Testing the NEC HVAC

MEMBER INFORMATION

Electric Account Number

Member Name *

First Last

Facility Address

Street Address Address Line 2 City State ZIP Code

Is this the mailing address?

Yes
No

Mailing Address

Street Address Address Line 2 City State ZIP Code

Rate

Application Number

Member's Email

Enter Email Confirm Email

Contact Person

First Last

Title

Phone

Incorporated

Yes
No
Exempt

Incentive Payment Preference

Check
Bill Credit
Pay Contractor

Please Assign Payment to Contractor

Member Signature

Additional Information

Member Signature

By signing and dating, member 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.

Accept Terms & Conditons?

Yes
No

CONTRACTOR INFORMATION

Contact Person

First Last

Contact's Title

Contractor Name

Contact Person's Signature

Mailing Address

Street Address Address Line 2 City State ZIP Code

Email

Enter Email Confirm Email

Phone

Additional Info

Incorporated?

Yes
No
Exempt

INCENTIVE

Manufacturer / Model Number

Quantity (D) *

Unit Type

I. Tons for Unitary AC & Split Sys

Tons are LESS than 5.4
Tons are GREATER THAN OR EQUAL TO 5.4 but LESS THAN 11.25
Tons are GREATER THAN OR EQUAL TO 11.25 but less than 20
Tons are GREATER THAN OR EQUAL TO 20 but less than 63
Tons are GREATER THAN OR EQUAL TO 63

New Condenser and New Coil

I. Unit Size (tons) (A) *

How many tons?

I. BTUH for less than 5.4 tons

BTUH is less than 65,000 Split System
BTUH is less than 65,000 Packaged System

Please choose the correct answer

I. BTUH for EQUAL TO OR GREATER THAN 5.4 tons but LESS THAN 11.25

BTUH is EQUAL TO OR GREATER THAN 65,000 but LESS THAN 135,000
BTUH is less than 65,000
BTUH is GREATER THAN 135,000

Please choose the correct answer

I. BTUH for 11.25 to 20 tons

BTUH is EQUAL TO OR GREATER THAN 135,000 but less than 240,000
BTUH is less than 135,000
BTUH is greater than 240,000

Please choose the correct answer

I. Min Efficiency - Split System

EQUAL TO OR GREATER THAN 14.0 SEER but LESS THAN 15.0 SEER
EQUAL TO OR GREATER THAN 12.0 EER but LESS THAN 12.5 EER
LESS THAN 14.0 SEER
LESS THAN 12.0 EER
EQUAL TO OR GREATER THAN 15.0 SEER
EQUAL TO OR GREATER THAN 12.5 SEER

I. BTUH for 20 TO 63

BTUH is EQUAL TO OR GREATER THAN 240,000 but less than 760,000
BTUH is less than 240,000
BTUH is greater than 760,000

Please choose the correct answer

I. BTUH for EQUAL TO OR GREATER THAN 63

BTUH is EQUAL TO OR GREATER THAN 760,000
BTUH is less than 760,000

Please choose the correct answer

I. Min Efficiency - Packaged System

EQUAL TO OR GREATER THAN 14.0 SEER but LESS THAN 15.0 SEER
EQUAL TO OR GREATER THAN 11.6 EER but LESS THAN 12.0 EER
LESS THAN 14.0 SEER
LESS THAN 11.6 EER
EQUAL TO OR GREATER THAN 15.0 SEER
EQUAL TO OR GREATER THAN 12.0 EER

I. Min Efficiency - 11.5 EER and 12.3

EQUAL TO OR GREATER THAN 11.5 EER and 12.3 IEER
EQUAL TO OR GREATER THAN 12.0 EER and 13.0 IEER

I. Min Efficiency - 10.3 eer AND 11.1 IEER

EQUAL TO OR GREATER THAN 10.3 EER and 11.1 IEER
EQUAL TO OR GREATER THAN 10.6 EER and 12.1 IEER

I. Min Efficiency - 65,000-135,000

EQUAL TO OR GREATER THAN 11.5 EER and 12.8 IEER but LESS THAN 12.0 EER and 13.8 IEER
LESS THAN 11.5 EER and 12.8 IEER
EQUAL TO OR GREATER THAN 12.0 EER and 13.8 IEER

I. Min Efficiency - 10.2 EER and 11.4 IEER

EQUAL TO OR GREATER THAN 10.2 EER and 11.4 IEER

I. Incentive $30 (C)

Please enter a value between 30 and 30.

I. Total Estimated Incentive (E) @ $30

I. Incentive $70 (C) *

Please enter a value between 70 and 70.

I. Total Estimated Incentive (E) @ $70

I. Incentive $125 (C) *

Please enter a value between 125 and 125.

I. Total Estimated Incentive (E) @ $125

I. Incentive $50 (C) *

Please enter a value between 50 and 50.

I. Total Estimated Incentive (E) @ $50

I. Incentive $80 (C) *

Please enter a value between 80 and 80.

I. Total Estimated Incentive (E) @ $80

II. Tons for Air to Air Heat Pump Systems

Tons are LESS than 5.4
Tons are GREATER THAN OR EQUAL TO 5.4 but LESS THAN 11.25
Tons are GREATER THAN OR EQUAL TO 11.25 but less than 20
Tons are GREATER THAN OR EQUAL TO 20

II. Unit Size (tons) (A) *

How many tons?

II. BTUH for less than 5.4 tons

BTUH is less than 65,000 Ductless Split System
BTUH is less than 65,000 Split System
BTUH is less than 65,000 Packaged System

Please choose the correct answer

II. BTUH for GREATER THAN OR EQUAL TO 5.4 but LESS THAN 11.25

BTUH is GREATER THAN or EQUAL to 65,000 but LESS THAN 135,000
BTUH is LESS THAN 135,000
BTUH is GREATER THAN 135,000

II. BTUH for GREATER THAN OR EQUAL TO 20

BTUH is GREATER THAN or EQUAL to 20,000
BTUH is LESS THAN 20,000

II. BTUH for GREATER THAN OR EQUAL TO 11.25 but LESS THAN 20

BTUH is GREATER THAN or EQUAL TO 135,000 but LESS THAN 240,000
BTUH is LESS THAN 135,000
BTUH is GREATER THAN 240,000

II. Min. Eff. for 5.4 to 11.25

The unit efficiency is GREATER THAN or EQUAL TO 11.1 EER and 3.4 COP but less than 12.0 EER and 3.4 COP
Thu unit efficiency is less than 11.1 EER and 3.4 COP
The unit efficiency is GREATER THAN or EQUAL TO 12.0 EER and 3.4 COP

II. Min Efficiency - Split System

EQUAL TO OR GREATER THAN 14.0 SEER and 8.5 HSPF but LESS THAN 15.0 SEER and 9.0 HSPF
LESS THAN 14.0 SEER and 8.5 HSPF
GREATER THAN 15.0 SEER and 9.0 HSPF

II. Min Efficiency - Package System

EQUAL TO OR GREATER THAN 14.0 SEER and 8.0 HSPF but LESS THAN 15.0 SEER and 8.5 HSPF
LESS THAN 14.0 and 8.0 HSPF
GREATER THAN 15.0 SEER and 8.5 HSPF

II. Min. Eff. for 11.25 to 20

The unit efficiency is GREATER THAN or EQUAL TO 11.5 EER and 3.2 COP but less than 12.0 EER and 3.2 COP
Thu unit efficiency is less than 11.1 EER and 3.2 COP
The unit efficiency is GREATER THAN or EQUAL TO 12.0 EER and 3.2 COP

II. Min. Eff. for 20

The unit efficiency is GREATER THAN or EQUAL TO 10.5 EER and 3.2 COP but less than 10.8 EER and 3.2 COP
The unit efficiency is less than 10.8 EER and 3.2 COP
The unit efficiency is GREATER THAN or EQUAL TO 10.8 EER and 3.2 COP

II. Min. Efficiency - Air to Air

The unit efficiency is GREATER THAN OR EQUAL TO 20.0 SEER and 9.6 HSPF BUT LESS THAN 25.0 SEER and 12.0 HSPF
The unit efficiency is LESS THAN 20.0 SEER and 9.6 HSPF
The unit efficiency is GREATER THAN OR EQUAL TO 25.0 SEER and 12.0 HSPF

II. Incentive $30 (C)

Please enter a value between 30 and 30.

II. Incentive $50 (C)

Please enter a value between 50 and 50.

II. Incentive $80 (C)

Please enter a value between 80 and 80.

II. Incentive $70 (C) *

Please enter a value between 70 and 70.

II. Total Estimated Incentive (E) @ $30

II. Incentive $125 (C) *

Please enter a value between 125 and 125.

II. Incentive $200 (C) *

Please enter a value between 200 and 200.

II. Incentive $300 (C) *

Please enter a value between 300 and 300.

II. Total Estimated Incentive (E) @ $50

II. Total Estimated Incentive (E) @ $70

II. Total Estimated Incentive (E) @ $80

II. Total Estimated Incentive (E) @ $125

II. Total Estimated Incentive (E) @ $200

II. Total Estimated Incentive (E) @ $300

III. Water Source Heat Pumps

Tons are LESS THAN OR EQUAL TO 11.25
Tons are GREATER THAN 11.25

Choose the correct statement

III. Unit Size (tons) (A) *

Please enter a value between 0 and 11.25.

How many tons?

III. BTUH for Water Source Heat Pumps

BTUH is LESS THAN OR EQUAL TO 135,000
BTUH is GREATER THAN 135,000

Choose the correct statement

III. Min. Efficiency - Water Source Heat Pumps

The Unit Efficiency is EQUAL TO OR GREATER THAN 14.0 EER and 4.6 COP
The Unit Efficiency is LESS THAN 14.0 EER and 4.6 COP

Choose the correct statement

III. Incentive @ $80 (C)

Please enter a value between 80 and 80.

III. Total Estimated Incentive (E)

IV. Tons for Ground Water - Open Loop

Tons are LESS THAN OR EQUAL TO 11.25
Tons are GREATER THAN 11.25

Choose the correct statement

IV. BTUH for Ground Water - Open Loop

BTUH is LESS THAN OR EQUAL TO 135,000
BTUH is GREATER THAN 135,000

Choose the correct statement

IV. Min. Efficiency - Ground Water - Open Loop

The Unit Efficiency is EQUAL TO OR GREATER THAN 18.0 EER and 4.0 COP
The Unit Efficiency is LESS THAN 18.0 EER and 4.0 COP

Choose the correct statement

IV. Unit Size (tons) (A) *

Please enter a value between 0 and 11.25.

How many tons?

IV. Incentive @ $150 (C) *

Please enter a value between 150 and 150.

IV. Total Estimated Incentive (E)

V. Tons for Ground Water - Closed Loop

Tons are LESS THAN OR EQUAL TO 11.25
Tons are GREATER THAN 11.25

Choose the correct statement

V. BTUH for Ground Water - Closed Loop

BTUH is LESS THAN OR EQUAL TO 135,000
BTUH is GREATER THAN 135,000

Choose the correct statement

V. Min. Efficiency - Ground Water - Closed Loop

The Unit Efficiency is EQUAL TO OR GREATER THAN 15.0 EER and 3.2 COP
The Unit Efficiency is LESS THAN 15.0 EER and 3.2 COP

Choose the correct statement

V. Unit Size (tons) (A) *

Please enter a value between 0 and 11.25.

How many tons?

V. Incentive $150 (C) *

Please enter a value between 150 and 150.

Sorry, based on your selections it does not qualify for an incentive.

Does the proposal include either of these energy saving control options? *

Yes - Dual Enthalpy Economizer
Yes - Demand Control Ventilation
No

When installed with new & qualifying Tier 1 or 2 equipment.

What Quantity?

Estimated Incentive for Dual Enthalpy

Estimated Incentive for Demand Control Ventilation

V. Total Estimated Incentive (E)

CAPTCHA

Testing the NEC HVAC

2018 NEC HVAC Incentive Form

MEMBER INFORMATION

CONTRACTOR INFORMATION

INCENTIVE

DOCUMENT APPROVALS

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