All sections must be filled out by the installer at the time of installation. A copy of this completed form, the purchase receipt or invoice, and the manufacturer's Installation Checklist must be promptly submitted to the homeowner's utility in accordance with our policy.
Please follow this llink to NEEA's Qualified Product List for more information: www.nea.org/img/documents/qualified-products-list.pdf.
Follow the manufacturer’s installation instructions exactly. Failure to do so will result in disqualification from the program, may void the manufacturer’s warranty, and may result in lower than expected energy savings.
Both signatures are required. If installed by the homeowner, the homeowner must also sign the installer section.
By signing this application, the homeowner certifies that they understand and agree that they may be contacted for the purpose of scheduling an on-site installation quality assurance visit by a representative of the Heat Pump Water Heater (HPWH) program. This form must be signed by the person whose name appears on the electric utility account. ENERGY INFORMATION RELEASE: The undersigned utility customer requests and authorizes the specified utility to release billing and usage information for the account listed below to the HPWH program. With this authorization, the HPWH program can request billing information for up to two years pre-installation and two years post-installation. The utility customer also hereby releases the utility company from any and all liability arising from or connected with providing this information.
By signing this application, installer certifies that this form and any accompanying documentation are complete and accurate; that all measures associated with this project were completed as of the signature date below; that all equipment was installed according to the manufacturer’s specifications and any additional specifications required by Bonneville Power Administration; and that unit is functional and operational prior to submission of this rebate form.
Basic authority for collecting this information is authorized by 16 U.S.C. §§ 832 et. seq., and 838 et. seq., pursuant to Bonneville Power Administration’s Conservation Program system of records established in 46 FR 31700. This information is primarily intended to further, but is incidental to the performance of, BPA’s overall Energy Efficiency Program, the objective of which is to acquire energy resources through energy efficiency, to determine what cost-effective conservation and direct application renewable resources measures should be installed or adopted under different circumstances, and to provide incentives for the installation of such measures. Other routine issues of this information include: aggregation into a public database on energy efficiency; furnished to authorized personnel for installation/repair of equipment; aggregated into a database for program publicity; and in some instances information regarding buildings will be made available to subsequent purchasers of the buildings. Your disclosure of the requested information is voluntary; however failure to provide requested information means that it will not be possible for you to participate in this BPA Energy Efficiency program.
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