Testing the NEC HVAC 2018 NEC HVAC Incentive Form MEMBER INFORMATIONElectric Account NumberMember Name * Required First Last Facility Address 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?YesNoMailing Address 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 RateApplication NumberMember's Email Enter Email Confirm Email Contact Person First Last TitlePhoneIncorporatedYesNoExemptIncentive Payment PreferenceCheckBill CreditPay ContractorPlease Assign Payment to ContractorMember SignatureAdditional InformationMember SignatureBy 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?YesNoCONTRACTOR INFORMATIONContact Person First Last Contact's TitleContractor NameContact Person's SignatureMailing Address 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 Enter Email Confirm Email PhoneAdditional InfoIncorporated?YesNoExemptINCENTIVEBuilding TypeHospitalOfficeRetail StoreSchoolManufacturer / Model NumberQuantity (D) * RequiredUnit TypePlease select oneI. Unitary AC and Split System (new condenser and new coil)II. Air to Air Heat Pump SystemsIII. Water Source Heat PumpsIV. Ground Water - Water Source Heat Pump Equipment (Open Loop)V. Ground Water - Water Source Heat Pump Equipment (Closed Loop)I. Tons for Unitary AC & Split SysTons are LESS than 5.4Tons are GREATER THAN OR EQUAL TO 5.4 but LESS THAN 11.25Tons are GREATER THAN OR EQUAL TO 11.25 but less than 20Tons are GREATER THAN OR EQUAL TO 20 but less than 63Tons are GREATER THAN OR EQUAL TO 63New Condenser and New CoilI. Unit Size (tons) (A) * RequiredHow many tons?I. BTUH for less than 5.4 tonsBTUH is less than 65,000 Split SystemBTUH is less than 65,000 Packaged SystemPlease choose the correct answerI. BTUH for EQUAL TO OR GREATER THAN 5.4 tons but LESS THAN 11.25BTUH is EQUAL TO OR GREATER THAN 65,000 but LESS THAN 135,000BTUH is less than 65,000BTUH is GREATER THAN 135,000Please choose the correct answerI. BTUH for 11.25 to 20 tonsBTUH is EQUAL TO OR GREATER THAN 135,000 but less than 240,000BTUH is less than 135,000BTUH is greater than 240,000Please choose the correct answerI. Min Efficiency - Split SystemEQUAL TO OR GREATER THAN 14.0 SEER but LESS THAN 15.0 SEEREQUAL TO OR GREATER THAN 12.0 EER but LESS THAN 12.5 EERLESS THAN 14.0 SEERLESS THAN 12.0 EEREQUAL TO OR GREATER THAN 15.0 SEEREQUAL TO OR GREATER THAN 12.5 SEERI. BTUH for 20 TO 63BTUH is EQUAL TO OR GREATER THAN 240,000 but less than 760,000BTUH is less than 240,000BTUH is greater than 760,000Please choose the correct answerI. BTUH for EQUAL TO OR GREATER THAN 63BTUH is EQUAL TO OR GREATER THAN 760,000BTUH is less than 760,000Please choose the correct answerI. Min Efficiency - Packaged SystemEQUAL TO OR GREATER THAN 14.0 SEER but LESS THAN 15.0 SEEREQUAL TO OR GREATER THAN 11.6 EER but LESS THAN 12.0 EERLESS THAN 14.0 SEERLESS THAN 11.6 EEREQUAL TO OR GREATER THAN 15.0 SEEREQUAL TO OR GREATER THAN 12.0 EERI. Min Efficiency - 11.5 EER and 12.3EQUAL TO OR GREATER THAN 11.5 EER and 12.3 IEEREQUAL TO OR GREATER THAN 12.0 EER and 13.0 IEERI. Min Efficiency - 10.3 eer AND 11.1 IEEREQUAL TO OR GREATER THAN 10.3 EER and 11.1 IEEREQUAL TO OR GREATER THAN 10.6 EER and 12.1 IEERI. Min Efficiency - 65,000-135,000EQUAL TO OR GREATER THAN 11.5 EER and 12.8 IEER but LESS THAN 12.0 EER and 13.8 IEERLESS THAN 11.5 EER and 12.8 IEEREQUAL TO OR GREATER THAN 12.0 EER and 13.8 IEERI. Min Efficiency - 10.2 EER and 11.4 IEEREQUAL TO OR GREATER THAN 10.2 EER and 11.4 IEERI. Incentive $30 (C)Please enter a number from 30 to 30.I. Total Estimated Incentive (E) @ $30I. Incentive $70 (C) * RequiredPlease enter a number from 70 to 70.I. Total Estimated Incentive (E) @ $70I. Incentive $125 (C) * RequiredPlease enter a number from 125 to 125.I. Total Estimated Incentive (E) @ $125I. Incentive $50 (C) * RequiredPlease enter a number from 50 to 50.I. Total Estimated Incentive (E) @ $50I. Incentive $80 (C) * RequiredPlease enter a number from 80 to 80.I. Total Estimated Incentive (E) @ $80II. Tons for Air to Air Heat Pump SystemsTons are LESS than 5.4Tons are GREATER THAN OR EQUAL TO 5.4 but LESS THAN 11.25Tons are GREATER THAN OR EQUAL TO 11.25 but less than 20Tons are GREATER THAN OR EQUAL TO 20II. Unit Size (tons) (A) * RequiredHow many tons?II. BTUH for less than 5.4 tonsBTUH is less than 65,000 Ductless Split SystemBTUH is less than 65,000 Split SystemBTUH is less than 65,000 Packaged SystemPlease choose the correct answerII. BTUH for GREATER THAN OR EQUAL TO 5.4 but LESS THAN 11.25BTUH is GREATER THAN or EQUAL to 65,000 but LESS THAN 135,000BTUH is LESS THAN 135,000BTUH is GREATER THAN 135,000II. BTUH for GREATER THAN OR EQUAL TO 20BTUH is GREATER THAN or EQUAL to 20,000BTUH is LESS THAN 20,000II. BTUH for GREATER THAN OR EQUAL TO 11.25 but LESS THAN 20BTUH is GREATER THAN or EQUAL TO 135,000 but LESS THAN 240,000BTUH is LESS THAN 135,000BTUH is GREATER THAN 240,000II. Min. Eff. for 5.4 to 11.25The unit efficiency is GREATER THAN or EQUAL TO 11.1 EER and 3.4 COP but less than 12.0 EER and 3.4 COPThu unit efficiency is less than 11.1 EER and 3.4 COPThe unit efficiency is GREATER THAN or EQUAL TO 12.0 EER and 3.4 COPII. Min Efficiency - Split SystemEQUAL TO OR GREATER THAN 14.0 SEER and 8.5 HSPF but LESS THAN 15.0 SEER and 9.0 HSPFLESS THAN 14.0 SEER and 8.5 HSPFGREATER THAN 15.0 SEER and 9.0 HSPFII. Min Efficiency - Package SystemEQUAL TO OR GREATER THAN 14.0 SEER and 8.0 HSPF but LESS THAN 15.0 SEER and 8.5 HSPFLESS THAN 14.0 and 8.0 HSPFGREATER THAN 15.0 SEER and 8.5 HSPFII. Min. Eff. for 11.25 to 20The unit efficiency is GREATER THAN or EQUAL TO 11.5 EER and 3.2 COP but less than 12.0 EER and 3.2 COPThu unit efficiency is less than 11.1 EER and 3.2 COPThe unit efficiency is GREATER THAN or EQUAL TO 12.0 EER and 3.2 COPII. Min. Eff. for 20The unit efficiency is GREATER THAN or EQUAL TO 10.5 EER and 3.2 COP but less than 10.8 EER and 3.2 COPThe unit efficiency is less than 10.8 EER and 3.2 COPThe unit efficiency is GREATER THAN or EQUAL TO 10.8 EER and 3.2 COPII. Min. Efficiency - Air to AirThe unit efficiency is GREATER THAN OR EQUAL TO 20.0 SEER and 9.6 HSPF BUT LESS THAN 25.0 SEER and 12.0 HSPFThe unit efficiency is LESS THAN 20.0 SEER and 9.6 HSPFThe unit efficiency is GREATER THAN OR EQUAL TO 25.0 SEER and 12.0 HSPFII. Incentive $30 (C)Please enter a number from 30 to 30.II. Incentive $50 (C)Please enter a number from 50 to 50.II. Incentive $80 (C)Please enter a number from 80 to 80.II. Incentive $70 (C) * RequiredPlease enter a number from 70 to 70.II. Total Estimated Incentive (E) @ $30II. Incentive $125 (C) * RequiredPlease enter a number from 125 to 125.II. Incentive $200 (C) * RequiredPlease enter a number from 200 to 200.II. Incentive $300 (C) * RequiredPlease enter a number from 300 to 300.II. Total Estimated Incentive (E) @ $50II. Total Estimated Incentive (E) @ $70II. Total Estimated Incentive (E) @ $80II. Total Estimated Incentive (E) @ $125II. Total Estimated Incentive (E) @ $200II. Total Estimated Incentive (E) @ $300III. Water Source Heat PumpsTons are LESS THAN OR EQUAL TO 11.25Tons are GREATER THAN 11.25Choose the correct statementIII. Unit Size (tons) (A) * RequiredPlease enter a number from 0 to 11.25.How many tons?III. BTUH for Water Source Heat PumpsBTUH is LESS THAN OR EQUAL TO 135,000BTUH is GREATER THAN 135,000Choose the correct statementIII. Min. Efficiency - Water Source Heat PumpsThe Unit Efficiency is EQUAL TO OR GREATER THAN 14.0 EER and 4.6 COPThe Unit Efficiency is LESS THAN 14.0 EER and 4.6 COPChoose the correct statementIII. Incentive @ $80 (C)Please enter a number from 80 to 80.III. Total Estimated Incentive (E)IV. Tons for Ground Water - Open LoopTons are LESS THAN OR EQUAL TO 11.25Tons are GREATER THAN 11.25Choose the correct statementIV. BTUH for Ground Water - Open LoopBTUH is LESS THAN OR EQUAL TO 135,000BTUH is GREATER THAN 135,000Choose the correct statementIV. Min. Efficiency - Ground Water - Open LoopThe Unit Efficiency is EQUAL TO OR GREATER THAN 18.0 EER and 4.0 COPThe Unit Efficiency is LESS THAN 18.0 EER and 4.0 COPChoose the correct statementIV. Unit Size (tons) (A) * RequiredPlease enter a number from 0 to 11.25.How many tons?IV. Incentive @ $150 (C) * RequiredPlease enter a number from 150 to 150.IV. Total Estimated Incentive (E)V. Tons for Ground Water - Closed LoopTons are LESS THAN OR EQUAL TO 11.25Tons are GREATER THAN 11.25Choose the correct statementV. BTUH for Ground Water - Closed LoopBTUH is LESS THAN OR EQUAL TO 135,000BTUH is GREATER THAN 135,000Choose the correct statementV. Min. Efficiency - Ground Water - Closed LoopThe Unit Efficiency is EQUAL TO OR GREATER THAN 15.0 EER and 3.2 COPThe Unit Efficiency is LESS THAN 15.0 EER and 3.2 COPChoose the correct statementV. Unit Size (tons) (A) * RequiredPlease enter a number from 0 to 11.25.How many tons?V. Incentive $150 (C) * RequiredPlease enter a number from 150 to 150.Sorry, based on your selections it does not qualify for an incentive.Does the proposal include either of these energy saving control options? * RequiredYes - Dual Enthalpy EconomizerYes - Demand Control VentilationNoWhen installed with new & qualifying Tier 1 or 2 equipment.What Quantity?Estimated Incentive for Dual EnthalpyEstimated Incentive for Demand Control VentilationV. Total Estimated Incentive (E)CAPTCHADOCUMENT APPROVALS Resources Program Terms & Conditions 2018 NEC HVAC Incentive Instructions