Central Heating with Electric Thermal Storage Installation Certificate

2021G919A

To be completed by the Installer:

Installation location address (apartment/number/street/city/province)

Postal code

Make and model of the installed central heating Electric Thermal Storage (ETS) system (e.g., Steffes 4120)

Brand of heat pump

AHRI number of heat pump

Model number of heat pump

Meter identification number starting with: G4, G7, G8 or G9

Central heating ETS system activation date

Installation company’s name

NEQ*

*Quebec enterprise number

I certify:

That the central heating ETS system has been programmed according to the specifications set out by Hydro-Québec;

That all central heating ETS system peripherals (heat pump, humidifier and recirculating pump, dust collector, etc.) were inspected prior to installing said system and that the Participant was informed of their condition;

That the manufacturer’s internal clock, has been installed in the central heating ETS system and set to Eastern Standard Time (regardless of installation date);

That the time-delay relay has been installed in the central heating ETS system as per the manufacturer’s instructions;

That quality control has been carried out to verify the proper working order of the central heating ETS system and heat pump (if relevant);

That the Participant has been given a verbal explanation on how the central heating ETS system works, including:

– The meaning of the information on the display

– The meaning of the stickers on the system’s casing

– The location of the external temperature sensor

– The system’s general maintenance, including changing the air filter

– The location of the breaker and the maximum duration of interruption to maintain the clock’s programming

That all documentation relative to the central heating ETS system has been given to the Participant.

I, the undersigned, do solemnly declare that the information provided in this document is true and correct.

Installer’s signature

Name Date AAAA-MM-JJ

Signature

Note to Installer: Give this form to the participant.

Note to the participant: Attach this form and other documents to send to Hydro-Québec with the Rebate Form.