The HVAC Program provides rebates for the installation of high-efﬁciency HVAC equipment to residential customers ofWest Penn Power. This equipment must be installed by a participating contractor and must meet all program requirements.
Please complete this application and mail it to the address provided below along with:
1) a sales receipt (must be dated from January 1, 2012 through May 31, 2013) from a participating contractor, and2) an AHRI* certiﬁcate including model number and efﬁciency performance rating
(account holder on record)
West Penn Power Account No.Installation AddressCityStateZip CodeEmail Address
(Your email address will be used only for transactional communications regarding energy efﬁciency programs)
Home PhoneWork PhoneDate InstalledParticipating Contractor NameContractor Phone NumberHow did you hear about this program: Bill Insert Contractor Direct Mail Email Event FirstEnergy EmployeeFamily/Neighbor/Friend Online Advertising Radio Print Advertising www.energysavePA.comWhat type of residence do you live in? Single Family 2-4 Units Other:Is this system installed as part of a new home construction project? Yes NoIs natural gas available at your residence? Yes No
By signing this application, I agree to the terms and conditions of this document. I understand West Penn Power reserves the right to audit my rebate application and if requested, will allow a West PennPower representative reasonable access to verify the installation of qualifying products.
Customer Signature Date
West Penn Power Terms and Conditions
1. Equipment and services must be purchased from January 1, 2012 through May 31, 2013.Rebate application must be postmarked by June 7, 2013.2. Please submit one rebate application form per unit.3. Work must be completed by a participating contractor.4. Applicant must be a Pennsylvania residential customer of West Penn Power.5. Customers who purchased qualiﬁed equipment before January 1, 2012, also may be eligible forrebates. Call 1-888-265-6684 for more details.6. It is the responsibility of the customer to assure that all requirements for the rebate are met. Failureto provide any of the required information will prevent processing of your application.7. Rebate payments are based on the equipment purchase date. Customers must abide by the rulesand rebate levels in effect on the date of purchase.8. Purchase must be of a high-efﬁciency electric central air conditioner, heat pump or geothermal unitas deﬁned in the table called HVAC Energy Efﬁciency Systems. Both the condenser and coil must bereplaced and installed as a matched set.9. West Penn Power and/or its designees including program administrators and evaluation contractorsreserve the right to review installations to verify completion and measure energy savings to ensurecompliance with all program requirements. Such reviews will be made at a time convenient to theapplicant. Misrepresentation of installation location or measure eligibility may result in forfeiture ofthe rebate.10. Program procedures, requirements and rebate levels are subject to change or cancellation withoutnotice and are subject to available program funds.11. Payment will be issued to the account holder and mailing address on record with the utility.12. Please allow up to 90 days from the date all required information is received to process yourrebate(s).13. Installations must be completed in accordance with all laws, codes and other requirements applicableunder federal, state and local authority.14. You are urged to seek appropriate consultation concerning any tax liabilities that could be associatedwith the receipt of the rebate.15. West Penn Power, its parents, subsidiaries, employees, afﬁliates and agents assume no responsibilityfor the performance of the equipment or equipment warranty, the quality of the work, labor and/ormaterials supplied, and/or the acts or omissions of the participating contractor.16. The customer hereby agrees to indemnify, defend and hold harmless West Penn Power, its parents,subsidiaries, employees, afﬁliates and agents from any and all liability associated with this project.17. I understand that I may be contacted by West Penn Power via survey or questionnaire to providefeedback on my satisfaction with the program.18. By participating in this program, customer agrees to allow the local utility (West Penn PowerCompany) to take ownership of the energy efﬁciency resource credits associated with the measuresgenerated through this program. Your local utility may at its sole discretion then aggregate yourcredits with other similarly situated customers and bid the credits into the PJM market through anauction. Any proceeds from any such bids accepted by PJM will be used to offset the costs chargedto the utility’s customers for compliance with state mandated energy efﬁciency and/or peak demandrequirements.
HVAC Equipment Rebate Application
West Penn Power HVAC Program
Offer #H644244 · P.O. Box 130016 · El Paso, TX 88513-0016
(Please do not send this form with your utility bill payment)
ENERGY EFFICIENCY PROGRAM
The costs of energy efﬁciency programs are recovered through residential customer rates in accordance with Pennsylvania Act 129 of 2008. You will not be charged any additional fees to participate.