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2020 Residential efficiency rebate application
For purchases made between Jan. 1, 2020 - Dec. 31, 2020
Account Number
Customer Name
(Ten-digit number)
(As shown on utility bill)
Service Address
Address
City
State
Zip Code
Email
Home Phone
Cell Phone
Do you have central air conditioning? (answer required to qualify for smart thermostat rebate)
Yes
No
Pikes Peak Regional Building permit number required for a Natural gas storage water heater and Natural gas furnace rebate.
Pikes Peak Regional Building Permit #
UTILITY SERVICE
REQUIREMENTS
REBATE AMOUNT
QUANTITY
EXPECTED REBATE
REBATE
Dryer
Electric
ENERGY STAR® certified products, limit 1 per service address.
$50
$
0
1
Recycled Refrigerator or Freezer
Electric
Must include written receipt provided by recycling vendor (ARCA); 10 cu. ft. to 32 cu. ft. only; limit 2 per service address.
$50 each
$
0
1
2
Smart Thermostat
Electric or Natural Gas
ENERGY STAR® certified products, limit 2 per service address.
$50 each
$
0
1
2
Natural Gas Storage Water Heater
Natural Gas
≤ 55 gallons: Energy factor (EF) ≥ 0.67: First-hour rating (FHR) ≥ 0.67
> 55 gallons: Energy factor (EF) ≥ 0.77: First-hour rating (FHR) ≥ 0.67
ENERGY STAR® certified products; limit 1 per service address.
$50
$
0
1
Natural Gas Condensing Furnace
Natural Gas
Annual fuel utilization efficiency (AFUE) ≤ 95%
ENERGY STAR® certified products; limit 1 per service address.
$250
$
0
1
REBATE
UTILITY SERVICE
R-VALUE
INSTALLED SQ. FT.
REQUIREMENTS
INSTALLATION/
LABOR/
MAT'L COSTS
REBATE AMOUNT
(40% OF JOB COST
UP TO $200 MAX)
PRE
POST
Attic Insulation & Bypass Sealing
Electric or Natural Gas
R49+
Read specific instructions in the qualifications and program rules.
$
Wall Insulation
Electric or Natural Gas
R13+
Read specific instructions in the qualifications and program rules.
$
REBATE
UTILITY SERVICE
REQUIREMENTS
REBATE AMOUNT
QUANTITY
PURCHASE
PRICE/UNIT
EXPECTED REBATE
Wired Rain Sensor
Water
Sensor must connect to an automated in-ground sprinkler system. Limit 2 per service address.
Up to $25 each
$
0
1
2
Wireless Rain Sensor
Water
Sensor must connect to an automated in-ground sprinkler system. Limit 2 per service address.
Up to $50 each
$
0
1
2
High-efficiency Nozzles
Water
Minimum of 5 nozzles, maximum of 80 nozzles per service address.
Up to $4 each
$
0
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
Sprinkler Heads w/ Check Valves or Pressure Reducing Stem
Water
Minimum of 5 heads, maximum of 80 heads per service address.
Up to $5 each
$
0
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
WaterSense Certified Smart Irrigation Controller
Water
Limit 2 per service address.
Up to $50 each
$
0
1
2
Please consider a
tax-deductible
donation to Project COPE.
EVERY donation is doubled
, thanks to a matching fund grant from Colorado Springs Utilities. 100 percent of your contribution goes toward assisting our friends and neighbors pay their utility bill.
Donation amount: $
I swear/affirm under penalty of perjury under the laws of the State of Colorado that I am:
a United States citizen, or
a Permanent Resident of the United States, or
am lawfully present in the United States pursuant to Federal Law.
Signature Required:
Date:
I understand that this sworn statement is required by law because I have applied for a public benefit. I understand that state law requires me to provide proof that I am lawfully present in the United States prior to receipt of this public benefit or prior to entering a contract with the state. I further acknowledge that making a false, fictitious, or fraudulent statement or representation in this affidavit is punishable under the criminal laws of Colorado as perjury in the second degree under Colorado Revised Statute 18-8-503 and it shall constitute a separate criminal offense each time a public benefit is fraudulently received.
** ATTACHMENTS **
Please do not use any special characters when adding attachments
Include a copy of your approved photo I.D.
Include copies of receipts related to the requested rebate items.
Add Attachment
Select a file
Name
The maximum file size allowed is: 100 MB
Signature above also certifies that the account holder
1)
is solely responsible for the accuracy of the application;
2)
has read and understands the program general requirements and
terms and conditions.
3)
verifies installation is complete and operational;
4)
understands the liability waiver if recycling a refrigerator/freezer; and
5)
has included a copy of approved
photo ID
and invoice.