Vectren Indiana 2018 Residential New Construction Program ...

Vectren Indiana 2018 Residential New Construction Program Application

Part 1--Builder Participation Form

Thank you for participating in Vectren Indiana's Residential New Construction Rebate Program! Refer to the information below to ensure you are eligible for program rebates and your application is complete. Please retain a copy of your completed application and all invoices for your records. Visit SaveEnergy to apply online and view complete terms and conditions.

Need Help? For assistance completing this application, call 1-866-240-8476 or email SaveEnergy@ to reach a Vectren Energy Efficiency Advisor.

What You Will Need

Home Builder information

H O W T O A P P LY F O R A R E B AT E

Step 1: Sign Up as a Participating Builder

Builder Information Builders only have to complete the Builder Participation Form one time. The form will remain on file for the entire program year.

You can send this form along with the Part 2 application paperwork for your first home rebate or send it ahead of time and we will be ready and waiting for your first application.

Builders must submit a completed W9 form prior to requesting rebates.

Step 2: Build an Energy-Efficient Home

HERS Certification The HERS rating must have been completed by a RESNET certified HERS rater. The Part 2 application must be postmarked within 90 calendar days of HERS certification.

Active Service The property must be serviced by Vectren Energy Delivery of Indiana, Inc. ("Vectren") under an active residential account.

Step 3: Submit Part 2 Paperwork

Double-check Information When you've finished a project, send us the home info and a copy of the HERS certificate. Qualifying Vectren Indiana homes with a HERS score of 63 or lower will receive a rebate.

Submit Application Submit the completed application and a copy of the HERS certificate within 90 calendar days of certification in one of the following ways:

Mail your application to: Vectren Energy Delivery of Indiana

ATTN: Rebates, P.O. Box 3552 Evansville, IN 47734-3552

Email your application to: INrebates@

If you choose to email your application, be sure to include a copy of the HERS certificate as an email attachment.

Fax your application to: 1-866-741-5584

1-866-240-8476 | SAVEENERGY

IN RESIDENTIAL NEW CONSTRUCTION REBATE APPLICATION 2018 1014497

Address of New Home

City

State ZIP

Email Address

Vectren Account Number (REQUIRED--as shown on your Vectren bill) HOME BUILDER INFORMATION

Home Builder / Contractor Information

Company Name

Phone NVuemcbtreern Indiana 20187 ResideAntltiearlnate Phone Number New Construction Rebate Application--Part 1

Service Type (REQUIRED--please ? type of service utilized by your home)

? Vectren Natural Gas Service + Vectren Electric Service ? Vectren Electric Service Only ? Vectren Natural Gas Service Only

Email Address

Contact Person

Phone Number

Alternate Phone Number

Address

City

State

ZIP

Federal Tax ID Number (TIN/EIN) or SSN

Federal Tax Classification

? Individual/Sole Proprietor ? Limited Liability

? Corporation ? Exempt

? Partnership ? Other

Mailing Information for Rebate Checks Payable to Home Builders

This information will be used to process payment when you check the "Home Builder/Contractor" box on page 2 of the Part 2 application.

Payable to:

Address

City

State

ZIP

Signature

I hereby certify that:

1) The information contained in this application is accurate and complete.

2) All rules of this incentive application have been followed.

3) I have read and understand the Terms and Conditions found at SaveEnergy. I agree to verification of equipment installation which may include a site inspection by a program or utility representative. I understand that I am not allowed to receive more than one residential new construction rebate incentive for this address from this program. I hereby agree to indemnify, hold harmless and release the utility and the program administrator from any actions or claims in regard to the installation, operation and disposal of equipment (and related materials) covered herein, including liability from any incidental or consequential damages.

Home Builder / Contractor Signature

Signature is required.

Date

1-866-240-8476 | SAVEENERGY

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Vectren Indiana 2018 Residential New Construction Program Application

Part 2--Home Information Form

Thank you for participating in Vectren Indiana's Residential New Construction Rebate Program! Refer to the information below to ensure you are eligible for program rebates and your application is complete. Please retain a copy of your completed application and all invoices for your records. Visit SaveEnergy to apply online and view complete terms and conditions.

Need Help? For assistance completing this application, call 1-866-240-8476 or email SaveEnergy@ to reach a Vectren Energy Efficiency Advisor.

What You Will Need

A copy of the Home Energy Rating System (HERS) certificate (please keep the original for your records)

Your Vectren account number

Part 1--Builder Participation Form

H O W T O A P P LY F O R A R E B AT E

Step 1: Determine Eligibility

Applicant The property must be serviced by Vectren Energy Delivery of Indiana, Inc. ("Vectren") under an active residential account.

New single-family homes, duplexes, and end-unit townhomes where only one wall is shared are eligible for rebates.

Only one account number can be submitted on an application. For additional account numbers, please complete a separate application.

Participation must occur between January 1, 2018 and December 31, 2018.

By requesting a Vectren Residential New Construction Program rebate, participants are not eligible for rebates on qualifying equipment through Vectren's Residential Rebate Program.

HERS certification--The HERS rating must have been completed by a RESNET certified HERS rater. The application must be postmarked within 90 calendar days of HERS certification.

Step 2: Complete Application & Attach Certificate

Complete Application Unless noted otherwise, all fields must be completed on the application to receive a rebate. Incomplete applications will not be processed.

Sign Application The application must be signed in the space provided on page 2 of the application to receive a rebate.

Attach HERS Certificate Ensure that you have attached a copy of the Home Energy Rating System (HERS) certificate to the application.

Step 3: Submit Paperwork

Double-check Information Make sure the information listed on the application is correct and that you have provided all required information and documentation. If you have not already submitted the Part 1 form, include that with your Part 2 paperwork.

Submit Application Submit the completed application and a copy of the HERS certificate within 90 calendar days of certification in one of the following ways:

Mail your application to: Vectren Energy Delivery of Indiana

ATTN: Rebates, P.O. Box 3552 Evansville, IN 47734-3552

Email your application to: INrebates@

If you choose to email your application, be sure to include a copy of the HERS certificate as an email attachment.

Fax your application to: 1-866-741-5584

1-866-240-8476 | SAVEENERGY

IN RESIDENTIAL NEW CONSTRUCTION REBATE APPLICATION 2018 1014497

Address of New Home Email Address

City

State ZIP

VVeecctrterennInInddiaiannaa22001817RReesisdidenentitailal NNeewwCCPoohnnossntrteuruNcctuitomionbnReRreebbaateteAAppppliclicaatitoion--n--PParaAtrltt2e2rnate Phone Number

VeCctUreSn TAcOcoMunEtRNuImINNbFeFrOO(RRREMMQUAAIRTTEIIDOO--NaNs shown on your Vectren bill)

New Home Address Information

HoWmhoeshBouuldildweerco/ntCacot nwitthraqcuetsotironIns?formaHtoiwondid you hear about the program?

C?omCpuasntoymNaemr/Ae ccount Holder ? Home Builder/Contractor

? Contractor ? Bill Insert ? Direct Mail ? Vectren Website ? Family/Friend ? Trade Ally Rep

Who will receive the rebate?

? Customer/Account Holder ? Home Builder/Contractor

Total Rebate Requested from page 3

$

Contact Person First Name of Account Holder (as shown on your Vectren bill)

Phone Number

Alternate Phone Number

Last Name of Account Holder (as shown on your Vectren bill)

Address Address of New Home

City

State

ZIP

City

State ZIP

Federal Tax ID Number (TIN/EIN) or SSN Email Address

Federal Tax Classification

?PhoInndeivNiduumable/Sr ole Proprietor ? Limited Liability

? CAoltrepronraatetioPnhone Nu?mPbearrtnership

? Exempt

? Other

MVeacitrleinnAgccIonufnot Nrmumabetiro(RnEQfUoIRrERD--easbsahotwen oCn yhouer Vcekctren bill)

Check Payable to: ? Customer/Account Holder ? Home Builder/Contractor

Payable to:

Home Builder / Contractor Information

CAdodmrpeassny Name

City

State

ZIP

Contact Person

Signature

Phone Number

Alternate Phone Number

AIdhdereressby certify that:

City

1) The information contained in this application is accurate and complete.

State

ZIP

2) All rules of this incentive application have been followed. F3e)deraIl hTaavxeIDreNaudmabnedr (uTnINde/ErsINta) nodr SthSeNTerms and Conditions found at vectrenF.ecdoemral/STaaxveCElansesirfgicya.tioI nagree to verification of equipment installation which

may include a site inspection by a program or utility representative. I unde?rsItnadnidvidthuaatl/ISaomle nPortoaplrlioewtoerd to ?recCeoivrepomraotrioenthan on?ePreasrtidneenrstihailpnew construction rebate incentive for this address from this program. I hereby?agLriemeitteodinLdiaebmilintyify, hold harmle?ssEaxnedmrpetlease the u?tilitOythaenrd the program administrator from any actions or claims in regard to the installation, operation and disposal of equipment (and related materials) covered herein,

MailiningcluIdninfogrlimabailittyiofrnomfoarnRy einbciadetentaCl ohreccoknsequential damages.

Check Payable to: ? Customer/Account Holder ? Home Builder/Contractor

PHaoyambeleBtou:ilder / Contractor Signature

Signature is required.

Date

Address

City

State

ZIP

Signature

I hereby certify that:

1) The information contained in this application is accurate and complete.

2) All rules of this incentive application have been followed.

3) I have read and understand the Terms and Conditions found at SaveEnergy. I agree to verification of equipment installation which may include a site inspection by a program or utility representative. I understand that I am not allowed to receive more than one residential new construction rebate incentive for this address from this program. I hereby agree to indemnify, hold harmless and release the utility and the program administrator from any actions or claims in regard to the installation, operation and disposal of equipment (and related materials) covered herein, including liability from any incidental or consequential damages.

Home Builder / Contractor Signature

Signature is required.

Date

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HERS INDEX SCORE INFORMATION

Vectren Indiana 20187 Residential New Construction Rebate Application--Part 2

The HERS rating must have been completed by a RESNET certified HERS rater.

Only one address/account number can be submitted on the application. Please complete a separate application for each address/account number.

Please the requested rebate. Please print legibly.

Home utilizing Vectren Natural Gas Service and Vectren Electric Service (Natural Gas Heat with Electric AC)

Required HERS Score

HERS Index Score Certification Date

Rebate

Gold Star:

HERS Index Score 63

$700

Platinum Star: HERS Index Score 60

$800

Home utilizing Only Vectren Electric Service (Electric Heated Home)

Required HERS Score

HERS Index Score Certification Date

Gold Star:

HERS Index Score 63

Platinum Star: HERS Index Score 60

Rebate $700 $800

Home utilizing Only Vectren Natural Gas Service (Natural Gas Heated Home)

Required HERS Score

HERS Index Score Certification Date

Gold Star:

HERS Index Score 63

Platinum Star: HERS Index Score 60

Rebate $350 $400

1-866-240-8476 | SAVEENERGY

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