High-Efficiency Natural Gas Equipment Rebate Program
REBATES
APPLICATION AND OFFICIAL RULES
QUALIFICATIONS:
PLEASE NOTE:
All qualifying energy efficient equipment must be natural gas, and installed at a residential
or commercial location of a customer receiving natural gas service from Atmos Energy,
Colorado Natural Gas, Eastern Colorado Utility or SourceGas in Colorado.
Equipment must be installed by a licensed heating or plumbing contractor, or installed
by the customer at the customer address listed on the form. Low-cost measures and
thermostats do not need to be installed by contractors.
Offer is valid from January 1, 2011 until funds are depleted. All applications must be
postmarked no later than 60 days after the installation.
Qualifying furnaces and boilers must be listed on the qualifying list of devices and meet
the required AFUE rating.
Qualifying tank water heaters must have an energy factor (EF) of .62 or greater and
tankless water heaters an energy factor of .82 or greater.
Programmable thermostats, limited to two rebates per account.
Attach a copy of all dated receipts and/or invoices that document the installation. Make
sure that these receipts indicate the name, license #, address, and phone number of the
contractor that completed the installation. For proper sizing, please submit a copy of a
Manual J or heat load calculation.
All receipts and/or invoices must include equipment make, model and size to
qualify for a rebate.
Please mail your completed form below and a copy of your sales receipt to:
Excess Is Out
3800 Watt Ave., Suite 105
Sacramento, CA 95821
or
P apply online at www.conservationrebates.com and mail your receipts to the address above.
Atmos Energy, Colorado Natural Gas, Eastern Colorado Utility and SourceGas
have partnered with Electric & Gas Industries Association (EGIA) for the
administration of this Program.
Do not include rebate application with your utility bill.
Program is subject to change without prior notice, and rebate offers may
decrease or increase without notice.
For questions regarding rebate status, please contact EGIA at
866-971-7347, Monday through Friday 9:00 a.m. to 6:00 p.m.
For more information, to verify eligibility, or confirm products, visit
www.conservationrebates.com.
Customer must fill out and sign the application below or apply online at
www.conservationrebates.com.
Rebate amount may vary by utility, and will not exceed the cost of the measure.
Devices installed may be verified for both the efficiency and installation
of equipment.
Atmos Energy, Colorado Natural Gas, Eastern Colorado Utility, SourceGas and
EGIA are not responsible for items lost or delayed in the mail, or any rebate
delayed due to incomplete or incorrect rebate applications.
Atmos Energy, Colorado Natural Gas, Eastern Colorado Utility, SourceGas and
EGIA are not responsible for any taxes that may be imposed as a result of
receipt of any rebate.
Atmos Energy, Colorado Natural Gas, Eastern Colorado Utility, SourceGas and
EGIA disclaim any and all liability, loss or damage that may arise as a result of
the applicant’s or contractor’s participation in the program.
KEEP THIS STUB!
Retain this portion for your records. Return bottom portion with copy of sales receipt in an envelope to the address above.
Please complete the required information below:
APPLICATION INFORMATION SECTION
Please include a gas service account number and mail with a photocopy of your sales receipt or invoice.
Please Check Your Gas Utility
Atmos Energy
Colorado Natural Gas
Eastern Colorado Utility
SourceGas
Gas Service Account Number
Applicant E-mail Address
Applicant First and Last Name
Eastern Colorado Utility
SourceGas
Applicant Phone
Number
Installation Address
City
State
Zip
Mailing Address (if different)
City
State
Zip
Contractor Name
Contractor License #
Contractor Address
Unit Replaced
Efficiency Rating
Contractor Phone Number
City
State
Size
Fuel Type
Zip
I hereby request a rebate for the work listed below. Attached are copies of all receipts. I have read and agree to the Qualifications of the
program listed on this form. I certify the high-efficiency natural gas device has been installed in accordance with Program Qualifications.
Applicant
Signature
I hereby
request a rebate for the work listed below. Attached are copies of all receipts. I have read and agree
Dateto the Qualifications of the
X p
I certify the high-efficiency natural gas device has been installed in accordance with Program Qualifications.
HIGH-EFFICIENCY EQUIPMENT INFORMATION
Measure
Required Efficiency
High-Efficiency Gas Furnace
High-Efficiency Gas Furnace
High-Efficiency Gas Furnace
High-Efficiency Gas Boiler
Proper Sizing Furnace/Boiler
Proper Maintenance Furnace/Boiler
Furnace Maintenance
Storage Tank Water Heater
Tankless Water Heater
Integrated Space and Water Heat
Programmable Thermostat
Misc. Hot Water Insulation & Infiltration
92-93.9% AFUE
94%+ AFUE
92%+ AFUE w/ECM Motor
84%+ AFUE
Proper Sizing Criteria
Proper Maintenance Criteria
Propane-to-Gas Fuel Conversion
EF 0.62+
EF 0.82+
Integrated System
Any
Tank Wrap, Pipe Wrap, Etc.
SG=SourceGas rebate only; CNG=Colorado Natural Gas rebate only
Date
Date
Purchased Installed
Brand
Model
Equip.
Cost
Total
Cost
Incentive
Amount
$200
$300
$200/$250 SG
$150
$50
$0
$40
$50
$300
$300
$25
$25*
*Based upon combined minimum purchase of $40 (See page 2 for list of qualifying low-cost measures)
Rebate Amounts
Measure
Efficiency Level
Colorado
Natural Gas
SourceGas
Atmos
Energy
Eastern
Colo. Utility
High-Efficiency
Gas Furnace
92%-93.9% AFUE
94%+ AFUE
92% AFUE w/ECM Motor
$200
$300
$200
$200
$300
$250
$200
$300
$200
$200
$300
$200
High-Efficiency Boiler
84%+ AFUE
$150
$150
$150
$150
Proper Sizing of
Furnace/Boiler
For proper sizing, please
submit a copy of a Manual J
or heat load calculation.
$50
$50
$50
$50
Proper Maintenance
of Furnace/Boiler
For proper maintenance
please submit an invoice for
a professional tune-up
$40
$0
$0
$0
Furnace Maintenance
Propane-to-Gas
Fuel Conversion
$40
$40
$40
$40
Water Heater
Tank EF 0.62+
Tankless EF 0.82+
$50
$300
$50
$300
$50
$300
$50
$300
Integrated Space
and Water Heat
Integrated System
$300
$300
$300
$300
Programmable
Thermostat
Any
$25
$25
$25
$25
Miscellaneous Hot
Water Insulation and
Infiltration Measures
Tank Wrap, Pipe Wrap,
Caulking, Faucet Aerator,
Low Flow Shower Head,
Weather Stripping
$25, based on $25, based on $25, based on $25, based on
combined
combined
combined
combined
minimum
minimum
minimum
minimum
purchase or $40 purchase or $40 purchase or $40 purchase or $40
Thank you for participating in the
High-Efficiency Natural Gas
Equipment Rebate Program
Valid on purchases from January 1, 2011 until available funds are depleted.
REMINDER:
Please ensure you included all copies of all dated receipts and/or invoices that document the
installation. Make sure that these receipts indicate the name, license #, address, and phone
number of the contractor that completed the installation, and mail to:
Excess Is Out
3800 Watt Ave., Suite 105
Sacramento, CA 95821
Rebate amounts will not exceed the cost of the measure. Program is subject to funding availability.
Rebate levels can change or end at any time.
Your rebate application must be postmarked no later than 60 days after installation.
- SAVE A COPY FOR YOUR RECORDS -