Get Swepco Gridsmart Rebate Form

Customer Signature Date Please return completed rebate form with invoice by email fax or mail to Fax 866 401-5383 Email SWEPCO-CoolSaver clearesult.com 4301 Westbank Dr. Building A - Suite 250 Austin TX 78746 gridSMART is provided by SWEPCO as part of the company s commitment to reduce energy consumption and demand. CoolSaver HVAC Replacement Information Form Contractor Information Company Name Technician ID Date Customer Information Name ESI Id Project ID Address City Zip Old Equipment Fill out for EARLY RETIREMENT ONLY Cond. Air Temp* Split must be greater than 0 F Manufacturer Cond. Model Heat Type Unit Type Split AC / Gas or Propane Nominal SEER Operable Electric Split Heat Pump Cond. Serial Packaged AC Cond. Air Temp Split Packaged Heat Pump System Age In Years Nominal Capacity BTU/hr Yes / No F Maintained Regularly Estimated Remaining Useful Life in Years 0-1 years / 1-3 years / 4 years New Equipment No Fuel Switching Indoor Coil Model Was an AHRI-matched evaporator coil installed at the same time AHRI Certificate AHRI SEER AHRI HSPF AHRI Cooling Capacity BTU/hr Coupon Amount Please use the matrix to determine the coupon amount for your specific project. Tons 15 SEER Early Retirement Customer Invoice Information Total Parts and Labor Installation Cost Total Coupon Amount Final Amount Paid by Customer Add 25 CUSTOMER COMPLETION I acknowledge the above designated work was completed to my satisfaction and discounted by the coupon amount. By signing below I agree to give AEP SWEPCO and/or CLEAResult access to the project site for inspections if necessary. I acknowledge that AEP SWEPCO and CLEAResult make no warranty or representation of the qualifications or technical feasibility capability safety or reliability of the work completed by the participating contractor. Customer Signature Date Please return completed rebate form with invoice by email fax or mail to Fax 866 401-5383 Email SWEPCO-CoolSaver clearesult*com 4301 Westbank Dr. Building A - Suite 250 Austin TX 78746 gridSMART is provided by SWEPCO as part of the company s commitment to reduce energy consumption and demand. CoolSaver HVAC Replacement Information Form Contractor Information Company Name Technician ID Date Customer Information Name ESI Id Project ID Address City Zip Old Equipment Fill out for EARLY RETIREMENT ONLY Cond. Air Temp* Split must be greater than 0 F Manufacturer Cond. Model Heat Type Unit Type Split AC / Gas or Propane Nominal SEER Operable Electric Split Heat Pump Cond. Air Temp* Split must be greater than 0 F Manufacturer Cond. Model Heat Type Unit Type Split AC / Gas or Propane Nominal SEER Operable Electric Split Heat Pump Cond. Serial Packaged AC Cond. Air Temp Split Packaged Heat Pump System Age In Years Nominal Capacity BTU/hr Yes / No F Maintained Regularly Estimated Remaining Useful Life in Years 0-1 years / 1-3 years / 4 years New Equipment No Fuel Switching Indoor Coil Model Was an AHRI-matched evaporator coil installed at the same time AHRI Certificate AHRI SEER AHRI HSPF AHRI Cooling Capacity BTU/hr Coupon Amount Please use the matrix to determine the coupon amount for your specific project.