$100 ECM Replacement Motor on Forced Air
Furnace or Air Handler Rebate Form
Get cash back by mail from Minnesota Power
Offer valid January 1, 2016 – December 31, 2016
CUSTOMER INFORMATION
Name of Customer (As it appears on utility bill.)
Minnesota Power Account Number (Required for MP customers. Located on MP electric bill.)
Name of Electric Utility (Must be a customer of a participating utility.*)
Mailing Address
City
State
ZIP
Installation Address (Unit must be installed at a location served by MP or participating utility.)
City
State
ZIP
Daytime Phone Number
Email Address
This ECM replacement motor will be used in a:
q Single Family Home (1-3 units) q Apartment/Condo building (4 or more units)
INSTALLER/CONTRACTOR INFORMATION
Business Name
Phone Number
Name of Product Trained Installer (must be completed)
BUSINESS/LANDLORD INFORMATION
Make Rebate Check Payable to: q Residential Customer (skip to next section) q Landlord/Property Owner
Complete section below only if rebate will be paid to a business or the Landlord/Property Owner
Payee Legal Name (as shown on income tax return)
Payee Federal Tax Classification (check ONE only) q Sole Proprietor/Individual q LLC q Corporation q Partnership
q Other tax exempt organization or gov’t agency
Payee Legal Address
Make Check to: q Payee Legal Address
q Alternate Address (complete below):
Alternate Pay Address (optional)
Payee Taxpayer Identification Number (TIN) (Complete ONE only. Must match payee legal name above)
FEIN #: ____ ____ – ____ ____ ____ ____ ____ ____ ____ OR SSN: ____ ____ ____ – ____ ____ – ____ ____ ____ ____
Certification: the following certifications are required in order for this form to substitute for the IRS form W-9. Under penalties of perjury, I certify that:
1. The payee’s TIN is correct
2. The payee is not subject to backup withholding due to failure to report interest and dividend income, and
3. The payee is a U.S. citizen
The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.
CUSTOMER SIGNATURE
To the best of my knowledge, the information in this application is accurate and complete. I have read and agree to the terms and conditions of the rebate program.
Equipment will be purchased, installed, and operating at the facility listed above.
Sign or Initial here:
*For a list of participating utilities visit www.mnpower.com/hvacutilities.
800.677.8423 (option 2) | [email protected]
FORM 6278A REV. 120915 - PAGE 1
$100 ECM Replacement Motor on Forced Air
Furnace or Air Handler Rebate Form
Get cash back by mail from Minnesota Power
Offer valid January 1, 2016 – December 31, 2016
ELECTRONICALLY COMMUTATED MOTOR (ECM) REPLACEMENT TO FURNACE OR AIR HANDLER TYPE
REBATE – $100 (Limit one per dwelling and must replace an existing PSC motor)
Date of Installation
System Type Brand Name
Model Number
q Furnace, please specify: ___electric ___gas ___oil ___propane
q Air Handler for Heat Pump q Air Handler for Electric Thermal Storage
Age of Motor Being Replaced
Serial Number
Furnace Size
q 0–100,000 BTU q 101,000–160,000 (MAX BTU)
Type of Motor Being Replaced
PROGRAM REQUIREMENTS CHECKLIST (must be completed)
q
q
q
q
Visually inspected ductwork
Provided air sealing at additional cost
Complete all appropriate information on rebate form
Manufacturer trained installer signs rebate
q Contractor reviews information with customer
q Complete and sign manufacturer installation checklist/data collection form
Note: AC/data flow collection not necessary if weather conditions do not permit.
q Provide customer information on operation and maintenance of system
TERMS AND CONDITIONS
General Eligibility: This offer is valid for Minnesota Power or participating municipal utility* customers only. In order for a customer to receive a rebate on heating/
cooling equipment, products must be purchased through a participating contractor. Online purchases will only qualify if made through a participating contractor
website. Programs may vary between utilities. If you have a question about a specific utility program, please call 800.677.8423 (option 2) or contact your utility directly.
See program overviews for equipment and installation requirements.
Verification: Minnesota Power reserves the right to verify sales receipts and/or installations of products and services before issuing rebates. A random inspection may
be conducted to verify installation(s) or service(s).
Program Modifications: Minnesota Power and the Participating Utilities reserve the right to alter or discontinue this rebate offer at any time without notice.
Disclaimer: Minnesota Power reserves the right to deny or limit any rebate request. In addition, Minnesota Power offers no warranties on product or service installations
provided nor does the program warranty, guarantee or endorse the energy efficiency services provided by any specific contractor participating in the program.
ELIGIBILITY DATES
This rebate form is eligible for qualified installations and/or services performed between January 1, 2016, and December 31, 2016; based on approval of the Minnesota
Department of Commerce Division of Energy Resources (DER) and available dollars. All forms must be postmarked within 30 days of installation and/or service to be
considered eligible for the rebate. Please allow 8 - 10 weeks to receive the rebate(s).
CONTRACTOR INSTRUCTIONS
Verify that customer’s electric utility at the installation address is Minnesota Power or a participating municipal utility.
Contractor is responsible for submitting rebate forms and required paperwork to the address below. See page 4 for submission instructions.
REQUIREMENTS FOR REBATE PROCESSING
q Completed/signed copy of this form q Copy of invoice that includes: installation address, equipment type, manufacturer, model number, cost, date of installation
*For a list of participating utilities visit www.mnpower.com/hvacutilities.
800.677.8423 (option 2) | [email protected]
FORM 6278A REV. 120915 - PAGE 2
ECM Replacement Data Sheet
Get cash back by mail from Minnesota Power
Offer valid January 1, 2016 – December 31, 2016
FOR ECM REPLACEMENT
Customer Information
Contractor
Date
HVAC SYSTEM INFORMATION
Check all that apply: q Furnace q Air Handler q A/C q Heat Pump q Geothermal q Up flow q Down flow q Horizontal Flow q Split q Package
Package Systems: Enter one Make/Model#/Serial# and complete all other information in appropriate sections.
FURNACE INFORMATION (DATA PLATE)
Make
Model Number
AFUE (%)
Serial Number
Fuel
High Fire TR
Low Fire TR
AIR HANDLER INFORMATION (DATA PLATE)
Make
Model Number
Serial Number
Evaporator BTUh (Ton)
Refrigerant Type
Electric Strip KW
FURNACE INFORMATION (DATA PLATE)
Make
Model Number
Serial Number
BTUh (Ton)
Regional CFM/Ton Value
PSC MOTOR INFORMATION
Brand
Model
Total # of Speeds
Rotation
Constant Fan Speed
Low Heat Speed
FLA Rating
Voltage
Horse Power Rating
Heat (Hight Heat) Speed
Cool (High Cool) Speed
Low Cool Speed
Electric Strip Heat Speed
If this is not the original motor, check the data plate for original motor horse power and list here:
ECM INFORMATION (Minimum required set-up, configure ECM to the same speeds as PSC motor per demand.)
Horse Power Rating
Configured Horse Power
Cool (High Cool) Speed
Constant Fan Speed
Configured Voltage
Low Heat Speed
Heat (High Heat) Speed
Low Cool Speed
Electric Strip Heat Speed
POST INSTALLATION MEASUREMENTS
Fossil Fuel Systems - The measured temperature rise per demand must match the data plate rating. A/C or Heat Pump Systems - The cooling TD should match the chart below.
PSC measurements are optional if motor is
operational for a baseline.
High Heat Speed
Low Heat Speed
High Cool Speed
Low Cool Speed
PSC
PSC
PSC
PSC
ECM
ECM
ECM
ECM
Supply Air-Dry Bulb (°F)
Return Air-Dry Bulb (°F)
Temp Rise/Temp Drop
REQUIRED INDOOR AIRFLOW CHART Match the %RH of the indoor air to the required evaporator temperature difference (TD)
Indoor Measured Relative Humidity
Required Evaporator Coil Dry Bulb TD
ECM REPLACEMENT DATA SHEET AND DIAGRAMS PROVIDED BY
30%
40%
50%
60%
70%
80%
90%
20-23
18-21
15-19
12-17
11-15
9-14
9-12
FORM 6278A REV. 120915 - PAGE 3
ECM Replacement Data Sheet
Get cash back by mail from Minnesota Power
Offer valid January 1, 2016 – December 31, 2016
PRE-INSTALLATION SUGGESTIONS
Many airflow issues are due to lack of maintenance. Airflow restrictions will decrease efficiency and increase operating noise. Some of the following suggestions
may lead to additional service requirements and cost.
■■ Open and clear all registers and grilles.
■■ Inspect the filter(s). Recommend cleaning or replacement if visibly dirty.
■■ Inspect the blower wheel. Recommend cleaning if visibly dirty.
■■ Inspect the evaporator coil if accessible. Recommend cleaning if visibly dirty.
■■ Measure the TESP at the highest airflow demand. If TESP is above .8, diagnose and repair the airflow issue.
■■ There is a worksheet at the bottom of this page for measurements.
Suggestions for measuring Total ESP (External Static Pressure)
Fossil Fuel Systems With External Evaporator
Air Handlers and Package Systems
Suggestions to reduce TESP
■■ Inspect and clean all airside coils and heat exchange surfaces
■■ Inspect ductwork for restrictions and sizing. Recommend repairs or replacement as needed.
■■ Measure filter static pressure drop. If above .2 in. wc. recommend a larger or less restrictive filter.
Formulas
■■ Watts = Volts x Amps x Power Factor (Power Factor cannot be calculated, it must be measured)
(Amperage should be measured with an RMS or True RMS meter for accuracy)
■■ CFM = Output BTUh / TR x 1.08 ■ CFM = Cubic Feet per Minute
■■ CFM = Velocity (FPM) x Area (Square Feet)
■ FPM = Feet Per Minute
OPTIONAL POWER AND STATIC PRESSURE MEASUREMENTS ANALYSIS
High Heat Speed
Low Heat Speed
High Cool Speed
Low Cool Speed
PSC
PSC
PSC
PSC
ECM
ECM
ECM
ECM
Voltage
Amps
Watts
Supply ESP
Return ESP
Total ESP
CFM
REQUIREMENTS FOR REBATE PROCESSING
q Completed/signed copy of this form q Copy of invoice that includes: installation address, equipment type, manufacturer, model number, cost, date of installation
Completed rebate applications must be postmarked within 30 days of installation and/or service and submitted to:
Minnesota Power HVAC Rebates
431 Charmany Drive
Madison, WI 53719
[email protected]
COPY OF THE INVOICE MUST BE SUBMITTED WITH THIS FORM
All information must be completed and submitted by the contractor before rebate application can be processed.
If you have not received your rebate within 8-10 weeks of submission, please contact your contractor or the Minnesota
Power HVAC Rebate Program at 800-677-8423.
800.677.8423 (option 2) | [email protected]
FORM 6278A REV. 120915 - PAGE 4