Commercial ENERGY STAR Qualified Food Service Equipment Rebate Application Asterisks (*) indicate required fields.CUSTOMER INFORMATIONAccount Number* Company Name on Account* Company Name Contact Name* First Last Contact Phone*Contact Email* Enter Email Confirm 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 Business Type* Office Retail School K-12 Residential Care Assembly Grocery Food Service Hospital Warehouse REBATE INFORMATIONPlease click the button below to find current rebate amounts. This will open a new tab. Rebate Amounts NEW PRODUCT INFORMATIONNew Equipment:* Electric Steam Cooker - 6 Pan Electric Convection Oven Electric Fryer Large Vat Fryer Only Hot Food Holding Cabinet Electric Combination Oven Demand Controlled Kitchen Ventilation Electric Steam CookerBrand* Model Number* Quantity*Installation Cost*Installation Date* MM slash DD slash YYYY Electric Convection OvenSize* Half-Size Full-Size Double-Size Brand* Model Number* Quantity*Installation Cost*Installation Date* MM slash DD slash YYYY Electric Fryer Large VatBrand* Model Number* Quantity*Installation Cost*Installation Date* MM slash DD slash YYYY Hot Food Holding CabinetSize* Half-Size Full-Size Double-Size Brand* Model Number* Quantity*Installation Cost*Installation Date* MM slash DD slash YYYY Electric Combination OvenNumber of Pans:* 6 - 15 Pan 16 - 20 Pan Brand* Model Number* Quantity*Installation Cost*Installation Date* MM slash DD slash YYYY Demand Controlled Kitchen VentilationHow many Demand Control Kitchen Ventilation (DCKV) units?* 1 2 3 DCKV 1Control Sensors:* One DCKV Control Sensor Multiple DCKV Control Sensors Total Fan Horsepower that is Served by the DCKV*Manufacturer* Model Number* Installation Cost*Installation Date* MM slash DD slash YYYY DCKV 2Control Sensors:* One DCKV Control Sensor Multiple DCKV Control Sensors Total Fan Horsepower that is Served by the DCKV*Manufacturer* Model Number* Installation Cost*Installation Date* MM slash DD slash YYYY DCKV 3Control Sensors:* One DCKV Control Sensor Multiple DCKV Control Sensors Total Fan Horsepower that is Served by the DCKV*Manufacturer* Model Number* Installation Cost*Installation Date* MM slash DD slash YYYY UPLOAD YOUR DOCUMENTSPlease upload the following documents with your application: Final invoice with equipment order/purchase date & installed cost A copy of the ENERGY STAR product list or ENERGY STAR product packaging that shows the ENERGY STAR logo (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 product(s) listed above for any materials or labor associated with installation, maintenance, repair, or any energy savings associated with use. Rebate offer(s) apply to new product(s) only. CPUD reserves the right to inspect installed product(s). Product(s) must meet all program criteria to qualify for rebate(s). I understand the above and certify that I am a customer of CPUD, that the product(s) are installed and operating at the location indicated and that this address is within the CPUD service territory. I agree Rebate Applications are due within six (6) months of purchase to qualify. Allow 4 to 6 weeks for rebate processing. Call 1-888-883-9879 to learn about additional energy efficiency programs.
