Business Customer Information. Account Number (9 digits) Account Holder Name Phone (As shown on your utility bill) Service Street Address

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1 Commercial Lighting Rebate Application Please complete the application including existing and installed information. Application will be returned without valid purchase receipt/invoice or if equipment requirements are not met. Submit application and invoices to or fax to WE CARE Program at or mail to Holy Cross Energy, Attn: WE CARE Program, PO Box 2150, Glenwood Springs, CO Questions: contact Mary Wiener at or Business Customer Information Account Number (9 digits) Account Holder Name Phone (As shown on your utility bill) Service Street Address Account holder hereby certifies that 1. The account holder is solely responsible for the accuracy of the application information; 2. All installation is complete and operational prior to submitting this application; 3. All rules of Holy Cross energy efficiency program have been followed; 4. Holy Cross is not liable for any work performed; 5. Account is in good standing (no more than 2 delinquent payments in 12 months); 6. Business agrees to have project written up as a case study. By typing in your name below, you are agreeing to all terms of this rebate application. Account Holder Signature Date Rebate Check Issued to Another Party Note: Complete this section only if the rebate should be issued to someone other than the account holder named above. Name Phone Address City State Zip I authorize the above party to receive the rebate check. Account Holder Signature Date Contractor Information Contractor Company Contact Person Phone 1

2 Lighting Rebates Read All Rebate Requirements at Holycross.com/rebates New Equipment Specifications All LEDs must be DLC, Lighting Facts, or Energy Star Qualified Minimum 30% wattage reduction for all LEDprojects LED s or Retrofit Kits, common recessed, suspended or surface-mounted T12 LED or Retrofit Kit s must replace like s -Level Lighting Controls for LED s Integral Occupancy or Daylight Sensor must be permanently integrated into the by the manufacturer. Rebate/Unit x Limited to 50% of Project Cost $25 Qty = Rebate LED Linear ment Lamps, 2 or 4 foot replacement LED Plug-n-Play UL Type A; operate off an existing electronic instant start ballast $5 LED T8 Tube T12 UL Type B: internal driver wired to main voltage strict safety measures required-exposure to main voltage; OR UL Type C; external-driver powers LED $10 $5 or Linear Fluorescent Removal Linear Fluorescent Exit Sign LED or LEC Exit Sign Remove entire Reduce # of lamps per incandescent Permanent removal of including troffers, surfacemounted, and recessed cans; Entire LED lighting project must reduce wattage at least 30% Permanently remove sockets from ; Fluorescent to LED upgrade only; example: 4-lamp T8 to 2-lamp LED T8 Tube $10 Must replace entire exit sign $15 $3 LED Screw-in Lamps; A-bulbs, Candelabra, MR16, BR, PAR, etc LED Screw-in incandescent or halogen No rebate for replacing CFL with LED $5 Interior LED Downlight Luminaires; any size recessed can 2 or 4-pin LED 2 or 4- pin LED Screw-in (push-ntwist) Retrofit kit incandescent or halogen Wattage must be reduced at least 50% $10 Retrofit kits include integrated LED and trim $10 2

3 Interior LED High/Low Bay s, High Ceiling Indoor Applications LED high or low bay or retrofit kit LED Screw-in high or low bay (corn cob) 275 to 750 to 1, to Includes horticultural LEDs (LM test results required) Must be on Lighting Facts or DLC Exterior LED Wall Pack s, Walkway or Security Lights Affixed to Building Wall 100 watt or less HID $225 $30 LED Wall Pack Equipment must be hardwired and rated for exterior use 400 LED Parking Garage s, Parking Structures Underground or Semi-enclosed Above Ground Lighting must operate 24 hours a day 70 watt or less HID LED Parking Garage 100 to 250 to Ceiling-mounted s for outdoor use or location open to elements $175 LED Parking Garage Controls Integral Occupancy Sensor Sensor must be permanently integrated into the by the manufacturer Exterior Canopy or Soffit s; Fuel Station Canopies, Office Buildings Soffits, etc LED Canopy or Soffit 100 to 250 to Hardwired ceiling-mounted s for outdoor use or location open to elements $150 3

4 LED Metered Street Lights or Area Lights, or Retrofit Kit; Street Lights, Parking Lot Lights, etc 70 watt or less HID LED Street or Area Lights 100 to 250 Hardwired s rated for exterior use. Must be on photocell or timer. 400 $ to 1,000 $250 LED Non-Metered (tariff) Street Light or Security Lights; Must Supply 4 Digit Pole Number LED Street or Security Light nonmetered HID For lights on monthly tariff fee; hardwired s rated for exterior use. Must be on photocell or timer. Exterior LED Screw-in (Corn Cob); Post Top, Bollards, Area Lighting, Parking Lot Lighting 100 watt or less HID $25 LED Screw-in Lamp 275 to Must be on Lighting Facts or DLC; Must be rated for exterior use $40 $80 Permanently Installed Lighting Controls; Controls not Integrated into by Manufacturer Photocell No controls or non-working $15 photocell Must be permanently installed. Lighting controls may be Wall Occupancy Sensor No Controls wall, or ceiling-mounted, passive infrared, ultrasonic, $15 Daylighting, Wireless, No Controls wireless, or dual technology sensors. or Ceiling Sensor Must provide wattage controlled. Refrigerated LED Case Lighting 5- and 6-foot Doors (DLC Required) Strip LED lights in refrigerator cases, vertically mounted along refrigerator case door mullions. or T12 with LED refrigerated strip lighting Rebates based on replacement of T12 or T8 linear 5- or 6-foot refrigerated case door lighting with 5- or 6-foot LED refrigerated case door strip lighting. Rebate per LED strip light. Labor cost only apply to installing LED lighting not reconfiguring circuitry or bringing wiring up to code. LED Case Occupancy Control No Controls Rebate is per LED strip/tube controlled. $10 *High-intensity discharge (HID) systems include mercury vapor, high-pressure sodium, and metal halide. $65 4

5 Below Information Required to Process Rebate Old (Sample below) Old Wattage Qty New New Wattage Qty Annual Hours of Operation Sensor Yes or No 4-lamp 40-watt T12/magnetic ballast 40 watt 50 LED 2x4 troffer ,600 No Rev 10/2016 5