Commercial Lighting
Rebate Form
Valid July 1, 2017 - December 31, 2017
In this form, you can find rebate
information for:
How to apply
›› Exterior LED Lighting
…… Read the Terms and Conditions to determine if you are eligible
and Controls
›› Interior LED Lighting
and Controls
›› Exterior & Interior
HID LED Replacement
Lamps
for a rebate.
…… Verify that the product(s) you are going to purchase and install
meet the eligibility requirements listed in the corresponding
product section, or contact us.
…… Purchase and install qualifying product(s) during the rebate
eligibility term (July 1, 2017 - December 31, 2017).
…… Complete and sign the application. If you prefer to submit
online, visit https://rebates.efficiencyvermont.com/lighting.
Efficiency Vermont and Burlington
Electric Department offer technical
assistance and rebates to help
businesses make cost-effective
improvements. We also partner
with distributors to offer discounted
lighting products in their stores. Please
contact us with any questions or for
additional assistance.
…… Include a copy of your invoice(s) as proof of purchase.
…… Submit completed application form and invoice(s).
Need help?
For more information or to confirm
eligibility, call 888-921-5990 or email
[email protected].
Efficiency Vermont and Burlington
Electric Department can help finance
your project at a low rate with no
collateral down. Please call us for
more information.
New in 2017
This rebate form is no
longer applicable for new
construction projects.
Contact us today to enroll
your project and maximize
impact and incentives.
Why controls?
What is the DLC
qualified products list?
Your business can use lighting controls to automatically turn lights on
and off as needed. Adding sensors or other controls to your upgrade
can yield impressive results. Many projects using lighting controls
have documented energy savings ranging from 30–75%.
The DesignLights Consortium™ (DLC) Qualified Products List is a
leading resource for efficient commercial LED products. Efficiency
Vermont and BED provides rebates based on DLC qualifications to
ensure that you receive high quality products for your business.
Daylight sensors switch or dim lighting
depending on the level of daylight.
Occupancy sensors turn on lights based
on movement detected in the area.
How to use the DLC:
• Use this rebate form to find your desired product category.
Lighting fixtures listed on this form can be paired with any sensor
listed in the same section (except refrigeration and case fixtures, which
should be paired with the corresponding sensor indicated).
• Visit www.designlights.org/qpl to search for a specific product by
keyword, manufacturer, etc.
Instant Rebates
Instant rebates are available for select lighting equipment purchased from participating distributors.
Visit https://contractors.efficiencyvermont.com/programs/lighting for details.
ENERGY STAR® Screw- or Pin-based LED Replacement Lamps
ENERGY STAR® LED Fixtures and Retrofit Kits
DLC Linear Replacement Lamps
Exterior LED Lighting and Controls
Type
Lighting Eligibility Requirements
• Products must be qualified by DesignLights
Consortium (DLC). To verify a product is
qualified, visit www.designlights.org/qpl.
• Interior products used in exterior applications,
and vice versa, may be eligible for rebates.
Please call for details.
Area Fixtures & Retrofit Kits:
•Outdoor Pole-Mounted
•Outdoor Decorative Area
& Post-Top
Outdoor —
Low Output
•Parking Garage & Canopy
•Outdoor Wall-Mounted
• Please call to inquire about rebate eligibility for
stairwell fixtures.
Bollard Fixtures
(Including Wall Packs)
Outdoor —
Mid Output
Outdoor Flood and Spot Light
Fixtures
Soffit Lighting
Control Eligibility Requirements
Outdoor —
High Output
< 5,000
lumens
$100
1.1
5,001 –
10,000
lumens
$175
$200*
1.2
> 10,000
lumens
$250
$275*
1.3
Minimum
45 watts
controlled
$40
$50*
1.4
Lighting Controls (can be paired with any of the above fixtures)
• For use on exterior LED or induction equipment.
Exterior Occupancy Sensors
• Lights must be turned off or reduced by at least 50%
during unoccupied times.
• Timers and dusk-to-dawn sensors are not eligible
for a rebate.
Rebate
per
Code
Product
LED Fixtures
• Fixtures leased from an electric utility company are
not eligible.
• Lumens are based on the values reported by DLC.
DLC Category Specification
n/a
* Higher rebate amount is a reflection of the 2017 bonus and is available for a limited time only.
Commercial Lighting Rebate Form: July 1, 2017 - December 31, 2017
Page 2
Interior LED Lighting and Controls
Type
Lighting Eligibility
Requirements
• Products must
be qualified by
DesignLights
Consortium (DLC).
To verify a product is
qualified, visit
www.designlights.org/qpl.
• Interior products used in
exterior applications, and
vice versa, may be eligible for
rebates. Please call for details.
Specification
Standard
Rebate
Code
Linear Ambient Luminaires
n/a
$50
$60*
2.1
1x4, 2x2, 2x4 Luminaires
n/a
$50
$60*
2.2
< 10,000 lumens
$50
$60*
2.3
$110
$125*
2.4
$30
2.5
DLC Category
LED Fixtures and Controls
Surface & Suspended
Linear Fixtures
Troffer Fixtures
Low-Bay
Luminaires
High- &
Low-Bay Fixtures
High-Bay
Luminaires
Retrofit Kits for 1x4, 2x2,
2x4, Direct Linear Ambient,
Low-Bay Luminaires, and
High-Bay Luminaires
Retrofit Kits
• Lumens are based on the
values reported by DLC.
Sensors can be used with any of the above fixtures.
Dual Daylight &
Occupancy Sensors
n/a
$50
$60*
2.6
Control Eligibility
Requirements
Integrated or fixturemounted. Minimum
30 watts controlled.
Ceiling & Wall
Remote Mounted
Occupancy Sensors
n/a
Hard-wired or wireless.
Minimum 150 watts
controlled.
$75
2.7
• For use on interior LED or
fluorescent equipment.
Switch Mounted
Occupancy Sensors
n/a
Minimum 60 watts
controlled
$30
2.8
• Commissioning is
recommended for daylight
and integrated controls.
Fixture Mounted
Occupancy Sensors
n/a
Minimum 30 watts
controlled
$40
$50*
2.9
Ceiling & Wall
Remote Mounted
Daylight Sensors
n/a
Minimum 150 watts
controlled
$60
2.10
Switch &
Fixture Mounted
Daylight Sensors
n/a
Minimum 30 watts
controlled
$30
2.11
Refrigerator & Freezer
Case Light Fixtures
Vertical & Horizontal
Refrigerated Case
Luminaires
n/a
$40
2.12
Refrigerator & Freezer
Case Light Sensors
n/a
Minimum 3 doors
per sensor
$40
2.13
< 5,000 lumens
$30
2.14
5,001 - 10,000 lumens
$60
2.15
10,001 - 15,000 lumens
$100
2.16
> 15,000 lumens
$125
2.17
• Companion switches for
wireless sensors are not
eligible for rebates.
LED Case Fixtures and Controls
* Higher rebate amount is a reflection of the 2017 bonus and is available for a limited time only.
Exterior & Interior HID LED Replacement Lamps
Lighting Eligibility
Requirements
• Lumens are based on the
values reported by DLC.
Mogul (E39)*
Screw-Base Replacements
for HID Lamps
• Products can be installed
in interior and exterior
applications regardless of
DLC product category.
Types B & C only**
* Sibling products with an edison or E26 base are eligible for incentives if the E39 base is on DLC.
For eligibility questions, call Efficiency Vermont at 888-921-5990.
** Type A‘s: Please call for eligibility.
Commercial Lighting Rebate Form: July 1, 2017 - December 31, 2017
Page 3
Commercial Lighting
Rebate Form
Step 1
Don’t forget to include
a copy of your invoice(s)
Customer Information & Agreement
Business Name:
Contact Name/Title:
Installation Address:
City/Town: State: Zip:
Mailing Address (if different):
City/Town:
State: Zip:
E-mail Address:
Telephone #:
 Check to receive energy-saving offers and updates via e-mail.
Electric Utility Company
Electric Utility Account # (of installation location)
New construction projects cannot use this rebate form. Call Efficiency Vermont for more information.
I certify that all equipment for which I am requesting a rebate has been installed, that I meet the eligibility requirements of this rebate
program, and that all information submitted as part of this application, including proof of purchase and Federal Tax ID Number, is
correct to the best of my knowledge. I agree to the terms and conditions listed on the back of this form.
CUSTOMER SIGNATURE (required even if rebate is going to vendor)
Step 2
Date
Rebate Payee Information
Rebate check payable to (must match EIN/TIN or SSN below):
 Contact information same as above
Contact Name:
Mailing Address:
City/Town:
State:Zip:
Payee’s Federal Tax ID Number (TIN) — check one and provide EIN/TIN or SSN:
 Corporation or Tax-Exempt Organization (provide TIN)
 City, County, or State Dept., Govt. or Agency (provide TIN)
Employer Identification Number
 Other (provide EIN/TIN or SSN)
Social Security Number
or
I certify that the “Payee Information” above, including Federal Tax ID Number, is correct to the best of my knowledge.
I acknowledge that as Payee I am responsible for any tax liability associated with my receipt of the rebate payment.
For Internal Use
PAYEE SIGNATURE (if different from customer)
Commercial Lighting Rebate Form: July 1, 2017 - December 31, 2017
W
Project #
Page 4
Step 3
Code
(from page
2 & 3)
Product and Rebate Information
Installation
Date
# of Hours
Lights are
on per Week*
Manufacturer
Model #
A=
Quantity of
Products
B=
Rebate
(see pages 2 & 3)
AxB=
Total Rebate
Amount
*For lighting controls, enter the number of hours per week the lights were on before controls were installed.
REBATE FORM TOTAL $
Step 4
Submit Form and Invoice
Mail to:
Mail:
Fax:
Efficiency Vermont
c/o Rebate Coordinator
128 Lakeside Ave., Suite 401
Burlington, VT 05401
Prefer to submit online?
Visit https://rebates.efficiencyvermont.com/lighting
802-658-1643
E-mail: [email protected]
Burlington projects, submit form to:
Mail:
Burlington Electric Department
c/o Energy Services Area
585 Pine Street
Burlington, VT 05401
Fax:
802-865-7500
Burlington Electric Department (BED) administers
efficiency programs for the City of Burlington,
including the rebates listed on this form.
For more information, call 802-865-7342.
E-mail: [email protected]
Need help?
For more information or to confirm eligibility,
visit www.efficiencyvermont.com or call 888-921-5990.
Commercial Lighting Rebate Form: July 1, 2017 - December 31, 2017
Page 5
EV-4377-0717-RNAX
Terms & Conditions
1.
REBATE is for new equipment purchased and installed between July 1, 2017
and December 31, 2017 by commercial, industrial and agricultural customers
of Vermont electric utilities, except that rebates are not available to the
following customers: IBM, GlobalFoundries, Omya, and electric utility
companies. Equipment must be installed within the state of Vermont
in a commercial, industrial or agricultural facility. Rebate forms must be
postmarked or received by January 31, 2018. Rebate offer is subject to
change without notice and may not be combined with any other offer.
2. LIMITATIONS: This form cannot be used for any project involving more
than 250 individual items subject to rebate, or for any project involving
new construction. For information on such projects, please call Efficiency
Vermont (or Burlington Electric Department for projects within the City of
Burlington).
3. PROOF OF PURCHASE: Invoice(s) must include the quantity, size, type,
manufacturer, model or part number, purchase date, and vendor of the
efficient equipment. All sales transactions and installations are subject to
verification and inspection. By signing this form, the customer consents to
allow Efficiency Vermont (or, within the City of Burlington, Burlington Electric
Department) 1.) to access the equipment for purposes of verification and
inspection, and 2.) to disclose the customer’s information (including but not
limited to the customer’s information included on this form and information
on the invoices(s)) to the vendor and/or contractor who sold or installed
the equipment to verify equipment purchase/installation and to collect
additional information about the equipment and its installation.
4. LIMITATION OF LIABILITY: Performance of installed equipment is not
guaranteed expressly or implicitly.
5. ENDORSEMENT: No particular manufacturers, products, or system designs
are endorsed through this program.
6. PAYMENT: Allow 60 calendar days for delivery of payment. Incomplete or
missing information will delay processing of rebate form and payment.
7. MAXIMUM PAYMENT will not exceed 100% of the equipment purchase
price. Customer is responsible for all costs associated with sales tax,
installation, and disposal/recycling. Customer is responsible for any tax
liability associated with rebate payment.
8. CAPACITY CREDITS/ENVIRONMENTAL CREDITS: In accepting these
financial incentives, the customer agrees that Efficiency Vermont (or, for
customers within its service territory, Burlington Electric Department) holds
the sole rights to any electric system capacity credits and environmental
credits associated with the energy efficiency measures for which incentives
have been received.
www.efficiencyvermont.com
128 Lakeside Avenue, Suite 401
Burlington, VT 05401
888-921-5990
© 2017 Efficiency Vermont