New Equipment and Construction EC Motor Incentive NEC EC Motor Incentive Form 2018 Step 1 of 2 50% Section A: CUSTOMER INFORMATIONCustomer Name * Required First Last Facility Address * Required Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Is this the mailing address? * RequiredYesNoMailing Address * Required Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Electric Account Number * RequiredRate * RequiredApplication NumberService Location IdentificationEmail * Required Contact Person * Required First Last Title * RequiredPhone * RequiredIncorporated * RequiredYesNoExemptIncentive Payment Preference * RequiredCheckBill CreditPay ContractorPlease Assign Payment to ContractorCustomer SignatureAdditional InformationSection B: CONTRACTOR INFORMATIONContact Person * Required First Last Contact Title * RequiredContractor Name * RequiredContact Person SignatureMailing Address * Required Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email * Required Phone * RequiredAdditional InfoIncorporated * RequiredYesNoExemptSection C: DOCUMENT APPROVALSBy signing and dating below, customer accepts this Incentive offer and agrees to the Utility Terms and Conditions available from your Utility. Pursuant to a Commission order, customers also agree that the utility alone may capture all kW and kWh savings and any ISO-NE capacity payments resulting from this energy efficiency project. This agreement is contingent upon continued approval and authorization by the Commission to recover said amounts from the System Benefits Charge. The Incentive, in conjunction with all other sources of funding, cannot exceed the total project cost.Customer SignatureDate - must be mm/dd/yyyy format NE&C EC Motor Incentive WorksheetROW 1System Type * RequiredRefrigerationHVACFan Load * RequiredkW for Refrigeration/CFM for HVACEvap Fan Controls * RequiredYesNoAnnual Hours * RequiredQuantity of Motors * RequiredTotal IncentiveWould you like to submit another?YesNoROW 2System Type * RequiredRefrigerationHVACFan Load * RequiredkW for Refrigeration/CFM for HVACEvap Fan Controls * RequiredYesNoAnnual Hours * RequiredQuantity of Motors * RequiredTotal IncentiveWould you like to submit another?YesNoROW 3System Type * RequiredRefrigerationHVACFan Load * RequiredkW for Refrigeration/CFM for HVACEvap Fan Controls * RequiredYesNoAnnual Hours * RequiredQuantity of Motors * RequiredTotal IncentiveWould you like to submit another?YesNoROW 4System Type * RequiredRefrigerationHVACFan Load * RequiredkW for Refrigeration/CFM for HVACEvap Fan Controls * RequiredYesNoAnnual Hours * RequiredQuantity of Motors * RequiredTotal IncentiveWould you like to submit another?YesNoROW 5System Type * RequiredRefrigerationHVACFan Load * RequiredkW for Refrigeration/CFM for HVACEvap Fan Controls * RequiredYesNoAnnual Hours * RequiredQuantity of Motors * RequiredTotal IncentiveAttached Vendor quote * RequiredSection BreakMotor Grand TotalCAPTCHA