APPLICATION FORM Under the Future Energy Jobs Act, ComEd retail customers taking service under the provisions of Rider POGCS Parallel Operation of Retail Customer Generating Facilities Community Supply (CS), or such retail customers assignee, are eligible to apply for a rebate. This rebate offer is also available to nonresidential retail customers taking service under Rider POGNM - Parallel Operation of Retail Customer Generating Facilities with Net Metering, or such nonresidential retail customers assignee. Please follow the steps below to ensure eligibility to receive a rebate from the ComEd Renewable Energy Distributed Generation Rebate Program. How to Apply 1. Verify eligibility Ensure your project meets the eligibility requirements as stated in the terms and conditions section of this form. Eligible renewable generating facilities installed after June 1, 2017, must be interconnected to the Company s distribution system by means of a smart inverter (see the California Energy Commission list of approved smart inverters at GoSolarCalifornia.org/equipment/inverters.php) Eligible renewable generating facilities with a nameplate or rated capacity of no more than 2,000 kw measured as nominal AC power output of such project. For a CS Beneficiary or CS Subscriber taking service under Rider POGCS, check with the CS Project developer/owner/operator to determine rebate eligibility. (NOTE: a rebate may have already been provided to the developer/owner/operator of the CS Project.) 2. Install equipment (Net Metering or Community Supply Project) For Rider POGNM qualified projects, install the eligible renewable generating facilities equipment in accordance with ComEd s interconnection requirements and the Illinois Administrative Codes. For Rider POGCS qualified community supply projects, install the eligible renewable generating facilities equipment in accordance with ComEd s interconnection requirements and the Illinois Administrative Codes. 3. Complete application Visit ComEd.com/DGRebate to apply online or to download the PDF application. 4. Submit application Submit your completed application, material invoices, specification sheets, and W-9. 5. Receive incentive payment ComEd will pay a rebate within 60 days of receipt of all required paperwork for a qualifying installation. Applications should be submitted by ONE of the following methods We strongly recommend completing the application process online, as ComEd is making an effort to reduce paper use and streamline the application process. However, printable, mailable options are available. Email: ComEd.DGRebate@dnvgl.com (10MB file size limit; submit multiple emails if necessary) Mail: ComEd DG Rebate, 700 Commerce Drive, Suite 330, Oak Brook, IL 60523 Questions? Email: ComEd.DGRebate@dnvgl.com or call 833-688-7730 1
APPLICATION FORM Directions: Please save a copy of this form to your computer by selecting File/Save As before entering text and numbers. Then fill in your information electronically and select Save. Note that this form requires Adobe Reader version 11.0 to function properly. Download the most recent version of Adobe Acrobat Reader DC at http://get.adobe.com/reader. Pre-Approval Application (OPTIONAL) Final Application ESTIMATED PROJECT COST TOTAL PROJECT COST TOTAL INCENTIVE REQUESTED (TOTAL FROM PAGE 4 WORKSHEET) TOTAL INCENTIVE REQUESTED (TOTAL FROM PAGE 4 WORKSHEET) ESTIMATED COMPLETION DATE ACTUAL COMPLETION DATE Application Checklist Pre-approval is optional. If the installation has been completed, please skip to FINAL checklist. PRE FINAL ATTACH THE FOLLOWING (Incomplete applications will not be processed and applicants will be notified) 1. Completed application checklist (page 2 of this application) 2. Completed applicant and contractor information (page 3 of this application) N/A 3. Dated and itemized invoices listing the type and quantity of installed equipment, including final invoices 4. Specification sheets for all proposed / installed equipment 5. Rebate worksheet (page 4 of this application) N/A N/A 6. Customer W-9 form; third party W-9 form (if applicable) 7. Third party payment authorization (page 5 of this application, if applicable) Project Type (select one) Non-Residential Net Metering Customer (skip to Customer Information, page 3) Community Supply Project Developer (skip to Customer Information, page 3) Community Supply Subscriber/Beneficiary COMMUNITY SUPPLY SUBSCRIBER/BENEFICIARY ONLY PROJECT NAME (REQUIRED) EFFECTIVE DATE OF COMMUNITY SUPPLY SUBSCRIPTION TOTAL kw SUBSCRIBED Please fill in the Customer Information section at the top of page 3. This will complete your application as a CS Subscriber/Beneficiary. 2
CUSTOMER INFORMATION APPLICANT INFORMATION CUSTOMER NAME TAXPAYER ID: FEIN (NOTE: MUST ATTACH W-9 FORM, REV OCT 2018) ComEd ACCOUNT NUMBER NAME AS IT APPEARS ON YOUR ENERGY BILL CUSTOMER CONTACT NAME TITLE EMAIL PHONE ADDRESS WHERE MEASURES INSTALLED CITY STATE ZIP MAILING ADDRESS, IF DIFFERENT THAN ABOVE CITY STATE ZIP CONTRACTOR INFORMATION (Primary point of contact for your project) CONTRACTING COMPANY CONTACT NAME TITLE EMAIL PHONE ADDRESS CITY STATE ZIP 3
Energy Generation Source WORKSHEET Non-residential Net Metering and Community Supply customers are eligible for a $250/kW rebate on qualified distributed generation installations. Please see the Terms and Conditions for further details regarding eligibility and qualified equipment. * Specification sheets required for all model numbers listed below. Product / Type Model Number * DC Rating (kw) Qty Rebate (kw x Qty x $250) TOTAL REBATE $ Smart Inverter Information (required if installed after June 1, 2017) Manufacturer Model Number AC Rating (max 2000 kw) Voltage Qty Customer Signature Required at Pre-Application and Final Application I certify that the information provided in this application is true and correct. I have read and understand the program requirements and terms and conditions set forth in this application and agree to abide by these requirements. I verify by my signature hereto that I have authority to submit this application. ComEd CUSTOMER AUTHORIZED SIGNATURE SIGNATURE TITLE AND/OR RELATIONSHIP TO COMPANY PRINTED NAME DATE 4
OPTIONAL THIRD-PARTY PAYMENT AUTHORIZATION Payment Preference ComEd offers the option to assign your project s rebate payment to a third party. Please complete the third party payment authorization and submit it with your final application if you are interested in this option. OPTIONAL THIRD PARTY PAYMENT AUTHORIZATION (Please skip if check will be made payable to ComEd customer) COMPANY NAME TAXPAYER ID: FEIN (NOTE: MUST ATTACH W-9 FORM, REV NOV 2017) TAX STATUS (CHECK ONE) Individual / Sole Proprietor Partnership LLC Corporation Exempt CONTACT NAME EMAIL PHONE MAILING ADDRESS CITY STATE ZIP Customer Signature Required When Assigning Rebate to a Third Party I am authorizing the payment of the rebate to the third party named below and I understand that I will not be receiving the rebate payment from ComEd. I also understand that my release of the payment to a third party does not exempt me from the program requirements outlines in the measure specifications and terms and conditions. ComEd CUSTOMER AUTHORIZED SIGNATURE SIGNATURE TITLE AND/OR RELATIONSHIP TO COMPANY PRINTED NAME DATE 5
TERMS AND CONDITIONS The Rider DG REBATE Renewable Energy Distributed Generation Rebate ( Rider DG REBATE ) program, offers qualifying retail customers a $250 rebate per kilowatt ( kw ) of nameplate generating capacity for an eligible project. The DG Rebate Program serves ComEd s non-residential customers that take service under the provisions of ComEd s Rider POGNM - Parallel Operation of Retail Customer Generating Facilities with Net Metering. The DG Rebate Program is also available to retail customers taking service under Rider POGCS Parallel Operation of Retail Customer Generating Facilities Community Supply as a CS Project, CS Beneficiary or CS Subscriber. Service under the DG Rebate Program is not restricted to retail customers that obtain electric power and energy supply from ComEd. Residential customers taking service under POGCS as a CS Subscriber or CS Beneficiary are not eligible for the DG Rebate Program if the CS Project owner or operator collected the rebate amount for the CS Project in whole. Residential customers taking service under POGCS as a CS Subscriber or CS Beneficiary are not eligible for the DG Rebate Program if the CS Project owner or operator collected the rebate amount for the CS Project in whole. Check with your CS Project administrator regarding your Rider DG Rebate eligibility prior to submitting this application. Additional Rider DG Rebate program qualification information regarding the size, location, and renewable generation requirements can be found in the Terms & Conditions of this DG Rebate Application Form. A qualified distributed generation facility includes; For a retail customer taking service under Rider POGNM - the retail customer must own or operate solar, wind, or other electric generating facilities powered by solar electric energy, wind, dedicated crops grown for electricity generation, agricultural residues, untreated and unadulterated wood waste, landscape trimmings, livestock manure, anaerobic digestion of livestock or food processing waste, fuel cells or microturbines powered by renewable fuels, or hydroelectric energy, provided such generating facilities;. (a) have a total rated capacity that does not exceed 2,000 kw,. (b) are located on the retail customer s premises, and. (c) are intended to offset the retail customer s electric power and energy requirements. For a retail customer taking service under Rider POGCS a retail customer that owns or operates a renewable generating facility;. (a) with a nameplate or rated capacity that does not exceed 2,000 kilowatts (kws),. (b) that is located in the Company s service territory and interconnected to the Company s distribution system under rules adopted by the Illinois Commerce Commission (ICC), and. (c) is powered by solar energy, wind, dedicated crops grown for electricity generation, agricultural residues, untreated and unadulterated wood waste, landscape trimmings, livestock manure, anaerobic digestion of livestock or food processing waste, fuel cells or microturbines powered by renewable fuels, or hydroelectric energy, provided such hydroelectric energy does not involve construction or significant expansion of hydropower dams. Retail customers who begin taking service under Rider POGNM or Rider POGCS after June 1, 2017 must have a smart inverter associated with the distributed generation facility in order to be eligible for a rebate. Nonresidential retail customers taking service under Rider POGNM prior to June 1, 2017 must be interconnected to ComEd s distribution service. Such retail customers are not required to have a smart inverter installed to qualify for the rebate. A retail customer taking service under Rider POGCS that is a CS Beneficiary, CS Project or a CS Subscriber, as those terms are defined in the Definitions section of the rider, are eligible for a DG Rebate as follows; a CS Beneficiary is a retail customer, residential or nonresidential, that has an interest in the electric power and energy produced by a CS Project that is not a community renewable generation project, as defined in Section 1-10 of the Illinois Power Agency (IPA) Act, with such interest expressed as a portion of the total nameplate or rated capacity of the CS Project and sized primarily to offset part or all of such retail customer s electric power and energy requirements. NOTE: Such CS Beneficiary is NOT eligible for a DG Rebate whenever the owner or operator of the CS Project that the CS Beneficiary has an interest in previously applied for and received a DG Rebate for the CS Project. a CS Project is a renewable generating facility that is a nonresidential retail customer that includes. (a) properties owned or leased by multiple retail customers that contribute to the operation of a renewable generating facility through an ownership or leasehold interest of at least 200 watts in such facility, such as a 6
TERMS AND CONDITIONS community-owned wind project, a community-owned biomass project, a community owned solar project, or a community methane digester processing livestock waste from multiple sources, provided that the facility is also located within the utility s service territory;. (b) individual units, apartments, or properties located in a single building that are owned or leased by multiple retail customers and collectively served by a common renewable generating facility, such as an office or apartment building, a shopping center or strip mall served by photovoltaic panels on the roof; or. (c) a community renewable generation project as defined in Section 1-10 of the IPA Act. a CS Subscriber is a retail customer, residential or nonresidential, that has an interest in the electric power and energy produced by a CS Project that is a community renewable generation project, as defined in Section 1-10 of the IPA Act, with such interest expressed as a portion of total nameplate or rated capacity of the CS Project and sized primarily to offset part or all of such retail customer s electric power and energy requirements. NOTE: Such CS Subscriber is NOT eligible for a DG Rebate whenever the owner or operator of the CS Project that the CS Subscriber has an interest in previously applied for and received a DG Rebate for the CS Project. Equipment must be installed in compliance with state codes. You must be a current ComEd delivery service customer. Commonwealth Edison Company (ComEd) is offering a distributed generation rebate (DG Rebate) under the ComEd RIDER DG REBATE tariff in accordance with the provisions of the Public Utilities Act, Section 16-106.7. The DG Rebate is available to: 1) nonresidential retail customers taking service under ComEd s net metering tariff, Rider POGNM Parallel Operation of Retail Customer Generating Facilities with Net Metering, or 2) retail customers taking service as a Community Supply (CS) Project, CS Beneficiary or a CS Subscriber under ComEd s Community Supply tariff, Rider POGCS - Parallel Operation of Retail Customer Generating Facilities Community Supply. NOTE: CS Beneficiary and CS Subscriber customers may not be eligible for the DG Rebate under circumstances where the CS Project they have entered into an agreement with has already received the DG Rebate. Check with your CS Project administrator regarding your DG Rebate eligibility prior to submitting this application. Service is not restricted to retail customers that obtain electric power and energy supply from ComEd. Retail customers obtaining electric power and energy supply from alternative retail electric suppliers are also eligible. The DG Rebate is not available to residential retail customers receiving net metering service under ComEd s Rider POGNM. The applicant warrants that it 1) has not assigned any rights associated with the rebate and 2) has the right to allow the Company to operate and control and Smart Inverter(s) associated with such distributed electric renewable generating facility for purposes of contributing to grid support during excursions from normal operating conditions, including, but not limited to, voltage and frequency, operating conditions utilizing the Smart Inverter functionality and conforming to the requirements in the DG Rebate Required Smart Inverter Settings Informational Sheets of the Company s Schedule of Rates, as applicable. PROGRAM EFFECTIVE DATES DG Rebates are offered in accordance with ComEd s tariffs, RIDER DG REBATE RENEWABLE ENERGY and RIDER DG REBATE ADJUSTMENT RENEWABLE ENERGY ADJUSTMENT. The effective date of the DG Rebate is December 12, 2018 and will continue to be available as provided for in RIDER DG REBATE. In the event of a conflict between the tariffs and the information provided herein, the tariffs prevail. PROGRAM AND PROJECT ELIGIBILITY Project requirements under the ComEd DG Rebate program include the following: Equipment must be installed in a property owned by the applicant, or the applicant must receive permission from the property owner to install the equipment. Submission of an application indicates that the tenant has obtained this permission. PARTICIPATION RELEASE If receiving a DG Rebate from ComEd, the customer authorizes the release of any application data, including customer name and address, to any contractor or other vendor providing services or support under this program. 7
TERMS AND CONDITIONS APPLICATION PROCESS Completed and customer-signed applications must be accompanied by an itemized contractor invoice(s) or proof of purchase receipt(s), which contains all of the required information as listed on page 1 of the application. Failure to complete the rebate application in full and provide the required supporting documentation will either delay the payment process or result in the application being denied. INSTANT REBATE REQUIREMENTS If the customer is releasing payment of the rebate to the installing contractor for an instant rebate, the contractor must submit a customer-signed copy of the customer job order/invoice showing the full and correct rebate amount deducted from the total purchase price and labeled as a ComEd rebate. It is the installing contractor s sole responsibility to verify customer, equipment and installation eligibility prior to providing an instant rebate. Contractor assumes all liability by providing the instant rebate. LANDLORD APPLICATION REQUIREMENTS A landlord with a tenant who holds the property s ComEd account may receive a DG Rebate payment for a qualifying installation paid for by the landlord and completed in a property owned by the landlord. The customer may release payment of the DG Rebate to the landlord in the application and include a copy of the contractor invoice signed by the purchaser (i.e. the landlord). INSPECTIONS ComEd reserves the right to inspect all rebated equipment to verify compliance with program rules and the accuracy of project documentation. This may include post-installation inspections or participant interviews. Upon reasonable notice by ComEd, the customer must allow access to project documents and the installed equipment for a period of one year after receipt of a DG Rebate payment by ComEd. Customer also agrees that by receiving a DG Rebate, he or she may be contacted by an evaluator to complete a customer survey. Replaced equipment must be permanently removed and disposed of in accordance with local codes and ordinances. Resale of replaced equipment is expressly forbidden. Resale equipment, new parts installed in existing equipment, or equipment that is leased, rebuilt, rented, received from insurance claims, received from a warranty, received with rewards points or won as a prize do not qualify. TAX LIABILITY Rebates may be taxable under federal and state tax codes and, if more than $600, will be reported to the IRS unless the customer provides acceptable proof that it is exempt from payment of such applicable taxes. In any event, ComEd is not responsible for any taxes that may be imposed as a result of your receipt of a DG Rebate, or for providing legal or accounting advice regarding such. Customer should consult with its tax accountant or advisor regarding potential tax liability. DISPUTES/GOVERNING LAW This application shall be exclusively governed by and interpreted in accordance with the laws of the State of Illinois. Any litigation between the parties shall be prosecuted only in the state or federal courts located in Cook County, Illinois. TOXIC MATERIALS Neither ComEd, nor its consultants, contractors and/or subcontractors, shall have any responsibility for the discovery, presence, handling, removal, disposal of, or exposure to hazardous materials of any kind in connection with customer s home or business, including, without limitation, asbestos, asbestos products, PCBs or any other toxic substances. LIMITATIONS OF LIABILITY The customer shall independently evaluate any advice or information offered by ComEd related to estimates of electricity savings or program costs and is solely responsible for the selection and installation of generation equipment. Each party hereby agrees to defend, indemnify and hold harmless the other party, its consultants, contractors and 8
TERMS AND CONDITIONS subcontractors, and their respective officers, employees, agents, assigns, and successors-in-interest ( Indemnified Parties ) from and against any third-party claims, damages, losses, liability, costs (including attorney s fees and expenses) for bodily injury to any person (including death resulting therefrom) and property damage arising out of or in connection with the program, except to the extent such claims, damages, losses, liability and costs are caused by the negligence or willful misconduct of the other party. DISCLAIMER ComEd does not guarantee that certain energy savings will be achieved and does not make any warranties associated with the generation facilities eligible for rebates under this program. ComEd has no obligations regarding, and does not endorse or guarantee, any claims, promises, representations, or work made or performed, or equipment furnished or installed by any contractors, subcontractors, or vendors that sell or install distributed generation facilities. The customer shall be entitled to the energy cost savings realized by the customer that result from the installation of distributed generation at the customer s site. RELEASE OF LIABILITY ComEd program administrators and implementers disclaim any and all liability, loss or damage and make no guarantees related to: Participation in the program, including use or installation of the equipment. Loss or delay of rebate check in the mail. Terms and conditions apply. Commonwealth Edison Company, 2019 9