It’s easy to get your cash back rebate in 3 steps! 1. Purchase a qualifying Bacharach analyzer from the list below.2. Mail in your claim form & proof of purchase. 3. Receive your rebate (or free sensor coverage plan) - in the mail!

Get Get Get On the purchase of

Part #0024-8523

Fyrite® InTech™ Kit(O2, CO sensors)

Kit includes: protective rubber boot, detachable probe, 4 AA

batteries, and hard-carry case. Does not include printer.

On the purchase of

Part #0024-8518

INSIGHT® PlusReporting Kit

(Long-Life O2, CO sensors)

Kit includes: detachable probe, spare filters, protective rubber boot,

wireless printer, 8 AA batteries,and hard-carry case.

(*5-yr. FREE sensor coverage includes O2 and CO sensorson this model only. Select sensor coverage or cash back option

on rebate form.)

On the purchase of Part # 0024-8447

PCA® 3 Reporting Kit(O2, CO sensors)

OR the purchase of Part # 0024-8451

PCA® 3 Reporting Kit(O2, CO, NO and NO2 sensors)

Each kit includes: protective rubber boot, detachable probe,

8 AA batteries, hard-carry case, and wireless printer.

Print clearly or type. Make a copy of all documents for your records. Get additional forms at www.MyBacharach.com/SAVE

HOW TO GET YOUR CASH BACK REBATE / 5-YEAR FREE SENSOR COVERAGE:1. Between Nov. 1 2012 and Dec. 31, 2012, purchase a minimum quantity of 1 qualifying product from the list above (no substitu-tions). 2. Complete this form. Be sure to include serial number of qualifying product. 3. Include original sales receipt showing the itemized purchase / part number, date of purchase, purchase price and the name of the participating authorized Bacharach dealer clearly legible. 4. Circle the qualifying purchase(s) on the receipt. 5. Mail the form and receipt to the address below.TERMS & CONDITIONS OF OFFER:Claim requests (that include all requirements listed above) must be postmarked by January 31, 2013 and are valid on new product purchases only from an authorized Bacharach dealer. Claims that do not include the required proof of purchase information, are illegible or do not comply with all terms of the offer will not be honored. This promotion is not available to Bacharach distributor partners or their employees. Orders cannot be cancelled or returned. One rebate per each qualifying new product purchased. One claim form is required for each eligible purchase (if multiple products are purchased). Rebate checks will be made out only to the company submitting the claim - not to an individual or employee; the company will be responsible for the appropriate reimbursement to employees. Free sensor coverage cannot be returned for credit or cash refund. Promotion is not retroactive to purchases before the promotion start date. Shipping addresses for 5 year sensor coverage option must be shippable by UPS (Post Office/ PO Box not allowed). Bacharach reserves the right to choose the carrier and best way. Allow up to 4 weeks for processing and fulfillment of your claim. Bacharach and/or its agent(s) reserve the right to validate all claims and request additional identification and/or documentation if necessary. Offer valid in the United States, Canada, the District of Columbia and Puerto Rico on eligible product(s) purchased by end-user customers from a participating Bacharach authorized dealer. Offer void where taxed, restricted or prohibited by Federal, State or Local law. Bacharach is not responsible for lost, stolen, misdirected or undelivered shipments - any claims must be filed with shipper. Value of free products for this promotion is calculated on list prices and any related shipping and handling charges. You can check the status of your claim by contacting us via email at: KenE@MyBacharach.com.

Please complete the following information and send this entire claim form with your original proof of purchase (in a sealed, stampedenvelope) to: Bacharach CASH BACK, 621 Hunt Valley Circle, New Kensington, PA 15068 USA

NAME: COMPANY:

ADDRESS: APT. / STE#:

CITY: STATE / PROV.: ZIP:

PHONE: EMAIL:

SERIAL # and DATE OF PURCHASE: (serial number can be found on calibration certificate provided with product)

□CASH BACK□FREE 5-YEAR SENSOR PKG. (for INSIGHT Plus Reporting Kit only)

UPS Cannot Ship To A Po Box - Street Address Only

Include Area Code

**Select rebate choice:

$200 CASH BACK 5 YEARSFREE SENSORCOVERAGE*

UPTO

OR

Contractor Cash Back Offer Claim FormExtra Savings On The Industry’s Leading Combustion Analyzers

On purchases made between November 1 - December 31, 2012