Heating & Cooling Rebates

Heating & Cooling Rebates

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Member Information

Member Name

(as it appears on electric bill)

Electric Utility Account Number

(found on monthly bill)

Email

Primary Phone

Enter your 10-digit phone number without the dashes.

Service Address

(where equipment is installed)

City

State Abbreviation

Zip Code

Is your mailing address different than you service address?

YesNo

Mailing Address

City

State Abbreviation

Zip Code

Instructions: Fill out the quantity of each item you wish to receive a rebate for and upload any/all itemized receipts or invoices.

A licensed Michigan mechanical contractor installation is required for all measures, except as noted.
Members cannot perform the verification themselves, even if they perform the installation. Members are responsible for payment to the contractor if a service call is needed. An installation invoice must be provided with all rebate applications.
Equipment must be new and in working condition. Used or refurbished equipment is not eligible for incentives.
Heat pump efficiency can be verified at: AHRIdirectory.org and/or ashp.neep.org.

HomeWorks Tri-County Electric reserves the right to inspect installation site prior to rebate approval.

Air-to-Water Heat Pump

Must be listed on ashp.neep.org
Requires licensed mechanical contractor

AHRI#

Date Installed

Manufacturer

Model #

Type of system being replaced or displaced:

Electric	Gas
Propane	Other

Quantity

Incentive Amount

$

Total Incentive

$

Total kWh Savings

Heat Pump (Hybrid Electric) Water Heater

ENERGY STAR Qualified
Requires licensed mechanical contractor

Manufacturer

Model #

Date Installed

Quantity

Incentive Amount

$

Total Incentive

$

kWh Savings - Heat Pump

Total kWh Savings

Central Air-Source Heat Pump

Must be listed on ashp.neep.org
Requires licensed mechanical contractor

Manufacturer

Indoor Model #

Outdoor Model #

AHRI#

Date Installed

Type of heating system being replaced or displaced:

Electric	Gas
Propane	Other

Quantity

Incentive Amount

$

Total Incentive

$

Total kWh Savings

Efficient Circulation Pump

Must be ECM/permanent magnet motor
For hydronic heating systems only
Requires licensed mechanical contractor

Manufacturer

Model #

Date Installed

Quantity

Incentive Amount

$

Total Incentive

$

kWh Savings - Circulation Pump

Total kWh Savings

Central Air Conditioner

Requires licensed mechanical contractor
Minimum efficiency requirement SEER2 14.3+

Type of Air Conditioner:

Tier 1: SEER2 14.3 - 16.1

Tier 2 SEER2 16.2+

AHRI#

Date Installed

Manufacturer

Model #

Quantity

Incentive Amount

$

Incentive Amount

$

Total Incentive

$

Total kWh Savings

Smart Thermostat

Must feature wi-fi connectivity.
Thermostat must control an HVAC system with an air conditioner and/or electric heat.
Does not require licensed contractor
Limit 2

*Sensi, Nest, or Honeywell brands allow participation in demand response incentive programs.

Manufacturer

Model #

Date Installed

Quantity

Incentive Amount

$

Total Incentive

$

Total kWh Savings

kWh Savings - Smart Thermostat

Mini Split Air-Source Heat Pump

Must be NEEP ccASHP listed on ashp.neep.org.
Requires a Licensed mechanical contractor.
Limit 4 outdoor units.

AHRI#

Indoor Model #

Outdoor Model #

Manufacturer

Date Installed

Quantity

Type of heating system being replaced or displaced:

Electric	Gas
Propane	Other

Incentive Amount

$

Total Incentive

$

Total kWh Savings

Whole-Home Dehumidifier

Must be ENERGY STAR certified
Portable units are not eligible (must be applied for though Appliance Rebates)
Requires licensed mechanical contractor
Limit 1

Manufacturer

Model #

Date Installed

Quantity

Incentive Amount

$

Total Incentive

$

Total kWh Savings

kWh Savings - WH Dehumidifier

Residential AC Tune Up

Requires a licensed mechanical contractor
Unit is >2 tons

Model #

Tons

Incentive Amount

$

Total Incentive

$

Total kWh Savings

kWh Savings - Res AC Tune Up

Receipts and Invoices Upload

Additional Receipts and Invoices Upload

Additional Receipts and Invoices Upload

Additional Receipts and Invoices Upload

Contractor Information

Select Contractor License Type

Electrical

Plumbing

HVAC

No Contractor Required

Electrical Contractor Name

Electrical Company Name

Street Address

City

State Abbreviation

Zip Code

Office Phone

Cell Phone

Contractor Email

Electrical License Number

Electrical License's Name

Plumbing Contractor Name

Plumbing Company Name

Street Address

City

State Abbreviation

Zip Code

Office Phone

Cell Phone

Contractor Email

Plumbing License Number

Plumbing License's Name

HVAC Contractor Name

HVAC Company Name

Street Address

City

State Abbreviation

Zip Code

Office Phone

Cell Phone

Contractor Email

HVAC License Number

HVAC License's Name

Comments

Total Heating & Cooling Incentives Requested

$

Reminder: All rebates will be credited to the account.

Do you qualify as a low-income household?

Yes

No

Unsure/Prefer not to say

This helps us ensure our programs reach members who may benefit most. Your response is confidential.

Income Qualified Services Eligibility

Persons in the family/household must be at or below 200% of the Federal Poverty Level

Family Size	Gross Annual Income
1	$31,300
2	$42,300
3	$53,300
4	$64,300
5	$75,300
6	$86,300
7	$97,300
8	$108,300

Terms and Conditions

I certify that this information is true and accurate. I understand that HomeWorks Tri-County Electric reserves the right to inspect my items at any time and may charge me the full amount of this rebate, plus interest should they find the information presented here to be false in any way.

Type your name to electronically sign this application

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