ENERGY EFFICIENCY REBATES FOR BUSINESS

Helping You Save Money And Energy

Effective January 2012

Rebate Guide aNd applicatioN 20102012

IntroductIon
The Southern California Gas Company (SoCalGas) offers an array of Energy Efficiency Programs as part of our commitment to exceptional customer service. While this guide offers information on several ways SoCalGas can save you money and energy, it is focused on the Energy Efficiency Rebates for Business (EERB) program. The EERB program offers rebates on qualifying energy-efficient products and improvements for your business. It is just one of the energy-efficiency programs and services at SoCalGas designed to help businesses like yours save money and energy. This document will guide you through the easy application process. Carefully read the program requirements, qualified equipment requirements, and Terms and Conditions before purchase to determine eligibility requirements.

Who can apply?

Any commercial, industrial, or agricultural customer with an active, valid, and non-delinquent account can apply for a rebate under the EERB program. Whether youre a small business or a large industrial customer, we have rebates for you.

For more InFormatIon

Visit socalgas.com (search REBATES). You are encouraged to reserve funds by calling (800) 508-2348 before you purchase and install equipment. Questions? Call us toll-free at (800) GAS-2000 or email us at EERebatesforBusiness@socalgas.com.

table oF contents
Program Requirements ..............................................................3 Using a Licensed Contractor .....................................................3 Energy Efficiency Benchmarking .............................................3 Rebate Payment ...........................................................................3 Disclaimer ......................................................................................3 Qualified Equipment .................................................................. 4 Boilers....................................................................................... 4 Commercial (Non-Space Heating) Boiler....................... 4 Space Heating Boiler .......................................................... 4 Process Heating Boiler for Manufacturing.................... 4 Storage Water Heater ........................................................... 5 Instantaneous/Tankless Water Heater ............................. 5 Direct Contact Water Heater for Manufacturing ............ 5 Pool/Spa Heater ..................................................................... 5 Steam Trap .............................................................................. 5 Pipe Insulation ........................................................................ 6 Tank Insulation ....................................................................... 6 Residential High Efficiency Clothes Washers for Businesses ........................................................................ 6 Greenhouse Curtain ...............................................................7 Infrared Film for Greenhouses.............................................7 Commercial Cooking Equipment ........................................ 8 Customer Checklist .................................................................... 9 Glossary .......................................................................................10 Rebate Application ..................................................................... 11 Terms and Conditions ............................................................... 12

pRoGRam RequiRemeNts
General
Customers eligible for the Energy Efficiency Rebates for Business (EERB) program are defined as active, valid, and non-delinquent commercial, industrial, and agricultural accounts. The total rebate limit for the EERB program is $200,000 per customer, per year, including corporate (multiple) accounts.

For more information, visit socalgas.com (search CONSERVE ENERGY).

usiNG a liceNsed coNtRactoR

How well your Heating, Ventilating, and Air Conditioning (HVAC) system performs, and how much it costs to operate, depend in part on the proper installation of the system. Hiring a licensed contractor who obtains the required building permit and has knowledge of, and complies with, local codes, ordinances and the requirements of the Building Energy-Efficiency Standards (State Administrative Code, Title 24, Part 6) increases the likelihood that your system will be properly installed and will work efficiently, quietly, and safely.

equIpment requIrements
Equipment must meet the requirements as outlined in the following rebate guide. SoCalGas reserves the right to verify installation and deny payment for products that do not meet the requirements. All equipment must be new and within the same rating capacity of the equipment that was replaced. Used or rebuilt equipment is not eligible. Fuel switching (changing from electricity to gas) does not qualify. New equipment must replace older, less efficient equipment, with the exception of commercial cooking equipment. Commercial cooking equipment that does not replace old equipment may be eligible for either the EERB program or the Energy Efficiency Calculated Incentive Program (EECIP). For more information, visit socalgas.com (search INCENTIVES). Qualified equipment must be installed at the facility served by the SoCalGas account listed on the application and must be operational according to local building codes, ordinances, and/or manufacturers requirements. If you are not sure whether the equipment qualifies, please contact a SoCalGas representative at EERebatesforBusiness@socalgas.com. Equipment efficiency listed ratings from the California Energy Commission (CEC) and/or Gas Appliance Manufacturers Association (GAMA) prevail over all submitted technical documentation, unless otherwise approved.

eNeRGy efficieNcy beNchmaRkiNG

SoCalGas encourages customers to benchmark their facilitys energy usage by using the complimentary online ENERGY STAR Portfolio Manager benchmarking tool. Energy efficiency benchmarking is a method of comparing a facilitys level of energy efficiency with that of similar facilities nationwide. It allows building owners and managers to track and assess the energy performance of their buildings over time. Benchmarking is a key step in identifying opportunities to increase profitability by lowering energy and operating costs. For more information, visit socalgas.com (search BENCHMARKING).

Rebate paymeNt
Qualified customers with complete applications will receive their rebate payment within four to six (4-6) weeks (if verification is not necessary), provided that funding is still available or you have reserved funds. The precise rebate amount may be subject to subsequent adjustments by SoCalGas.

proGram lImItatIons
No rebates will be paid on new equipment that replaces equipment for which the customer has received a rebate from SoCalGas within the last five (5) years. Customers who have received rebates, incentives, or services for the same equipment from other utilities, states, or local programs funded by the Public Purpose Program Surcharge (PPPS) are not eligible. However, customers can apply for rebates from water agencies if the equipment qualifies for one. Residential dwellings such as single-family attached and detached homes, condominiums, or apartments do not qualify for rebates under this program but may under the Home Energy Efficiency Rebates Program. Some common areas of multi-family residential properties that are served under the GN-10 rate schedule may qualify for the EERB program.

disclaimeR
The selection, purchase, and ownership of equipment are the sole responsibility of the customer. SoCalGas makes no representation as to the safety, reliability, and/or efficiency of the equipment. SoCalGas makes no warranty, whether expressed or implied, including warranty of merchantability or fitness for any particular purpose, use, or application of the equipment. The 2010-2012 EERB program may be modified or terminated without prior notice. Visit the SoCalGas website at socalgas.com for program modifications and updates. Please see the EERB Policies and Procedures Customer Handbook for complete information and other applicable restrictions. For more information, visit socalgas.com (search BUSINESS REBATES CUSTOMER HANDBOOK).

qualified equipmeNt
Before you buy product(s), carefully read the specifications below.

boIlers:
Boiler rebates cannot exceed $25,000 per unit.

commercial (non-space heating) boiler

Equipment Non-Space Heating Boiler Input Rating 75 MBtuh Required Efficiency 84% Rebate Amount $0.50/MBtuh

space heating boiler

Equipment must be used for space heating to provide human comfort (as defined by CEC Titles 20 and 24 Standards). customers must verify, by checking the box on the signature page, that they have used a licensed contractor. Type of Boiler Large Steam Small Water Large Water Input Rating >300 MBtuh <300 MBtuh 300 MBtuh <2,000 MBtuh Required Efficiency Annual Fuel Utilization Efficiency (AFUE) 77% AFUE 82% Thermal Efficiency 84% Rebate Amount $0.25/MButh $0.25/MButh $0.25/MButh

process heating boiler for manufacturing (naIcs codes 31-33)

Manufacturing involves the mechanical or chemical transformation of materials or substances into a new product that is neither a structure nor any other fixed improvement. A flue gas analysis (FGA) measured under full load conditions is required to document combustion efficiency under full load conditions after the installation is complete. SoCalGas offers free FGAs; please call (800) GAS-2000 to set up an appointment. Process Boilers >2,000 MBtuh may participate in either the Energy Efficiency Rebates for Business program or the Energy Efficiency Calculated Incentive Program (EECIP). Equipment Boiler Combustion Efficiency 82% Rebate Amount $0.50/MBtuh

storaGe Water heater:

Storage Water Heater Size Small Large Input Rating 75 MBtuh >75 MBtuh Required Efficiency Energy Factor 0.62 Thermal Efficiency 82% Rebate Amount $2/MBtuh $2/MBtuh

Instantaneous/tankless Water heaters:

Large tankless water heater rebates cannot exceed $25,000 per unit. Water heaters must meet efficiency requirements based on size, as shown below. Large water heaters >2,000 Btuh are eligible for either the Energy Efficiency Rebates for Business program or the Energy Efficiency Calculated Incentive Program (EECIP). Tankless Water Heater Size Small Large Input Rating <200MBtuh 200 MBtuh Required Efficiency Energy Factor 0.63 Thermal Efficiency 82% Rebate Amount $2/MBtuh $0.50/MBtuh

dIrect contact Water heater For manuFacturInG (naIcs codes 31-33):

In direct contact water heater systems design, heat from a flame comes into direct contact with small droplets of cold water that run through a stainless steel heat exchange media. Droplets composed from this process come into direct contact with rising heat from the flame and as a result the water is heated directly. Equipment Direct Contact Water Heater Direct Contact Water Heater Input Rating 300 MBtuh >300 MBtuh Required Efficiency Annual Fuel Utilization Efficiency (AFUE) 88% Thermal Efficiency >90% Rebate Amount $2/MBtuh $2/MButh

pool/spa heater:
Must have an on/off switch and have no pilot light. Equipment Pool/Spa Heater Efficiency Requirement Thermal Efficiency 84% Rebate Amount $2/MBtuh

steam trap:
Customer may be asked to verify the location of the replaced steam trap(s) in steam loop. Equipment in service for a minimum of five (5) years is eligible. Must replace one-for one, existing-failed-open steam traps. Drycleaning businesses are not eligible for commercial steam trap rebates. Steam trap replacements for industrial customers (NAICS codes 31-33) do not qualify for a rebate under this program, but may qualify under SoCalGas Energy Efficiency Calculated Incentive Program (EECIP). Equipment Steam Trap Facility Hours of Operation >12 hours Rebate Amount $100/unit

pIpe InsulatIon:
Minimum qualifying pipe diameter is 1/2. A minimum of 1 of pipe insulation must be added to existing bare commercial or industrial steel or copper pipe. Replacing existing insulation is not eligible. The pipes must transfer hot water, low-pressure or high-pressure steam directly from gas-fired equipment. Acceptable types of insulation for hot water pipes include elastomeric foam rubber, polyethylene foam, UV-resistant polyethylene foam, and rigid polyurethane foam. Acceptable types of insulation for steam pipes include silicone foam rubber, melamine foam, rigid urethane-based foam, cellular glass, rigid fiberglass, and rigid mineral wool. Insulation required by Title 24 and OSHA or the replacement of damaged (existing) insulation is not eligible for a rebate. The manufacturers specification sheet must be submitted with the application. Insulation for straight pipes are eligible: insulation for elbows and valves between pipes is not eligible. Type of Pipe Hot Water Hot Water Steam <15 psig Steam <15 psig Steam 15 psig Steam 15 psig Pipe Size <1" 1" <1" 1" <1" 1" Rebate Amount $2/linear ft. $2/linear ft. $3/linear ft. $3/linear ft. $3/linear ft. $3/linear ft.

tank InsulatIon:
1 or 2 of fiber glass or foam insulation must be added to existing bare liquid storage or transfer tanks that are coupled to gas-fired commercial or industrial equipment that transfers heat to the liquid or solution. Replacing existing insulation is not eligible. Insulation required by Title 24 and OSHA or the replacement of damaged (existing) insulation is not eligible for a rebate. The manufacturers specification sheet must be submitted with the application. Insulation Thickness 1" 1" 2" 2" Tank Temperature Requirement Low temperature application: 120-170 degrees F solution High temperature application: 170-200 degrees F solution Low temperature application: 120-170 degrees F solution High temperature application: 170-200 degrees F solution Rebate Amount $2/square ft. $3/square ft. $3/square ft. $4/square ft.

resIdentIal hIGh eFFIcIency clothes Washers For busInesses:

Must be used in a business and not be coin operated. Must be Tier 2 or 3 and listed on Consortium for Energy Efficiency (CEE) website: cee1.org/com/cwsh/cwshspec.pdf. Equipment CEE Tier 2 CEE Tier 3 Efficiency Requirement Modified Energy Factor 2.2 Water Factor 4.5 Modified Energy Factor 2.4 Water Factor 4.0 Rebate Amount $35/unit $75/unit

Greenhouse curtaIn:
Curtain must be new or replace curtains that are at least five (5) years old. Curtain must be located so that the gas heat source provides hot air to a conditioned space bounded by the curtain. Must be designed by the manufacturer to be a heat curtain and the installation must have the ability to move the curtain automatically or manually into place. The total rebate cannot be more than the lesser of: $50,000 per account per year, or 50 percent of the accounts preceding 12-month gas consumption (therms) X $0.80 (average prorated if less than 12 months usage is available). Rebate amount cannot exceed the cost of purchasing and professionally installing curtains for the square footage of the greenhouse. Overhang and overlap curtain material cannot be included in the square footage calculation. All greenhouse curtain installations are inspected before the rebate application is approved. The manufacturers specification sheet must be submitted with the application. Equipment Greenhouse Curtain Energy Efficiency Requirement 40% Rebate $0.20/square ft.

InFrared FIlm (For Greenhouses):

Film must be a single sheet of infrared anti-condensate polyethylene plastic for heat retention in an existing, heated greenhouse. The manufacturers specification sheet must be submitted with the application. Equipment Infrared Film (for Greenhouses) Energy Efficiency Requirement Single sheet, minimum thickness of six mil Rebate $0.05/square ft.

commercIal cookInG equIpment

All cooking equipment eligible for the EERB program is based on the American Society for Testing and Materials (ASTM) standards listed on the Fishnick website: fishnick.com/saveenergy/rebates/. The Fishnick website is subject to change, please check for updates on eligible equipment. All gas equipment listed on the Fishnick website is qualified for the EERB program. Equipment Combination Oven Commercial Fryer Commercial Griddle Convection Oven Double-Rack Oven Large Conveyor Oven (25 wide) Large Vat Fryer Pressureless Steamer Required Efficiency Steam mode 38% and convection mode 44% 50% Heavy load cooking energy efficiency 38% 44% 50% 42% 50% 38% Idle Energy Rate Differs based on model, see Fishnick website Differs based on model, see Fishnick website 2,650 Btuh per ft2 of cooking surface 13,000 Btuh Differs based on model, see Fishnick website 57,000 Btuh Differs based on model, see Fishnick website Differs based on model, see Fishnick website Rebate Amount $750/oven $500/vat $125/unit $500/oven $2,000/oven $750/oven deck $500/vat $2,000/unit

customeR checklist
You are encouraged to reserve funds by calling (800) 508-2348 before you purchase and install equipment. Payment will be delayed if applications are incomplete. Before submitting your application, make sure you have completed the following:

section 1 account Information

Did you provide the following?

attached documents
Did you provide/attach the following?

q Copy of paid itemized invoice that clearly indicates zero

balance or that it has been paid in full. Invoices should clearly state the cost of the equipment, installation, and tax. If your invoice is not itemized, please contact your vendor for the breakdown.

q SoCalGas account number q Taxpayer ID or Social Security Number q Customer name, as it appears on your SoCalGas bill q Installation and mailing address q Contact information q Checks marks on the boxes that apply

q Product manufacturer specification sheet, or a print out

from the Fishnick website verifying that the foodservice equipment qualifies for a rebate. Submit the completed application form and other required documentation with proof of purchase(s) by mail, fax, or email:

section 2 rebate equipment Information

Did you provide the following?

q Installation date (must be before application is signed) q Manufacturer name, model number, and serial number
(if applicable)

q Equipment type, quantity, input rating (if applicable),

rebate per unit, and rebate total. Please use pages 4-8 of this rebate guide for the correct rebate amount.

southern california Gas company attn: c/I energy efficiency rebates for business boX 513249 ml 28h2 los angeles, ca 90051 Fax: 213-244-8252 email: eerebatesforbusiness@socalgas.com
q Kept a copy of the completed application form
and all required documentation, such as receipts, and invoices for my records. For more information, visit socalgas.com (search REBATES) or email us at EERebatesforBusiness@socalgas.com.

q For insulation, note whether you purchased it for pipes

or tanks, hot water or steam, and size.

section 3 person & place to receive check

Did you provide the following?

q Person authorizing payment. q Signature of person authorizing payment. q Payees name and address. q Payee tax status & ID number
If you are releasing your rebate check to a vendor, they must have a signed agreement with SoCalGas.

section 4 customer signature

q Checked box confirming the use of a licensed contractor
for space heating boiler rebates.

q Accepted the Terms and Conditions

by dating and signing.

eeRb Guide GlossaRy

aFue - annual Fuel utilization efficiency- The AFUE is a measure of annual efficiency of boilers and furnaces. It takes into account the cyclic on/off operation and associated energy losses of the heating unit as it responds to changes in the load. california energy commission (cec)- The CEC is the states primary energy policy and planning agency. california public utilities commission (cpuc)- The CPUC regulates privately owned electric, natural gas, telecommunications, water, railroad, rail transit, and passenger transportation companies. energy efficiency benchmarking- Benchmarking is a method of comparing a facilitys level of energy efficiency with that of similar facilities nationwide. energy efficiency calculated Incentive program (eecIp)- EECIP is a SoCalGas program for business customers that offers financial incentives and recognition awards for a variety of qualifying energy-efficiency improvements not covered by the Energy Efficiency Rebates for Business (EERB) Program. The incentive payment for qualifying projects amounts to the following (whichever is less), subject to caps of $1 million per project and $2 million per premise per year: $1.00 per therm saved annually, or 50 percent of the project cost (excluding taxes and internal labor). energy efficiency rebates for business (eerb) program- EERB is a SoCalGas program that gives rebates to business customers who buy qualifying energy-efficient gas equipment and improvements. energy Factor- The energy factor is an efficiency rating for water heaters. It is the ratio of useful energy output to the total amount of energy used. Flue Gas analysis (FGa)- FGA measures the fuel/air ratio and combustion pollutants in the flue gases of combustion equipment. It is used for optimizing combustion efficiency. Idle energy rate- An appliances idle energy rate is its rate of energy consumption while it is holding or maintaining a stabilized operating condition or temperature. Input rating- The input rating measures the gas-burning capacity of an appliance in Btu per hour as specified by the manufacturer. mbtu- Thousand British thermal units mbtuh- Thousand British thermal units per hour psig- Pounds per square inch, a unit of measure for pressure thermal efficiency- Thermal efficiency is an energy-efficiency measure of combustion equipment. For boilers it is the percentage of energy consumed that converts to heat for the water or steam.

2011 Southern California Gas Company. All copyright and trademark rights reserved.

N1140016 1111

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2010-2012 ENERGY EFFICIENCY REBATE APPLICATION

Helping You Save Money And Energy
Effective January 2012

sectioN 1 accouNt iNfoRmatioN

x____x____x____x____x____x____x____x____x____x____x ____________________________________

x____x____x____x____x____x____x____x____x____x____x Reservation Number (optional)

SoCalGas Account Number

Facility Square Footage

1. 2. 3. 4. 5.

Tax Status: q Corporation q Partnership q Individual/Sole Proprietor q Exempt (Tax exempt, non-profit) Tax ID Number: q EIN q Federal Tax ID q SSN_________________________
x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x

For uTIlITy uSe oNly Product Code Quantity

Name as it Appears on Your SoCalGas Bill

x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x

Address Where Item(s) Installed City State

Unit/Suite Number Zip

x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x

Commercial Industrial Agricultural AE Name: ____________________ Employee ID: _________________ CST/IST Name: ________________ Employee ID: _________________ Assistance Provided:___________ ______________________________ ______________________________ NAICS Code: __________________ Rate Schedule: ________________ For cuSToMer proGraMS: Customer BP#:________________ Date Received: ________________ Total Cost of Equipment (w/o labor, tax, or shipping): _____________________________

x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x

Mailing Address (If different from installation address)

x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x

City Contact Name

x____x____x____x - x____x____x____x - x____x____x____x____x

State Contact Title

x____x____x____x - x____x____x____x - x____x____x____x____x

Zip

x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x

Contact Telephone Number E-Mail Address

Fax Number

x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x

pleaSe check all ThaT apply q Primary language spoken is other than English q Lease building q Less than 10 employees q Received a SoCalGas Energy Analysis
sectioN 2 Rebate equipmeNt iNfoRmatioN

Not all equipment qualifies. Please refer to the requirements listed on pages 4-8.
IInstall Date
(mm/day/yr)

Equipment Type
Water Heater Pipe Insulation <1" hot water

Manufacturer
Smiths Co. Jones Co.

Model #
L-K4-OS N/A

(if applicable)

Serial #

Input Rating Quantity

(if applicable)

Rebate/Unit
$2/MBtuh =

Rebate Total
$380

5/27/11 6/1/11

6300056 N/A

190MBtuh N/A

1. 2. 3. 4. 5.
Submit the completed application form and other required documentation with proof of purchase(s) by mail, fax, or email: Southern california Gas company Fax: 213-244-8252 attn: c/I energy efficiency rebates for business email: eerebatesforbusiness@socalgas.com boX 513249 Ml 28h2 los angeles, ca 90051

* 3,238 ft. *
1

$2/ln. ft. = $6476

ToTal rebaTe Due:

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sectioN 3 peRsoN & place to Receive check

THE REBATE CHECK SHOULD GO TO THE PARTY NAMED BELOW. I UNDERSTAND THAT I WILL NOT BE RECEIVING THE REBATE CHECK FROM SOCALGAS, IF MY BUSINESS IS NOT NAMED BELOW. I ALSO UNDERSTAND THAT MY RELEASE OF THE PAYMENT TO ANOTHER PARTY DOES NOT EXEMPT ME FROM PROGRAM REQUIREMENTS. x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x

/
Signature of Authorized Date

Authorized By (please print) Checks should be made payable and sent to: Payee Business Name/Individual Payee Mailing Address

x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x

x____x____x____x - x____x____x____x - x____x____x____x____x

Telephone Number State

x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x____x

City

Zip

payee Tax Status: q Corporation q Partnership q Individual/Sole Proprietor q Exempt (Tax exempt, non-profit) payee Tax ID Number: q EIN q Federal Tax ID q SSN _________________________________________________________ IrS Tax reporting: SoCalGas will report this payment made to another party on IRS form 1099 as Other Income to you (the customer receiving the benefit of the EERB rebate payment) unless the payment is less than $600, or you have identified yourself as a corporation or exempt. SoCalGas is not responsible for any taxes that may be imposed on you as a result of this incentive/rebate.

customer of SocalGas. I understand that this program may be modified or terminated without prior notice. I understand that this rebate form and the paid itemized invoice must be As a qualified SoCalGas customer, I certify that I purchased and received at SoCalGass Central Processing Center or postmarked no later installed the indicated energy saving products between January 1, than December 31, 2012. I acknowledge that I would not have undertaken 2010 and December 31, 2012 for use in my business facility and not for an energy-efficiency equipment upgrade at this time if SoCalGas had not resale. I have attached documents establishing paid proof of purchase offered a monetary rebate. for the items applied for on this rebate form. In the event that I choose to participate in the On-Bill Financing Program I will allow, if requested, a representative from SoCalGas, the (OBF) offered by SoCalGas to obtain financing for the products listed on California Public Utilities Commission (CPUC), or any authorized third this form, I understand that the OBF terms and conditions will control party reasonable access to my property to verify the installed product (including, without limitation, the rebate amount for the products listed before a rebate is paid. I understand that a rebate will not be paid if here) if there is any conflict between the EERB terms and conditions and OBF. I refuse to participate in any required verification. I understand that In no case will the utility pay more than 100% of the actual SoCalGas may contact the qualifying product vendor and/or installer purchase price of the items to be rebated or the maximum to verify purchase and/or installation and may provide my name and/ allowance per unit. purchase price includes materials cost plus or address to complete this verification. installation labor for pipe insulation, tank insulation, greenhouse Additionally, I understand that this project may be selected for heat curtain, greenhouse infrared film, and steam traps. labor evaluation studies and/or program measurement by external charges apply to vendors only. customers who self-install may contractors appointed by the CPUC. These studies are used to not charge installation labor. Sales taxes and freight (shipping) analyze and improve program performance. I agree to participate by are not included in the items purchase prices. responding to inquiries from these external contractors. This program has a limited budget. If no reservation has been made, I certify that the information on this rebate form is true and correct, rebate forms will be accepted on a first-come, first-served basis, until and that the tax ID provided is accurate. I understand that rebate allocated funds are no longer available, or by December 31, 2012. payments are based on related energy benefits over the life of the I agree that I have not received rebates, incentives, or services for the product. I agree to: same equipment from other utilities, states, or local programs funded by n Provide SoCalGas with 100% of the related energy benefits the Public Purpose Program Surcharge (PPPS). However, I understand that specified in the rebate form for the life of the product or water utilities are not funded by the PPPS and I may apply for their rebates. for a period of five (5) years from receipt of rebate, whichever I understand rebates are taxable, if greater than $600 for business is less, and customers, and will be reported to the IRS on Form 1099 unless I have n Continue to be a customer of SoCalGas during said time period. identified myself as a corporation or exempt. I am urged to consult my tax If the above ceases to be the case, I shall refund a prorated advisor concerning the taxability of rebates. SoCalGas is not responsible amount of rebate dollars to SocalGas based on the actual period for any taxes that may be imposed on me or my business as a result of of time for which I provided the related energy benefits as a receipt of this rebate. I have read and understand the program requirements and terms and conditions set forth in this rebate form and I agree to abide by those requirements. Furthermore, I concur that I must meet all eligibility criteria in order to be paid under this program. sectioN 4 customeR siGNatuRe
teRms aNd coNditioNs

q by checking this box, I confirm that I have used a licensed contractor, as appropriate, and followed applicable permitting requirements for this installation. / Customer Signature (please sign in blue or black ink) Customer Name (please print) Date /

For more information, visit socalgas.com (search REBATES).

pleaSe Make a copy oF ThIS DocuMeNT For your recorDS
This program is funded by California utility customers and administered by the states investor-owned utilities, under the auspices of the California Public Utilities Commission. 2011 Southern California Gas Company. All copyright and trademark rights reserved. E Printed on recycled paper, 30% post-consumer waste, with soy-based ink. 9047 REV 8/2011 N1140016 1111

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