Office Buildings Soffits, etc LED Canopy or Soffit Fixture to canopy or soffit fixtures with new LED fixtures rated for exterior use. Equipment must be hardwired and is not limited to gas station installations. $125 3

4 LED Metered Street Lights or Area Lights, Fixture or Retrofit Kit; Street Lights, Parking Lot Lights, etc 70 watt or less HID LED Street or Area Lights For street lighting, member must be on a metered rate to qualify for these LED street light rebates. Rebates based on one-for-one replacement of HID fixtures with new LED fixtures. Fixtures must be hardwired and rated for exterior use. 750 to 1,000 $150 LED Non-Metered (tariff) Street Light or Security Lights; Must Supply 4 Digit Pole Number LED Street or Security Light nonmetered HID For street lights on monthly tariff fee; hardwired fixtures rated for exterior use. LED Mogul Screw Base ments for HID Lamps; Post Top, Bollards, Area Lighting, Parking Lot Lighting 100 LED Screw-in Lamp 150 to mogul-based screw-in lamps with new LED mogul screw base lamps rated for exterior and wet conditions as well as for enclosed fixtures. $40 $80 Lighting Controls Lighting control No Controls Permanently installed in fixture, wall, ceiling, or wireless; must provide wattage controlled Refrigerated LED Case Lighting 5- and 6-foot Doors (DLC Required) Strip LED lights in refrigerator cases, vertically mounted along refrigerator case door mullions. T8 or T12 with LED refrigerated strip lighting Rebates based on replacement of T12 or T8 linear 5- or 6-foot fluorescent refrigerated case door lighting with 5- or 6-foot LED refrigerated case door strip lighting. Rebate per LED strip light. Labor cost only apply to installing LED lighting not reconfiguring circuitry or bringing wiring up to code. *High-intensity discharge (HID) systems include mercury vapor, high-pressure sodium, and metal halide. $10 4

5 Below Information Required to Process Rebate Old Fixture (Sample below) Old Wattage Qty New Fixture New Wattage Qty Annual Hours of Operation Sensor Yes or No 4-lamp 40-watt T12/magnetic ballast 40 watt 50 LED 2x4 troffer ,600 No Rev 03/2018 5