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Bergen's Appliance
Application
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The Village of Bergen and the Independent Energy Efficiency Program
(IEEP) are sponsoring this program to encourage Bergen Electric residential
customers to replace any needed appliances with ENERGY STARŪ appliances.
This rebate is available for any purchase made April 1, 2004 through
September 30, 2004. To receive your rebate, please fill out this form
completely and mail it to the address below with a copy of your dated
sales receipt and a recent electric bill showing that you are a customer
of Bergen Electric.
IEEP Appliance Rebate Program
P.O. Box 2489
Syracuse, New York 13220-2489
(Do not include this form with your utility bill payment)
Name: _____________________________________________ Home Phone #: _____________________
Address: ___________________________________________ Work Phone #: ______________________
City: ____________________________________ State: ____________________
Zip: ________________
Electric Company: Bergen Electric -------------------- Account # ___________________________________
Please list Mfr.and model # of ENERGY STAR appliances purchased, Retailer
where purchased and purchase
price and date (to help match up receipts). I am replacing the following
appliances: _________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
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Measure
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Incentive Amount
|
Installation / Efficiency
Criteria
|
Qty
|
Total
|
| Clothes Washer |
$100 |
ENERGY STAR Certified |
|
|
| Attic Fan (Solar powered) |
$100 |
Permanently mounted on roof or in attic.
|
|
|
| Refrigerator |
$75 |
ENERGY STAR Certified |
|
|
| Dishwasher |
$50 |
ENERGY STAR Certified |
|
|
| Room Air Conditioner |
$50 |
ENERGY STAR Certified |
|
|
| Central Air Conditioner |
$50/ton |
ENERGY STAR Certified |
|
|
| Swimming Pool pump motor |
$50 |
Must be listed high efficiency by manufacturer
|
|
|
| Windows |
$25 |
ENERGY STAR Certified |
|
|
| Ceiling Fan |
$25 |
ENERGY STAR Certified |
|
|
| Programmable Thermostat |
$10 |
ENERGY STAR Certified |
|
|
| Attic Fan (Standard electric) |
$15 |
Permanently mounted on roof or in attic
with automatic thermostat. |
|
|
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GRAND TOTAL
|
|
Incomplete information will delay or disqualify your rebate.
All rebates must be postmarked no later than October 31, 2004