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LIGHTING EQUIPMENT 2019 ILLINOIS 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, 2019, and Dec. 31, 2019. Equipment must be installed and operating prior to submission of fnal rebate application. Commercial new construction projects are not eligible for prescriptive lighting rebates through this program. All commercial new construction projects must participate in the Commercial New Construction program in order to receive lighting rebates. Industrial new construction projects are eligible. Rebate application must be submitted within 90 days of dealer invoice or by Jan. 31, 2020, whichever comes frst for the equipment/material purchased. Applications can be submitted via email at [email protected]. The rebate will be based on the rebate schedule in effect on the date of dealer invoice for the equipment/material purchased.
Rebates cannot exceed 50 percent of the installed cost (materials and reasonable labor). You will receive the lesser of the rebate amount listed or 50 percent of installed cost. Installed cost includes contractor labor only and does not include internal labor.
Custom equipment: If specifc 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. Projects must be completed within six months of preapproval. See the Nonresidential Equipment Custom Systems application for details.
SECTION 1 (REQUIRED) Customer Information Name on account Self-installed
q Yes q No
Installation address
City State ZIP
Phone
MidAmerican Energy Company account number (found on bill; frst seven digits only)
Mailing address (if different than installation address)
City State ZIP
Contact name
Title
Email address*
*This email address only will be used for communication regarding this rebate application. Your email address never will be shared and you can unsubscribe at anytime.
SECTION 2 (REQUIRED)
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 facility where equipment will be installed conditioned? (check one) q Cooled only q Heated only q Not cooled or heated q Both heated and cooled If facility is heated, what fuel type is used? (check one) q Natural gas (furnace) q Electric (resistance heating) q Propane q Natural gas (boiler) q Electric (heat pump)
Page 1 of 12Questions about the forms or need assistance with the forms? Call our energy efficiency representatives at 800-894-9599. 1874835170 122718
SECTION 2 CONT. (REQUIRED) Equipment installed in what type of facility? (check one)
Industrial MEC Use Only
q Apparel manufacturing IND
q Chemical manufacturing IND
q Computer/electronic product manufacturing IND
q Electrical equipment, appliance/component manufacturing
IND
q Food/beverage/tobacco product manufacturing
IND
q Furniture and related product manufacturing IND
q Leather and allied product manufacturing IND
q Machinery manufacturing IND
q Nonmetallic mineral product manufacturing IND
q Oil and gas extraction; mining IND
q Paper manufacturing; printing and related support activities
IND
q Personal and laundry services IND
q Petroleum and coal products manufacturing IND
q Plastics and rubber products manufacturing IND
q Primary metal/fabricated metal product manufacturing
IND
q Textile mill and textile product mill IND
q Transportation equipment manufacturing IND
q Utility IND
q Warehouse and storage IND
q Warehouse – large refrigerated IND
q Wood product manufacturing IND
q Miscellaneous manufacturing IND
q Other industrial O
Agriculture MEC Use Only
q Corn farming AG
q Dairy cattle and milk production DF
q Hog facility HF
q Soybean farming AG
q All other animal production AG
q All other miscellaneous crop farming AG
Commercial MEC Use Only
q Apartment, halfway house MF
q Condo MF
q Convenience store/gasoline station CV
q Dealership − small <30k square feet RS
q Dealership − large >30k square feet RL
q Financial institution − small <30k square feet OS
q Financial institution − large >30k square feet OL
q Grocery store and supermarket GR
q Healthcare (outpatient) HC
q Healthcare (inpatient, including hospital, nursing home, senior care facility)
HS
q Healthcare − senior housing - individual apartment
MF
q Health club/exercise facility − small <30k square feet
RS
q Health club/exercise facility − large >30k square feet
RL
q Library ED
q Lodging – hotel LO
q Lodging – motel LO
q Mixed use O
q Other - commercial O
q Offce – small ≤ 4 foors OS
q Offce – large > 4 foors OL
q Offce – government – small ≤ 4 foors OS
q Offce – government – large > 4 foors OL
q Offce − public order and safety – small ≤ 4 foors
OS
q Offce – public order and safety – large > 4 foors OL
q Pharmacy and drug store − small <30k square feet
RS
q Pharmacy and drug store − large >30k square feet
RL
q Public assembly − events/conventions/casinos − small <30k square feet
HY
q Public assembly − events/conventions/casinos − large >30k square feet
HY
q Religious worship/church RE
q Restaurant − fast food RST
q Restaurant − full service RST
q Retail – small <30k square feet RS
q Retail – large >30k square feet RL
q Retail – department store – small <30k square feet
RS
q Retail – department store – large >30k square feet
RL
q School − elementary ED
q School – jr. high ED
q School − high school ED
q School − college, university and professional school
ED
q School − lodging (school/dorm) MF
q Service – small <30k square feet RS
q Service – large >30k square feet RL
q Truck stop CV
q Warehouse and storage WH-C
q Warehouse − large refrigerated WH-C
Page 2 of 12 Questions about the forms or need assistance with the forms? Call our energy efficiency representatives at 800-894-9599. 1874835170 122718
SECTION 3 (REQUIRED) Complete all felds for each piece of equipment purchased and installed.
LED Screw-in Lamps and LED Retroft Kit Downlights ENERGY STAR® certifed screw-in LED lamps and LED retroft downlights are eligible for instant rebates at the time of purchase from participating distributors. For a list of participating retailers and distributors, visit www.iowabebright.com or call 800-339-6856.
LED Troffer Fixtures and Retroft Kits (Design Lights Consortium™ Qualifed Product List Required) Rebates are based on a one-for-one replacement of existing linear fuorescent troffer systems. The program accepts LED troffer fxtures and retroft kits. Linear ambient (or strip and wrap) fxtures are not eligible in this category. With preapproval before purchase or installation, they may qualify through the Nonresidential Equipment Custom Systems program.
Eligible DLC primary use designations: ¡ 1’ x 4’, 2’ x 2’ and 2’ x 4’ luminaires for ambient ¡ Lamp-style retroft kits for linear panels
lighting of interior commercial spaces (1’ x 4’, 2’ x 2’ and 2’ x 4’ troffers) ¡ Retroft kits for 1’ x 4’, 2’ x 2’ and 2’ x 4’ ¡ Linear retroft kits for 1’ x 4’, 2’ x 2’ and
luminaires for ambient lighting of interior 2’ x 4’ luminaires commercial spaces ¡ Integrated retroft kits for 1’ x 4’, 2’ x 2’
and 2’ x 4’ luminaires Annual operating hours of equipment Date of installation
Equipment Size/
Lumens
LED Troffer Fixture
Replace fuorescent T8 and T12 existing fxtures; Troffers must replace like-sized
2’ x 4’
3,000-7,500
New brand/ manufacturer
New model number
DLC product ID
Actual lumens/fxture New wattage
Watts replaced
Rebate calculation
X $30/fxture = Qty Rebate Total
Total cost calculation
+ = Equipment Contractor Total installed
cost labor cost cost
fxtures; for example, a 1’ x 4’ must replace
2’ x 2’ New brand/ manufacturer
New model number Actual lumens/fxture New wattage
Watts replaced
Rebate calculation Total cost calculation
a 1’ x 4’. 2,000-5,000 DLC product ID
X $30/fxture = Qty Rebate Total
+ = Equipment Contractor Total installed
cost labor cost cost
1’ x 4’ New brand/ manufacturer
New model number Actual lumens/fxture New wattage
Watts replaced
Rebate calculation Total cost calculation
1,500-6,000 DLC product ID
X $30/fxture = Qty Rebate Total
+ = Equipment Contractor Total installed
cost labor cost cost
Retroft Kit for LED Troffer Fixtures
Replace fuorescent T8 and T12 existing fxtures. Troffers must
2’ x 4’
3,000-7,500
New brand/ manufacturer
New model number
DLC product ID
Actual lumens/fxture New wattage
Watts replaced
Rebate calculation
X $15/fxture = Qty Rebate Total
Total cost calculation
+ = Equipment Contractor Total installed
cost labor cost cost
replace like-sized fxtures; for example,
2’ x 2’ New brand/ manufacturer
New model number Actual lumens/fxture New wattage
Watts replaced
Rebate calculation Total cost calculation
a 1’ x 4’ must replace a 1’ x 4’
2,000-5,000 DLC product ID
X $15/fxture = Qty Rebate Total
+ = Equipment Contractor Total installed
cost labor cost cost
1’ x 4’ New brand/ manufacturer
New model number Actual lumens/fxture New wattage
Watts replaced
Rebate calculation Total cost calculation
1,500-6,000 DLC product ID
X $15/fxture = Qty Rebate Total
+ = Equipment Contractor Total installed
cost labor cost cost
Page 3 of 12 Questions about the forms or need assistance with the forms? Call our energy efficiency representatives at 800-894-9599. 1874835170 122718
LED Hanging/Suspended Linear Fixtures with Indirect Components (DLC QPL Required) Linear ambient (or wrap and strip) fxtures are not eligible in this category. With preapproval before purchase or installation, they may qualify through the Nonresidential Equipment Custom Systems program.
Eligible DLC primary use designation: ¡ Linear ambient luminaires with indirect component
Annual operating hours of equipment Date of installation
Size/Lumens
3,000-30,000 New brand/manufacturer New model number
DLC product ID
Actual lumens/fxture New wattage
Watts replaced
Rebate calculation
X $30/fxture = Qty Rebate Total
Total cost calculation
+ = Equipment
cost Contractor labor cost
Total installed cost
Refrigerated LED Case Lighting 5- and 6-Foot Doors (DLC QPL Required) Rebates are based on replacement of T12 or T8 linear 5- to 6-foot fuorescent refrigerated case door lighting with 5- to 6-foot LED refrigerated case door strip lighting. Rebates are per door, not per lamp. Linear LED tube lights do not qualify for this rebate. With preapproval before purchase or installation, they may qualify through the Nonresidential Equipment Custom Systems program. The program adopts the DLC defnition: Strip lights in refrigerator cases vertically mounted along refrigerator case door mullions. Category only covers complete luminaires with all necessary components. Replacement lamps currently are not eligible under this category.
Eligible DLC primary use designations: ¡ Horizontal refrigerated case luminaires ¡ Vertical refrigerated case luminaires ¡ Refrigerated case luminaires
Annual operating hours of equipment Date of installation
Equipment
Cooler Case q 5-foot door q 6-foot door Replace fuorescent T12 or T8 systems with LED case lighting
New brand/manufacturer New model number
DLC product ID
New wattage
Watts replaced
Rebate calculation
X $45/door = Qty Rebate Total
Total cost calculation
+ = Equipment
cost Contractor labor cost
Total installed cost
Freezer Case q 5-foot door q 6-foot door Replace fuorescent T12 or T8 systems with LED case lighting
New brand/manufacturer New model number
DLC product ID
New wattage
Watts replaced
Rebate calculation
X $45/door = Qty Rebate Total
Total cost calculation
+ = Equipment
cost Contractor labor cost
Total installed cost
Page 4 of 12 Questions about the forms or need assistance with the forms? Call our energy efficiency representatives at 800-894-9599. 1874835170 122718
LED High- and Low-Bay Fixtures and Retroft Kits (DLC QPL Required) Rebates are based on a one-for-one replacement of HID equipment. Rebates are available for new LED high- and low-bay Eligible DLC primary use designations:
lighting. Linear ambient (or wrap and strip) fxtures are not eligible in this category. With preapproval before purchase or ¡ Low-bay luminaires for commercial and industrial buildings installation, they may qualify through the Nonresidential Equipment Custom Systems program. High-bay must be installed 15' ¡ High-bay luminaires for commercial and industrial buildings
or higher. ¡ High-bay aisle luminaires ¡ Retroft kits for low-bay luminaires for commercial and industrial buildings
This program adopts the DLC defnition for high- and low-bay fxtures: Pendant, recessed, or surface-mounted fxtures specifc ¡ Retroft kits for high-bay luminaires for commercial and industrial buildings for indoor ceiling spaces. This program adopts the DLC defnition for high- and low-bay retroft kits: Integrated-style kits that replace all refectors and optical systems of existing luminaires; not screw-in lamps intended as HID replacements. Annual operating hours of equipment Date of installation
Equipment Lumens
LED Low- or ≤10,000 New brand/ New model number Actual lumens/fxture New Watts Rebate calculation Total cost calculation High-Bay Fixtures manufacturer wattage replaced
X $135/fxture = + = HID system DLC product ID Qty Rebate Total Equipment Contractor Total installed
replacement cost labor cost cost
Annual operating hours of equipment Date of installation
Equipment Lumens
LED High-Bay 10,001- New brand/ New model number Actual lumens/fxture New Watts Rebate calculation Total cost calculation Fixtures 15,000 manufacturer wattage replaced
X $135/fxture = + = HID system DLC product ID Qty Rebate Total Equipment Contractor Total installed
replacement cost labor cost cost
15,001- New brand/ New model number Actual lumens/fxture New Watts Rebate calculation Total cost calculation 20,000 manufacturer wattage replaced
X $150/fxture = + = DLC product ID Qty Rebate Total Equipment Contractor Total installed
cost labor cost cost
20,001- New brand/ New model number Actual lumens/fxture New Watts Rebate calculation Total cost calculation 30,000 manufacturer wattage replaced
X $200/fxture = + = DLC product ID Qty Rebate Total Equipment Contractor Total installed
cost labor cost cost
>30,000 New brand/ New model number Actual lumens/fxture New Watts Rebate calculation Total cost calculation manufacturer wattage replaced
X $325/fxture = + = DLC product ID Qty Rebate Total Equipment Contractor Total installed
cost labor cost cost
(cont. on next page)
Page 5 of 12 Questions about the forms or need assistance with the forms? Call our energy efficiency representatives at 800-894-9599. 1874835170 122718
LED High- and Low-Bay Fixtures and Retroft Kits (DLC QPL Required) Rebates are based on a one-for-one replacement of HID equipment. Rebates are available for new LED high- and low-bay Eligible DLC primary use designations: lighting. Linear ambient (or wrap and strip) fxtures are not eligible in this category. With preapproval before purchase or ¡ Low-bay luminaires for commercial and industrial buildings installation, they may qualify through the Nonresidential Equipment Custom Systems program. High-bay must be installed ¡ High-bay luminaires for commercial and industrial buildings 15' or higher. ¡ High-bay aisle luminaires
¡ Retroft kits for low-bay luminaires for commercial and industrial buildings This program adopts the DLC defnition for high- and low-bay fxtures: Pendant, recessed, or surface-mounted fxtures specifc ¡ Retroft kits for high-bay luminaires for commercial and industrial buildings for indoor ceiling spaces. This program adopts the DLC defnition for high- and low-bay retroft kits: Integrated-style kits that replace all refectors and optical systems of existing luminaires; not screw-in lamps intended as HID replacements.
Annual operating hours of equipment Date of installation
Equipment Lumens
LED Retroft Kit for ≤10,000 New brand/ New model number Actual lumens/fxture New Watts Rebate calculation Total cost calculation Low- or High-Bay manufacturer wattage replaced Fixtures X $40/fxture = + =
DLC product ID Qty Rebate Total Equipment Contractor Total installed HID system cost labor cost cost replacement
Annual operating hours of equipment Date of installation
Equipment Lumens
LED Retroft Kit for 10,001- New brand/ New model number Actual lumens/fxture New Watts Rebate calculation Total cost calculation High-Bay Fixtures 15,000 manufacturer wattage replaced
X $40/fxture = + = HID system DLC product ID Qty Rebate Total Equipment Contractor Total installed replacement cost labor cost cost
15,001- New brand/ New model number Actual lumens/fxture New Watts Rebate calculation Total cost calculation 20,000 manufacturer wattage replaced
X $50/fxture = + = DLC product ID Qty Rebate Total Equipment Contractor Total installed
cost labor cost cost
20,001- New brand/ New model number Actual lumens/fxture New Watts Rebate calculation Total cost calculation 30,000 manufacturer wattage replaced
X $80/fxture = + = DLC product ID Qty Rebate Total Equipment Contractor Total installed
cost labor cost cost
>30,000 New brand/ New model number Actual lumens/fxture New Watts Rebate calculation Total cost calculation manufacturer wattage replaced
X $120/fxture = + = DLC product ID Qty Rebate Total Equipment Contractor Total installed
cost labor cost cost
Page 6 of 12 Questions about the forms or need assistance with the forms? Call our energy efficiency representatives at 800-894-9599. 1874835170 122718
LED Linear Replacement Lamps (DLC QPL Required) Rebates are based on one-for-one replacement of fuorescent lamps with LED linear replacement lamps listed on the DLC QPL. Eligible DLC primary use designations: Two 4' LED lamps cannot replace one 8' lamp. ¡ Replacement lamps (“Plug and Play”) (UL Type A)
¡ Internal driver/line voltage (UL Type B) lamps This program adopts the DLC defnitions: ¡ Two-lamp external driver (UL Type C) lamps Replacement lamps (UL Type A). Products in this category employ lamp holders to connect to the fxture being retroftted and are ¡ Three-lamp external driver (UL Type C) lamps designed to be “plug and play” replacements for fuorescent lamps. That is, products in this category can operate off an existing ¡ Four-lamp external driver (UL Type C) lamps fuorescent ballast and do not require mechanical or electrical changes to the fxture. Note that due to testing considerations, at ¡ Dual mode internal driver (UL Type A or B) this time only products that can operate off electronic instant start ballasts are eligible. Replacement lamps designed to operate off existing magnetic ballasts, or other types of electronic ballasts, are not eligible. Dual mode internal driver lamps (UL Type A/B) are allowed in this category if installed as a “plug and play” operating off existing fuorescent ballast. Internal driver/line voltage (UL Type B) lamps and external driver (UL Type C) lamps must utilize existing pin sockets. Annual operating hours of equipment Date of installation
Equipment/specifcations
LED Linear Lamp New brand/manufacturer New model number New Watts Rebate calculation Total cost calculation Type A, 4' wattage replaced
X $5/lamp = + = 4' T12, T8 and T5 DLC product ID Qty Rebate Total Equipment Contractor Total installed fuorescent cost labor cost cost replacement lamps
LED Linear Lamp New brand/manufacturer New model number New Watts Rebate calculation Total cost calculation Type B and Dual wattage replaced
Mode Type A/B, 4’ X $5/lamp = + = DLC product ID Qty Rebate Total Equipment Contractor Total installed
4' T12, T8 and T5 cost labor cost cost fuorescent replacement lamps
LED Linear Lamp New brand/manufacturer New model number New Watts Rebate calculation Total cost calculation Type C, 4’ wattage replaced
X $5/lamp = + = 4’ T12, T8 and T5 DLC product ID Qty Rebate Total Equipment Contractor Total installed fuorescent cost labor cost cost replacement lamps
LED Replacement for Pin-Based CFL Lamps (DLC QPL Required) Rebates are based on a one-for-one replacement of CFL pin-based lamps. Replacement LED pin-based lamps must replace Eligible DLC Primary use designation: CFL pin-based lamps. Only lamps that are intended to operate using the existing CFL ballast (UL Type A) are eligible. ¡ Replacement lamps (plug and play) (UL Type A) UL Type B pin-based lamps do not qualify for prescriptive rebates. With preapproval before purchase or installation, AND they may qualify through the Nonresidential Equipment Custom Systems program. Eligible main category:
¡ Four pin-base replacement lamps for CFLs Annual operating hours of equipment Date of installation
Equipment
LED Pin-Based Lamp New brand/manufacturer New model number New Watts Rebate calculation Total cost calculation wattage replaced
X $5/lamp = + = DLC product ID Qty Rebate Total Equipment Contractor Total installed
cost labor cost cost
Page 7 of 12 Questions about the forms or need assistance with the forms? Call our energy efficiency representatives at 800-894-9599. 1874835170 122718
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LED Exterior Fixtures (DLC QPL Required) Rebates are based on one-for-one replacement of exterior HID fxtures and wall packs with LED fxtures rated for exterior use.
Eligible DLC primary use designations: ¡ Outdoor full cut-off wall-mounted area luminaires ¡ Outdoor noncut-off and semicut-off wall-mounted
area luminaires ¡ Architectural food and spot luminaires
¡ Bollards ¡ Landscape/accent food and spot luminaires ¡ Outdoor pole/arm-mounted area and roadway luminaires ¡ Outdoor pole/arm-mounted decorative luminaires ¡ Stairwell and passageway luminaires
Annual operating hours of equipment Date of installation
Equipment Lumens
LED Outdoor Area Lighting
Replace HID systems
<10,000 New brand/ manufacturer
New model number
DLC product ID
Actual lumens/fxture New wattage
Watts replaced
Rebate calculation X $50/fxture =
Qty Rebate Total
Total cost calculation
+ = Equipment
cost Contractor labor cost
Total installed cost
10,001-30,000
New brand/ manufacturer
New model number
DLC product ID
Actual lumens/fxture New wattage
Watts replaced
Rebate calculation X $75/fxture =
Qty Rebate Total
Total cost calculation
+ = Equipment
cost Contractor labor cost
Total installed cost
>30,000 New brand/ manufacturer
New model number
DLC product ID
Actual lumens/fxture New wattage
Watts replaced
Rebate calculation X $150/fxture =
Qty Rebate Total
Total cost calculation
+ = Equipment
cost Contractor labor cost
Total installed cost
Annual operating hours of equipment Date of installation
Equipment Lumens
Building Exterior
Replace HID systems. Replacement LED wall pack fxtures must be used for building exteriors. Equipment must be hardwired and rated for exterior use.
<10,000 New brand/ manufacturer
New model number
DLC product ID
Actual lumens/fxture New wattage
Watts replaced
Rebate calculation X $50/fxture =
Qty Rebate Total
Total cost calculation
+ = Equipment
cost Contractor labor cost
Total installed cost
10,001-15,000
New brand/ manufacturer
New model number
DLC product ID
Actual lumens/fxture New wattage
Watts replaced
Rebate calculation X $75/fxture =
Qty Rebate Total
Total cost calculation
+ = Equipment
cost Contractor labor cost
Total installed cost
>15,000 New brand/ manufacturer
New model number
DLC product ID
Actual lumens/fxture New wattage
Watts replaced
Rebate calculation X $100/fxture =
Qty Rebate Total
Total cost calculation
+ = Equipment
cost Contractor labor cost
Total installed cost
Annual operating hours of equipment Date of installation
Is parking garage where equipment will be installed conditioned? (check one) q Cooled only q Heated only q Not cooled or heated q Both heated and cooled
If parking garage is heated, what fuel type is used? (check one) q Natural gas (furnace) q Natural gas (boiler) q Electric (resistance heating) q Electric (heat pump) q Propane
Equipment Lumens Parking Garage
Replace HID systems. Replacement LED wall pack fxtures must be used inside parking garages and must be attached to a wall (parking garage ceiling fxtures are not eligible for this rebate but may qualify for the ceiling-mounted LED parking garage fxture rebates). Equipment must be hardwired and rated for exterior use.
<10,000 New brand/ manufacturer
New model number
DLC product ID
Actual lumens/fxture
New wattage
Watts replaced
Rebate calculation X $50/fxture =
Qty Rebate Total
Total cost calculation
+ = Equipment
cost Contractor labor cost
Total installed cost
10,001-15,000
New brand/ manufacturer
New model number
DLC product ID
Actual lumens/fxture
New wattage
Watts replaced
Rebate calculation X $75/fxture =
Qty Rebate Total
Total cost calculation
+ = Equipment
cost Contractor labor cost
Total installed cost
>15,000 New brand/ manufacturer
New model number
DLC product ID
Actual lumens/fxture
New wattage
Watts replaced
Rebate calculation X $100/fxture =
Qty Rebate Total
Total cost calculation
+ = Equipment
cost Contractor labor cost
Total installed cost
Page 8 of 12 Questions about the forms or need assistance with the forms? Call our energy efficiency representatives at 800-894-9599. 1874835170 122718
Ceiling-Mounted LED Parking Garage Fixtures (DLC QPL Required) Eligible parking garage structures need to be either underground or semi-enclosed above ground. The lighting within the garage must operate 24 hours a day. Rebates are based on a one-for-one replacement of HID equipment (including mercury vapor, high-pressure sodium, metal halide or pulse-start metal halide). LED retroft kits are not available for prescriptive rebates. With preapproval before purchase or installation, they may qualify through the Nonresidential Equipment Custom Systems program. The program adopts the DLC defnitions: Ceiling-mounted luminaires for use outdoors or in locations open to elements in multideck garages.
Eligible DLC primary use designation: ¡ Parking garage luminaries
Annual operating hours of equipment Date of installation
Is parking garage where equipment will be installed conditioned? (check one) q Cooled only q Heated only q Not cooled or heated q Both heated and cooled
If parking garage is heated, what fuel type is used? (check one) q Natural gas (furnace) q Natural gas (boiler) q Electric (resistance heating) q Electric (heat pump) q Propane
Equipment Lumens
Ceiling-Mounted LED Parking Garage Fixtures
Replace HID systems; parking garage must be illuminated 24/7.
<5,000 New brand/ manufacturer
New model number
DLC product ID
Actual lumens/fxture New wattage
Watts replaced
Rebate calculation
X $135/fxture = Qty Rebate Total
Total cost calculation
+ = Equipment
cost Contractor labor cost
Total installed cost
5,001-15,000
New brand/ manufacturer
New model number
DLC product ID
Actual lumens/fxture New wattage
Watts replaced
Rebate calculation
X $200/fxture = Qty Rebate Total
Total cost calculation
+ = Equipment
cost Contractor labor cost
Total installed cost
>15,000 New brand/ manufacturer
New model number
DLC product ID
Actual lumens/fxture New wattage
Watts replaced
Rebate calculation
X $400/fxture = Qty Rebate Total
Total cost calculation
+ = Equipment
cost Contractor labor cost
Total installed cost
Exterior LED Fuel Pump Canopy Fixtures (DLC QPL Required) Rebates are based on one-for-one replacement of HID canopy fxtures with LED fxtures rated for exterior use. The program adopts the DLC defnition: Ceiling-mounted luminaires for use outdoors or in locations open to elements in gas station canopies. Equipment must be hard-wired and rated for exterior use. Fixtures can be installed in either the canopy or sofft of the gas station building structure.
Eligible DLC primary use designation: ¡ Fuel pump canopy luminaires
Annual operating hours of equipment Date of installation
Equipment Lumens
Exterior LED Fuel Pump Canopy Fixtures
Replace HID systems
<5,000 New brand/ manufacturer
New model number
DLC product ID
Actual lumens/fxture New wattage
Watts replaced
Rebate calculation
X $135/fxture = Qty Rebate Total
Total cost calculation
+ = Equipment
cost Contractor labor cost
Total installed cost
5,001-15,000
New brand/ manufacturer
New model number
DLC product ID
Actual lumens/fxture New wattage
Watts replaced
Rebate calculation
X $200/fxture = Qty Rebate Total
Total cost calculation
+ = Equipment
cost Contractor labor cost
Total installed cost
>15,000 New brand/ manufacturer
New model number
DLC product ID
Actual lumens/fxture New wattage
Watts replaced
Rebate calculation
X $400/fxture = Qty Rebate Total
Total cost calculation
+ = Equipment
cost Contractor labor cost
Total installed cost
Page 9 of 12 Questions about the forms or need assistance with the forms? Call our energy efficiency representatives at 800-894-9599. 1874835170 122718
LED Exit SignsDate of installation
Equipment
< 2 watts
Existing building only replacing incandescent or fluorescent sign
New brand/manufacturer New model number Rebate calculation
X $25/fixture =Qty Rebate Total
Total cost calculation
+ =Equipment
costContractor labor cost
Total installed cost
Occupancy SensorsOccupancy sensors may be wall- or ceiling-mounted, including passive infrared, ultrasonic or dual technology sensors.Annual operating hours of equipment Date of installation
Equipment
Occupancy Sensor
Minimum 45 watts controlled; rebate level is based on controlled load (watts)/sensor.
New brand/manufacturer New model number Rebate calculation
X$0.10/watt controlled =
Total watts controlled
Rebate Total
Total cost calculation
+ =Equipment
costContractor labor cost
Total installed cost
Lighting Timer or Clock
Commercial-grade only
New brand/manufacturer New model number Total watts controlled
Rebate calculation
X $35/unit =Qty Rebate Total
Total cost calculation
+ =Equipment
costContractor labor cost
Total installed cost
Page 10 of 12Questions about the forms or need assistance with the forms? Call our energy efficiency representatives at 800-894-9599. 1874835170 122718
Specific Terms and Conditions ¡ Participants must be commercial or industrial customers with facilities located in MidAmerican Energy Company’s Illinois service territory.
¡ MidAmerican Energy Company must deliver the electricity to the equipment at the facility for which the rebate is being paid.
¡ One-for-one replacement only. Lighting redesigns where the quantity of lamps or fixtures is changed may be eligible for a rebate through Nonresidential Equipment Custom Systems.
¡ For prescriptive rebates, the rebate payment cannot exceed 50 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.
¡ Wattage and lumen output is based on DesignLights Consortium (DLC) listing. Lighting options must meet standards listed in DLC Technical Requirements Table 4.0 and be listed on the most current DLC Qualified Products List (QPL) to be eligible for incentives. Application must include the DLC listing from the QPL when "DLC QPL required" is referenced on the application. Lighting options delisted from the DLC QPL are not eligible for incentives.
¡ Commercial new construction projects are not eligible for prescriptive lighting rebates through this program. All commercial new construction projects must participate in the Commercial New Construction program in order to receive lighting rebates.
¡ Industrial new construction projects are eligible.
¡ Equipment must be purchased between Jan. 1, 2019, and Dec. 31, 2019. Equipment must be installed and operating prior to submission of final rebate application.
¡ Rebate application must be submitted within 90 days of dealer invoice or by Jan. 31, 2020, whichever comes first for the equipment/material purchased. Applications can be submitted via email at [email protected]. The rebate will be based on the rebate schedule in effect on the date of dealer invoice for the equipment/material purchased.
¡ A minimum of 1,000 annual operating hours required.
¡ Rebate checks will be issued to the building owner or account holder.
¡ Allow up to 4 weeks for rebate processing once application and supporting documents are received (excluding on-site verification time, if needed).
General Qualifications and ConditionsImportant: Before completing and signing this form, please read the General Qualifications and Conditions at MidAmericanEnergy.com/ee.
DisclaimerMidAmerican 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.
Customer AgreementI certify that I have purchased the equipment described on this form and that it has been installed at the service address indicated. I agree to the terms and conditions associated with this form. I understand that MidAmerican Energy Company reserves the right to inspect and verify installation before issuing payment.Customer signature Date
Installer/Dealer InformationDealer name
Contact name
Address
City State ZIP
Phone Fax
Email address
Dealer AgreementI certify that all equipment and installation information provided on this application is correct and accurate.
Dealer signature Date
Before you submit your form:
q Fill out this form completely.q Attach a copy of the itemized sales receipt
or invoice.q Include required documentation with
each measure.q Sign the Customer Agreement section.
Send completed forms to:
Mail: MidAmerican Energy Company P.O. Box 4628 Des Moines, IA 50305-4528
Fax: 515-244-8825
Email: [email protected]
For MidAmerican Energy UseProject #________________________________ Project #_____________________________
Received date__________________________ Method: E M F IO
Assessment # _________________________________________________________________
Assessment date________________________ KAM-BAM ____________________________
Sector type_____________________ Rebate total amount $________________________
Page 11 of 12Questions about the forms or need assistance with the forms? Call our energy efficiency representatives at 800-894-9599. 1874835170 122718
Example of DLC Primary Use Designations
DLC Product ID ication)
(Required on appl
f Example o
DLC Primary esignation
Use D
INVOICE #: 25000
y 31, 2019 Date: Januar
Sample Invoice y TO: XYZ Compan
234 Jersey St. y IA 50309
SHIP TO: XYZ Compan Des Moines,
234 Jersey St. 555-123-4567
Des Moines, IA 50309
555-123-4567
17-2500 PO number:
Terms: Net 25
Include project codes Specify the quantity Identify manufacturer’s List price for each and/or item numbers for each item part information item and total
AMOUNTTE SERVICE DATE
RA $3,500.00DESCRIPTION
$35QTY $3,125.00
ITEM Acme 30W LED lamp$125
100 $32.00LED30WCW Acme 27W LED lamp
$0.1625 $6,657.00
DEC27W4000 72B blue wire nut Subtotal200 $499.28
HD 30-072 Installed LED lamps and downlights7.5% $448.00
Local sales tax 1/2/2019$448 $0
Labor $641 $82.11
Labor Travel 1/2/2019$82.11
0 $7,686.39Environmental Fee Total
Travel
Environmental Fee
Note labor and other expenses Give accurate description separately from material costs of work completed
Page 12 of 12Questions about the forms or need assistance with the forms? Call our energy efficiency representatives at 800-894-9599. 1874835170 122718