Non-Residential Connected Thermostat Rebate Application Asterisks (*) indicate required fields.CUSTOMER INFORMATIONAccount Number* Company Name on Account* 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 SITE INFORMATIONBusiness Type* Office Retail School K-12 Residential Care Assembly Grocery Food Service Hospital Warehouse PROJECT INFORMATIONHow many thermostats are you installing?* 1 2 3 4 5 Thermostat 1 Heat Source* Electric Gas Thermostat 2 Heat Source* Electric Gas Thermostat 3 Heat Source* Electric Gas Thermostat 4 Heat Source* Electric Gas Thermostat 5 Heat Source* Electric Gas Is the equipment on the Qualified Products List?* Yes No BPA Connected Thermostats Qualified Products ListThe equipment must be on BPA's Qualified Products List to be eligible for the rebate.Manufacturer* Model Number* Equipment Size (In Tons)*Installed Cost (per attached invoice before rebate)*Order/Purchase Date (per attached invoice)* MM slash DD slash YYYY Date 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 Product must be on the BPA Qualified Products List, which can be found here. This measure is available for retrofits only. This measure is not eligible for lodging, 24/7 occupancy, or semi-conditioned spaces. Connected Thermostat projects are not eligible for an ARC payment. This measure provides for both initial installation and verification of programming for eligible connected thermostats and cannot be used for enabling features sets on existing thermostats. Rebate(s) will not exceed 70% of total installed cost. To ensure availability of funds, project must be pre-approved.UPLOAD YOUR FINAL DOCUMENTSPlease upload the required final documents with your application: The contractor final invoice(s) including equipment order or purchase date and the installed cost. * 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 Modern Electric Water Company (MODERN). MODERN disclaims any warranty, whether expressed or implied, regarding the energy efficient upgrade(s) listed on this application for any materials or labor associated with installation, maintenance, repair, or any energy savings associated with use. I understand that the energy efficient upgrade(s) must be installed to MODERN 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 business owner’s responsibility to request proof of insurance and licensing that meets the statutes and rules of the Washington Construction Contractors Board. MODERN strongly recommends validating qualifications before work begins. I understand the above and certify that I am a customer of MODERN, that the energy efficient upgrade(s) are installed at the address indicated and that this address is within the MODERN service territory. I agree* Allow 8 to 10 weeks for rebate processing, after the receipt of the final invoice and paperwork. Call 888-883-9879 to learn about additional energy efficiency programs.