ASHP and CCASHP Rebate

Note: This rebate request can only be submitted by the contractor completing installation of the equipment.
Are you a contractor?
Are you a qualified installer?
Member information
Name on account

First NameLast Name
Connexus account number
Phone number
Format: 000-000-0000.
Email address
Installation address

Street Address

Street Address Line 2

CityState

Zip Code
Contractor information
Company
HVACREDU/NATE ID
Primary rebate contact name

First NameLast Name
Company address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone number
Please enter a valid phone number.Format: (000) 000-0000.
Primary rebate contact email address
example@example.com
Equipment information
Installation type
Applicable to Cold Climate (Low Ambient) Air Source Heat Pump only: Heating capacity at 5°F is at least 70% of the 47°F rated heating capacity. Auxiliary heat switch over set point degrees set to 20°F or less. The cold climate air source heat pump must have a minimum qualifying efficiency of 15.2 SEER2, 10.6 EER2, 8.1 HSPF2, low temp heating efficiency of COP ≥ 1.75 at 5°F.

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Installed equipment
SEER/SEER2 rating
Warning: Ducted ASHP & Ducted Cold Climate ASHP must be greater than 15.2. Ductless ASHP must be greater than 17.2.
EER/EER2 rating
Warning: Ducted ASHP must be greater than 10.6. Ducted Cold Climate ASHP must be greater than 10.6.
HSPF/HSPF2 rating
Warning: Ducted and Ductless ASHP must be greater than 7.8. Ducted Cold Climate ASHP must be greater than 8.1.
COP (must be 1.75 or greater for Cold Climate (Low Ambient) Air Source Heat Pump rebate)
Warning: COP must be 1.75 or greater
Compressor type
Auxiliary heat switchover set point (must be 20 degrees or lower for Cold Climate (Low Ambient) Air Source Heat Pump rebate)
AHRI certificate number
Date of installation

MonthDayYear
Date
Manufacturer
ASHP/Condenser model number
ASHP/Condenser serial number
Evaporator coil model number
Evaporator coil serial number
Furnace model number
Furnace serial number
Previous primary heating source

Other
Furnace replaced
Previous cooling source
Attach all itemized invoices/receipts, specification sheet and AHRI Certificate associated with the purchase/installation of the project.

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Member or contractor hereby certifies that 1) the member or contractor is solely responsible for the accuracy of the application information; 2) all installation is complete and operational prior to submitting this application; 3) acknowledges that nothing contained in the application shall impose any liability on Connexus Energy for any work performed or information presented by the member’s engineer, contractor, or vendor; and 4) Connexus reserves the right to verify performed work.
Signature

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Member information

Contractor information

Equipment information