Lighting Rebate 2016 Rebate Application Nobles Cooperative Electric, P.O. Box 788, Worthington, MN 56187 Ph: 5073727331 Business Member Information Company name Billing address Phone Installation address (if different from above) Account number Contact name Email Vendor Information Vendor name Vendor address City, State, ZIP Vendor contact name Email City State ZIP Phone Phone The undersigned does hereby certify that 1) The undersigned, and not the cooperative, is solely responsible for the accuracy of the information contained in this application, 2) all rules of the Lighting Rebate program have been followed, and 3) the installation is complete. Further, the undersigned acknowledges that nothing contained in the application shall impose any liability on the cooperative for the work performed and information presented by the member s engineer, contractor or vendor. Nobles Cooperative Electric will be referred to hereafter in this application as "the cooperative". Member signature Date How to Apply for This Rebate 1. Fill out this rebate application. All information needs to be supplied before a rebate check can be issued. Please note all warranty information, rules, and qualifications on the rules and information tabs of this form. 2. Complete and sign rebate forms. Mail or fax pages to the cooperative. 3. Call your cooperative with any questions. Application #
Lighting Retrofit Rebate Business Name Air Conditioned (Y/N) 0 LED Lamps Watts $/Unit Quantity Rebate Energy Star or DLC Qualified : Interior LED lamps (includes screw or pin) LED Lamp LED Lamp LED Lamp LED Lamp LED 2x4 Troffer LED 2x2 Troffer LED 2x4 Troffer (retrofit kit) LED 2x2 Troffer (retrofit kit) LED 4/ tubular lamp 5W or less $5 6W10W Replaces Incandescent, Halogen, CFL or Fluorescent Lamps with an Energy Star qualified LED Lamp that $10 11W20W uses 38 times less energy (e.g. a 10W LED replaces 30W80W) $13 21W30W $18 19W40W Replaces T12 or T8 lamp $26 15W30W Replaces T12 or T8 system $18 19W40W Replaces T12 or T8 lamp $20 15W30W Replaces T12 or T8 system $12 18W or less Replaces T12 or T8 system $6 Refrigerator/Freezer LED Lighting LED Case Lamp 5'6' Replaces T12 or T8 system with LED Case Lighting $50 s Watts $/Unit Quantity Rebate Energy Star or DLC Qualified : Exterior & Interior Commercial LED fixtures (including downlights, recessed cans, pendants and surface mounted fixtures) 25W or less Replaces Incandescent, Halogen, CFL or Fluorescent $20 26W50W Lamps with an Energy Star qualified LED fixture that uses 36 times less energy (25W LED fixture replaces $25 51W75W 75W150W) $30 Energy Star or DLC Qualified (Equivalent may be approved by cooperative) : Exterior & Interior Commercial LED fixtures; wallpacks, soffit, canopy, hibay / lobay and pole mount 40W or less Replace 36 x HID $35 41W80W Replace 36 x HID $60 81W120W Replace 36 x HID $90 121W200W Replace 36 x HID $120 201W250W Replace 36 x HID $140 LED exit sign (retrofit only) LED Exit Sign (retrofit only) 8W or less Replace Incandescent Exit Sign $10 (lighting rebates continued over)
Lighting Retrofit Rebate (continued) Flourescent Fixture HID Fixture Fluorescent T5 Lamps with Electronic Ballasts Fluorescent T8 Lamps with Electronic Ballasts Fluorescent Super T8 Lamps with Electronic Ballasts LowWattage Fluorescent T8 Lamps 4 ft., 28W 1 lamp 2lamp T5HO, 3lamp T5HO, 4lamp T8 3lamp T8VHO, 46 lamp T5HO, 68 lampt8 6lamp T8VHO, 8lamp T5HO, 1216 lamp T8 8lamp T8VHO, 10lamp T5HO, 1820lamp T8 Automated control / fixture (photo/motion) Hardwired or Modular Compact Fluorescent Fixtures (does not include screwbase CFL's) ScrewBase Compact Fluorescent Lights Industrial MultiCFL Fixtures 4 ft. 4 ft. 5 ft. to 8 ft. 4 ft. 5 ft. to 8 ft. Replace HID 1000W lamp systems > 56W 33W to 56W 19W to 32W 18W 3 and 4 lamp 1 and 2 lamp 2 lamp 1 lamp 3 and 4 lamp 1 and 2 lamp 2 lamp 1 lamp Replace HID 150250W lamp systems Replace HID 310400W lamp systems Controls hibay fluorescent fixture > 56W 33W to 56W 19W to 32W 18W 3 and 4 lamp 1 and 2 lamp Replace HID 750W lamp systems Replace T12 or metal halide systems $/Unit Quantity Rebate $ 17.00 $ 11.00 $ 16.00 $ 10.00 $ 16.00 $ 10.00 $ 16.00 $ 10.00 $ 16.00 $ 10.00 $ 0.55 $ 36.00 $ 65.00 $ 80.00 $ 100.00 $ 5.00 $ 25.00 $ 21.00 $ 16.00 $ 8.00 $ 10.00 $ 6.00 $ 4.00 $ 2.00 $ 33.00 $/Unit Quantity Rebate High Pressure Sodium Fixtures PulseStart Metal Halide Fixtures Ceramic Metal Halide Fixtures Reflectors Automatic Controls (hard wired) (Must be permanently installed) Photocell Ceiling Mount Occupancy Sensor Wall Mount Occupancy Sensor Fixture Mount Sensor (> 120 W fix.) 251W 151W 250W 150W 750W 320W 749W 176W 319W 175W 251W 151W 250W 51W to 150W 50W Must result in permanent removal of lamps from the existing systems. Hours of operation % Operating hour reduction ** *Apply the total wattage of all controlled fixtures associated with total control quantity $ 45.00 $ 30.00 $ 20.00 $ 70.00 $ 60.00 $ 45.00 $ 28.00 $ 75.00 $ 50.00 $ 35.00 $ 25.00 sq. ft. $ 1.00 sq. ft. $ 1.00 Connected $/Unit Quantity Rebate Total kw* $14.00 $25.00 $14.00 $5.00 ***Project Cost $
**Apply hour reduction based on difference between hour used w/out controls & hours w/ control type ***Required Information. Must enter total project cost to determine rebate. Total Rebate $
Hrs/Yr Hrs/Yr
Hrs/Yr Hrs/Yr Hrs/Yr reduced**
Application # New Construction Lighting 2016 Rebate Application Nobles Cooperative Electric, P.O. Box 788, Worthington, MN 56187 Ph: 5073727331 Business Name 0 Lighting project in air conditioned space (Y/N) LED Lamps Energy Star or Design lights Consortium qualified : Interior LED lamps (includes screw or pin) LED Lamp 5W or less LED Lamp 6W10W LED Lamp 11W20W LED Lamp 21W30W LED 4' tubular lamp 18W or less LED troffer 19W40W Refrigerator/Freezer LED Lighting LED Case Lamp 5'6' $/Unit Quantity Rebate Hrs/Yr $4.00 $0.00 $8.00 $0.00 $10.00 $0.00 $12.00 $0.00 $5.00 $0.00 $25.00 $0.00 $40.00 $0.00 s $/Unit Quantity Rebate Hrs/Yr Energy Star or Design lights Consortium qualified : Interior & Exterior Commercial LED fixtures (including downlights, recessed cans, pendants and surface mounted fixtures) 25W or less $17.00 $0.00 26W50W $23.00 $0.00 51W75W $28.00 $0.00 Energy Star or DLC Qualified (Equivalent may be approved by cooperative) : Interior & Exterior Commercial LED fixtures; wallpacks, soffit, canopy, hibay / lobay and pole mount 40W or less $30.00 $0.00 41W80W $50.00 $0.00 81W120W $70.00 $0.00 121W200W $105.00 $0.00 201W250W $120.00 $0.00 Fluorescent Fluorescent T5 Lamps with Electronic Ballasts Fluorescent Super T8 Lamps with Electronic Ballasts LowWattage Fluorescent T8 Lamps Hardwired or Modular Compact Fluorescent Fixtures (does not include screwbase CFL's) Highbay Fluorescent T8 Lamps with Electronic Ballasts Highbay Fluorescent T5 HO Lamps with Electronic Ballasts HID High Pressure Sodium PulseStart Metal Halide Fixtures Ceramic Metal Halide Fixtures 3 and 4 lamp 4 ft 1 and 2 lamp 3 and 4 lamp 4 ft. 1 and 2 lamp 2 lamp 5 ft to 8 ft 1 lamp 4 ft., 28W 1 lamp 33W to 56W 19W to 32W 18W 4 ft 6 and 8 lamp 4 ft. 6 and 8 lamp 4 ft 4 lamp 150W 750W 320W 749W 176W 319W 175W 251W 151W 250W 150W 2025W integrated CMH w/ electronic ballast $/Unit Rebate Hrs/Yr $2.75 $0.00 $2.20 $0.00 $2.50 $0.00 $1.90 $0.00 $2.75 $0.00 $2.00 $0.00 $0.55 $0.00 $8.80 $0.00 $5.50 $0.00 $3.30 $0.00 $15.00 $0.00 $20.00 $0.00 $15.00 $0.00 $/Unit Rebate Hrs/Yr $6.60 $0.00 $19.80 $0.00 $13.20 $0.00 $8.80 $0.00 $6.50 $0.00 $16.50 $0.00 $11.00 $0.00 $22.00 $0.00 $8.00 $0.00 Automatic Controls (Must be permanently installed) Hours of operation % Operating hour reduction** Connected kw* Total $/Unit Rebate Hrs/Yr reduced** Photocell $7.00 $0.00 Ceiling Mount Occupancy Sensor $15.00 $0.00 Wall Mount Occupancy Sensor $7.00 $0.00 Fixture Mount Sensor (> 120 W fix.) $4.00 $0.00 $0.00 *Apply the total wattage of all controlled fixtures associated with total control quantity ***Project Cost $ **Apply hour reduction based on difference between hour used w/out controls & hours w/ control type ***Required Information. Must enter total project cost to determine rebate. Total Rebate $
Lighting Retrofit Rebate Rules and Qualifications 2016 Rebate Application Nobles Cooperative Electric, P.O. Box 788, Worthington, MN 56187 Ph: 5073727331 Specific Rules and Qualifications The cooperative offers rebates to qualifying members who purchase and install qualifying energy efficient lighting products in existing buildings. If the system configuration does not fit one of the prescriptive rebates shown, the project may still qualify for a rebate through the Custom Energy Rebate program. The Custom Energy Rebate requires review and approval by the participating member cooperative. Illuminating Engineering Society (IES) light levels are recommended. 1. Fluorescent T8 or T5 Lamps with Electronic Ballast Rebates based on installed equipment of one for one replacement of incandescent fixtures, fluorescent T12 lamps controlled by magnetic ballasts, or other fixture type that produce similar kw savings. 2. Fluorescent Super T8 Lamps with Electronic Ballast Rebate based on installed equipment of one for one replacement of incandescent fixtures, fluorescent T12 lamps controlled by magnetic ballasts, or other fixture type that produce similar kw savings. Super T8 systems must meet the following CEE criteria: Lamps must produce at least 3,100 initial lumens; have a color rendering index of (CRI) 81; have mean lamp lumens of per watt 90 for instant start ballast or 88 for programmed rapid start ballast; a lamp life of 24,000 hours (at 3 hrs/start); and have lumen maintenance of 94%. Ballasts must have a ballast efficacy factor (BEF) at least as high as the factors shown in the tables below. t Start Ballast (BEF) Lamps Low (BF 0.85) Normal (0.85<BF 1.0) High (BF 1.01) 1 3.08 3.11 N/A 2 1.60 1.58 1.55 3 1.04 1.05 1.04 4 0.79 0.80 0.77 Programmed Rapid Start Ballast (BEF) Lamps Low (BF 0.85) Normal (0.85<BF 1.0) High (BF 1.01) 1 2.84 2.84 N/A 2 1.48 1.47 N/A 3 0.97 1.00 N/A 4 0.76 0.75 N/A 3. Low wattage T8 Lamps Rebates are based on the installation of 4 ft T8 lamps 28W or less. Rebate is based on the number of lamps. Example A: Replace a 4 lamp 4 ft. T12 fixture with a 4 lamp 4 ft. T8 fixture with 28W T8 lamps; Rebate equals the T12 to T8 fixture retrofit rebate of $20 plus the low wattage T8 rebate of $2.20 ($.55 x 4) for a total rebate of $22.20. Example B: Remove standard 32W 4 ft. T8 lamp from a fixture and install a 28W T8 lamp. Rebate equals $0.55. 4. High bay Fluorescent T8 and T5HO Lamps with Electronic Ballast Rebates are based on one for one replacement of various wattage HID fixtures including mercury vapor, high pressure sodium, metal halide, pulse start metal halide, or other fixture type that produce similar kw savings. See table on inputs page for examples. High bay fluorescent T8, T8 VHO, and T5 HO of various lamp quantities must maintain corresponding lumen output and produce kw savings based on their respective replacements. Fixtures must meet the following conditions: Lumen maintenance >90% Fixture efficiency >80% Fixtures must have reflectors Fixtures with individual automatic controls installed qualify to receive additional rebate per fixture. 5. Compact Fluorescent Fixtures (CFLs) Rebates are based on one for one replacement of incandescent fixtures with new hard wired (dedicated) or modular fixtures containing pin based CFLs. For fixtures that house more than one lamp, the rebate is based on the total fixture wattage. (i.e., one fixture that houses (2) 18W CFLs would be rebated as (1) 36W CFL fixture). Screw based CFLs qualify at lower monetary levels. 6. Industrial Multi Compact Fluorescent Fixtures Rebates are based on one for one replacement of metal halide or fluorescent T12 lamps controlled by magnetic ballasts. 7. High Pressure Sodium (HPS) Fixtures Rebates are based on one for one replacement of incandescent, metal halide, or mercury vapor fixtures. High pressure sodium lamp wattage must be lower than existing lamp wattage. 8. Pulse Start Metal Halide (PSMH) Fixtures Rebates are based on one for one replacement of incandescent, mercury vapor, high pressure sodium, or metal halide fixtures. Pulse start lamp wattage must be lower than existing lamp wattage.
Lighting Retrofit Rebate Rules and Qualifications 2016 Rebate Application Nobles Cooperative Electric, P.O. Box 788, Worthington, MN 56187 Ph: 5073727331 9. Ceramic Metal Halide Fixtures Rebates are based on one for one replacement of incandescent, halogen, mercury vapor, high pressure sodium, metal halide, or pulse start metal halide fixtures. Ceramic metal halide lamp wattage must be lower than existing lamp wattage. 10. Reflectors Rebates are for permanently installed reflectors that have a minimum four year manufacturer s product warranty, are U.L. approved and result in the permanent removal of fluorescent lamps from the 11. Automatic Controls Occupancy Sensors, Photocells. Automatic controls must be permanently installed wall or ceiling mounted, passive infrared, ultrasonic, or dual technology sensors. Rebate for controlling an area, not individual fixtures. 12. LED Exit Signs Rebates are based on one for one replacement of the entire incandescent exit sign to LED exit sign. CFL exit signs do not qualify. Warranty Information Rebate qualifications do not imply any representation or warranty of such equipment, design or installation by the cooperative. The cooperative shall not be responsible or liable for any personal injury or property damage caused by this equipment. The cooperative does not guarantee that a specific level of energy or cost savings will result from the implementation of energy conservation measures or the use of products funded under this program. In no event shall the cooperative be liable for any incidental or consequential damages. Other Important Program Rules 1. Installation must be complete before rebate funds will be issued. 2. Members and vendors must submit itemized equipment invoices, along with rebate application and worksheet, to the cooperative. To ensure that the equipment installed meets the cooperative s performance standards, these invoices must itemize labor charges, quantity and price of the equipment installed, as well as information regarding the manufacturer and model numbers for all lamps, ballasts and fixtures included in the rebate. 3. The cooperative reserves the right to conduct random inspections of installations. 4. The member is responsible for checking with the cooperative to determine whether funding is available and to verify program parameters. 5. Project must comply with all program specific rules and qualifications. 6. The maximum rebate amount shall be the lesser of 50 percent of the project cost or $##,000. 7. Qualifying members must apply for rebates no later than November 18, 2016.
New Construction Lighting Rebate Rules and Qualifications 2016 Rebate Application Nobles Cooperative Electric, P.O. Box 788, Worthington, MN 56187 Ph: 5073727331 Specific Rules and Qualifications The cooperative offers rebates to qualifying members who purchase and install qualifying energy efficient lighting products in new buildings. If the system configuration does not fit one of the prescriptive rebates shown, the project may still qualify for a rebate through the Custom Energy Rebate program. 1. Fluorescent T5 Lamps with Electronic Ballast Rebate based on the installation of fluorescent T5 controlled by electronic ballasts. 2. Fluorescent Super T8 Lamps with Electronic Ballast Lamps: produce at least 3,100 initial lumens; colorrendering index (CRI) 81; mean lamp lumens per watt 90 for instant start ballast or 88 for programmed rapid start ballast; lamp life 24,000 hours (at 3 hrs/start); and lumen maintenance 94%. Ballast must have a ballast efficacy factor (BEF) at least as high as the factors shown in the tables below. Instant Start Ballast (BEF) Lamps Low (BF 0.85) Normal (0.85<BF 1.0) High (BF 1.01) 1 3.08 3.11 N/A 2 1.60 1.58 1.55 3 1.04 1.05 1.04 4 0.79 0.80 0.77 Programmed Rapid Start Ballast (BEF) Lamps Low (BF 0.85) Normal (0.85<BF 1.0) High (BF 1.01) 1 2.84 2.84 N/A 2 1.48 1.47 N/A 3 0.97 1.00 N/A 4 0.76 0.75 N/A 3. Low wattage T8 Lamps Rebate based on the installation of 4 ft T8 lamps less than or equal to 28W. Rebate is based on the number of lamps. 4. High bay Fluorescent T8 and T5HO Lamps with Electronic Ballast Rebate Eligible 6, 8 lamp T5 or 4 lamp T5 HO systems. High bay fluorescent T8 6 or 8 lamp and high bay fluorescent, T5HO 4 lamp fixtures must meet the following minimum eligibility criteria: Total fixture wattage < 240W Lumen maintenance >90% Initial lumens 20,000 Fixtures must have reflectors Fixture efficiency >80% 5. Compact Fluorescent Fixtures (CFLs) Rebates are available for new hard wired (dedicated) or modular fixtures containing pin based CFLs. For fixtures that house more than one lamp, the rebate is based on the total fixture wattage. (i.e., one fixture that houses (2) 18W CFLs would be rebated as (1) 36W CFL fixture. Screw based (integral) CFLs do not qualify. 6. High Pressure Sodium (HPS) Fixtures Rebate is based on installation of HPS fixtures less than or equal to 150W. 7. Pulse Start Metal Halide (PSMH) Fixtures Rebate is based on the installation of a PSMH fixture. 8. Ceramic Metal Halide Fixtures Rebate is based on the installation of a ceramic metal halide fixture. 9. LED Rebates Rebate is based on the installation of a like delivered lumen output lamp / fixture based on typically used technology (refer to ranges on rebate sheet). The cooperative offers rebates to qualifying members who purchase and install qualifying energy efficient LED lighting products. Energy Star and Design Lights Consortium (DLC) are recognized approving agencies for LED lamps and fixtures. LED interior lamps and downlight luminaires/fixtures must be ENERGY STAR or DLC qualified. The lists of ENERGY STAR qualified products are available at energystar.gov/ssl Partners. Lamps are listed under the section Partner Resources for LED Lamps. Luminaires/ fixtures are listed under Partner Resources for LED Fixtures. The ENERGY STAR list of qualified luminaires includes a variety of products. In order to qualify for the prescriptive rebates for LED downlight luminaires/fixtures, the product must be listed as Commercial or Both in the Application column of the ENERGY STAR product list. In addition, the product description in the Product Type column must include the word Downlight. ENERGY STAR does not have a qualified products list for LED canopy or soffit lighting or LED refrigerated case lighting (therefore, an ENERGY STAR rating is not required for those specific prescriptive rebates. See DLC for qualifying guidelines). For exterior LED canopy and soffit lights eligibility, the member must be replacing HID fixtures only. If the system configuration does not fit one of the prescriptive rebates shown, the project may still qualify for a rebate through the Custom Energy Rebate program. The Custom Energy Rebate requires review and approval by the participating member cooperative. Illuminating Engineering Society (IES) light levels are recommended. A project falling below recommended levels may be denied rebate.
Lighting Rebate 2016 Rebate Application Nobles Cooperative Electric, P.O. Box 788, Worthington, MN 56187 Ph: 5073727331 Business Name 0 Completion of the LED lighting worksheet is required before rebate will be issued. Existing Lighting System # Fixtures Watts/ Fixture Annual Hours New Lighting System # Fixtures Watts/ Fixture Annual Hours Saved kw Saved kwh Replaces Incandescent, Halogen or Fluoresc 1 111 111 1 15 111 0.10 11 Total 0.10 11 Controls kw connected Hrs/Yr reduced Saved kwh Automatic Controls Example How to Complete Form Photocell Ceiling Mount Occupancy Sensor Wall Mount Occupancy Sensor Fixture Mount Occupancy Sensor 0.000 0 0.000 0 0.000 0 0.000 0 Total Incandescent Bulb Halogen PAR 30 Refrigerated Case, F60T12/CW/HO, 75 W 1 75 4000 LED Lamp 15 Watt 1 15 4000 0.06 240 1 65 2500 LED Lamp PAR 30 Downlight 1 11 2500 0.05 135 10 75 8000 LED Case Light 10 15 8000 0.60 4,800 Total $ 0.71 5,175
LED Traffic Signal Retrofit 2016 Rebate Application Nobles Cooperative Electric, P.O. Box 788, Worthington, MN 56187 Ph: 5073727331 Signal Type Existing Equipment QTY New Proposed Equipment QTY Rebate Rebate 9" Signals Incandescent Pedestrian LED Pedestrian Signals $ 21.25 $ Signals Walk/Don't 12" or Larger Signals Walk/Don't Walk Walk $ 34.00 $ 8" Red Balls $ 12.75 $ 8" Green Balls $ 34.00 $ Incandescent Traffic LED Traffic Balls and 12" Red Balls $ 21.25 Balls and Arrows Arrows $ 12" Green Balls $ 55.00 $ 12" Red Arrows $ 21.25 $ $ *Project Cost Rebate $ *Required Information. Warranty Information Rebate qualifications do not imply any representation or warranty of such equipment, design or installation by the cooperative. The cooperative shall not be responsible or liable for any personal injury or property damage caused by this equipment. The cooperative does not guarantee that a specific level of energy or cost savings will result from the implementation of energy conservation measures or the use of products funded under this program. In no event shall the cooperative be liable for any incidental or consequential damages. Other Important Program Rules 1. Installation must be complete before rebate funds will be issued. 2. Members and vendors must submit itemized equipment invoices, along with rebate application and worksheet, to the cooperative. To ensure that the equipment installed meets the cooperative's performance standards, these invoices must itemize labor charges, quantity and price of the equipment installed, as well as information regarding the manufacturer and model numbers for all lamps included in the rebate. 3. The cooperative reserves the right to conduct random inspections of installations. 4. The member is responsible for checking with the cooperative to determine whether funding is available and to verify program parameters. 5. The maximum rebate amount shall be the lesser of 50 percent of the project cost or $##,000. 6. Qualifying members must apply for rebates no later than November 18, 2016.