Small Commercial ■ Non-Profit ■ Multi-Family
Lighting Prescriptive Measures
We Energies Account Number:
(Account # listed on your Billing Statement)
To be completed by Trade Ally or Customer
(Please check one):
Small Commercial
Multi-Family
Non-Profit
Management Co. /Owner Name:
Building Name:
Address:
City:
State:
ZIP:
Building Contact:
Phone & Fax:
E-mail:
Trade Ally Name:
Phone:
Address:
Fax:
City:
State:
ZIP:
E-Mail:
TERMS & CONDITIONS:
1) Incentive Offer: Projects must be implemented by Dec. 31, 2008. An original signed application and invoices for materials and
labor must be delivered to Energy Incentives from We Energies, 2665 S. Moorland Road Suite 112, New Berlin, WI 53151 within
30 calendar days of installation and no later than Jan. 30, 2009. Please keep a copy for your records.
2) Proof of Purchase: This application must have complete information and be submitted with an invoice itemizing the new
equipment purchased. The invoice must indicate date of purchase, the size, type, make, model, serial number, part number,
and/or equipment manufacturer (OEM) specification sheets. The signed application and invoices for materials and labor must be
sent to the address at the bottom of this form.
3) Compliance:
a) All projects are expected to comply with federal, state, and local codes.
b) All equipment must be new (with the exception of surveys, audits, and service buydowns). Used or rebuilt equipment is
not eligible for incentives. Existing equipment must be removed.
c) Equipment must meet specification requirements and be purchased and operating prior to submitting an incentive
application form.
d) Only one incentive will be granted for each project.
4) Payment: Once completed paperwork is submitted, incentive payments are usually made within 30 calendar days. Incomplete
applications will either delay payments or be denied. We Energies reserves the right to refuse payment and participation if the
customer or contractor violates program rules and procedures.
5) Inspection: Program staff may conduct an inspection of the facility to survey installed projects.
6) Publicity: We Energies reserves the right to publicize your participation in this program, unless you specifically request otherwise.
7) Program Discretion: Incentives are available on a first-come, first-served basis. This incentive is subject to change or termination
without notice at the discretion of We Energies.
8) Logo Use: Customers or allies may not use the We Energies name or logo in any marketing, advertising, or promotional material.
9) Disclaimers: We Energies
a) Does not endorse any particular manufacturer, product, labor or system design by offering these programs;
b) Will not be responsible for any tax liability imposed on the customer as a result of the payment of incentives;
c) Does not expressly or implicitly warrant the performance of installed equipment or contractor’s quality of work (contact
your contractor for detailed warranties);
d) Is not responsible for the proper disposal/recycling of any waste generated as a result of this project; and,
e) Is not liable for any damage caused by the installation of the equipment or for any damage caused by the malfunction of
the installed equipment.
INCENTIVE LIMIT:
Purchase and install qualifying equipment and receive an energy efficiency incentive of up to $15,000 per project. An incentive exceeding
$15,000 must receive written approval BEFORE project installation.
ELIGIBILITY:
These incentives are offered by We Energies to qualifying retail electric service customers with locations in Wisconsin. For questions
regarding eligibility, call 877-598-4376.
Return completed form and itemized invoice within 30 calendar days to:
Energy Incentives from We Energies, 2665 S. Moorland Road, Suite 112, New Berlin, WI 53151
Page 1 of 4
August 2008
Small Commercial ■ Non-Profit ■ Multi-Family
Lighting Prescriptive Measures
Management Co./Owner Name:
Installation Address:
ADDITIONAL GUIDELINES FOR INCENTIVES:
Programs are designed to help reduce energy use during peak demand; equipment must be operational between 1 p.m. and 4 p.m.,
▪
Monday through Friday, from June through August.
▪ Incentives not to exceed 75 percent of project cost.
Installed in small commercial (independent – not chain), non-profit or multi-unit building, Rate Cg1, Cg2, Cg3, Cg6, Fg1, Fg2, Fg3, or Rg1
▪
customer.
▪ Is retrofit / replacement installation (not available for new construction).
▪ If self installed, Exit Kits incented only up to the purchase price.
▪ If leased, the term of the lease must be at least 5 years.
Outdoor Lighting: Outdoor lighting, outdoor parking lot lighting, and other “night-time only” lighting do not qualify. Parking structure
▪
lighting that is on 24 hours per day does qualify for these incentives.
Custom Lighting: Lighting re-design, other custom lighting and “night-time only” lighting may qualify for custom incentives. Call 877-598▪
4376 for more information.
Compact Fluorescent Fixtures: Only complete, hard-wired, ENERGY STAR® qualified new fixtures that replace existing
incandescent fixtures, qualify. Must contain electronic ballast, be UL-listed for application, and provide equal (or better) light output.
Installed Measures
ENERGY STAR® Qualified
Compact Fixtures
CFL Reflector Flood Lamps
CFL, Cold Cathode,
LED Lamps
High Wattage CFL Lamps
Existing Equipment Information
and Requirements
Qty.
Installed
Incandescent Watts per Fixture__________
(Must contain pin based CFL lamp)
Replace 100W or less incandescent with CFL Flood Lamps
with integrated reflector up to 30 Watts. Screw in only. (Not
for pin-based CFLs).
Replace 100W or less incandescent. Screw in only.
Incentive
Per Unit
Total Incentive
(Qty. x Per
Unit)
$40.00/ea.
$4.00/Bulb
$2.00/Bulb
Replace 100W or greater incandescent with CFL from 31-115
Watts.
Screw in only. (Not for pin-based CFLs).
$5.00//Bulb
LED Exit Fixtures and Hardwired Retrofit Kits: Must replace an existing incandescent or fluorescent exit fixture. All new exit
signs and retrofit kits must be UL-or ETL-listed for fixture that they are installed in, have a minimum lifetime of ten years, have input wattage of
<5 Watts and be ENERGY STAR® qualified.
Installed Measures
LED Exit Sign Hardwired
Retrofit Kit
LED Exit Sign – New Fixture
Existing Equipment Information
and Requirements
Incandescent or
Fluorescent
Watts / Fixture
Incandescent or
Fluorescent
Watts / Fixture
Qty.
Installed
Incentive
Per Unit
Total Incentive
(Qty. x Per Unit)
$10.00/ea.
$20.00/ea.
High-Bay Fluorescent: Replace high intensity discharge (HID) in lamp wattage with high-bay fluorescent fixtures in wattages as shown
on line item. Please read carefully. If fixture configuration is not one for one replacement, or differs from line items, please call 877-598-4376
for authorization. Incentive is per fixture replaced.
Total Incentive
Existing Equipment Information
Qty.
Incentive
(Qty. x Per
Installed Measures
and Requirements
Installed
Per Unit
Unit)
High-bay fluorescent <155W total fixture Watts. Check One:
4 lamp T8
2 lamp T5HO
$75.00/
250W Replacement
fixture
Other T8 or T5HO less than 155W
(List Wattage)
High-bay fluorescent <250W total fixture Watts. Check One:
6 lamp T8
4 lamp T5HO
$120.00/
400 W Replacement
fixture
Other T8 or T5HO less than 250W
(List Wattage)
Add occupancy sensors or automatic multi-level lighting control
$50.00/
system to high-bay fluorescent fixtures listed above. Incentive
High-Bay Control Adder
cannot be combined with occupancy sensor incentive below.
fixture
Total Wattage Controlled
Replace 400W HID fixtures/components with 320W pulse-start
$50.00/
320W PSMH
metal halide. Screw-in PSMH lamps do not qualify.
fixture
Return completed form and itemized invoice within 30 calendar days to:
Energy Incentives from We Energies, 2665 S. Moorland Road, Suite 112, New Berlin, WI 53151
Page 2 of 4
August 2008
Small Commercial ■ Non-Profit ■ Multi-Family
Lighting Prescriptive Measures
Management Co./Owner Name:
Installation Address:
High-Performance T8 (HPT8) System: Replace standard T12 systems with high performance T8 systems containing high lumen,
long life F32T8 lamps (minimum > 3100 initial lumens, 24,000 hour rated life at 3 hour start) from CEE approved list AND either of the
following: a low ballast factor electronic ballast (<78 Ballast Factor), or approved ballast from the *CEE High Performance T8” qualified product
list. Both ballast and lamp must be from approved list or system will not qualify for ANY incentive. View the list of qualified lamps and
ballasts at http://www.cee1.org/com/com-lt/lamps-ballasts.xls. Please call with any questions prior to initiating project.
Low-Watt T8 Systems and Low-Watt T8 Relamp: Replace standard T12 or T8 systems with 4’ 25W, 28W, or 30W T8 or 29W or
30W T8 U Lamps and approved ballast or relamp existing T8 fixtures with low Watt T8 lamps listed below. Ballast must be from approved
list or will not qualify for a system incentive. NOTE: Low-Watt T8 compatibility varies; consult manufacturer’s literature before specifying
products. Low-Watt T8 lamps should not be used in dimming applications unless the lamp and ballast manufacturers have approved a specific
application for dimming and frequent switching. May demonstrate dim light, spiraling, pulsing and other undesirable behavior in cooler
temperature rooms and while warming up. System performance varies based on lamp or ballast components. It is recommended that
compatibility is tested before proceeding to replace 32W lamps with any reduced wattage product. View the list of qualified ballast at
http://www.cee1.org/com/com-lt/lamps-ballasts.xls.
Existing Equipment Information
and Requirements
Installed Measures
1L or 2L-4FT High
Performance T8 or T5
w/Electronic Ballast (Retrofit)
3L or 4L-4FT High
Performance T8 or T5
w/Electronic Ballast (Retrofit)
1L or 2L-2FT High
Performance T8 or low watt
T8 U-tube or straight tube
w/Electronic Ballast
(Retrofit)
1L - 4L 4FT HPT8
New Fixture
8’T12 Conversion Kit
8’T12 HO/VHO Conversion
Kit
Low Watt T8 Lamp Only
HPT8 – Parking Garage
T12 34W
Existing:
New:
32W High Lumen
T12 34W
Existing:
New:
32W High Lumen
T12 20W
T12 40W
Qty.
Installed
T12 40W
30W
28W
25W
28W
25W
Total Incentive
(Qty. x Per Unit)
$30.00/ea.
T12 40W
30W
Incentive
Per Unit
$35.00/ea.
T12 34W
$30.00/ea.
Describe existing:
New:
32W High Lumen
30W
28W
$50.00/ea.
25W
Replace 8’T12 2-lamp fixture or components with 4-4’
HPT8 lamps and one HPT8 ballast from CEE approved
list
Replace 8’T12 2-lamp HO and VHO fixture or
components with 4-4’ HPT8 ballast from CEE approved
list
Replace existing 4’ 32W T8 lamp with
25W 28W
29W 30W or
30WT8 ULamp
Replace existing 8” 59W T8 with 54W 8’ T8 lamp
Replace HID system in covered parking areas with
High Performance T8, 1-4 lamp, High Lumen or Low
Watt Lamps
$35.00/
fixture
$50.00/
fixture
$1.00/
lamp
$50.00/
fixture
T5 Fixture (Non-High Bay):
Installed Measures
1L – 4L 4FT T5 New
Fixture
Existing Equipment Information
and Requirements
Describe existing:
Return completed form and itemized invoice within 30 calendar days to:
Energy Incentives from We Energies, 2665 S. Moorland Road, Suite 112, New Berlin, WI 53151
Qty.
Installed
Incentive
Per Unit
Total Incentive
(Qty. x Per Unit)
$70.00/
fixture
Page 3 of 4
August 2008
Small Commercial ■ Non-Profit ■ Multi-Family
Lighting Prescriptive Measures
Management Co./Owner Name:
Installation Address:
Occupancy Sensors – Wall or Ceiling Mounted (non-High Bay): Ultrasonic or PIR sensor controlling non-high bay fixture
types. Rapid or programmed start ballasts are recommended for fluorescent fixtures to extend lamp life. Socket based do not qualify.
Existing Equipment Information
and Requirements
Installed Measures
Wall Mounted
Wattage Controlled per Sensor
Ceiling Mounted
Wattage Controlled per Sensor
Qty.
Installed
Incentive
Per Unit
Total Incentive
(Qty. x Per Unit)
$15.00/
Sensor
$30.00/
Sensor
LED Refrigerated Reach-In Case Lighting: Replace existing linear fluorescent lighting in refrigerated or frozen food cases. Must
completely remove existing fluorescent end connection and ballasts to qualify. Include manufacturer and model number of LED lighting system
on invoice.
Installed Measures
LED Case Lighting
Replacement Fluorescent
Program Approval
Existing Equipment Information
and Requirements
Qty.
Installed
Incentive
Per Unit
Total Incentive (Qty. x
Per Unit)
$25.00/
Door
# of Case Doors Converted to LED
Date
Total Requested:
$
Certification:
I certify that I meet the eligibility requirements of the Energy Incentives from We Energies Program and that all information provided within this
application is correct to the best of my knowledge. I agree to the terms and conditions set forth in these programs. I certify that the number
shown on this form is the correct taxpayer identification number. I am not subject to backup withholding because: (a) I am exempt from backup
withholding; or (b) I have not been notified by the IRS that I am subject to backup withholding as a result of a failure to report all interest or
dividends; or (c) the IRS has notified me that I am no longer subject to backup withholding. I am a U.S. citizen (includes a U.S. resident alien).
Signature Required:
The undersigned agrees that the stated energy efficient measure(s) was (were) installed at the address listed above as part of the Energy
Incentives from We Energies Programs. I have read and agree to the Terms and Conditions listed on this application. To the best of my
knowledge, the statements made on this application are correct, and I have submitted the appropriate supporting documentation to receive an
incentive.
Customer Name (Print):
Customer Signature:
Date:
Trade Ally Name (Print): (Required only if receiving payment)
Trade Ally Signature: (Required only if receiving payment)
Date:
PAYMENT INFORMATION (All Information is required for payment)
Business Classification (check ONE):
Corporation
Partnership
Make Incentive Check Payable to:
Customer
Trade Ally*
(Check ONE on above and complete the information below):
Company
Corporation
Business Owner’s Legal Name
Name
Mailing Address
Sole Proprietorship-Individual
City
(must be 9-digits-not tax exempt number)
____ ____ - ____ ____ ____ ____ ____ ____ ____
Attn:
State
Company/Corporate Federal Tax ID of Payee
Other
ZIP
Social Security Number of Business Owner
OR
(if no Federal Tax ID#)
____ ____ ____ - ____ ____- ____ ____ ____ ____
Return completed form and itemized invoice within 30 calendar days to:
Energy Incentives from We Energies, 2665 S. Moorland Road, Suite 112, New Berlin, WI 53151
Page 4 of 4
August 2008