Application for the Con Edison 2017 Gas Conversion Incentive Program
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1 Application for the Con Edison 2017 Gas Conversion Incentive Program (for Service Addresses with 1-4 Residential Dwelling Units) 1 Date: Customer Name/Business Entity: Address: Con Edison Account Number: Telephone: City: State: Zip Code: Service Address: Number of residential dwelling units: Con Edison Gas Service Request # (Project Center Case #) Dear Con Edison Customer: Consolidated Edison Company of New York, Inc. ( Con Edison ) is pleased to inform you that as of March 1, 2017, eligible Con Edison customers, who have a service address with one (1) to four (4) residential dwelling units, and both convert to a natural gas-fired heating system and install eligible high-efficiency gasfired heating equipment, may be eligible to receive a conversion rebate of $2, To participate in this rebate program, Con Edison must be in receipt of this completed application (Application for the Con Edison 2017 Gas Conversion Incentive Program (for Service Addresses with 1-4 Residential Dwelling Units); and 2) meet and comply with the Eligibility Requirements and Other Terms and Conditions set forth below. For more information about this conversion program, please call (option #1). Converting customers, who install eligible equipment, may also participate in the Residential Gas Rebate Program. Visit coned.com/energyefficiency for further details on that incentive program. 1 Properties with more than four (4) residential dwelling units are not eligible to participate in this program. 2 This conversion rebate offer is limited to the first 250 customers who meet all the eligibility requirements and comply with all of the terms and conditions for the rebate (see pages 2-4).
2 ELIGIBILITY REQUIREMENTS AND OTHER TERMS AND CONDITIONS 1. You must be an existing Con Edison gas customer (other than a customer already heating with gas) for at least 1 year prior to participation in this Con Edison 2017 Gas Conversion Incentive Program, whose existing gas service at the Service Address is ruled service adequate by Con Edison for the total gas load, including for gas heating. 2. Oil must be the heating fuel currently used at the Service Address. 3. The only eligible equipment for this program is either a new gas-fired boiler or new gas-fired furnace, which meets a minimum efficiency of 82% for gas-fired steam heating equipment, a minimum efficiency of 85% for gas-fired hydronic heating equipment, and a minimum of 90% for gas-fired furnaces. a. If you are planning to install operable dual-fuel equipment or have the capacity to substitute another energy source for the output of the gas-burning equipment, you are not eligible for a rebate hereunder (e.g., conversion kits, gun replacement, burner replacement). 4. Con Edison must be in receipt of the following documentation by June 16, 2017: a. A copy of a completed and customer-signed Application for the Con Edison 2017 Gas Conversion Incentive Program (for Service Addresses with 1-4 Residential Dwelling Units) found at coned.com/gasconversions; b. A copy of the customer-signed contractor s proposal for the installation of qualifying high-efficiency gas-fired heating equipment; and c. A Gas Service Request received on or after January 1, 2017 by Con Edison online at coned.com/es (click Project Center). (Gas service requests received prior to January 1, 2017 will not be considered eligible for this rebate). We suggest that the application and contractor s proposal, referenced in a & b above, be sent to Con Edison Gas Customer Solutions by (Gasconversions@coned.com) and must be received by June 16, Customers can mail applications to the address below and these must also be received by Con Edison Gas Customer Solutions by June 16, However, Con Edison shall not be responsible for lost, late, illegible, or misdirected mail, and any required documents received after the deadline will not be considered. Therefore, we encourage you to confirm that we have received the required documents by ing (gasconversions@coned.com) or calling us at (option #1) and request an confirmation from us that we have received all required documents. Con Edison Gas Customer Solutions, Gas Conversion Group Re: Gas Conversion Incentive Program 4 Irving Place, 7 th floor - Box #4 New York, NY 10003
3 5. Eligible equipment must be installed, and Con Edison must be in receipt of the following on or before September 29, 2017: a. A completed Con Edison s 2017 Gas Conversion Incentive Program Equipment Affidavit (found on page 5 of this document); and b. A completed Con Edison Final Gas Checklist along with other required documentation for Con Edison to proceed with and complete its work in providing gas to the customer. The Final Gas Checklist is available at The completed Final Gas Checklist along with other required documentation must ed to OTG@coned.com with the associated gas service request # (MC-XXXXXX) or uploaded through Project Center to the gas service request number. In order to confirm our receipt, a copy of the completed Final Gas Checklist must be ed to us as well at gasconversions@coned.com. i. Customers with New York City Department of Buildings or applicable Municipality related issues may be granted an extension of the required Gas Checklist submission date until October 13, However, this extension request must be submitted, via , to gasconversions@coned.com and received by Con Edison prior to September 29, Approval of such request will be in Con Edison s sole discretion. No further extensions will be granted. Requests submitted after September 29, 2017 will not be considered. Final Gas Checklists and associated documentation submitted after September 29, 2017 or, if granted, after the extended deadline of October 13, 2017, will deem you ineligible for this conversion rebate. To confirm that your request has been received, please us and request written confirmation that your extension has been granted. 6. Eligible gas-fired equipment must be installed by a licensed contractor meeting all New York State and local municipality requirement. 3 All work to be performed by or on behalf of a customer applying for the rebates must be in compliance with all applicable federal, state and local laws, rules and regulations (including laws requiring the employment of licensed persons to perform such work) and all Con Edison requirements for gas service. You shall provide Con Edison, on a timely basis, with copies of all required governmental filings, permits, certificates of inspection and any other required documentation from the authorities having jurisdiction. 7. Eligible gas-fired heating equipment shall be installed at the Service Address by a licensed contractor meeting all New York State and local municipality requirements at customer s cost. Such equipment shall adequately meet all space-heating requirements for the Service Address and comply with all applicable laws and regulations related to its oil-to-gas conversion. 8. Con Edison will conduct a final inspection after all work has been completed and all necessary documentation has been received. If it is determined that you are eligible for the gas conversion rebate, please allow approximately six (6) to eight (8) weeks after such final inspection for receipt of the rebate. The rebate will be paid directly to customer. 9. You must be in good credit standing on all of your currently existing Con Edison accounts. 10. If you are a business entity, you must provide a federal Employer Identification Number in the space provided on this application and submit it to us ( is preferred) a completed and signed an IRS W-9 Form. For individuals applying for this rebate, please note that while we are not requesting your individuals Social Security numbers at this time; we may require that you provide it to us, prior to rebate issuance. You shall be responsible for all taxes that may be imposed with respect to the rebate. You may want to consult a tax adviser about any tax consequences of this offer. 3 Con Edison makes no promise warranty or representation regarding any work performed by such contractor. Con Edison shall not be responsible for such work or for the failure by a New York State licensed contractor to perform work.
4 11. Prior to issuance of the rebate, Con Edison or a Con Edison designated representative may perform an additional inspection to ensure that the installation of the high-efficiency equipment meets the eligibility requirements and terms and conditions of this program. 12. You will be eligible for the gas conversion rebate when, in Con Edison s sole discretion, you have complied with the requirements and terms and conditions hereof, you have contracted with a New York State licensed contractor for installation of gas-fired heating equipment, and you have met all legal and Con Edison requirements for gas heating equipment installation, as such requirements may be amended from time to time. You agree to reimburse Con Edison in an amount equal to the rebates received if the gas-fired heating equipment is not installed in accordance with all applicable federal, state and local laws, rules and regulations and Con Edison requirements for gas installation. We thank you in advance for your participation in our gas conversion incentive program. Very truly yours, CONSOLIDATED EDISON COMPANY OF NEW YORK, INC. CONFIRMED AND AGREED TO: Name of Customer (Print): Signature: Date: Business Federal Employer Tax ID (if applicable) (Must submit signed W-9 form): Customer s Address: Name of Participating Contractor performing work: Contractor s New York State License No.: Contractor s Phone Number: Contractor s Address:
5 CON EDISON S 2017 GAS CONVERSION INCENTIVE PROGRAM AFFIDAVIT To be completed and submitted to Con Edison s Gas Customer Solutions by September 29, Customer Name CUSTOMER INFORMATION Service Address City State Zip Code Phone Con Edison Gas Service Request # (Project Center Case #) CONTRACTOR INFORMATION Contractor Company/Name Contractor License # Contractor Address City State Zip Code Phone Address Please complete the following. Boiler Type Boiler (Furnace, Water, Install Date or Steam?) EQUIPMENT INSTALLED AFUE Boiler Manufacturer Model # Certified Reference # (See Below) * Serial # * To identify the Certified Reference number, go to To be completed by Customer: I have verified that the indicated boiler has been installed at the Service Address set forth above. Customer s Signature: Date: To be completed by NYS Licensed Contractor who installed boiler: The undersigned represents and warrants that the undersigned has installed required qualifying equipment as stated in the Application for the Con Edison 2017 Gas Conversion Incentive Program at the Customer s Service Address set forth above and that such installation is in compliance with all applicable federal, state, local laws and regulations and Con Edison requirements. Prior to issuance of the rebate, Con Edison or a Con Edison designated representative may perform an additional inspection to ensure that the installation of the high-efficiency equipment meets the eligibility requirements and terms and conditions of this program. Name of Contractor (Print): Contractor s Signature: Date:
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