SCV Family of Water Suppliers High Efficiency Toilet (1.28 GPF or less) Rebate Application

Transcription

1 SCV Family of Water Suppliers High Efficiency Toilet (1.28 GPF or less) Rebate Application # Voucher For office use only Please note: Applications will be funded on a first come, first serve basis, provided the applicant meets all qualifying criteria. There is no implied or expressed guarantee that funding will be available at the time the application is received by the water retailer. 1. The property in which the High Efficiency Toilet (HET) is installed must have been built prior to You must purchase and install a qualified HET. A HET is a toilet that uses 1.28 gallons per flush (GPF) 3. There is a limit of 3 toilets per residence and 50 per commercial account. 4. Complete the information below. 5. Read and sign the Application/Customer Agreement and Requirements (page 2). 6. Read and sign applicable water retailer (circled below) rebate rules (pages 3 6). Water Retailer Please circle your water retailer below: Los Angeles County Waterworks District#36 P.O. Box 1475 Alhambra, CA Santa Clarita Water Division Summit Circle Santa Clarita, CA Newhall County Water District P.O. Box Santa Clarita, CA Valencia Water Company Ave Rockefeller Valencia, CA Purchase Verification Section Manufacturer: Model #: Gallons Per Flush (GPF): Date on receipt: Applicant Information Section Account Holder Name: Address Installed: Zip Code: Phone #: Account #:

2 SCV Family of Water Suppliers High Efficiency Toilet (1.28 GPF or less) Rebate Application Customer Agreement and Requirements 1. This rebate program provides financial assistance to SCV Family of Water Suppliers customers wishing to conserve water. 2. Applications will be funded on a first come first serve basis, provided the applicant meets all qualifying criteria. There is no implied or expressed guarantee that funding will be available at the time the application is received by the water retailer. 3. An original, dated receipt must be provided. Rebates do not apply to sales tax or installation. 4. No rebate amount will exceed the cost of the item purchased. 5. Rebates will be paid to the previously indicated water retailer customer of record only. Customer s account must be in good standing or if not, all credits will be collapsed against any outstanding debts, and any remaining credit balance will be applied against future recurring services charges for all payment types. 6. Installation of appliance is the sole responsibility of the applicant. 7. Toilets must be installed at the location of the applicant and served by the previously indicated water retailer. 8. The SCV Family of Water Suppliers does not endorse specific brands, products or dealers; nor does it guarantee materials or workmanship; acceptance of such is the sole responsibility of the customer. 9. The SCV Family of Water Suppliers assumes no responsibility or liability for any damage that may occur to an applicant s property as a result of participation in this program. 10. The SCV Family of Water Suppliers cannot guarantee, due to circumstances beyond its control, that installation of rebated toilets will result in lower utility costs. 11. A representative of the SCV Family of Water Suppliers must be permitted to inspect the property to verify proper installation if it is deemed necessary and applicable. 12. Applicants agree to the attached water retailer rules corresponding with the indicated (circled) water retailer on this application and the form of rebate payment. APPLICANT MUST SIGN APPLICATION/AGREEMENT AND APPLICABLE RETAILER RULES BEFORE REBATE CAN BE ISSUED The SCV Family of Water Suppliers (Family) is comprised of Castaic Lake Water Agency, Los Angeles County Waterworks District #36, Newhall County Water District, Santa Clarita Water Division, Valencia Water Company and the City of Santa Clarita. Together, they work to promote the efficient use of water and fund programs to effectively reduce the per capita water use in our Valley. 2

3 Los Angeles County Waterworks District #36 1. Customers are eligible for an $80 rebate. 2. To receive a rebate, you must include completed application, original dated receipt, and a copy of your water bill. 3. Send completed application, original dated receipt, and a copy of your water bill to Los Angeles County Waterworks Districts (LACWD): Los Angeles County Waterworks Districts Attn: Water Conservation Manager P.O. Box 1475 Alhambra, CA Rebate check will be paid to the customer of record in LACWD s service area. 3

4 Newhall County Water District 1. Customers are eligible for an $80 rebate. 2. To receive a rebate, you must include completed application, original dated receipt, and a copy of water bill. 3. Send or deliver completed application, original dated receipt and copy of water bill to Newhall County Water District (NCWD): Mailing Address Physical Address Newhall County Water District Newhall County Water District Office P.O. Box Pine Street Santa Clarita, CA Santa Clarita, CA Rebate check will be paid to the customer of record in NCWD s service area. 4

5 Santa Clarita Water Division Rebate will be a credit on your water bill. 1. Customers are eligible for up to an $80 credit. 2. To receive a credit, you must present SCWD with the following items: a. All completed pages of this application (pages 1, 2 and 5); and b. Original receipt of the purchased toilet showing the Manufacturer and Model #. If you would like to keep your original receipt, you must come in to the office in person and we will stamp the receipt, make a copy and return the original receipt to you. If the receipt does not show the manufacturer and model #, provide additional proof of this information in order to qualify for the rebate. 3. Mail or hand deliver completed application and items listed above to Santa Clarita Water Division (SCWD): Santa Clarita Water Division Summit Circle Santa Clarita, CA Rebate credits will be paid to the SCWD customer of record only. Customer s account must be in good standing or, if not, all credits will be collapsed against any outstanding debts, and any remaining credit balance will be applied against future recurring service charges for all payment types. 5

6 Valencia Water Company 1. Customers are eligible for an $80 rebate. 2. Completed application and original, dated receipt and copy of water bill must be brought in person to Valencia Water Company: Valencia Water Company Ave Rockefeller Valencia, CA Rebate credits will be paid to the Valencia Water Company customer of record only. Customer s account must be in good standing or if not, all credits will be collapsed against any outstanding debts, and any remaining credit balance will be applied against future recurring services charges for all payment types. 4. Rebates will be issued as a credit on the water bill and Valencia Water Company will approve one rebate request per residential customer account. For multi family customers and CII customers, the total number of rebates shall not exceed five per customer account, unless otherwise approved by Valencia Water Company s Resource Conservation Manger. 5. A representative of Valencia Water Company must be permitted to inspect the property to verify proper installation if it is deemed necessary and applicable. Failure to comply will result in the disallowance of any rebate received. Valencia Water Company will place a new charge on your bill for the amount of the previously granted rebate credit. 6