Commercial Building Insulation Rebate Application Asterisks (*) indicate required fields.CUSTOMER INFORMATIONAccount Number* Company Name* Contact Name* First Last Contact Phone*Contact Email* Installation Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Do you have a different mailing address?* My mailing address is the same as above I have a different mailing address Mailing Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Building InformationIs the building electrically heated?* Yes No Electric Heat Source*To qualify, commercial buildings must have a permanently installed electric heat system capable of heating the entire structure. Wall Unit, Baseboard, Ceiling Forced Air Electric Heat Pump Hydronic Other Unfortunately, commercial buildings must have a permanently installed heat system capable of heating the entire structure to qualify.Commercial Building Type* Small Office (Less than 5,000 square feet) Medium Office (5,000-50,000 square feet) Small Retail (Less than 5,000 square feet) Medium Retail (5,000-50,000 square feet) Large Retail (50,000-100,000 square feet) Warehouse School K-12 Hospital Restaurant Lodging ENERGY EFFICIENCY UPGRADESI plan to install:* Attic Insulation Wall Insulation Attic InsulationPlease input any additional R-values into the Notes section at the bottom of this form.Existing R-Value*Final R-Value (proposed)*Area (sq ft)*Wall InsulationPlease input any additional R-values into the Notes section at the bottom of this form.Existing R-Value*Final R-Value (proposed)*Area (sq ft)*INSTALLER INFORMATIONCompany Name Contractor Email Total Installed Cost (before rebate)Include equipment, labor, permit, and taxDate of Installation MM slash DD slash YYYY REBATE PROGRAM GUIDELINESPlease click the button below to find current rebate amounts. This will open a new tab. Rebate Amounts Rebate(s) will not exceed 70% of total installed cost. Rebate(s) for self-installed measures will not exceed 70% of the cost of materials. To qualify, commercial buildings must have a permanently installed electric heat system capable of heating the entire structure. Insulation rebates apply to upgrades on existing buildings and are based on pre-condition wall, attic/roof levels. The existing insulation value must be R-5 or less. New construction does not qualify. Floor or crawl spaces are not eligible for the insulation rebate. Rebate(s) are available on a first come, first served basis and are subject to availability of funds. Final invoice & installation must be dated on or after October 1, 2019 to qualify for the current rebate amount. All energy efficient upgrades must be installed according to Clatskanie PUD (CPUD) specifications. Wall insulation: In-progress photographs required before, during, and after insulation installation. After installation: All final paperwork must be submitted before the rebate will be finalized. Verification of insulation is required. Upon receipt of the final paperwork, the project will either be added to the final inspection list or pictures of the insulation with a ruler inserted into the newly installed insulation must be submitted with the final paperwork. Contractor notes with pictures and final paperwork will also suffice for the final inspection. UPLOAD YOUR FINAL DOCUMENTSPlease upload the required final documents with your application: Copies of final invoice(s) showing R-value of existing insulation, R-value of final insulation, and square footage of added insulation. The date of the installation and invoice date must be on or after October 1, 2019 to qualify for the current rebate amount. In-progress pictures of wall insulation (if applicable) * Drop files here or Select files Max. file size: 20 MB. Application NotesPlease insert any notes that you would like us to review with your application.SUBMIT YOUR APPLICATIONTerms and Conditions*By clicking "submit," the applicant acknowledges the following: Rebate offer(s) may be changed or discontinued at any time by Clatskanie PUD (CPUD). CPUD disclaims any warranty whether expressed or implied, regarding the measure(s) listed above for any materials or labor associated with installation, maintenance, repair, or any energy savings associated with use. I understand that the measure(s) must be installed to CPUD specifications, and certify that I, or my contractor, have reviewed the specifications prior to beginning work. When selecting a contractor, I understand that it is the building owner's responsibility to request proof of insurance and licensing that meets the statutes and rules of the Oregon State Construction Contractors Board. CPUD strongly recommends validating qualifications before work begins. I understand the above information and certify that I am a customer of CPUD, that the measure(s) are installed at the address indicated on this application, and that this address is within the CPUD service territory. I agree* Allow 4 to 6 weeks after final inspection and the receipt of all final paperwork for processing. Call 888-883-9879 to learn about additional energy efficiency programs.