BUSINESS APPLIANCE REBATE
START HERE – PLEASE READ THIS FIRST
How to Apply
1) Review Program Eligibility on page 3. See www.energystar.gov for list of eligible ENERGY STAR commercial-
grade refrigerator and freezer models.
2) Contact vendors for price quotes on the appliance you intend to purchase. You will need to provide the
purchase price of the appliance during pre-registration.
3) Pre-register at www.broward.org/gogreen or call 954-357-REB8 (954-357-7328), Monday through Friday,
between 8:30 am to 5:00 pm, from September 7 to September 28, 2011, to obtain a Reservation Number.
Reservations and rebates will be dispersed on a first-come, first-served basis.
4) Complete a free Florida Power & Light (FPL) Business Energy Evaluation or call 1-877-748-4233 to schedule an
evaluation with a FPL representative or online at www.FPL.com. You may need to register with FPL for online
5) Purchase an eligible ENERGY STAR commercial-grade refrigerator or freezer on/after September 7, 2011.
Then, recycle/ dispose of the old appliance according to federal/state/local laws and regulations; make sure
the old appliance is not resold or put back into service.
6) Complete and sign the application form and gather the required documentation to include in your application
7) Mail the application packet to the address below. The application packet must be postmarked no later than
Friday, November 4, 2011 or your rebate reservation will be forfeited and made available to waiting list
Please allow 6-8 weeks after application deadline for the delivery of your
rebate check from Broward County.
ONLY COMPLETE AND ACCURATE APPLICATIONS WILL BE PROCESSED
Natural Resources Planning and Management Division
SEND FORMS TO ATTN: Energy Sense Appliance Rebate Program
115 S. Andrews Ave., Suite 329H
Fort Lauderdale, FL 33301
Call 954-357-REB8 (954-357-7328) with questions or inquires.
1. APPLICANT INFORMATION (Must match information on pre-registration form)
Business Name Owner/Principal First Name Last Name
Business Mailing Address City Zip Code
Business Phone # Cell Phone # Email Address
Reservation/Waiting List # NAICS Code OR Type of Business (describe)
BUSINESS APPLIANCE REBATE
2. APPLIANCE INFORMATION
Eligible Appliance Rebate Amount Check ONE box
ENERGY STAR commercial-grade Refrigerator* 20% of appliance cost up to a maximum of $1,000
ENERGY STAR commercial-grade Freezer* 20% of appliance cost up to a maximum of $1,000
Serial # (of new Appliance) Manufacturer/Brand Model Number
Purchase Price (without sales tax): Age of OLD Appliance
*A list of eligible USEPA ENERGY STAR Qualified Products may be found at www.energystar.gov. Purchase of an ineligible product will
result in disqualification for a rebate.
3. Additional Information (Please Check One)
A. My old appliance was disposed or recycled by/at: Retailer Landfill Other, please describe _____________
B. Did the Rebate Program influence your decision to purchase an Energy Star appliance? No Yes
C. My NEW refrigerator/freezer has a: Solid Door Glass Door
4. APPLICATION CHECK LIST (Include ALL items below with your COMPLETED application packet)
Completed Application Original Purchase Receipt Photocopy of most recent FPL utility bill
Photocopy of FPL Business Energy Evaluation (completed after April 30, 2011)
5. BUYER’S SIGNATURE
By signing this form, I certify that the information provided on this rebate application and in its supporting documents
is accurate, that I meet the eligibility requirements of the Broward County Business Appliance Rebate Program, and
that I have read, understand, and agree to comply with the program terms and conditions. I affirm that the new
appliance replaced an existing appliance which has been permanently taken out of service and been properly disposed.
Required Signature Date
Please retain a copy of the application packet for your records
BUSINESS APPLIANCE REBATE
TERMS AND CONDITION
1. Program Eligibility requested on the rebate application form,
To qualify for a rebate, the applicant must meet the including supporting documents. The purchaser
following criteria: must sign and date the application form.
Must be a legitimate small to medium- sized business Must pay sales tax on appliance purchased.
physically located in Broward County with a valid
Broward County address. Qualifying appliances must 2. Rebate Restrictions
be purchased and installed for business use in Limit one rebate per person and business.
Broward County. Small to medium sized businesses Rebates are limited to one appliance per rebate.
are defined as using less than 500 KWD as displayed Rebates are awarded on a first-come, first-served
on Florida Power & Light utility bill, with one of the basis.
following allowable rate code classifications By pre-registering for a rebate and receiving a
designations: General Service Non-Demand (GS-1), reservation confirmation, rebate funds are
General Service Demand (GSD-1), General Service reserved for the applicant.
Non-Demand Time of Use (GST-1), or General Service Rebates are not guaranteed and require full
Demand Time of Use (GSDT-1). Applicant must compliance of the governing rules to be issued. If
provide proof of business location to include a copy of each of the program requirements are not
the business’ most recent Florida Power & Light utility satisfied, the applicant gives up rights to the rebate
bill with the same business name and address as on and those rebate funds will no longer be available
the application. Post Office Boxes are ineligible. to the applicant. The rights to a rebate or a rebate
Must purchase a new ENERGY STAR commercial application may not be transferred or sold.
refrigerator or freezer based on the current list of Reservation Numbers expire if a valid and
eligible USEPA ENERGY STAR Qualified Products found complete submission of application packet is not
at www.energystar.gov. postmarked by November 4, 2011.
Must replace an existing appliance of the same type. Waiting list applicants will only receive rebates if
Must dispose/recycle the existing appliance according funds become available from unused reserved
to federal/state/local laws and regulations. The rebates or disqualified rebate applications.
existing appliance must not be resold or put back into Purchase of ineligible product will result in
service. Recycling methods for existing appliance is disqualification for a rebate.
available at www.broward.org/gogreen and click Original purchase receipt submitted with the
REBATE PROGRAMS. application must include: make and model of
Must be approved through a preregistration program, appliance; amount paid for appliance; date of
which opens September 7, and closes September 28, purchase; and retailer name where purchase was
2011 or until all rebate funds are reserved. made.
Must make the purchase of eligible products during Original purchase receipt must include a valid
the rebate offer period on or after September 7, model number for the applicable ENERGY STAR
Must install the appliance at the business listed on Based on purchase receipt, a maximum rebate will
the rebate application form, prior to submittal of the be awarded equal to but not greater than the
rebate application. amount requested on reservation form.
Must mail a complete rebate application to the Rebates will not be awarded for appliances
address specified on the rebate application form by purchased before the rebate offer period,
November 4, 2011(postmarked) in one mailing. September 7, 2011.
Application packets must include all information
BUSINESS APPLIANCE REBATE
TERMS & CONDITIONS
Rebates are subject to available funding. Due to appliance offered for sale or purchased, (2) services
grant requirements, all rebate monies and issues provided by a retailer, installer, contractor, hauler, or
must be expended/resolved by February 29, 2012. recycler.
Any unresolved issues after this date will be This program was prepared as an account of work
ineligible for rebates. sponsored by an agency of the United States
Purchase of products that are used, rebuilt, rented, Government. Neither the United States Government
leased, exchanged, won as a prize or purchased at nor any agency thereof, nor any of their employees,
auction or online auction are ineligible. nor any of their contractors, subcontractors or their
Rebate values vary based on price paid for product employess, makes any warranty, express or implied,
less discounts, and does not include: sales tax; or assumes any legal liability or responsibilty for the
auxiliary equipment purchases; or installation and accuracy, completeness, or third party’s use or the
delivery/freight charges. results of such of any information, apparatus,
product, or process disclosed, or represents that its
3. Public Records use would not infringe privately owned rights.
Under Florida law, information/documents submitted Reference herein to any specific commerical product,
by applicant will become public record and may be process, or serivce by trade name, trademark,
subject to public disclosure. manufacturer, or otherwise, does not necessarily
4. Verification of Installation constitute or imply its endorsement,
Application/purchase may be subject to visual recommendation, or favoring by the United States
inspection/verification of installation by Broward Government or any agency thereof or its contractors
County. The applicant must provide Broward County, or or subcontractors. The views and opinions of authors
agents of, with access to the business listed on rebate expressed herein do not necessarily state or reflect
application form based upon reasonable written those of the United States Government or any
notification. The County may deny or seek the return of agency thereof.
payment to an applicant that refuses to provide the Broward County is not responsible for: lost, late,
County with access to the business to verify appliance incomplete, damaged, misdirected, or postage due
installation. requests/mail; electronic transmission errors;
technical, network, telephone equipment, electronic,
5. Purchaser Compliance Responsibilities
computer, hardware or software malfunctions;
The applicant is responsible for compliance with all
limitations of any kind; inaccurate transmissions of
requirements of federal, state, county, and city
or failure to receive rebate submission on account of
governments. Tenants are responsible for obtaining the
technical problems or traffic congestion on the
property owner’s permission to install the purchased
internet or at any website; or any combination
appliance, if needed. Any fraudulent activities are a
violation of criminal and civil laws; Broward County
reserves the right to seek damages from rebate 8. Acknowledgement
applicant to the fullest extent of the law. Funding for the Energy Sense program is made
possible by an Energy Efficiency and Conservation
Block Grant through the American Recovery and
Broward County does not endorse any particular
Reinvestment Act.This material is based upon work
appliance, retailer, manufacturer, installer, contractor,
supported by the U.S. Department of Energy, Office
hauler, or recycler that provides products or services
of Energy Efficiency and Renewable Energy grant
related to the Broward County Appliance Rebate
agreement # DE-E000800 and the Florida Energy and
Climate Commission grant agreement # ARE010.
7. Disclaimer of Warranty & Limitation of Liability
Broward County makes no warranties, nor shall be
liable for damages regarding/related to: (1) the