Commercial and Industrial LED Retrofit Lighting Rebate 2018 Rebate Application Business Member Information Connexus Energy 14601 Ramsey Blvd NW Ramsey, MN 55303 ConnexusEnergy.com 763.323.2600 Company name Date submitted Billing address City State ZIP Installation address (if different) City State ZIP Account number Contact name (print) Phone E-mail Vendor Information Vendor name Vendor contact name Vendor address City State ZIP Phone Fax E-mail The undersigned does hereby certify that 1) The undersigned, and not Connexus Energy, is solely responsible for the accuracy of the information contained in this application, 2) all rules of the LED Lighting Rebate program have been followed, and 3) the installation is complete. Further, the undersigned acknowledges that nothing contained in the application shall impose any liability on Connexus Energy for the work performed and information presented by the member s engineer, contractor or vendor. I verify the information on this application is correct and request consideration for participation in this program. Member signature Date page 1 Rev 5/18
Specific Rules and Qualifications Connexus Energy offers rebates to qualifying members who purchase and install qualifying energy-efficient LED lighting products. Illuminating Engineering Society (IES) light levels are recommended. 1. LED interior and exterior lamps and downlight luminaires/fixtures must be ENERGY STAR or DesignLights Consortium (DLC) qualified. The lists of ENERGY STAR qualified products are available at energystar.gov/ssl- Partners. Lamps are listed under the section Partner Resources for LED Lamps. Luminaires/ fixtures are listed under Partner Resources for LED Fixtures. 2. The ENERGY STAR list of qualified luminaires includes a variety of products. In order to qualify for the prescriptive rebates for LED downlight luminaires/fixtures, the product must be listed as Commercial or Both in the Application column of the ENERGY STAR product list. In addition, the product description in the Product Type column must include the word Downlight. 3. For exterior LED canopy and soffit lights eligibility, the member must be replacing HID fixtures only. 4. Illuminating Engineering Society (IES) light levels are recommended. 5. If the projects is not a 1:1 retrofit, additional new lighting may be applied for under New Construction. A project with a reduction in fixtures may be applied for under Custom Lighting. If a project is a lighting redesign which results in higher lighting system wattage, it may be reviewed using IES light level recommendations. 6. LED linear replacement lamps are based on a one-forone replacement of fluorescent lamps. LED lamp must be ENERGY STAR or DLC listed and can be the following types of lamps: UL Type A plug and play, UL Type B internal-driver/line voltage, or UL Type C external driver. 7. Automatic controls must be permanently installed. 8. LED exit sign rebates are for incandescent to LED only. 9. LED Traffic Signal rebates are for incandescent to LED only. Contact Account Rep. for details. page 2
Warranty Information Rebate qualifications do not imply any representation or warranty of such equipment, design or installation by Connexus Energy. Connexus Energy shall not be responsible or liable for any personal injury or property damage caused by this equipment. Connexus Energy does not guarantee that a specific level of energy or cost savings will result from the implementation of energy conservation measures or the use of products funded under this program. In no event shall Connexus Energy be liable for any incidental or consequential damages. Rebate Application Process and Program Rules 1. Pre-approval is required for all prescriptive rebates over $2,500 and ALL custom rebates. Information required for pre-approval includes: detailed project scope, estimated energy savings in kwh and kw, manufacturer s specifications, estimated project completion date and estimated equipment costs. If changes to project scope will impact your estimated rebate, please notify Connexus Energy immediately to update your pre-approval. 2. The member is responsible for checking with Connexus Energy, prior to project start, to determine if project qualifies, and to verify availability of funds. 3. Project must comply with all program Specific Rules and Qualifications (varies by rebate type). 4. Installation must be complete before final rebate application and required supporting documentation is submitted to Connexus Energy. Supporting documentation includes: Itemized equipment invoices (detailing line item quantity, price, and model number). Manufacturers equipment specifications (cut sheets). 5. Rebates are capped at 50% of the invoiced equipment cost or the prescriptive/custom rebate, whichever is less. 6. The maximum annual rebate per member, for all projects, is $30,000. 7. Rebate checks will be made payable to the Connexus Energy account holder named on the application (not to contractors). 8. Connexus Energy rebates are offered on a first-come, first-paid basis, pending fund availability, and are subject to change. Check website for current application forms. 9. Connexus Energy reserves the right to conduct inspections of all rebated installations. 10. Email completed application packet, along with the account holder s W-9 tax identification form, to your account representative, OR mail to Connexus Energy (c/o Business Accounts), 14601 Ramsey Blvd., Ramsey, MN 55303, no later than November 16, 2018. Your submitted application MUST include: Completely filled out and signed rebate application form(s). Itemized equipment invoices. Equipment specifications (cut sheets). Account holder s W-9 tax ID form. page 3
Equipment and Rebate Information Business Name Air Conditioned (Y/N) Retrofit LED Lamps Screw & pin LED Lamp Watts 20W 50% of equipment cost up to rebate value listed $/Unit Quantity Rebate Hrs/Yr $ 5.00 LED Lamp 21W-40W $ 10.00 LED Lamp 41W-60W Replaces Incandescent, Halogen, HID, $ 15.00 CFL, or Fluorescent Lamps with an LED Lamp 61W-80W $ 20.00 ENERGY STAR or DLC Qualified LED LED Lamp 81W-100W $ 25.00 Lamp (including Omni-Cob LED technology) LED Lamp 101W-120W that uses 50% less energy. $ 30.00 LED Lamp 121W-140W $ 35.00 LED Lamp 141W-160W $ 40.00 LED Lamp 161W+ Contact Business Account Rep. LED Lamps Retrofit Rebate per Lamp LED Lamp 4 18W or Less Per lamp $ 5.00 LED Case Lighting Case Lamp 4-6 Refrigerator/Freezer $ 20.00 Note: Percentage reduction based on rebate for 2 lamps or 4 lamps/fixture. LED Fixtures Watts $/Unit Quantity Rebate Hrs/Yr Downlights, Recessed Cans, Pendants, Surface Mounted, & Troffers LED Fixture 25W or less Replaces Incandescent, Halogen, HID $ 15.00 LED Fixture 26W-50W CFL or Fluorescent Fixtures with an ENERGY STAR or DLC Qualified LED $ 20.00 LED Fixture 51W-75W Fixture that uses 50% less energy. $ 25.00 LED Fixture 76W+ Contact Business Account Rep. $ Wallpacks, Soffits, Canopy, Hi-Bay/Lo-Bay, & Pole Mounted LED Fixture 40W or less $ 30.00 LED Fixture 41W-80W $ 45.00 LED Fixture 81W-120W Replaces HID Fixture with an ENERGY $ 60.00 STAR or DLC Qualified (as per requirements) LED Fixture that uses 50% less LED Fixture 121W-200W $ 80.00 LED Fixture 201W-250W energy. $ 100.00 LED Fixture 251W-300W $ 130.00 LED Fixture 301W-400W $ 140.00 LED Fixture 401W+ Contact Business Account Rep. $ LED Exit Signs Exit Sign 8w or less Replaces incandescent only $ 5.00 Automatic Controls Hours/ year* % reduction Total kw** Photocell $ 7.00 Ceiling Mount Occupancy Sensor $ 20.00 Wall Mount Occupancy Sensor $ 10.00 Fixture Mount Occupancy Sensor $ 5.00 $/Unit Quantity Rebate *annual operating hours before controls **total connected load (kw) to control ***Project Cost *** Required information. Must enter total project cost to determine rebate. Total Rebate page 4 Hrs/Yr reduced**
Lighting Retrofit Worksheet Business name: Completion of the LED lighting worksheet is required before rebate will be issued. Existing Lighting Number Watts/ Annual New Lighting Number Watts/ Annual Saved Saved System Fixtures Fixture Hours System Fixtures Fixture Hours kw kwh Total Example How to Complete the Form Existing Lighting Number Watts/ Annual New Lighting Number Watts/ Annual Saved Saved System Fixtures Fixture Hours System Fixtures Fixture Hours kw kwh Incandescent bulb 1 75 4000 LED Lamp 15 watt 1 15 4000 0.06 240 Halogen PAR 30 1 65 2500 LED Lamp PAR 30 downlight 1 11 2500 0.05 135 Refrigerated case, F60t12/Cw/Ho, 75 W 10 75 8000 LED case light 10 15 8000 0.60 4,800 Total 0.71 5157 page 5