Gas Replacement Rebate Program Form

Click here to download a PDF application.

(* denotes a required field.)
HOMEOWNER INFORMATION Flint Energies Meter No.*
Homeowner* Installation Date*
Street Address*
Mailing Address* Phone
City State Zip
SELECT REBATE:*
HVAC CONTRACTOR INFORMATION
Company Name
Contact Name Phone
HEAT PUMP INFORMATION
#1 - Manufacturer BTUH Capacity SEER/HSPF
Model Number of Outdoor Unit
Model Number of Indoor Unit Coil Number
#2 - Manufacturer BTUH Capacity SEER/HSPF
Model Number of Outdoor Unit
Model Number of Indoor Unit Coil Number
PLUMBER INFORMATION
Company Name
Contact Name Phone
ELECTRIC WATER HEATER INFORMATION
#1 - Manufacturer Model No. Capacity (MIN. 40 GAL)
#2 - Manufacturer Model No. Capacity (MIN. 40 GAL)

Please Note:

Flint Energies reserves the right to inspect any installation prior to rebates being paid. If any participant is found abusing the rebate process, Flint Energies reserves the right to restrict their participation in this program.

Flint Energies reserves the right to alter program requirements without prior notification.

This form must be completed in full and returned to Flint Energies within sixty (60) days of work being completed.

Flint Energies is not responsible for the workmanship of any contractor and does not in any way certify the installation. All contractors should be licensed by the state.



I understand that in order to qualify for the Gas Replacement Rebate Program, I will be required to have a Switch N’ Save load management switch installed on the following appliance replaced in my home. I also understand that I will receive an installation credit of $36.00 on my electric bill once the switch is installed. I will also receive a participation credit of $25.00 at the end of a successful operational season.


 




   
   

 
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