Food Service Equipment Application

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1 Food Service Equipment Application July 1, June 30, 2014 Customer Information Company Anticipated Installation Date (Approval required prior to installation) Electric Utility Serving Applicant Electric Account No. Gas Utility Serving Applicant Gas Account No. Facility Address City State Zip Type of Project Size of Building New Construction Renovation Equipment Replacement Company Mailing Address City State Zip Contact Person (Name/Title) Telephone No. Fax No. ( ) ( ) Incorporated? Yes No Exempt Federal Tax ID# or SSN Address Incentive Payment to Customer Contractor Other Customer Signature Please assign payment to contractor/vendor/other indicated below Payee Information (must submit W-9 form with application) Address Company Contact Name Incorporated? Federal Tax ID# Yes No Street Address City State Zip Telephone No. Fax No. ( ) ( ) Contractor/Vendor Information (if different from Payee) Address Company Contact Name Incorporated? Federal Tax ID# Yes No Street Address City State Zip Telephone No. Fax No. ( ) ( ) Building Type (circle one) Education-Primary School; Education-Community College; Education-University; Grocery; Medical-Hospital; Medical-Clinic; Lodging Hotel(Guest Rooms); Lodging Motel; Manufacturing-Light Industrial; Office-Large; Office-Small; Restaurant-Sit Down; Restaurant-Fast Food; Retail-3 Story Large; Retail- Single Story Large; Retail-Small; Storage Conditioned; Storage Unconditioned; Warehouse; Other

2 Commercial Combination Oven/Steamer Fuel Use # of Steamer Convection Mode Steam Mode Convection Mode Steam Mode Manufacturer Model # of Units Incentive Amount Total Incentives (Electric or Gas) Pans Idle Energy Rate Idle Energy Rate Efficiency Efficiency Name Number (A) From Table (A x B) (kw or Btu/h) (kw or Btu/h) (%) (%) (B) Electric 15 2 kw 5 kw 75% 55% 3 $1,000 $3,000 Commercial Ovens, Steamers, Fryers and Griddles Fuel Use Type Sizing Idle Energy Rate Heavy Load Manufacturer Model # of Units Incentive Amount Total Incentives (Electric or Gas) (Convection Oven, Conveyor (See Below) (kw or Btu/h) Efficiency Name Number (A) From Table (A x B) Oven, Rack Oven, Fryer, Large (%) (B) Vat Fryer, Griddle, or Steamer) Gas Rack Oven Double-Rack 3200 Btu/h 58% 2 $2,000 $4,000 Electric Large Vat Fryer N/A 0.8 kw 90% 4 $200 $800 Please consult the guide below for "Sizing": Convection Ovens: Enter Half-Size or Full-Size Conveyor Ovens: Enter Small (Conveyor width 25-in. or less) or Large (Conveyor width greater than 25-in.) Rack Ovens: Enter Single-Rack or Double-Rack Steamers: Enter # of Pans Fryers and Large Vat Fryers: No Input Required Griddles: Enter Griddle Width in Feet (2, 3, 4, 5 or 6 Feet)

3 Insulated Food Holding Cabinets Fuel Use Cabinet Size Idle Energy Rate Manufacturer Model # of Units Incentive Amount Total Incentives (Electric or Gas) (1/2, 3/4, Full-Size) (kw or Btu/h) Name Number (A) From Table (A x B) (B) Electric Full-Size 0.28 kw 4 $300 $1,200 Commercial Refrigeration Equipment Type Internal Volume Daily Energy Rate Manufacturer Model # of Units Incentive Amount Total Incentives (Glass/Solid Door (ft 3 ) (kwh/day) Name Number (A) From Table (A x B) Refrigerator/Freezer) (B) Solid Door Refrigerator 41.8 ft kwh 2 $125 $250 Commercial Ice Machines Equipment Type Daily Ice Harvest Rate Energy Rate Manufacturer Model # of Units Incentive Amount Total Incentives (Ice Making Heads, F Water, 90 Ambient) (kwh/100 lbs ice Name Number (A) From Table (A x B) Remote F Water, 90 Ambient) (B) Self-Contained) Ice Making Heads 846 lbs 5.1 kwh 5 $250 $1,250 Commercial Dishwashers Equipment Type Cleaning Temperature Hot Water Booster Hot Water Manufacturer Model # of Units Incentive Amount Total Incentives (Under Counter, Door Type, (Low-Temp, High-Temp) Fuel Type Fuel Type Name Number (A) From Table (A x B) Single Tank Conveyor, (Electric or Gas) (Electric or (B) Double Tank Conveyor) Gas if applicable) Single Tank Conveyor High-Temp Gas Gas 2 $1,000 $2,000

4 Specific Program Requirements* (these requirements are in addition to the Program Terms and Conditions.) 1. Please refer to the table below for specific technical requirements. 2. Include the manufacturer's specification sheet with the application package and mail or fax directly to the Commercial/Industrial Program Manager. 3. Incentives must be applied towards the purchase of new or replacement energy-efficient equipment only. Equipment that is used or rebuilt is not eligible. ENERGY STAR Commercial Kitchen Package: energystar.gov/index.cfm?fuseaction=find_a_product. showproductgroup&pgw_code=ckp CEE Program Resources: cee1.org/com/com-kit/com-kit-equip.php3 cee1.org/content/cee-program-resources 4. Equipment must meet the performance requirements as defined in the incentives table below or be qualified by Energy Star or Consortium of Energy Efficiency (CEE). Application Checklist (before submitting your application, please make sure you have signed in the space below and completed the following items.) Payee Information is filled out and a signed W-9 form of the payee is included Manufacturer's specification sheets for proposed technology are included A copy (all pages) of a recent bill from a NJ utility (as defined in Terms and Conditions) Check the box if an Energy Savings Improvement Program (ESIP) will be a source of funding. ESIP allows government agencies to pay for energy related improvements using the value of the resulting energy savings. AcknowledgEment CUSTOMER S signature By signing, I certify that I have read, understand and agree to the Specific Program Requirements/Terms and Conditions listed on this application form, I will also submit for approval a properly completed application package, which includes this signed application, worksheet (if applicable), manufacturer s specification sheets and complete utility bill (name and address on utility bill must match name and address on application). Energy Star qualified; or Cooking Incentives Commercial Combination Oven/Steamer (Electric) Must have a cooking energy efficiency of 50 percent or greater in steam mode and 70 percent cooking energy efficiency or greater in convection mode, utilizing American Society for Testing and Materials (ASTM) F2861. Must meet the idle energy rate requirements in the Electric Combination Oven/Steamer Table, utilizing ASTM F2861. Electric Combination Oven/Steamer Table Pan Capacity Steam Mode Convection Mode Idle Energy Rate Idle Energy Rate Less than 15 pans* 5.0 kw or less 2.0 kw or less pans* 6.0 kw or less 2.5 kw or less Greater than 28 pans* 9.0 kw or less 3.5 kw or less * Combination oven/steamer pan capacity on based on the maximum capacity of full-size 2 1/2-inch deep hotel pans. This must be consistent with the number of pans used to meet the energy-efficiency qualifications per ASTM F2861. Commercial Combination Oven/Steamer (Electric) $1,000/oven Commercial Combination Oven/Steamer (Natural Gas) Must have a cooking energy efficiency of 38 percent or greater in steam mode and 44 percent or greater in convection mode, utilizing ASTM F2861. Must meet the idle energy rate requirements in the Gas Commercial Combination Oven/Steamer Table, utilizing ASTM F2861. Gas Combination Oven/Steamer Table Pan Capacity Steam Mode Convection Mode Idle Energy Rate Idle Energy Rate Less than 15 pans* 15,000 Btu/h or less 9,000 Btu/h or less pans* 18,000 Btu/h or less 11,000 Btu/h or less Greater than 28 pans* 28,000 Btu/h or less 17,000 Btu/h or less * Combination oven/steamer pan capacity on based on the maximum capacity of full-size 2 1/2-inch deep hotel pans. This must be consistent with the number of pans used to meet the energy-efficiency qualifications per ASTM F2861. Commercial Combination Oven/Steamer (Natural Gas) $750/oven

5 Commercial Convection Oven (Electric) Must have a tested heavy load (potato) cooking energy efficiency of 70 percent or more, utilizing ASTM F1496. Full-size electric ovens must have a tested idle energy rate of 1.6 kw or less, utilizing ASTM F1496. Half-size electric ovens must have a tested idle energy rate of 1.0 kw or less, utilizing ASTM F1496. Commercial Convection Oven (Electric) $350/oven Commercial Convection Oven (Natural Gas) Commercial Convection Oven (Natural Gas) Must have a tested heavy load (potato) cooking energy efficiency of 44 percent or greater and an idle energy rate of 13,000 Btu/h or less, utilizing ASTM F1496. $500/oven Commercial Rack Oven (Natural Gas) Commercial Rack Oven Single (Natural Gas) Commercial Rack Oven Double (Natural Gas) Must have a tested baking energy efficiency of 50 percent or greater, utilizing ASTM F2093. $1,000/single oven $2,000/double oven Commercial Conveyor Oven (Natural Gas) Must have a tested baking energy efficiency of 42 percent or greater, utilizing ASTM F1817. Small conveyor ovens with total conveyor width 25 inches or less must have a tested idle energy rate that is 29,000 Btu/h or less, utilizing ASTM F1817. Large conveyor ovens with total conveyor width greater than 25 inches must have a tested idle energy rate that is 57,000 Btu/h or less, utilizing ASTM F1817. Commercial Conveyor Oven Small (Conveyor width 25-in. or less) (Natural Gas) Commercial Conveyor Oven Large (Conveyor width greater than 25-in) (Natural Gas) ADDITIONAL DETAILS: Multiple-deck oven configurations are paid per qualifying oven deck. $500/deck $750/deck Commercial Fryer (Electric) Must have a tested heavy load cooking energy efficiency of 80 percent or greater and an idle energy rate of 1.0 kw or less, utilizing ASTM F1361. Commercial Fryer (Electric) ADDITIONAL DETAILS: Multiple vat configurations are paid per qualifying vat. $200/vat

6 Must meet a tested heavy load cooking energy efficiency of 50 percent or greater and an idle energy rate of 9,000 Btu/h or less, utilizing ASTM F1361. Commercial Fryer (Natural Gas) Must have a tested heavy load (French fry) cooking energy efficiency of 80 percent or greater, utilizing ASTM F2144. Commercial Fryer (Natural Gas) Commercial Large Vat Fryer (Electric) ADDITIONAL DETAILS: Multiple vat configurations are paid per qualifying vat. $749/vat ADDITIONAL DETAILS: Multiple vat configurations are paid per qualifying vat. Commercial Large Vat Fryer (Electric) $200/vat Must have a tested heavy load (French fry) cooking energy efficiency of 50 percent or greater, utilizing ASTM F2144. Commercial Large Vat Fryer (Natural Gas) ADDITIONAL DETAILS: Multiple vat configurations are paid per qualifying vat. Commercial Large Vat Fryer (Natural Gas) $500/vat Commercial Griddle (Electric) Commercial Griddle (Electric) Must have a tested heavy load cooking energy efficiency of 70 percent or greater and an idle energy rate of 355 watts per square foot of cooking surface or less, utilizing ASTM F1275. $300/griddle Commercial Griddle (Natural Gas) Commercial Griddle (Natural Gas) Must have a tested heavy load cooking energy efficiency of 38 percent or greater and an idle energy rate of 2,650 Btu/h per square foot of cooking surface or less, utilizing ASTM F1275. $125/griddle Commercial Steam Cooker (Electric) Must have a tested heavy load (potato) cooking energy efficiency of 50 percent or greater, utilizing ASTM F1484. Commercial Steam Cooker (Electric) $1,250/steamer Commercial Steam Cooker (Natural Gas) Commercial Steam Cooker (Natural Gas) Must have a tested heavy load (potato) cooking energy efficiency of 38 percent or greater, utilizing ASTM F1484. $2,000/steamer

7 Requirements: Must meet CEE Tier II specification. All measures must be electric hot food holding cabinets that are fully insulated and have solid doors. Holding Insulated Holding Cabinets Exclusions: Does not include cook and hold equipment. Insulated Holding Cabinets, Full Size Insulated Holding Cabinets, 3/4 Size Insulated Holding Cabinets, 1/2 Size $300/unit $250/unit $200/unit Requirements: The refrigeration system must be built-in (packaged). Must meet ENERGY STAR Version 2.0 specification. Cooling Commercial Glass Door Refrigerators Exclusions: Cases with remote refrigeration systems do not qualify. ENERGY STAR Glass Door Refrigerators Internal volume less than 15 ft 3 ENERGY STAR Glass Door Refrigerators Internal volume 15 ft ft 3 ENERGY STAR Glass Door Refrigerators Internal volume 30 ft ft 3 ENERGY STAR Glass Door Refrigerators Internal volume 50 ft 3 or greater $75/unit $100/unit $125/unit $150/unit Requirements: The refrigeration system must be built-in (packaged). Must meet ENERGY STAR Version 2.0 specification. Commercial Solid Door Refrigerators Exclusions: No cases with remote refrigeration systems. ENERGY STAR specification Version 1.0 refrigerators do not qualify ENERGY STAR Solid Door Refrigerators Internal volume less than 15 ft 3 ENERGY STAR Solid Door Refrigerators Internal volume 15 ft ft 3 ENERGY STAR Solid Door Refrigerators Internal volume 30 ft ft 3 ENERGY STAR Solid Door Refrigerators Internal volume 50 ft 3 or greater $50/unit $75/unit $125/unit $200/unit Requirements: The refrigeration system must be built-in (packaged). Must meet ENERGY STAR Version 2.0 specification. Commercial Glass Door Freezers Exclusions: No cases with remote refrigeration systems. ENERGY STAR Glass Door Freezers Internal volume less than 15 ft 3 ENERGY STAR Glass Door Freezers Internal volume 15 ft ft 3 ENERGY STAR Glass Door Freezers Internal volume 30 ft ft 3 ENERGY STAR Glass Door Freezers Internal volume 50 ft 3 or greater $200/unit $250/unit $500/unit $1,000/unit

8 Requirements: The refrigeration system must be built-in (packaged). Must meet ENERGY STAR Version 2.0 specification. Commercial Solid Door Freezers Exclusions: No cases with remote refrigeration systems. ENERGY STAR specification Version 1.0 freezers do not qualify. ENERGY STAR Solid Door Freezers Internal volume less than 15 ft 3 ENERGY STAR Solid Door Freezers Internal volume 15 ft ft 3 ENERGY STAR Solid Door Freezers Internal volume 30 ft ft 3 ENERGY STAR Solid Door Freezers Internal volume 50 ft 3 or greater $100/unit $150/unit $300/unit $600/unit Requirements: Proposed equipment MUST be on one of these two lists. A list of qualifying Tier 1/ENERGY STAR Ice Machines can be found by visiting the ENERGY STAR Commercial Kitchens Package Page. For Tier 2/Super-Efficient qualified products, please reference the Fisher-Nickel Qualified Products List at Includes machines generating ice cubes that are 60 grams (2 oz.) or lighter. It also includes flaked, crushed and fragmented ice makers. Only air-cooled machines (self contained, ice making heads, or remote condensing). The entire ARI tested ice making system must be purchased. ENERGY STAR Ice Machine ( lbs/day) ENERGY STAR Ice Machine ( lbs/day) ENERGY STAR Ice Machine ( lbs/day) ENERGY STAR Ice Machine ( lbs/day) ENERGY STAR Ice Machine ( lbs/day) ENERGY STAR Ice Machine ( lbs/day) ENERGY STAR Ice Machine (greater than 1500 lbs/day) Super-Efficient Ice Machine ( lbs/day) Super-Efficient Ice Machine ( lbs/day) Super-Efficient Ice Machine ( lbs/day) Super-Efficient Ice Machine ( lbs/day) Super-Efficient Ice Machine ( lbs/day) Super-Efficient Ice Machine ( lbs/day) Super-Efficient Ice Machine (greater than 1500 lbs/day) Commercial Ice Machines Cleaning Remote machines must be purchased with qualifying remote condenser or remote condenser/compressor unit. Ice machines must be tested in accordance with the Air Conditioning and Refrigeration Institute (ARI) Standard 810. Visit for product information and testing procedures. Additional Details: The efficiency specifications for the two qualifying tiers are equivalent to ENERGY STAR or Super-Efficient. Specifications are available at and $50/unit $50/unit $75/unit $75/unit $125/unit $200/unit $250/unit $100/unit $100/unit $150/unit $150/unit $250/unit $400/unit $500/unit Requirements: Equipment must meet either of the following criteria: ENERGY STAR qualified; or CEE qualified Under Counter Door Type Single Tank Conveyor Multiple Tank Conveyor Commercial Dishwasher $400 each $700 each $1,000 each $1,500 each Mail or fax your application package directly to the Commercial/Industrial Program Manager. New Jersey's Clean Energy Program c/o TRC Energy Services 900 Route 9 North, Suite 404 Woodbridge, NJ Phone: Fax: Visit our website: NJCleanEnergy.com/ssb New Jersey SmartStart Buildings is a registered trademark. Use of the mark without the permission of the New Jersey Board of Public Utilities, Office of Clean Energy is prohibited. *Incentives/Requirements subject to change.

9 NJ SmartStart Buildings Program Terms and Conditions Definitions: Design Incentives Incentives that may be offered to design professionals by the Program. Design Services Services that may be offered to design professionals under the Program. Energy-Efficient Measures Any device eligible to receive a Program Incentive payment through the NJ Clean Energy Commercial and Industrial Program (New Jersey SmartStart Buildings). New Jersey Utilities The regulated electric and/or gas utilities in the State of New Jersey. They are: Atlantic City Electric, Jersey Central Power & Light, Rockland Electric Company, New Jersey Natural Gas, Elizabethtown Gas, PSE&G, and South Jersey Gas. Administrator New Jersey Board of Public Utilities, Office of Clean Energy Participating Customers Those non-residential electric and/or gas service customers of the New Jersey Utilities who participate in this Program. Product Installation or Equipment Installation Installation of the Energy-Efficient Measures. Projects with a contract threshold of $14,187 (increasing to $15,444 effective July 1, 2014) are required to pay no less than prevailing wage rate to workers employed in the performance of any construction undertaken in connection with Board of Public Utilities financial assistance, or undertaken to fulfill any condition of receiving Board of Public Utilities financial assistance, including the performance of any contract to construct, renovate or otherwise prepare a facility, the operations of which are necessary for the receipt of Board of Public Utilities financial assistance. By submitting an application, or accepting program incentives, applicant agrees to adhere to New Jersey Prevailing Wage requirements, as applicable. Program The Commercial and Industrial Energy-Efficient Construction Program (New Jersey SmartStart Buildings) offered herein by the New Jersey Board of Public Utilities, Office of Clean Energy pursuant to state regulatory approval under the New Jersey Electric Discount and Energy Competition Act, NJSA 48:3-49, et seq. Program Incentives Refers to the amount or level of incentive that the Program provides to Participating Customers pursuant to the Program offered herein (see description under Incentive Amount heading). Program Offer Program Incentives are available to non-residential retail electric and/or gas service customers of the New Jersey Utilities identified above. Program Manager TRC Energy Services. Application and Eligibility Process The Program pays incentives after the installation of qualified energy-efficient measures that were pre-approved (for exceptions to this condition, please refer to Exceptions for Approval.) In order to be eligible for Program Incentives, a Customer, or an agent (contractor/vendor) authorized by a Customer, must submit a properly completed application package. The package must include an application signed by the customer; a complete (current) utility bill; and technology worksheet and manufacturer s cut sheets (where appropriate). This information must be submitted to the Program Manager before equipment is installed. Applications for measures that are self installed by customers must be submitted by the customer and not the sales vendor of the measure, however, the customer may elect to assign payment of the incentive to the sales vendor. This application package must be received by the Program Manager on or before June 30, 2014 in order to be eligible for the fiscal year July 1, 2013-June 30, 2014 incentives. The Program Manager will review the application package to determine if the project is eligible for a Program Incentive. If eligible, the Customer will receive an approval letter with the estimated authorized incentive amount and the date by which the equipment must be installed in order for the approval to remain in effect. Upon receipt of an approval letter, the Customer may then proceed to install the equipment listed on the approved application. Equipment installed prior to the date of the Program Manager s approval letter is not eligible for an incentive. The Program Manager reserves the right to conduct a pre-inspection of the facility prior to the installation of equipment. This will be done prior to the issuance of the approval letter. All equipment must be purchased within 12 months of date of application. Any Customer and/or agent who purchases equipment prior to the receipt of an incentive approval letter does so at his/her own risk. Exceptions for Approval The Application and Eligibility Process pertains to all projects except for those involving either Gas Heating, Unitary HVAC or Motors having an incentive amount less than $5,000 that were installed within 12 months of receipt of the application. These measures, at this incentive level, may be installed without prior approval. In addition, but at the sole discretion of the Program Manager, emergency replacement of equipment may not require a prior approval determination and letter. In such cases, please notify the Program Manager of such emergencies as early as possible, that an application will soon be sent in that was not pre-approved. Post-Installation Approval After installation is completed, the Customer, or an agent authorized by the Customer, must finalize and submit an invoice for the purchase of the equipment (material cost must be broken out from labor costs), and any other required documentation as specified on the equipment application or in the Program Manager s initial approval letter.

10 Please refer to the program guide on the NJCleanEnergy.com/ssb website for the complete Application and Eligibility Process. The Program Manager reserves the right to verify sales transactions and to have reasonable access to Participating Customer s facility to inspect both pre-existing product or equipment (if applicable) and the Energy-Efficient Measures installed under this Program, either prior to issuing incentives or at a later time. Energy-Efficient Measures must be installed in buildings located within a New Jersey Utilities service territory and designated on the Participating Customer s incentive application. Program Incentives are available for qualified Energy-Efficient Measures as listed and described in the Program materials and incentive applications. The Participating Customer must ultimately own the equipment, either through an up-front purchase or at the end of a short-term lease. Design Incentives are available to design professionals as described in the Program materials and applications. A different and separate agreement must be executed by participating design professionals to be eligible for this type of incentive. The design professional does not need to be based in New Jersey. Equipment procured by Participating Customers through another program offered by New Jersey's Clean Energy Program or the New Jersey Utilities, as applicable, is not eligible for incentives through this program. Customers who have not contributed to the Societal Benefits Charge of the applicable New Jersey Utility are not be eligible for incentives offered through this program. Incentive Amount Program Incentives will equal either: a) the approved Program Incentive amount, or b) the actual equipment cost of the Energy-Efficient Measure, whichever is less, as determined by the Program Manager. Products offered at no direct cost to the customer are ineligible. Incomplete application submissions, applications requiring inspections and unanticipated high volume of activities may cause processing delays. Program Incentives are limited to $500,000 per utility account in a calendar year. Contact the Program Manager regarding any questions. Tax Liability The Program Manager will not be responsible for any tax liability that may be imposed on any Participating Customer as a result of the payment of Program Incentives. All Participating Customers must supply their federal tax identification number or social security number to the Program Manager on the application form in order to receive a Program Incentive. In addition, Participating Customers must also provide a Tax Clearance Form (entitled "Business Assistance or Incentive Clearance Certificate") that is dated within 90 days of equipment installation. Endorsement The Program Manager and Administrator do not endorse, support or recommend any particular manufacturer, product or system design in promoting this Program. Warranties THE PROGRAM MANAGER AND ADMINISTRATOR DO NOT WARRANT THE PERFORMANCE OF INSTALLED EQUIPMENT, AND/OR SERVICES RENDERED AS PART OF THIS PROGRAM, EITHER EXPRESSLY OR IMPLICITLY. NO WARRANTIES OR REPRESENTATIONS OF ANY KIND, WHETHER STATUTORY, EXPRESSED, OR IMPLIED, INCLUDING, WITHOUT LIMITATIONS, WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE REGARDING EQUIPMENT OR SERVICES PROVIDED BY A MANUFACTURER OR VENDOR. CONTACT YOUR VENDOR/SERVICES PROVIDER FOR DETAILS REGARDING PERFORMANCE AND WARRANTIES. Limitation of Liability By virtue of participating in this Program, Participating Customers agree to waive any and all claims or damages against the Program Manager or the Administrator, except the receipt of the Program Incentive. Participating Customers agree that the Program Manager s and Administrator s liability, in connection with this Program, is limited to paying the Program Incentive specified. Under no circumstances shall the Program Manager, its representatives, or subcontractors, or the Administrator, be liable for any lost profits, special, punitive, consequential or incidental damages or for any other damages or claims connected with or resulting from participation in this Program. Further, any liability attributed to the Program Manager under this Program shall be individual, and not joint and/or several. Assignment The Participating Customer may assign Program Incentive payments to a specified vendor. Participating Customer s Certification Participating Customer certifies that he/she purchased and installed the equipment listed in their application at their defined New Jersey location. Participating Customer agrees that all information is true and that he/she has conformed to all of the Program and equipment requirements listed in the application. Termination The New Jersey Board of Public Utilities reserves the right to extend, modify (this includes modification of Program Incentive levels) or terminate this Program without prior or further notice. Acknowledgement I have read, understood and am in compliance with all rules and regulations concerning this incentive program. I certify that all information provided is correct to the best of my knowledge, and I give the Program Manager permission to share my records with the New Jersey Board of Public Utilities, and contractors it selects to manage, coordinate or evaluate the NJ SmartStart Buildings Program. Additionally, I allow reasonable access to my property to inspect the installation and performance of the technologies and installations that are eligible for incentives under the guidelines of New Jersey s Clean Energy Program.

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