Sunteți pe pagina 1din 3

Commercial, Industrial & Agricultural

Plan Review

2013 Rebate Application

Dakota Electric Association


4300 220th Street West
Farmington, Minnesota 55024

Business Member Information


Company name ________________________________________________________ Date submitted _________________
Billing address __________________________________________ City _______________ State _____ ZIP ___________
Installation address (if different) _____________________________ City _______________ State _____ ZIP ___________
Account number _______________________________________________________________________________________
Contact name (print) ______________________________________ Phone _______________________________________
E-mail _______________________________________________________________________________________________

Project Information
Project name _________________________________________________________________________________________
Project location _______________________________________________________________________________________
Total square footage _____________________________ Parking garage square footage ____________________________
The undersigned does hereby certify that 1) The undersigned, and not Dakota Electric Association, is solely responsible for the
accuracy of the information contained in this application, and 2) all rules of the Plan Review Rebate program have been followed.
Further, the undersigned acknowledges that nothing contained in the application shall impose any liability on Dakota Electric
Association for the work performed and information presented by the members engineer, contractor or vendor.

Member signature __________________________________________________ Date ____________________________

How to Apply for This Rebate


1. Rebate funds are limited. Contact rebates@dakotaelectric.com or 651-463-6243 to reserve funds. This is not a guarantee
of project approval.
2. Fill out this rebate application. All information needs to be supplied before a rebate check can be issued. Please note
any warranty, rules or qualications on page two of this form.
3. Complete and sign rebate forms. Mail or fax pages 1 and 3 to:
Rebates, Dakota Electric Association, 4300 220th Street West, Farmington, MN 55024
Fax number: 651-460-7524

Application # _____________________

page 1

Plan Review 2013 Rebate Application

Specic Rules and Qualications


1. For new construction or renovation commercial/retail
building projects.
2. The project building size must be less than 50,000 sq. ft.

4. Rebates may be available for implementing or installing


energy-efficient electrical equipment that performs beyond
the Minnesota State energy code requirements. Check with
your Dakota Electric account representative.

3. Analysis can begin when preliminary building designs


are completed, prior to the development of construction
documents.

Other Important Program Rules


1. The cost shall be shared; 75 percent Dakota Electric Association and 25 percent member.
2. The member is responsible for checking with Dakota Electric Association to determine whether funding is available
and to verify program parameters.
3. Dakota Electric Association reserves the right to conduct random inspections of installations.
4. The maximum rebate amount shall be the lesser of 75 percent of the project cost or $30,000.
5. Members must apply for 2013 rebates no later than November 15, 2013.

page 2

Plan Review 2013 Rebate Application


Business member name __________________________________________________________________________________
Project Information
Project name ___________________________________________________________________________________________
Project location __________________________________________________________________________________________
Total square footage ______________________________________________________________________________________
Parking garage square footage _____________________________________________________________________________
Plan Review Consultants Information
Architectural Firm ________________________________________________________________________________________
Address _____________________________________________________ Phone ____________________________________
City, State, ZIP ___________________________________________________________________________________________
Contact person _______________________________________________ E-mail _____________________________________
General Contractor _______________________________________________________________________________________
Address _____________________________________________________ Phone ____________________________________
City, State, ZIP ___________________________________________________________________________________________
Contact person _______________________________________________ E-mail _____________________________________
Mechanical Engineer _____________________________________________________________________________________
Address _____________________________________________________ Phone ____________________________________
City, State, ZIP ___________________________________________________________________________________________
Contact person _______________________________________________ E-mail _____________________________________
Electrical Engineer _______________________________________________________________________________________
Address _____________________________________________________ Phone ____________________________________
City, State, ZIP ___________________________________________________________________________________________
Contact person _______________________________________________ E-mail _____________________________________
Development Company _____________________________________________________________________________________
Address _____________________________________________________ Phone ____________________________________
City, State, ZIP ___________________________________________________________________________________________
Contact person _______________________________________________ E-mail _____________________________________

_________________________________________________________________________________________

____________________________

Dakota Electric Association Representative

Date

page 3