HEAT PUMPS/DUCTLESS MINISPLITS
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1 HEAT PUMPS/DUCTLESS MINISPLITS 2017 IOWA 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, 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) Name on account Customer Information Self-installed q Yes q No Installation address City State ZIP Phone MidAmerican Energy Company account number (found on bill; first seven digits only) Mailing address (if different than installation address) City State ZIP Contact name Title address* *This address only will be used for communication regarding this rebate application. Your 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 q No assessment has been completed Date assessment completed (month/year) Building size [sq. ft. (area)] Year building was constructed Do you: q Own 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
2 SECTION 2 CONT. (REQUIRED) Equipment installed in what type of facility? (check one) Industrial Commercial q Apparel manufacturing q Apartment, halfway house q Chemical manufacturing q Condo q Computer/electronic product manufacturing q Convenience store/gasoline station CN q Electrical equipment, appliance/component manufacturing q Dealership q Food/beverage/tobacco product manufacturing q Financial institution OF q Furniture and related product manufacturing q Grocery store and supermarket GR q Large refrigerated warehouse q Healthcare (outpatient) HC q Leather and allied product manufacturing q Healthcare (inpatient) HS q Machinery manufacturing q Health club/exercise facility FC q Nonmetallic mineral product manufacturing q Library ED q Oil and gas extraction; mining q Lodging - hotel HO q Paper manufacturing; printing and related support activities q Lodging - motel MO q Personal and laundry services q Mixed use O q Petroleum and coal products manufacturing q Office small q Plastics and rubber products manufacturing q Office - government - small q Primary metal/fabricated metal product manufacturing q Office public order and safety small q Textile mill and textile product mill q Office large q Transportation equipment manufacturing q Office government - large q Utility q Office - public order and safety - large q Warehouse and storage WH q Pharmacy and drug store RT q Warehouse - large refrigerated q Public assembly HY q Wood product manufacturing q Religious worship/church q Miscellaneous manufacturing q Restaurant - fast food F q Other O q Restaurant full service S q Retail - small Agriculture q Retail - large q Corn farming q Retail department store q Dairy cattle and milk production DF q Retirement home, nursing home, assisted living q Hog facility HF q School - elementary SE q Soybean farming q School - jr. high SJH q All other animal production AF q School - high school SJH q All other miscellaneous crop farming q School - college, university and professional school ED q School - lodging (school/dorm) q Service q Truck stop CV Page 2 of 5
3 Rebate: $400 per unit Add-On Desuperheater Include AHRI standard heating capacity and efficiency (HSPF or COP) ratings of GSHP. Manufacturer/brand name Ground-source heat pump AHRI reference number Install date Equipment model number Total cost calculation Serial number Equipment cost Contractor labor cost Total installed cost Air-Source Heat Pump Small (< 65 MBtu) Btuh 65,000 may be reviewed through Nonresidential Equipment Custom Systems. Qualifying Efficiency Equipment Rebate Qualifying Efficiency Equipment Rebate Total Rebate q SEER $350 per cooling ton q HSPF $150 per cooling ton q SEER 16 + $500 per cooling ton q HSPF 9 + Install date AHRI reference number Total cost calculation Supplemental heat: SEER q Electric resistance q Natural gas q Other HSPF Equipment cost Contractor labor cost Total installed cost q None Unit Indoor Outdoor Manufacturer Model Number Serial Number Cooling Capacity (MBtuh) Ground-Source Heat Pump Must be AHRI Certified. Documentation of capacities is required in addition to ENERGY STAR listing. The capacity and efficiency rating will be determined using the full heating load and full cooling load for multistage equipment. Use AHRI/ISO equipment rating for units < 135,000 Btuh. ENERGY STAR Tier 3, 32 deg. F and 77 deg. F efficiencies for units > 135,000 Btuh. New ground loop rebate is based on equipment capacity, not total loop tons. Install date AHRI reference number Qualifying Efficiency Equipment Rebate Loop Rebate Voltage: if dual voltage Manufacturer/brand name Model number q EER q EER q EER 25 q COP $450 per cooling ton $600 per cooling ton $150 per cooling ton $450 per cooling ton $600 per cooling ton $150 per cooling ton Serial number q COP 4.0 Heating capacity (MBtu) and COP (full load) Cooling capacity (MBtu) and EER (full load) q Open loop q Water loop q Water to air Add-on Total cost calculation q Closed loop q Ground loop q Water to water desuperheater q Ground water q DGX installed q Yes q No Equipment Contractor labor Total installed cost cost cost Total rebate $ Page 3 of 5
4 Ductless Minisplit Heat Pump Small (< 65 MBtu) Must heat and cool by the heat pump system. Electric resistance heat does not qualify. Btuh 65,000 may be reviewed through Nonresidential Equipment Custom Systems. Qualifying Efficiency Equipment Rebate. Qualifying Efficiency Equipment Rebate Total Rebate q SEER $350 per cooling ton q HSPF $150 per cooling ton q SEER 16 + $500 per cooling ton q HSPF 9 + Install date AHRI reference number Total cost calculation SEER Equipment cost Contractor labor cost Total installed cost HSPF Unit Manufacturer Model Number Serial Number Cooling Capacity (MBtuh) Indoor Outdoor Specific Terms and Conditions Participants must be commercial or industrial customers with facilities located in MidAmerican Energy Company s Iowa service territory. MidAmerican Energy Company must provide the electricity to the equipment at the facility for which the rebate is being paid. Equipment installed as a replacement unit, retrofit or in new construction is eligible. Rebate based on actual equipment rating in Btuh at AHRI-rating conditions. To convert Btuh to tons, divide the Btuh by 12,000. For example, if you are converting 24,000 Btuh into tons, divide by 12,000. The result is 2 tons. For 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. Cooling capacity, full-load efficiency rating and IPLV rating must be at standard AHRI testing conditions (AHRI standard 550/590). Equipment must be purchased between Jan. 1, 2017, and Dec. 31, Equipment must be installed and operating prior to submission of final rebate application. 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 will not be eligible for rebates. Allow 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 Iowa For Your Business rebate booklet or at 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. REMEMBER TO SIGN THE BACK PE Page 4 of 5
5 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 Dealer name Installer/Dealer Information Phone Address Fax City State ZIP Contact name 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. o Attach a copy of the itemized sales receipt or invoice. o Include documentation listed in the instructions. o Sign the Customer Agreement section. Send completed forms to: Mail: MidAmerican Energy Company P.O. Box 4628 Des Moines, IA Fax: rebateapplications@midamerican.com Invoice(s) submitted must include itemized quantity, price, manufacturer s make and model numbers and product codes for each material item and original equipment manufacturer (OEM) specification sheets. Itemized invoices are the key to fast processing of rebate forms. Specify the quantity for each item Identify manufacturing part information P.O. NO. TERMS BILL 2% OF NET 30 Detailed project codes Note labor and other expenses separately from other materials Item Qty Description Rate Installed Amount GWK500 1 Ground-source heat pump $5,000 6/20/2017 $5,000 HDPE pipe 750 ft. Loop piping $3.00/ft. 6/20/2017 $2,250 Labor 1 Installed ground-source heat pump with closed loop $2,000 6/20/2017 $2,000 Travel Travel $64 $64 Local sales tax 6% $555 Total $9,869 List price for each item and total Good description For more information call or go to Page 5 of 5
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