C&I Custom Incentive Application  

| Resume a previously saved form
Resume Later

In order to be able to resume this form later, please enter your email and choose a password.

Password must contain the following:
  • 12 Characters
  • 1 Uppercase letter
  • 1 Lowercase letter
  • 1 Number
  • 1 Special character
SECTION 1: Utility Member Information

(as it appears on electric utility bill)




SECTION 2: Job Site Information


(first and last name)


Enter your 10-digit phone number without the dashes.

Enter your 10-digit phone number without the dashes.


(where equipment is installed)




(found on monthly bill)

MM-DD-YYYY



SECTION 3: Trade Ally (Contractor) Information








SECTION 4: Payee and Mailing Address

(By checking Landlord or Trade Ally, member is authorizing payment to the third party indicated. See Third-Party Payees section of Terms and Conditions for details.)





SECTION 5: Payee IRS Form W-9 Information


The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding. Attach the payee’s IRS Form W-9 below

General Requirements

  • The specifications for eligible equipment are listed within each section on this form. If the equipment you are installing is specified differently than how it is listed on this form, please call to verify eligibility. Custom incentives are available for many technologies not listed. Replacements are one-for-one unless specified. Replaced equipment must be removed from service.
  • If applicable, all lighting projects must comply with all applicable electrical, safety, and energy codes. Electrical permits are required for most lighting projects including lamp replacements in some cases. Contact your local authority having jurisdiction for more information.
    • Post-installation light levels are expected to meet current IESNA (Illuminating Engineering Society of North America) recommendations.
    • Fixtures must be UL or CSA listed and either ENERGY STAR® or DesignLights Consortium® (DLC) qualified as noted.
  • Incentive will not exceed 75 percent of the project cost as defined in the Terms & Conditions.

Note: Member acknowledges and agrees that Member cannot apply for, nor receive, incentives for the same product, equipment or service from more than one utility unless there are both electric and gas savings.

Custom Lighting 

These incentives are available for energy-saving measures that are not covered by the prescriptive lighting portion of the program. Custom incentives are based on the first-year electrical energy (kWh) savings.

When applying for pre-approval, submit the following items:
  • Itemized quote/proposal for all related materials and any external (third-party) labor.
  • Manufacturer’s specification sheets for all equipment.
  • In lieu of filling out the application, calculations may be submitted in an unlocked spreadsheet (such as Excel).
Custom Incentive Rate: $0.07 per kWh saved


Max 2
Existing Fixture #1




(A x B x C / 1,000)
New Fixture #1




(E x F x G / 1,000)
kWh
Existing Fixture #2




(A x B x C / 1,000)
New Fixture #2




(E x F x G / 1,000)
kWh
Custom Lighting Project Totals

*Total of all invoices associated to project


(Cannot exceed 75% of the total project cost)

Custom Non-Lighting 

These incentives are available for energy-saving measures that are not covered by other prescriptive portions of the program. Custom incentives are based on the first-year electrical energy (kWh) savings.

When applying for pre-approval, submit the following items:
  • Itemized quote/proposal for all related materials and any external (third-party) labor.
  • Manufacturer’s specification sheets for all equipment.
  1. Provide a detailed written description of the project.
  2. Provide clear and logical step-by-step calculations detailing the estimated annual energy savings (kWh).
    1. Submit calculations in an unlocked spreadsheet format (such as Excel). Do not send PDF copies of spreadsheets.
    2. Provide detailed and orderly calculations that can be followed without prior knowledge of the project.
    3. Document any assumptions and inputs to calculations (e.g., hours of operation, load factor, power factor, motor efficiencies, etc., if applicable) and maintain consistency throughout calculations.
    4. Identify key numbers (circled, bold, highlighted, etc.) and show correct units.
Custom Incentive Rate: $0.07 per kWh saved


Max 4
Estimated Custom Non-Lighting Project Savings
a Measure description refers to specific energy efficient project components (i.e. chiller replacement, industrial process improvement, etc.)

b Measure cost is either the cost to remove/replace existing operational equipment, or it is the incremental cost to upgrade non-operational equipment from standard efficiency to high efficiency equipment.

c Costs itemized by measure are preferred.

d Include contracted labor costs, sales tax, disposal, permit fees, etc., related to the project.
1



2



3



4



Custom Non-Lighting Project Totals



(Cannot exceed 75% of the total project cost)










SECTION 6: Member Signature



Save my progress and resume later | Resume a previously saved form

Great Lakes Energy - Energy Wise