Water Conservation Rebate Program Commercial* Application OUTDOOR Customer Information/Installation Address FIRST NAME/BUSINESS NAME LAST NAME STREET ADDRESS APT/UNIT CITY, STATE, ZIP EMAIL PHONE NUMBER CAL WATER ACCOUNT NUMBER CONTACT FIRST NAME (IF DIFFERENT THAN CUSTOMER) CONTACT LAST NAME CONTACT EMAIL (IF DIFFERENT) CONTACT PHONE NUMBER (IF DIFFERENT) Contact Relationship to Account Holder Property owner Tenant Contractor Site Type Apartment/Multi-Family Coin Laundromat Government Facility Grocery Store Common Area Health Care Facility Hotel/Motel Industrial Park Manufacturing Facility Office Complex Retail Store/Shopping Center Restaurant/Bar School Other Payee and Mailing Address Check box if different than Customer/Installation Address PAYEE NAME MAILING ADDRESS PO BOX/APT/UNIT CITY, STATE, ZIP Payee Relationship to Account Holder** Property owner Tenant Contractor; CSLB License No. (required) * Commercial sites include apartment/multi-family common areas. **If rebate is paid directly to contractor, you must include a copy of the customer job order/contract signed by the customer and all applicable purchase invoices as well as a signed statement verifying products installed (manufacturer, model, and quantity). If rebate is paid directly to contractor, the contractor is required to have an active license with the State of California Contractors State License Board (CSLB). You can verify a license by visiting www.cslb.ca.gov or by calling the CSLB at (800) 321-2752. Page 1 of 6
Devices Installed If additional space is needed, please use the Unit Tracking Sheet on page 5. Select the high-efficiency device(s) installed: High-Efficiency Sprinkler Nozzle(s) Smart Irrigation Controller(s) Total number of stations: DATE Select the high-efficiency device(s) installed: (complete Parts A & B below for spray bodies and large rotary nozzles only) Spray Body(ies) with Integrated Pressure Regulation and Check Valve Large Rotary Nozzles Part A: Rebate on Materials DATE Part B: Rebate on Labor/Installation CONTRACTOR BUSINESS NAME CONTRACTOR C-27 LICENSE NUMBER DATE (LABOR ONLY) *If rebate total is estimated to be $600 or more, please provide Payee SSN/Tax ID. Rebate Program participants receiving $600 or more in rebates in a calendar year are required to receive an IRS Form 1099 unless exemptions apply. Rebate Program participants are responsible for all applicable taxes. *Pre-qualification is required if total rebate amount is $5,000 or more. See Qualifications section for details. Payee SSN/Tax ID Type of Tax ID Individual (SSN) Corporation (EIN) Non-Corporation (EIN) Continued on next page Page 2 of 6
Qualifications Commercial rebates are not currently available to those served by the City of Bakersfield or City of Commerce water systems. If the top of your water bill includes the words City of Bakersfield Water System or City of Commerce Water System, then you are not currently eligible. Pre-qualification is required if total rebate amount is $5,000 or more. Please contact the Cal Water Conservation Department at conservation@calwater.com to begin the pre-qualification process. Do not proceed with purchase and/or installation prior to receiving pre-qualification. Total rebates will not be issued for more than $25,000 for any individual site in a calendar year. Cal Water may elect to waive the $25,000 site limit on a case-by-case basis depending on available funding and other factors. Before applying for the rebate, applicant must purchase and install the smart irrigation controller(s), sprinkler nozzle(s), spray body(ies), and large rotary nozzle(s). These devices must be installed at a site served by California Water Service (Cal Water). Installation must be completed by a C-27 licensed contractor to be eligible for the spray body and large rotary nozzle Part B rebate. Applicant must submit a copy of the sales receipt with the application. This offer only applies to qualified smart irrigation controller(s), sprinkler nozzle(s), spray body(ies), and large rotary nozzle(s) purchased and installed from January 1, 2018 through December 31, 2018, or until rebate program funds are depleted, whichever comes first. Rebates are limited to a first-come, first-serve basis for up to: Smart Irrigation Controller: $25/station High-Efficiency Sprinkler Nozzle: $5/nozzle Spray Body with Integrated Pressure Regulation and Check Valve: $10/spray body (plus an additional $8/spray body for installation or labor) Large Rotary Nozzle: $30/nozzle (plus an additional $8/nozzle for installation or labor) Smart irrigation controllers must be EPA Watersense-labeled and on the qualified product list at www.calwater.com/rebates. High-efficiency sprinkler nozzles must be on the qualified product list at www.calwater.com/rebates. Spray bodies must be on the qualified product list at www.calwater.com/rebates. Large rotary nozzles must be on the qualified product list at www.calwater.com/rebates. The Cal Water account number must be for the location the smart irrigation controller(s), sprinkler nozzle(s), spray body(ies), and large rotary nozzle(s) are installed. Rebates are limited to one program. Customers cannot apply for the same rebate under multiple rebate programs. Do not submit final application prior to installation. Rebate will only be issued after installation. Cal Water reserves the right to verify customer eligibility, proof of purchase, and installation. If access to verify is denied, rebate will be voided. Offer is void where prohibited or restricted by law. Rebate offerings, amounts, and qualifications may change without notice. Continued on next page Page 3 of 6
Please Note Incomplete applications cannot be processed. Rebates will only be paid for up to the purchase price of the device(s). This does not include tax, shipping, or installation. Cal Water is not responsible for lost items or delays in the mail, or any remittance delayed because of incorrect or incomplete applications. Mail completed application and proof of purchase (sales receipt) to: Cal Water Rebate Program 2632 W. 237th Street Torrance, CA 90505 Please allow six to eight weeks for remittance of your rebate check. If your check has not been received after eight weeks or you have any questions, please contact your local Customer Center or the Cal Water Conservation Department at conservation@calwater.com. I certify that these smart irrigation controller(s), sprinkler nozzle(s), spray body(ies), and/or large rotary nozzle(s) were purchased new at retail price and not for resale. I agree that Cal Water may verify the sale, delivery, and installation of the device(s). I understand that Cal Water does not warrant any smart irrigation controller, sprinkler nozzle, spray body, and/or large rotary nozzle to be free of defects or warrant the quality of the workmanship, and that Cal Water is not responsible for the suitability of the premise for smart irrigation controller, sprinkler nozzle, spray body, and/or large rotary nozzle installation. I further agree to hold harmless Cal Water, its directors, officers, and employees against all loss, damages, expense, and liability resulting from the loss, destruction, or damage to property arising out of, or in any way connected to, the installation of the smart irrigation controller(s), sprinkler nozzle(s), spray body(ies), and/or large rotary nozzle(s). I have read, understand, and agree to the terms and conditions of the rebate program, including Qualifications and Please Note sections of this application. CUSTOMER SIGNATURE DATE Continued on next page Page 4 of 6
Unit Tracking Sheet NAME ON CAL WATER ACCOUNT INSTALLATION ADDRESS Select the high-efficiency device(s) installed: High-Efficiency Sprinkler Nozzle(s) Smart Irrigation Controller(s): Total number of stations: SUITE/ROOM/ UNIT NO. DATE REBATE AMOUNT* *If rebate total is estimated to be $600 or more, please provide Payee SSN/Tax ID. Rebate Program participants receiving $600 or more in rebates in a calendar year are required to receive an IRS Form 1099 unless exemptions apply. Rebate Program participants are responsible for all applicable taxes. *Pre-qualification is required if total rebate amount is $5,000 or more. See Qualifications section for details. Payee SSN/Tax ID Type of Tax ID Individual (SSN) Corporation (EIN) Non-Corporation (EIN) Continued on next page Page 5 of 6
Unit Tracking Sheet NAME ON CAL WATER ACCOUNT INSTALLATION ADDRESS Select the high-efficiency device(s) installed: Spray Body(ies) with Integrated Pressure Regulation and Check Valve Large Rotary Nozzles Part A: Rebate on Materials DATE Part B: Rebate on Labor/Installation CONTRACTOR BUSINESS NAME CONTRACTOR C-27 LICENSE NUMBER DATE (LABOR ONLY) *If rebate total is estimated to be $600 or more, please provide Payee SSN/Tax ID. Rebate Program participants receiving $600 or more in rebates in a calendar year are required to receive an IRS Form 1099 unless exemptions apply. Rebate Program participants are responsible for all applicable taxes. *Pre-qualification is required if total rebate amount is $5,000 or more. See Qualifications section for details. Payee SSN/Tax ID Type of Tax ID Individual (SSN) Corporation (EIN) Non-Corporation (EIN) Page 6 of 6