Professional Documents
Culture Documents
Customer Information (Customer agrees to be bound by the program rules as shown on back.)
Mailing address____________________________________ Apt. or Floor #_____ City_ _____________________ State_ _____ ZIP_______________
Installation address_________________________________ Apt. or Floor #_____ City_ _____________________ State_ _____ ZIP_______________
(if different from mailing address)
Customer type _ Homeowner Renter Landord Builder Contractor Commercial Other
Dwelling type Single family Duplex Triplex Fourplex Townhome Condominium Other
Alternate Rebate Recipient (Complete this section only if the rebate should be issued to someone other than the customer named above.)
Serial number _____________________________________________ Size or Capacity (gallons) _ _________ BTU_ _______ Energy Factor__________
$40 - .62 EF $60 - .65 EF $80 - .67EF $100 - .82 EF Tankless Water Heater
Contractor Information
The heating, ventilation and air conditioning (HVAC) contractor or builder signature certifies the Xcel Energy customer whose account number is on
this form is aware of the full rebate amount. These signatures also certify that if the rebate check is to be mailed to the HVAC contractor or retailer,
the customer is aware of the full rebate amount and has received full credit or has made arrangements with the contractor to negotiate the full
amount of the rebate.
08-10-218 CSS #: 1961 CO Charge code: 9785 Xcel Energy copy: white Retailer copy: yellow Customer copy: pink
Qualifying Customers A copy of the dated sales receipt or invoice must accompany
Xcel Energy natural gas residential customers in Colorado are complete information on the front of this form. The product invoice
eligible for rebates when buying qualifying, high-efficiency, new must specify all required information. Failure to complete this
natural gas water heaters (reconditioned equipment is information will result in a rejection of the application.
not eligible).
All information on the receipt or invoice must precisely match the
The program is applicable only for the purchase and installation information on the rebate application.
of qualifying new water heaters sold by participating HVAC
contractors or retailers for installation in new or replacement We reserve the right to conduct random inspections to verify
applications where natural gas is supplied by Xcel Energy at installation of the residential water heater at the address indicated
Xcel Energy retail rates. on the front of this form. If we select your application for a random
inspection, the rebate application will not be processed until the
Rebates for new home construction should be negotiated between inspection has been satisfactorily completed. Inspections may be
the builder and resident or new home buyer to determine who performed after rebate payment at our discretion.
receives the rebate.
Limitations
Equipment Efficiency Rating Rebate Rebate quantities are limited. Rebate qualifications and
Water Heater .62 EF $40 amounts are subject to change any time. Our conservation
Water Heater .65 EF $60 rebates program may be canceled with 30 days notice.
Water Heater .67 EF $80
Tankless Water Heater .82 EF $100 If you are building a new home, you must obtain a sales receipt for
the equipment from your builder or retailer. Only one rebate per
Efficiency ratings are determined using the Gas Appliance water heater will be paid.
Manufacturers Association (GAMA) directory, www.gamapower.org.
Only equipment listed on the GAMA site is eligible for rebate. If you have questions while filling out this form, please contact
your HVAC contractor or retailer for assistance. Please allow six
Participants understand they are not eligible to receive a rebate weeks for your rebate to arrive.
for this improvement earned under a different Xcel Energy Rebate
program. Please visit us at xcelenergy.com/homerebates or call 1-800-895-
4999 to determine whether any program changes have occurred.
Rebate Details
Xcel Energy issues cash rebates in the form of checks, not utility Send Complete Applications to:
bill credits. Xcel Energy is not responsible if your HVAC contractor Rebate Operations
provided inaccurate information about the amount and/or condi- P.O. Box 829
tions of the actual rebate or equipment eligibility. Rebate requests Minneapolis, MN 55440-0829
for water heaters within five years of a previous request will not Please include the items listed below on your application form
be accepted. and purchase receipt. If all of the items are not included the
Application Details application will be returned to the customer.
Qualifying equipment must be purchased and installed between Your application needs to include:
January 1, 2009, and December 31, 2009. Customers must apply for • Xcel Energy Account Number
this rebate by July 31, 2010. Applications must include complete • Xcel Energy HVAC Contractor Number
HVAC contractor or retailer information about water heater (Provided by your contractor)
information including: size or capacity, make, model number, • Your Signature
serial number and efficiency rating.
Your Purchase receipt/invoice needs to include:
Failure to complete this information will result in a rejection of the • Customer name
application. No phone calls will be accepted to provide verification • Installation address
of this information. • Brand
An application that is denied due to equipment ineligibility will not • Model number
be accepted with changed model numbers. • Size or capacity
• Serial number
• Invoice date
• Efficiency level
1-800-895-4999 | xcelenergy.com
© 2008 Xcel Energy Inc. | Xcel Energy is a registered trademark of Xcel Energy Inc. | Public Service Company of Colorado, an Xcel Energy Company
08-10-218 CSS #: 1961 CO Charge code: 9785 Xcel Energy copy: white Retailer copy: yellow Customer copy: pink