COMMERCIAL KITCHEN EQUIPMENT 2017 ILLINOIS FOR YOUR BUSINESS REBATE APPLICATION
Instructions: Fill out form completely and sign. Attach itemized invoices and supporting documentation, if applicable. Failure to complete the required sections and provide documentation will result in denial of claim. Equipment must be purchased between Jan. 1, 2017, and Dec. 31, 2017. Equipment must be installed and operating prior to submission of final rebate application. Rebates cannot exceed 70 percent of the installed cost (materials and reasonable labor). You will receive the lesser of the rebate amount listed or 70 percent of installed cost. Installed cost includes contractor labor only and does not include internal labor. Rebate application must be submitted within six months of dealer invoice for the equipment/material purchased. The rebate will be based on the rebate schedule in effect on the date of dealer invoice for the equipment/material purchased. Rebate applications received after six months of dealer invoice are not eligible for rebates. Custom Equipment: If specific equipment you intend to purchase and install is not listed, it may qualify under Nonresidential Equipment Custom Systems. However, custom projects must be preapproved by MidAmerican Energy prior to purchase and installation of equipment or system. See the Nonresidential Equipment Custom Systems application for details.
SECTION 1 (REQUIRED)
Customer Information
Name on account
Self-installed
q Yes q No Installation address
City
State
ZIP
State
ZIP
Phone
MidAmerican Energy Company account number (found on bill; first seven digits only) Mailing address (if different than installation address)
City
Contact name
Title
Email address*
*This email address only will be used for communication regarding this rebate application. Your email address will never be shared and you can unsubscribe at anytime.
SECTION 2 (REQUIRED) My facility had an energy assessment in the following program (check if applicable):
q Industrial
q Agribusiness
q Commercial
q Multifamily Housing
Date assessment completed (month/year)
Building size [sq. ft. (area)]
Year building was constructed
Do you:
q Own
q No assessment has been completed
q Rent this building
The new equipment is for:
q Replacement of existing equipment
q New installation (new to facility)
q New construction
Is space where equipment will be installed conditioned? (check one)
q Cooled only
q Heated only
q Not cooled or heated
q Both heated and cooled
q Other
If space is heated, what fuel type is used? (check one)
q Natural gas
q
Electric
q Other
Page 1 of 5 Questions about the forms or need assistance with the forms? Call our energy efficiency representatives at 800-894-9599.
1674830388
SECTION 2 CONT. (REQUIRED)
Equipment installed in what type of facility? (check one)
Industrial
MEC Use Only
Commercial
MEC Use Only
q
Apparel manufacturing
IND
q
Apartment, halfway house
MF
q
Chemical manufacturing
IND
q
Condo
MF
q
Computer/electronic product manufacturing
IND
q
Convenience store/gasoline station
CN
q
Electrical equipment, appliance/component manufacturing
IND
q
Dealership
RS
q
Food/beverage/tobacco product manufacturing
IND
q
Financial institution
OF
q
Furniture and related product manufacturing
IND
q
Grocery store and supermarket
GR
q
Large refrigerated warehouse
IND
q
Healthcare (outpatient)
HC
q
Leather and allied product manufacturing
IND
q
Healthcare (inpatient)
HS
q
Machinery manufacturing
IND
q
Health club/exercise facility
FC
q
Nonmetallic mineral product manufacturing
IND
q
Library
ED
q
Oil and gas extraction; mining
IND
q
Lodging - hotel
HO
q
Paper manufacturing; printing and related support activities
IND
q
Lodging - motel
MO
q
Personal and laundry services
IND
q
Mixed use
O
q
Petroleum and coal products manufacturing
IND
q
Office – small
OS
q
Plastics and rubber products manufacturing
IND
q
Office - government - small
OS
q
Primary metal/fabricated metal product manufacturing
IND
q
Office public order and safety – small
OS
q
Textile mill and textile product mill
IND
q
Office – large
OL
q
Transportation equipment manufacturing
IND
q
Office – government - large
OL
q
Utility
IND
q
Office - public order and safety - large
OL
q
Warehouse and storage
WH
q
Pharmacy and drug store
RT
q
Warehouse - large refrigerated
IND
q
Public assembly
HY
q
Wood product manufacturing
IND
q
Religious worship/church
RL
q
Miscellaneous manufacturing
IND
q
Restaurant - fast food
RSF
q
Other
O
q
Restaurant – full service
RSS
q
Retail - small
RS
q
Retail - large
RL
q
Retail – department store
RL
q
Retirement home, nursing home, assisted living
MF
q
School - elementary
SE
q
School - jr. high
SJH
q
School - high school
SJH
q
School - college, university and professional school
ED
q
School - lodging (school/dorm)
MF
q
Service
RS
q
Truck stop
CV
Agriculture
MEC Use Only
q
Corn farming
AG
q
Dairy cattle and milk production
DF
q
Hog facility
HF
q
Soybean farming
AG
q
All other animal production
AF
q
All other miscellaneous crop farming
AG
Page 2 of 5 Questions about the forms or need assistance with the forms? Call our energy efficiency representatives at 800-894-9599.
1674830388
Commercial Refrigeration Equipment Rebate:
q Refrigerator – transparent door cabinet (ENERGY STAR®): $500
q Freezer – solid door cabinet (ENERGY STAR): $75
q Refrigerator – solid door cabinet (ENERGY STAR): $35
q Anti-sweat heater controls for refrigerator/freezer transparent door cabinets: $50/door
Install date
Manufacturer/brand name
Number refrigeration/freezer doors for anti-sweat rebate:
Model number
Serial number
Size (cubic feet)
Total cost calculation +
=
Equipment cost
Contractor labor cost
Total installed cost
Refrigerated LED Case Lighting 5- and 6-Foot Doors (DLC QPL Required) Rebates are based on replacement of T12 or T8 linear 5- to 6-foot fluorescent refrigerated case door lighting with 5- to 6-foot LED refrigerated case door strip lighting. Rebates are per door, not per lamp. Linear LED tube lights do not qualify for this rebate. With preapproval before purchase or installation, they may qualify through the Nonresidential Equipment Custom Systems program. The program adopts the DLC definition: Strip lights in refrigerator cases vertically mounted along refrigerator case door mullions. Category only covers complete luminaires with all necessary components. Replacement lamps currently are not eligible under this category. Annual operating hours of equipment
Eligible DLC primary use designations: n Horizontal refrigerated case luminaires n Vertical refrigerated case luminaires n Refrigerated case luminaires
Date of installation
Equipment Cooler Case
q q
5-foot door 6 -foot door Replace fluorescent T12 or T8 systems with LED case lighting Freezer Case
q q
5-foot door 6 -foot door Replace fluorescent T12 or T8 systems with LED case lighting
New brand/ manufacturer
New model number
New wattage
Watts replaced
Rebate calculation
X
DLC product ID
New brand/ manufacturer
New model number
Qty
New wattage
Watts replaced
Total cost calculation
$75/door Rebate
+
=
X Qty
= Contractor labor cost
Total installed cost
Total cost calculation
Rebate calculation
DLC product ID
Equipment cost
Total
$75/door Rebate
+
= Equipment cost
Total
= Contractor labor cost
Total installed cost
Ice Makers Air-Cooled Remote Condensing or Ice - Making Head (ENERGY STAR) Manufacturer/brand name
Quantity Installed
Install date
Rebate =
x Model number
Serial number
Total Rebate
Total cost calculation + Equipment cost
= Contractor labor cost
Total installed cost
Page 3 of 5 Questions about the forms or need assistance with the forms? Call our energy efficiency representatives at 800-894-9599.
1674830388
Commercial Cooking – Hot Food Holding Cabinet Rebate:
q Hot food holding cabinet – electric (ENERGY STAR); full-size only: $400
Install date
Manufacturer/brand name
Cooking efficiency rating (watts/cu. ft.)
Model number
Annual operating hours
Serial number
Total cost calculation
Volume (cu. ft.)
+
=
Equipment
Contractor
Total installed
cost
labor cost
cost
Commercial Cooking – Other Rebate:
q Convection oven – natural gas (ENERGY STAR): $100 q Conveyor oven – natural gas with thermostatic control and a cooking efficiency rating ≥ 42%: $675 q Infrared upright broiler – natural gas with a cooking efficiency rating of ≥ 34%: $1,350 q Salamander broiler – natural gas with a cooking efficiency rating ≥ 34%: $125 q Steam cooker – natural gas (ENERGY STAR): $650
Install date
Manufacturer/brand name
Total cost calculation +
Model number
Serial number
=
Equipment
Contractor
Total installed
cost
labor cost
cost
Cooking efficiency rating
Motors Rebate:
q ECM – Display case fan: $75 Electronically commutated motors (ECM) must replace standard efficiency shaded pole evaporator fan motors in refrigerated display cases. q High-efficiency evaporator fan motor for walk-in coolers/freezers: $40 Electronically commutated motors (ECM) must replace standard efficiency shaded pole evaporator fan motors in walk-in coolers or walk-in freezers. q Demand controlled ventilation for kitchen range hoods: $400/range hood fan HP (100% both fuels; 70% gas-only; 30% electric-only) Requires temperature or optic sensors and VSD. No added VSD rebate. ENERGY STAR; see www.energystar.gov/emergingtech for qualifying products.
Motor No. 1
Install date
Manufacturer/brand name
Model number
Serial number
Total cost calculation + x $400/HP
=
Horsepower for range hood fan(s) Rebate:
Equipment cost
= Contractor labor cost
Total installed cost
Total rebate
q ECM – Display case fan: $75 Electronically commutated motors (ECM) must replace standard efficiency shaded pole evaporator fan motors in refrigerated display cases. q High-efficiency evaporator fan motor for walk-in coolers/freezers: $40 Electronically commutated motors (ECM) must replace standard efficiency shaded pole evaporator fan motors in walk-in coolers or walk-in freezers. q Demand controlled ventilation for kitchen range hoods: $400/range hood fan HP (100% both fuels; 70% gas-only; 30% electric-only) Requires temperature or optic sensors and VSD. No added VSD rebate. ENERGY STAR; see www.energystar.gov/emergingtech for qualifying products.
Motor No. 2
Install date
Manufacturer/brand name
Model number
Serial number
Total cost calculation + x $400/HP
=
Horsepower for range hood fan(s) Rebate:
Equipment cost
= Contractor labor cost
Total installed cost
Total rebate
q ECM – Display case fan: $75 Electronically commutated motors (ECM) must replace standard efficiency shaded pole evaporator fan motors in refrigerated display cases. q High-efficiency evaporator fan motor for walk-in coolers/freezers: $40 Electronically commutated motors (ECM) must replace standard efficiency shaded pole evaporator fan motors in walk-in coolers or walk-in freezers. q Demand controlled ventilation for kitchen range hoods: $400/range hood fan HP (100% both fuels; 70% gas-only; 30% electric-only) Requires temperature or optic sensors and VSD. No added VSD rebate. ENERGY STAR; see www.energystar.gov/emergingtech for qualifying products.
Install date
Manufacturer/brand name
Model number
Motor No. 3 Serial number
Total cost calculation + x $400/HP
Horsepower for range hood fan(s)
Equipment cost
=
= Contractor labor cost
Total installed cost
Total rebate
REMEMBER TO SIGN THE NEXT PAGE Questions about the forms or need assistance with the forms? Call our energy efficiency representatives at 800-894-9599.
Page 4 of 5 1674830388
Disclaimer
MidAmerican Energy Company does not guarantee that installation and operation of high-efficiency equipment will result in reduced usage or in cost savings. MidAmerican Energy Company makes no warranties, expressed or implied, with respect to any equipment purchased or installed, including, but not limited to, any warranty of merchantability or fitness for a particular purpose. In no event shall MidAmerican Energy Company be held liable for any incidental or consequential damages or injuries resulting from defective equipment or installation. MidAmerican Energy Company reserves the right to cancel or change these programs at any time. MidAmerican Energy Company’s acceptance of this application does not guarantee payment of rebate.
Specific Terms and Conditions nnParticipants must be commercial or industrial customers with facilities located in MidAmerican Energy Company’s Illinois service territory. nnMidAmerican Energy Company must deliver the electricity and/or natural gas to the equipment at the facility for which the rebate is being paid. nnFor prescriptive rebates, the rebate payment cannot exceed 70 percent of the installed cost (reasonable labor and material/equipment - reasonableness to be determined by MidAmerican Energy Company). Installed cost includes contractor labor only and does not include internal labor. nnFor equipment that requires ENERGY STAR® certification, visit www.energystar.gov/cfs and www.energystar.gov/emergingtech for information on qualifying commercial kitchen equipment. A manufacturer’s specification sheet with efficiency ratings of the product(s) installed must accompany the application. nnEquipment installed as a replacement unit, retrofit or in new construction is eligible. nnEquipment must be purchased between Jan. 1, 2017, and Dec. 31, 2017. Equipment must be installed and operating prior to submission of final rebate application. nnRebate application must be submitted within six months of dealer invoice for the equipment/material purchased. The rebate will be based on the rebate schedule in effect on the date of dealer invoice for the equipment/material purchased. Rebate applications received after six months of dealer invoice will not be eligible for rebates. nnAllow 4 – 6 weeks for rebate processing.
General Terms and Conditions
Important: Before completing and signing this form, please read the General Terms and Conditions located in the 2017 Illinois For Your Business rebate booklet or at www.midamericanenergy.com/ee.
Customer Agreement My signature indicates consent to and agreement with all program terms and conditions. It certifies that all information in this application is correct and equipment installed at the indicated location. I understand that MidAmerican Energy Company reserves the right to inspect and verify installation before issuing payment. Customer signature
Date
Installer/Dealer Information Dealer name
Phone
Address
Fax
City
State
ZIP
Contact name
Email address
Installer/Dealer Agreement I certify that all equipment and installation information provided on this application is correct and accurate. Installer/dealer signature
Date
Before you submit your form: o Fill out this form completely.
Send completed forms to: Mail:
MidAmerican Energy Company P.O. Box 4628 Des Moines, IA 50305-4628
Fax:
515-244-8825
o Attach a copy of the itemized sales receipt or invoice. o Include documentation listed in the instructions. o Sign the Customer Agreement section.
Email:
[email protected]
Page 5 of 5 For more information call 800-894-9599 or go to www.midamericanenergy.com/ee.
1674830388