Prescriptive Rebate Program

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1 Prescriptive Rebate Program Black Hills Power Commercial Installing energy-efficient technology is a smart way for Commercial and Industrial customers to lower energy bills. Energy-efficient equipment installed in new construction, replacement, or retrofit projects is eligible for rebates. Prescriptive commercial/industrial rebates are available from Black Hills Power for lighting, heat pumps, variable frequency drives, motors and water heaters. Rebate Checklist Get your rebate faster by checking off these easy steps before mailing your application form. Complete and accurate application forms mean less delays in getting you your rebate check. q Completely fill out application q Attach supporting documentation (Manufacturer s equipment cut sheets indicating model, efficiency criteria) q Attach itemized invoice(s) for equipment and labor q Review Terms and Conditions and sign and date application q Make and retain copies of all documents and application Terms and Conditions General Eligibility 1. Participants must be a Black Hills Power commercial/ industrial customer located in Black Hills Power s electric service territory. 2. This program is subject to regulatory rules and orders, and Black Hills Power reserves the right to change or to end any portion of this program without notice. 3. A final, itemized invoice for all materials and labor related to the installation must be attached to this rebate application. Manufacturer s equipment cut sheets must be included. Applications must be completed in full: incomplete or incorrect applications will delay processing and may be returned. 4. Funding for these rebates is limited. Applications will be processed on a first-come, first served basis. Additional information or assistance in completing your rebate application can be obtained by calling ,000 per year maximum rebate (custom and prescriptive measures combined) per facility. Mail completed application and itemized invoices to: Energy Services Black Hills Power P.O. Box 1400 Rapid City, SD ADDITIONAL INFORMATION For more information or to download additional applications visit or call our toll-free help line at q Send all documents to correct address listed on application 2011 BHP_633_11B Revised 9/11 Program 1 BHP Commercial 2012 BHP_834_12b

2 Qualifying Equipment Information LIGHTING Equipment Specifications Rebate per Unit X QTY = Rebate Fluorescent T8 Lamps with High Efficiency Electronic Ballasts and Low Ballast Factors (Retrofit only) 4 foot or less 1 to 2 lamp Replace incandescent or T12 systems 5 per system 3 to 4 lamp with T8 systems. Must include high efficiency electronic ballasts and low 9 per sysem 5 foot to 8 foot 1 to 2 lamp ballast factors ( 0.85). 8 per system High Performance T8 Lamps and Ballasts (Must conform to Consortium for Energy Efficiency specifications (CEE) Manufacturer s equipment cut sheets must be provided for lamps and ballasts.) NOTE: Can be combined only with fluorescent control rebates for same fixture HPT8 1 to 2 lamp System must have mean lumens 9 per system 3 to 4 lamp per watt 90 and be matched with selected instant start or programmed start electronic ballast. 18 per sysem Low-Wattage Fluorescent T8 Lamps (Manufacturer s equipment cut sheet for lamps must be provided.) 4 foot T8 Install 28 watt or less 0.50 per lamp Fluorescent Fixtures with Specular Reflectors (Manufacturer s equipment cut sheets for fixture, reflector, lamps and ballasts must be provided.) 4 foot Each unit shall have a minimum reflectivity of 87%. 12 per fixture Two 4 foot Tandem wired 12 per fixture 8 foot 16 per fixture Two 8 foot Tandem wired 16 per fixture High-Bay Fluorescent Fixtures with Electronic Ballasts (Manufacturer s equipment cut sheet for fixture, reflector, lamps and ballasts must be provided.) T8, 4 foot 6 to 8 lamps Replace 400 W HID systems with 75 per fixture 6-8 lamp T8 or 4-5 lamp T5HO T5HO, 4 foot or less 4 to 5 lamps systems. 75 per fixture T5HO, 4 foot or less 6 lamps Replace 400 W HID systems with 6 lamp T5HO systems. 40 per fixture T8, 4 foot 12 to 18 lamps Replace 1000 W HID systems with 125 per fixture T5HO, 4 foot or less 8 to 14 lamps lamp T8 or 8-14 lamp T5HO systems. 125 per fixture Hardwired or Modular Compact Fluorescent Fixtures (Manufacturer s equipment cut sheets must be provided.) 18 W or less Replace incandescent systems with 8 per fixture 19 W or 32 W hardwired or modular CFL systems. Does NOT include screw-base CFL s. 18 per fixture 32 W or greater 24 per fixture Industrial Multi-CFL Fixtures (Manufacturer s equipment cut sheet for fixture, lamps and ballasts must be provided.) Replace fluorescent T12 or HID systems with Multi-CFL systems 25 per fixture Pendant and Wall Mount Indirect Fixtures (Manufacturer s equipment cut sheets for fixtures, lamps and ballasts must be provided.) T8 or T5 Fixture efficiency must meet or exceed 80% and contain no more than 3 lamps with an indirect or direct/indirect distribution. 24 per 4 foot section Recessed Indirect Fixture (Manufacturer s equipment cut sheets for fixture, lamps and ballasts must be provided.) T8 or T5 Fixture efficiency must meet or exceed 80% and contain no more than 3 lamps with an indirect or direct/indirect distribution. 16 per fixture High-Efficiency Fluorescent Fixtures (New Construction Only) (Manufacturer s equipment cut sheets must be provided for fixtures, lamps and ballasts.) 1 Lamp Fixture efficiency shall meet or 4 per fixture 2 Lamp exceed 75% for parabolic and 83% for prismatic and shall contain no more than 3 lamps. 8 per fixture 3 Lamp 8 per fixture 21 Program BHP Commercial

3 LIGHTING (cont.) Equipment Specifications Rebate per Unit X QTY = Rebate Pulse-Start Metal Halide fixtures (Retrofit Only) (Manufacturer s equipment cut sheets must be provided.) 175 W or less Replace incandescent, mercury 25 per fixture 176 W to 319 W vapor, high pressure sodium, or metal halide systems with pulse-start metal 40 per fixture halide systems. 320 W to 749 W 55 per fixture 750 W or greater 65 per fixture Fluorescent Controls (Manufacturer s equipment cut sheets must be provided.) Ceiling Mounted Occupancy Wall Mounted Occupancy Fixture Mounted Photo Fixture Mounted Occupancy HID Controls Occupancy controlled Hi-Low Daylight controlled dimming Hardwired passive infrared and/or ultrasonic detector. Units with manual ON overrides are not eligible. Hardwired passive infrared and/or ultra sonic detector. Daylight Controlled On/Off. Unit shall be mounted on and control fixture with an On/Off control. Each unit shall control HID lamp. Fixtures controlled On/Off are not eligible 30 per control 12 per control 12 per control 28 per control 35 per fixture 35 per fixture AIR SOURCE HEAT PUMP QUALIFICATIONS (Note here or attach schedule) Total: Make/Model Quantity Capacity SEER HSPF Rebate Amount # of units 1-5 tons 15 or greater 8.5 or greater 150/ton Totals GEOTHERMAL HEAT PUMP QUALIFICATIONS (Note here or attach schedule) Make/Model Quantity Capacity EER COP Rebate Amount # of units 1-5 tons 16.5 or greater 3.6 or greater 150/ton/HP 125/ton/LF Heat Pump Total Loop Field Total Totals Program 3 BHP Commercial

4 Qualifying Equipment Information Continued VARIABLE FREQUENCY DRIVES (Manufacturer s equipment cut sheets must be provided.) Description of Use Hours/yr Size Rebate Amount Quantity Rebate VFD rebates used for HVAC fans, pumps, cooling towers, process equipment and industrial fans and operate in excess of 2,000 hours will qualify Fan, pump, process, etc. > hp to 200 hp 30 per hp Total: MOTORS Open Drip-Proof (ODP) Motor Size (HP) NEMA Nominal Efficiency Speed (RPM) Incentive for Replacement of Existing Motor (/Motor) % 85.5% 77.0% % 86.5% 84.0% % 86.5% 85.5% % 89.5% 85.5% % 89.5% 86.5% % 91.0% 88.5% % 91.7% 89.5% % 93.0% 90.2% % 93.0% 91.0% % 93.6% 91.7% % 94.1% 91.7% % 94.1% 92.4% % 94.5% 93.0% % 95.0% 93.6% % 95.0% 93.6% % 95.4% 93.6% % 95.4% 94.1% % 95.8% 94.1% % 95.8% 95.0% 600 Program 4 BHP Commercial

5 TOTALLY ENCLOSED FAN-COOLED (TEFC) Motor Size (HP) NEMA Nominal Efficiency Speed (RPM) Incentive for Replacement of Existing Motor (/Motor) % 85.5% 77.0% % 86.5% 84.0% % 86.5% 85.5% % 89.5% 86.5% % 89.5% 88.5% % 91.7% 89.5% % 91.7% 90.2% % 92.4% 91.0% % 93.0% 91.0% % 93.6% 91.7% % 93.6% 91.7% % 94.1% 92.4% % 94.5% 93.0% % 95.0% 93.6% % 95.4% 93.6% % 95.4% 94.1% % 95.4% 95.0% % 95.8% 95.0% % 96.2% 95.4% 600 EQUIPMENT INFORMATION (Manufacturer s equipment cut sheets must be provided.) Unit ID Manufacturer Model # Motor Size (HP) Motor Type (ODP/TEFC) NEMA Nominal Efficiency Incentive From Above Qty Rebate Total: WATER HEATER New or replacement units from 30 to 120 gallons. Maximum 4,500 watt rated. SUMMARY Measure Rebate Amount Make/Model EF Rating Minimum of 0.94 for 30 to 50 gal. tanks Minimum of 0.92 for over 50 gal. tanks Energy Factor (EF) Tank Size Gallons Rebate 1.50/gal. Lighting Motors TEFC/ODP Variable Frequency Drives Air Source Heat Pump Geothermal Heat Pump Electric Water Heater Total: Total: Program 5 BHP Commercial

6 Customer Information (To be completed by customer) Account Number (Located in upper right-hand corner of Black Hills Power electric bill) Company Name (Please print) Rebate Check Payable To Installation Address City State ZIP Contact Person Title Telephone Fax Customer Agreement I certify that all equipment listed has been purchased and installed at the installation address indicated. I agree to the terms and conditions in this brochure. Black Hills Power reserves the right to inspect installations before and/or after paying rebates. Customer Signature Date Where did you learn about our rebates? q Bill insert q Billboard q Door Hanger q q Event q Flyer q Newspaper Article q Print Ad q Radio q Website q Other (please specify) Referral by: q Auditor q Contractor/Dealer/Installer q Friend/Family q Other (please specify) Facility Information Type of Facility: New Facility Existing Facility Addition Year Built Square Footage Own or Rent: Own Rent Building Type: Office Retail Health Care Restaurant Education Lodging Grocery Warehouse Industrial Other Equipment Type: New Replacement Contractor Information Contractor Name (Please print) Contact Person Permit Number Mailing Address City State ZIP Telephone Fax Dealer Verification (To be completed by dealer/contractor) We certify that the indicated equipment was installed per the Terms and Conditions of this program at the address shown. All Terms and Conditions of the program have been met. We certify that all equipment information provided in the application is correct. Black Hills Power reserves the right to inspect and verify any equipment before or after issuing rebates. Name (Please print) Dealer Address City State ZIP Telephone Fax Signature Date Verification A firm and final bid or sales receipt indicating date of installation, dealer/contractor name, equipment manufacturer name and model number and manufacturer s equipment cut sheet must accompany the rebate application. Incomplete applications may be delayed. Black Hills Power reserves the right to verify sales receipts, cancelled checks, and installations. Tax Information Rebates may be subject to federal and/or state income tax reporting. Applicant is responsible for contacting a qualified tax advisor to determine tax liability. Black Hills Power is not responsible for any tax consequences of the rebate program. Disclaimer Black Hills Power does not guarantee that installation of equipment qualifying for rebates will result in reduced energy usage or demand, or in cost savings. The Customer will hold harmless Black Hills Power and its officers, directors, shareholders, agents, employees, and representatives from all claims, liabilities, fines, interest, costs, expenses, and damages incurred by the Customer, for any damage, injury, death, loss or destruction of any kind to persons or property, to the extent the damage, injury, death, loss or destruction arises out of or is related to the conduct, negligence, willful misconduct, misrepresentation, breach of warranty or other breach of this rebate form on the part of Black Hills Power. OFFICE USE ONLY Energy Services Approval Date Program 6 BHP Commercial

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