Single Family Dwelling and RowTownhouse

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					Power Smart New Home Rebate
Application Form
Single Family Dwelling and Row/Townhouse
Complete and sign before mailing along with copies of relevant receipts/invoices as proof of payment.
Mail to: BC Hydro Power Smart New Home Program, 900-4555 Kingsway, Burnaby, B.C. V5H 4T8
                                                                Company Information
Please print clearly

Company name ________________________________________ Contact name _________________________________
                                                                                                                       Last                         First

Company address ____________________________________________________________________________________
                                                                Street                                       City                                Postal code

Mailing address (if different from above) _________________________________________________________________
                                                                Street                                       City                                Postal code

Company phone __________________ Company fax ___________________ Email ______________________________

Company GST number __________________ Date building permit issued ______________________________

                                                             Development Information
Please print clearly

Development name (if applicable) _______________________________________________________________________

Development address _________________________________________________________________________________
                                                                Street                                       City                               Postal code

Total number of units being constructed ______________
Unit types (check boxes): J Detached home                           J Duplex            J Row/Townhouse
Primary Heating type (check boxes): J Natural gas                         J Electric        J Other (specify) ____________________________

Total Rebate Request: $________________________

                                                                 Terms and Conditions

1.   To be eligible for a rebate, I understand that the residence(s) must be a new residential premise constructed in the BC Hydro service area. The residence(s)
     located at the address stated in the Development Information portion above is eligible for incentives.
2.   I understand that the building permit must have been issued on or after June 1, 2006 to be eligible for EnerGuide (EG) rating rebates. Customers with
     building permits issued on or after September 5, 2008 are subject to different qualifying conditions and rebate amounts than those with permits issued between
     June 1, 2006 and September 4, 2008. I understand that tenders for products covered by this program must be let after June 1, 2006.
3.   I understand that I must supply BC Hydro a copy of the EG label, and copies of the clear, legible, original sales receipt(s) and/or invoice summary that
     clearly indicate make, model and any other required information about the product purchase in order to allow confirmation that the product purchase
     meets program criteria.
     I understand that all products installed in the developments must meet qualifications defined by BC Hydro. ENERGY STAR® labelled products must be
     listed on the NRCan website: http://www.energystar.gc.ca
4.                                                                .
     I understand that BC Hydro has the right to inspect the home to verify the installed products before a rebate is paid, and will allow, if requested, a
     BC Hydro representative reasonable access to the home. I understand that a rebate will not be paid if the inspection is refused.
5.   I understand the selection, purchase, installation and ownership/maintenance of the products and measures listed in the rebate application are not the
     responsibility of BC Hydro and that the supplier/installer of these products is not affiliated with BC Hydro.
     IT IS UNDERSTOOD THAT BC HYDRO MAKES NO WARRANTY WHETHER EXPRESSED OR IMPLIED, OF ANY PRODUCTS OR MEASURES THAT
     HAVE BEEN COMPLETED, INSTALLED OR CLAIMED FOR A REBATE. BC Hydro has no liability concerning (1) the quality, safety, and/or installation of
     the products or measures, (2) the estimated energy savings of the products or measures, (3) the workmanship of any third parties, (4) the installation or
     use of the products or measures.
6.   I understand that the ratings and products approved for rebates cannot be combined with any other BC Hydro Power Smart offer or promotion.
7.   I understand the terms of this program are to be determined by BC Hydro and may be modified or terminated without prior notice.


A06-260c May 2009                                                                                                                                   Over
Power Smart New Home Program
Rebate Application Form

Complete and sign before mailing along with copies of relevant receipts/invoices as proof of payment.
Mail to: BC Hydro Power Smart New Home Program, 900-4555 Kingsway, Burnaby, B.C. V5H 4T8

Total number of units on this application ___________________________ EG rating (if applicable) ___________________

  ENERGY STAR Rebates (select one package)                                     Products Installed
                                                                              ENERGY STAR Lighting
J $150 ENERGY STAR package
                                                                              Make: _______________ Model: __________________
ENERGY STAR fridge, dishwasher, 40 per cent compact
fluorescent lighting, ventilation fan                                          ENERGY STAR Ventilation Fan
                                                                              Make: _______________ Model: __________________
OR
                                                                              ENERGY STAR Appliances (Refrigerator)
J $200 full ENERGY STAR package                                               Make: _______________ Model: __________________
ENERGY STAR fridge, dishwasher, 40 per cent compact                           ENERGY STAR Appliances (Dishwasher)
fluorescent lighting, ventilation fan and clothes washer
                                                                              Make: _______________ Model: __________________
All ENERGY STAR labelled products are listed at                               ENERGY STAR Appliances (Clothes washer)
www.energystar.gc.ca
                                                                              Make: _______________ Model: __________________

  EG Rating Rebates                                                            Products Installed

J $400 EG 80 rating or higher –                                               Must include ENERGY STAR fridge, dishwasher,
  Single Family Dwelling                                                      ventilation fan and 40 per cent compact
    (not available in City of Vancouver where EG rating 80 is                 fluorescent lighting.
    mandated by City bylaws)


J $200 EG rating 80 or higher –                                               Must include ENERGY STAR fridge, dishwasher,
  Row/Townhouse/Duplex                                                        ventilation fan and 40 per cent compact
    (EG rating rebate available in City of Vancouver for row housing and      fluorescent lighting.
    townhouses, but NOT duplexes where mandated by City bylaws)

                                                                   Total Rebate

     $ ________________ Per unit                        x ______________ Total units                       = $ _____________ Total rebate




Declaration: I have read and understand the above terms and conditions. I certify that the information I have provided is true and correct and the
product(s) for which I am requesting a rebate meets the requirements listed on the rebate form. I have enclosed copies of invoices of all product
installation work, and/or EnerGuide file numbers.



X _______________________________________________________________________________________________________________________________

                     Signature                             Name of authorized signatory (print)                        Date (mm/dd/yy)



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A06-260c May 2009