Revised 08/30/11

APP # (Office Use Only)

Efficiency LA 2011-12
Non-Residential Rebate Programs
Building and Account Information – (Installation Address)
I. LADWP Account Number Applicant (Check one) Lighting Owner Refrigeration Tenant Chiller Other Rebate Application Type (Check All Appropriate Boxes)

Please Type or Print

Property Type (Check One) Apartment/Condo Building Factory Educational Facility Market/Grocery Restaurant Medical Facility Hotel/Motel Office Building Account Name (name that appears on the LADWP bill) Installation Address City Mailing Address (If different from above) City State State

Government Facility Retail Store Warehouse Unit or Suite No. Zip Code Zip Code

Inspection Contact Information
II. Customer Contact Person (Name and Title) Best Time to Call Contractor Company/Firm Name Contractor’s Contact Person Name Phone Number ( ) Fax Number ( ) Phone Number ( ) Fax Number ( )
8.

Email Address

Email Address

Terms and Conditions (Read, Sign and Date Below)
The choice of energy-efficient product(s), selection of contractor, manufacturer, dealer, purchase of materials, work performed and payment thereof is the sole responsibility of the applicant. Applicant waives any claims against LADWP arising out of the installation and/or use of the energy-efficient product referenced 2. in this application. LADWP makes no representations regarding manufacturers, dealers, materials or workmanship. 9. The applicant is responsible for meeting all program requirements and for checking with state/county/city governments, property owner and/or homeowner’s association regarding local conditions, restrictions, codes, ordinances, rules and regulations prior to installation. 10. Tenants must obtain the owner’s permission to install the measure for which the rebate is sought. The tenant’s signature on this application indicates such permission has been obtained. 11. LADWP is not responsible for rebate applications and/or 3. A rebate check will be mailed after final application approval, documents sent to LADWP that may be lost in the mail. provided all required documentation, including itemized receipts, 12. Incentives are taxable and if cumulatively greater than $600 will and LADWP inspections have been completed. LADWP reserves be reported to the IRS unless the applicant is exempt. LADWP is the right to request additional information regarding the location not responsible for any taxes that may be imposed on your and quantity of equipment installed. business as a result of the receipt of this rebate. 4. This application, signed and dated, a completed IRS Form W-9* 13. The selection, purchase, and ownership of products and and the product specifications for each measure must be sent to: equipment are the applicant’s responsibility and the LADWP LADWP Non-Residential Programs does not endorse or recommend any particular product, 111 N. Hope St., Room 1063 equipment manufacturer, installer or system design. LADWP Los Angeles, CA 90012 - 2607 makes no warranty, expressed or implied, including warranty of 5. All equipment must be new. Used, rebuilt, or refurbished equipment merchantability or fitness for any particular purpose, use or is not eligible. application of products and equipment. LADWP makes no 6. LADWP reserves the right to require and perform pre- and postrepresentations as to safety, reliability, and/or efficiency of the inspections as a qualifying condition of rebate approval. LADWP equipment selected or any of the components thereof and the may also return to the project site to perform measurement and applicant waives any claim against LADWP for any reason verification of the implemented measures for up to 3 years after the whatsoever arising out of the implementation of the Nondate of installation. Residential Rebate Program. 7. The rebate amount cannot exceed the purchase price of materials and 14. Rebates paid shall be based on the rebate rates in effect at the labor. time the completed application is received by LADWP. Rebate rates may change without prior notification. *See item “5” in the How To Apply section on next page for additional W-9 form information This program shall at all times be subject to change or termination without notice. I HAVE READ, UNDERSTAND, AND AGREE TO COMPLY WITH THE ABOVE TERMS AND CONDITIONS. I CERTIFY THAT THE INFORMATION I HAVE PROVIDED IS TRUE AND CORRECT AND THE ITEM(S) AND/OR EQUIPMENT FOR WHICH THE REBATE IS SOUGHT MEETS THE REQUIREMENTS LISTED ON THE REBATE FORMS Pay rebate to LADWP Customer Seller Other (NRRP Payment Assignment Form required for rebates paid to seller or other) 1. Must be a non-residential LADWP customer with an active electric meter. The applicant is only eligible to receive rebates for energyefficient products designed to reduce the consumption of the energy distributed to the installation address serviced by LADWP. To ensure payment under the 2011-12 Rebate Program, only qualifying equipment purchased, installed, and operational, on or after July 1, 2010, will be considered for rebates. Customers will have 12 months from the purchase date to submit a rebate application. All rebate measures must meet or exceed program requirements at the time of purchase. Program funding will be disbursed on a first-come, first-served basis. With the exception of chiller retrofits, funds will be reserved for 90 days. Rebate dollars allocated for projects not completed within 90 days will be returned to the program fund.

_________________________________ Customer Signature

________________________________ Name (Please Print)

______________________ Date

Revised 08/30/11

Efficiency L.A. 2011-12
Non-Residential Rebate Programs
HOW TO APPLY
Steps one through six below apply to all Non-Residential Rebate Program Applications:
1. 2. Read and Sign The Terms and Conditions Section included in this application. This program shall at all times be subject to change or termination without notice. Locate and Read the performance and efficiency requirements for the specific product(s) for which a rebate is sought. Product specifications are listed in the Program Sections of this application. All current Program Rebate Tables are available online at LADWP’s website, www.ladwp.com/non-res on the appropriate program link or you may request the tables by contacting the program staff at the email address or phone numbers listed below. Lighting, Chiller and Refrigeration Qualifying Products must be purchased, installed, operational, and applied for on or after July 1, 2010 to be eligible for rebates. Complete All Applicable Forms In This Application: i. Building and Account Information (Required) ii. Inspection Contact Information (Required) iii. Appropriate Program Section(s). See below for additional instructions Complete and Sign an IRS Form W-9 (Required) The W-9 form is available for download along with the Non-Residential Rebate Program Application at www.ladwp.com/nr-appl or contact the program staff to request the form. Mail the completed application, W-9 form, invoice and other required documentation to: LADWP NON-RESIDENTIAL REBATE PROGRAMS 111 N. HOPE STREET, ROOM 1063 LOS ANGELES, CA 90012 - 2607 CLEO Rebate Instructions: o Before Installation: you must submit an application to reserve funds o All Projects Require Pre-Approval and Pre-Inspection o Mail the completed Application to address above o Applications are available for download online at www.ladwp.com/cleo o E-mail the CLEO Program Manager a completed LADWP CLEO Spreadsheet detailing the proposed lighting retrofit The CLEO Spreadsheet is available for download online at www.ladwp.com/cleo or by contacting the program staff at cleo@ladwp.com or calling (213) 367-4215 o Once the application is received you will be contacted to arrange a Pre-Inspection o If your project is approved, you will be notified to proceed with your retrofit project o Customers with approved projects are allowed 90-days, or until the program ends which ever occurs first to complete the project and submit all required documents o Once the project is complete, the customer must submit a detailed final invoice or purchase order to schedule a Post-Inspection o A rebate check will be mailed after final project approval (Post-Inspection) and all required documentation (e.g. itemized invoice, receipts, specification sheet, W-9 form, etc.) have been received o Rebate denials, whether in part or full, shall be explained to the customer Chiller Rebate Instructions: o Contact Program Staff at (213) 367-4134 to arrange a preliminary meeting, or complete the application prior to purchasing the chiller. You will be contacted and advised of the estimated rebate amount o Applications are available for download online at www.ladwp.com/cep o Mail a copy of the executed purchase order for your new chiller and you will receive a reservation confirmation letter reserving your estimated rebate o After all required documentation is approved, an agreement will be developed and must be executed by the applicant and LADWP. The rebate will be paid once a final field verification/inspection is approved Refrigeration Rebate Instructions: o Contact Program Staff at (213) 367-4134 to insure that the equipment you are planning to install meets product requirements and qualifications o Before installation, you must submit an application to reserve funds. All projects require pre-approval. LADWP reserves the right to require and perform a pre- and post-inspection as a condition of approval o Applications are available for download online at www.ladwp.com/nr-appl o Install the qualifying equipment, once the project is complete the customer must submit a detailed final invoice or purchase order to schedule a Post-Inspection. Mail a copy of the detailed invoice/receipt to the address in step six above o After the final project approval (post-inspection and receipt of all required documentation) the rebate will be mailed Other Non-Residential Incentive Programs: o Custom Performance Program (CPP) – visit www.ladwp.com/custom for details or contact the Program Staff at (213) 367-2308 or via email to custom@ladwp.com to discuss the energy efficient measures or equipment you are planning to install that does not qualify under the menu based programs listed above o New Construction Incentive Program – visit www.ladwp.com/newconst for details or contact the Program Staff at (213) 367-2308 or via email to newconstruction@ladwp.com to discuss the options available for developers and building owners seeking to participate in this exciting new program

3. 4.

5. 6.

Refrigeration Product Requirements and Qualifications
A. Commercial Ice Machines This measure covers commercial ice machines that produce 60 grams (2 oz.) of lighter ice cubes, as well as flaked, crushed or fragmented ice that meets the energy efficiency thresholds by Ice Harvest Rate in the table below. Performance data is based on Air-Conditioning and Refrigeration Institute (ARI) Standard 810. Only air-cooled ice machines (self-contained or remote condensing units) are eligible. Visit www.ari.org for product information and testing procedures. Product Ice Harvest Incentive Threshold Type Rate Capacity * kWh/100 lbs. of Ice (or less) Air-Cooled 101-200 lbs/day 9.4 Air-Cooled 201-300 lbs/day 8.5 Air-Cooled 301-400 lbs/day 7.2 Air-Cooled 401-500 lbs/day 6.1 Air-Cooled 501-1,000 lbs/day 5.8 Air-Cooled 1,001-1,500 lbs/day 5.5 Air-Cooled >1,500 lbs/day 5.1 * Ice harvest rate (capacity in lbs.) is the amount of ice produced in 24 hours. B – E . Commercial Reach-In Refrigerators and Freezers This incentive applies towards the purchase of new or replacement energy efficient commercial reach-in solid door refrigerators and freezers, and glass door reach-in refrigerators. In all categories, the refrigeration system shall be built-in (packaged), cases with remote refrigeration systems do not qualify. Used or rebuilt equipment is not eligible. Customers must provide proof (manufacturer’s specification sheet) that the appliance meets the Consortium for Energy Efficiency (CEE) Tier I or Tier II energy efficiency specifications using ASHRAE Standard 117-1992 (38°F +/- 2°F). Commercial Solid Door Reach-In Refrigerators and Freezers, and Glass Door Reach-In Refrigerators Measure Code B C D E Measure Description Solid Door Reach-In Refrigerators Tier II CEE Solid Door Reach-In Freezers Tier II CEE Glass Door Reach-In Refrigerator Tier I CEE Glass Door Reach-In Refrigerator Tier II CEE CEE Maximum Daily Energy Usage ≤ 0.06 V + 1.22 kWh/day ≤ 0.28 V + 0.97 kWh/day ≤ 0.12 V + 3.34 kWh/day ≤ 0.086 V + 2.39 kWh/day

• Low temperature covers temperatures below 0°F. • Medium temperature refers to refrigerated space temperatures between 1°F and 35°F. F. Night Covers for Open Vertical and Horizontal Display Cases Must install a cover on an otherwise open display case to decrease cooling load of the refrigerated case during off hours. The rebate is based on the linear footage of the installed night cover. It is recommended that these film type covers have small, perforated holes to decrease moisture buildup. The cover must be applied for a period of at least six hours in a 24-hour period. Customer should consider the following: using proper compressor capacity modulation mechanisms (such as variable speed drive (VSD) or cylinder un-loader); using evaporator pressure regulator (EPR) and possibly resetting to higher suction temperatures when shields are applied; resizing TXV and resetting suction pressure to a higher value. Consult with the case manufacturer or an authorized representative to determine if installing night covers will impact system performance. G. Strip Curtains for Walk-in Boxes Must install new strip curtains or plastic swinging doors on doorways of walk-in boxes and refrigerated warehouses. This rebate is not available for replacement of existing strip curtains that have useful life left. Rebate is based on the square footage of the doorway. H. New Refrigeration Display Case with Doors (Low and Medium Temperatures) Must replace an existing open multi-deck display case with a new high efficiency reach-in unit with standard glass doors with electronically commutated motor (ECM) fan, T-8 lamps and electronic ballast. This measure can be applied to self-contained or remote cases. New display cases are rebated based on their length. New case length must be equal to or shorter than original case. I. New High Efficiency Refrigeration Display Case with Special Doors (Low Temp) A new high efficiency reach-in display case must have a minimum of 20% energy savings compared to the display case replaced. Lamps must be 800 series (CRI ≥ 80) with electronic ballast, must have ECM fan and low/no anti-sweat glass double pane doors meeting the requirements of measure J. This measure cannot be used in conjunction with measure K. Continued On Next Page

Revised 08/30/11

J. Special Doors with Low/No Anti-Sweat Heat on Low Temperature Display Cases Must replace an existing standard glass door of a low temperature reach-in display case with a special glass door that requires minimum to no anti-sweat heat (ASH). Doors must prevent condensation from occurring within the frame assembly. Total door rail, glass, and frame heater amperage (at 120 volts) cannot exceed 0.39 amps per foot of display case. Rebate is based on number of doors replaced. This measure cannot be used in conjunction with measure K. K. Anti-Sweat Heat (ASH) Controls Must install a device that senses the relative humidity in the air outside of the display case and reduces or turns off the glass door (if applicable) and frame anti-sweat heaters at low humidity conditions. Equivalent technologies that can reduce or turn off anti-sweat heater based on the amount of condensation formed on the inner glass pane may also qualify. This measure cannot be used in conjunction with measures I & J. Rebate is based on the total linear footage of the case. L. Insulation for Bare Suction Lines Must insulate bare refrigeration suction lines of 1 5/8 inches or less on existing equipment only. Medium temperature lines require 3/4-inch of flexible closed-cell nitrite rubber, or equivalent insulation, and low temperature lines require 1-inch of the same insulation. Insulation exposed to outside weather must be jacketed (such as with a medium-gauge aluminum jacket) or protected from the weather in some way. Rebate is based on the length, in linear feet, of the insulation installed. M. Door Gaskets on Solid Doors Must replace a worn gasket on the insulated opaque door of a walk-in or reach-in cooler or freezer. Replacement gaskets must meet the manufacturer’s installation specifications, specifically regarding dimensions, materials, attachment method, style, compression, and magnetism. Rebate is based on total door perimeter in linear feet. N. Door Gaskets on Glass Doors Must replace a worn gasket on a reach-in glass door(s) of a cooler or freezer. Replacement gaskets must meet the manufacturer’s installation specifications, specifically regarding dimensions, materials, attachment method, style, compression, and magnetism. Rebate is based on total door perimeter in linear feet. O. Auto-Closers for Main Cooler or Main Freezer Doors The auto-closer should be applied to the main insulated opaque door(s) of a walk-in cooler or freezer. The auto-closer must be able to firmly close that door when it is within one inch of full closure. P. Evaporator Fan Controller for Walk-in Coolers Must reduce airflow of evaporator fans in medium-temperature walk-in coolers when compressor(s) cycle off and there is no refrigerant flow through the evaporator. Must control a minimum fan load of 1/20 horsepower where the fan(s) operate continuously at full speed. Must reduce fan motor power by at least 75% during the compressor off-cycle. Do not use if any of the following conditions apply: 1) The compressor runs all the time with high duty cycle; 2) The evaporator fan does not run at full speed all the time; 3) The evaporator fan motor runs on poly-phase power; 4) The evaporator fan motor is not shaded-pole; or 5) Evaporator does not use off-cycle or time-off defrost. Q. Vending Machine Controller Intended for refrigerated vending machines containing only non-perishable bottled and canned beverages. Controller must include a passive infrared occupancy sensor to turn off fluorescent lights and compressor when surrounding area is unoccupied for 15 minutes or longer. Control logic should periodically power up machine at two-hour intervals to maintain product temperature and provide compressor protection. Refurbished vending machines that include this option are eligible. R. Efficient Evaporator Fan Motor Applicable to existing standard efficiency shaded pole evaporator fan motor of refrigerated display cases or fan coil systems in walk-ins. Shaded pole motors to be replaced by either electronically commutated motors (ECM) or permanent-split-capacitor (PSC) motors. This measure cannot be used in conjunction with Evaporator Fan Controller Measure P.

Revised 08/30/11

Refrigeration Program
Important: See product requirements and qualifications
Measure Code
REA0100 REA0200 REA0300 REA0400 REA0500 REA0600 REA0700 REB0100 REB0200 REB0300 REB0400 REC0100 REC0200 REC0300 REC0400 RED0100 RED0200 RED0300 RED0400 REE0100 REE0200 REE0300 REE0400 REF0100 REF0200 REG0100 REH0100 REH0200 REI0100 REJ0100 REK0100 REL0100 REM0100 REM0200 REN0100 REO0100 REO0200 REP0100 REQ0100 RER0100 RER0200

Measure Description
A. Commercial Ice Machines Air Cooled 101-200 lbs per 24 hrs. Air Cooled 201-300 lbs per 24 hrs. Air Cooled 301-400 lbs per 24 hrs. Air Cooled 401-500 lbs per 24 hrs. Air Cooled 501-1,000 lbs per 24 hrs. Air Cooled 1,001-1,500 lbs per 24 hrs. Air Cooled > 1,500 lbs per 24 hrs. B. Solid Door Reach-in Refrigerator Refrigerator Tier II CEE, 1 Solid Door / <19 cu. ft. Refrigerator Tier II CEE, 1 Solid Door / 19-30 cu. ft. Refrigerator Tier II CEE, 2 Solid Door / 31-60 cu. ft. Refrigerator Tier II CEE, 3 Solid Door / 61-90 cu. ft. C. Solid Door Reach-in Freezer Freezer Tier II CEE, 1 Solid Door / <19 cu. ft. Freezer Tier II CEE, 1 Solid Door / 19-30 cu. ft. Freezer Tier II CEE, 2 Solid Door / 31-60 cu. ft. Freezer Tier II CEE, 3 Solid Door / 61-90 cu. ft. D. Glass Door Reach-in Refrigerator Tier I CEE Refrigerator Tier I CEE, 1 Glass Door / <19 cu. ft. Refrigerator Tier I CEE, 1 Glass Door / 19-30 cu. ft. Refrigerator Tier I CEE, 2 Glass Door / 31-60 cu. ft. Refrigerator Tier I CEE, 3 Glass Door / 61-90 cu. ft. E. Glass Door Reach-in Refrigerator Tier II CEE Refrigerator Tier II CEE, 1 Glass Door / <19 cu. ft. Refrigerator Tier II CEE, 1 Glass Door / 19-30 cu. ft. Refrigerator Tier II CEE, 2 Glass Door / 31-60 cu. ft. Refrigerator Tier II CEE, 3 Glass Door / 61-90 cu. ft. F. Night Covers Night Covers for Open Vertical and Horizontal Display Cases - med temp Night Covers for Open Vertical and Horizontal Display Cases - low temp G. Strip Curtains Strip Curtains for Walk-ins Boxes H. Reach-In Refrigeration Display Case New Refrigeration Display Case with Doors (Low Temp) New Refrigeration Display Case with Doors (Medium Temp) I. Reach-In Refrigeration Display Case With Special Doors New High Eff. Refrigeration Display Case with Special Doors (Low Temp) J. Special Doors with Low/No Anti-Sweat Heat Special Doors with Low/No Anti-Sweat Heat on LowTemp Display Case K. Anti-Sweat Heat (ASH) Controls Anti-Sweat Heat (ASH) Controls L. Insulation for Bare Suction Lines Insulate Bare Suction Pipes M. Door Gaskets on Solid Doors Door Gaskets on Solid Doors for Coolers Door Gaskets on Solid Doors for Freezers N. Door Gaskets on Glass Doors Door Gaskets on Glass Doors O. Auto-Closers for Main Cooler or Main Freezer Auto-Closer for Main Cooler Doors Auto-Closer for Main Freezer Doors P. Evaporator Fan Controller for Walk-In Coolers Evaporative Fans Controller for Walk-in Coolers Q. Vending Machine Controller Vending Machine Controller R. Efficient Evaporator Fan Motor Efficient Evaporator Fan Motor - Electronically Controlled Motor (ECM) Efficient Evaporator Fan Motor - Permanent Split Capacitor (PSC) Motor

Rebate / Measure A $300 / unit $300 / unit $300 / unit $300 / unit $400 / unit $500 / unit $500 / unit $75 / unit $100 / unit $150 / unit $225 / unit $100 / unit $200 / unit $325 / unit $500 / unit $100 / unit $125 / unit $150 / unit $200 / unit $125 / unit $150 / unit $200 / unit $300 / unit $9 / linear foot $9 / linear foot $3 / square foot $200 / linear foot $150 / linear foot $200 / linear foot $50 / door $14 / linear foot $1 / linear foot $4 / linear foot $4 / linear foot $4 / linear foot $40 / closer $50 / closer $75 / controller $90 / controller $20 / motor $20 / motor

Quantity B

Rebate AxB

Ver # DWP Use Only

Revised 08/30/11

Total Refrigeration Rebate

$

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