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COMMERCIAL

ENERGY STAR APPLIANCE REBATES


To receive your UGI Utilities rebate check by mail, follow these steps:

Promotion Dates: 06/01/2012 - 05/31/2013 Requests must be postmarked by 06/30/2013.

Funds are limited, and UGI Utilities reserves the right at any time to extend, modify or terminate the rebate program.

1) Purchase a Qualifying ENERGY STAR Product during the promotion dates listed above. Must be installed in a commercial property within UGIs electric service territory. 2) Mail the following to the address on right (1 application per unique qualifying product):

This signed and dated application with all information completed accurately and legibly. A copy of the first page of your most recent UGI Utility bill. A copy of your itemized receipt/invoice reflecting the retailer name, purchase and/or
3) IMPORTANT: Photocopy your entire submission for your records.
QUALIFYING PRODUCTS DATE INSTALLED MANUFACTURER

UGI Utilities Rebates Offer # H244893 PO Box 130002 El Paso, TX 88513-0002

install date, description, manufacturer, model, purchase price and proof of payment.

MODEL #

REBATE

Steam Cooker
Number of Pans: ___________
_____/______/________
Replaces an existing appliance? Yes No Existing appliance is in working condition? Yes No

per unit

$40

Ice Maker
Harvest Rate: ___________

_____/______/________
Replaces an existing appliance? Yes No Existing appliance is in working condition? Yes No

per unit

$115

Residential Size Refrigerator


Capacity: ___________
*UGI Utilities Account #

_____/______/________
Replaces an existing appliance? Yes No Existing appliance is in working condition? Yes No

$50
*Denotes Required Fields *Business Name

CUSTOMER INFORMATION
_____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____

*Business Address *First Name

*City *Last Name

*State

*Zip Code

*Mailing Address (Your rebate check will be mailed to the address provided in this field.)

*City Email (Used to send status updates regarding this application.)

*State

*Zip Code Phone

If you are a business, please indicate your Tax Status:

Sole-Proprietor

Partnership

Government

Non-Profit

Corporation

Religious

SSN or Fed. Tax ID: _______________________________________________ How did you hear about UGI Utilities' rebates? UGI Bill Insert

Legal Name: ______________________________________________________________ Newspaper Television Internet Store Other

TERMS & CONDITIONS


Rebate checks will be mailed to qualifying customers within 60 days of the postmark date on your request. To review the status of your application or to ask questions, call 1-855-300-3792 or visit www.smartenergy-zone.com/UGI at any time. Your right to receive this rebate will not be earned unless you purchase a qualifying product and follow each of the steps above. This rebate cannot be combined with any other UGI Utilities rebate, unless specified in writing by UGI Utilities. This rebate is available to UGI Utilities customers with mailing addresses in the United States. UGI Utilities is not responsible for lost, late, damaged, illegible, misdirected or postage-due applications. Your rights to this rebate cannot be assigned or transferred. Excessive submissions constitute fraud and may result in federal prosecution under the U.S. mail fraud statutes (Title 18, USC 1341 and 1342). All submitted materials become property of UGI Utilities and will not be returned. Rebate paid by check in US Dollars.

ACCEPTANCE OF TERMS
I accept the Terms of this rebate appliaction and understand UGI Utilities reserves the right to audit my application and if requested, I will allow UGI representatives reasonable access to verify the installation of qualifying product(s) and potentially the removal of older products. UGI Utilities may provide my name and address to UGI representatives to verify this information and I approve sending the rebate to the address I have provided above.

*Customer Signature:

Date: _______________________________

x ___________________________________________________________________________
H244893 (UAI)

UGI Utilities Commercial ENERGY STAR Appliance Rebates