Pre-Qualification Rebate Form | Energy Efficiency Rebate Program | WNY Businesses | National Fuel Gas Company

2024 Non-Residential Pre-Qualified Rebate Application

2024 Non-Residential Pre-Qualified Rebate Application

Fill out the information below to get your 2024 rebates from National Fuel’s Energy Efficiency Rebate Program.

    Non-Residential Conservation Incentive Program - Application for Natural Gas Efficiency Measure Incentives

    Pre-Qualified Incentives

    1. Complete the National Fuel Non-Residential Conservation Incentive Program Application; review the terms and conditions and sign the application form. New construction is eligible for this program.

    2. Include the following items:

    3. Submit this application and supporting documents online. If desired, you can mail the supporting documents to:

      C.J. Brown Energy, P.C.

      4245 Union Road, Suite 204

      Buffalo, NY 14225

      Attn: NRCIP

    Applicant Information

    All fields must be completed. Payment will be issued to the applicant.

    *required

    *required

    *required

    *required

    *required

    *required

    *required

    *required

    Facility Information

    Location where conservation measures were installed (if different from above).

    Utility Information

    Project Description

    Agreement to Terms and Conditions

    Applicant Information

    Facility Information

    Required unless same as applicant

    Completing the Natural Gas Efficiency Measure Worksheets

    • Fill in the appropriate fields for individual natural gas efficiency measures.

    • To calculate the Total Incentive for each measure, multiply the Count (quantity of installed equipment) by the Unit Incentive and enter this amount in the Total Incentive column.

    • Enter the sum of the Total Incentive for each category on the summary worksheet and add these Total amounts together for the Grand Total amount on the last line.

    Be sure to include:

    Questions regarding the process, incentives, or requirements? Contact a C.J. Brown representative at NFRebateHelp@cjbrownenergy.com or call 1-844-365-3493.

    General Eligibility Requirements for Natural Gas Efficiency

    Is this a fuel conversion?*

    *required

    *required

    Does this replace existing equipment?*

    *required

    If yes, list equipment and age of equipment below.*

    Equipment Type

    Estimated Age of Equipment

    Add Additional Equipment

    Natural Gas Air Furnace Incentive Table

    Measure Code

    Unit Incentive

    Minimum Efficiency

    AF-1

    $3/MBtu/h

    ≥ 90% AFUE

    AF-2

    $4/MBtu/h

    ≥ 92% AFUE

    AF-3

    $5/MBtu/h

    ≥ 95% AFUE

    *MBtu/h = 1,000 Btu/h

    Natural Gas Unit Heater Incentive Table

    Measure Code

    Description

    Unit Incentive

    Minimum Efficiency

    UH-i

    Low-intensity, infrared natural gas-fired heater

    $2.50/MBtu/h

    Any efficiency

    UH-a

    Natural gas-fired air unit heater

    $2.00/MBtu/h

    ≥ 90% Et or AFUE

    *MBtu/h = 1,000 Btu/h

    Natural Gas Air Furnace and Unit Heater Data Collection Table

    Measure Code

    Manufacturer

    Model Number

    (A) Input Capacity (MBtu/h)

    Efficiency (AFUE or Et)

    (B) Count

    (C) Incentive/Unit

    Total Incentive (A x B x C)

    Add Additional Equipment

    (enter total in 'Individual Measure Incentive Totals')

    Natural Gas Non-Condensing Hot Water Boiler Incentive Table

    Measure Code

    Incentive/Unit

    Eligibility Criteria - MBtu/h

    Eligibility Criteria - Efficiency

    B-1

    $600

    ≤ 300

    ≥ 85% AFUE

    B-2

    $750

    301 - 500

    ≥ 85% Et

    B-3

    $1,500

    501 - 1,000

    ≥ 85% Et

    B-4

    $2,500

    1,001 - 1,700

    ≥ 85% Et

    B-5

    $3,000

    > 1,700

    ≥ 85% Et

    *Qualifying equipment must fit within the appropriate size range for input capacity (MBtu/h)

    *MBtu/h = 1,000 Btu/h

    Natural Gas Condensing Hot Water Boiler Incentive Table

    Measure Code

    Incentive/Unit

    Eligibility Criteria - MBtu/h

    Eligibility Criteria - Efficiency

    CB-1

    $1,000

    ≤ 300

    ≥ 90% AFUE

    CB-2

    $1,500

    301 - 500

    ≥ 90% Et

    CB-3

    $2,500

    501 - 1,000

    ≥ 90% Et

    CB-4

    $3,500

    1,001 - 1,700

    ≥ 90% Et

    CB-5

    $4,500

    > 1,700

    ≥ 90% Et

    *Qualifying equipment must fit within the appropriate size range for input capacity (MBtu/h)

    *MBtu/h = 1,000 Btu/h

    Natural Gas Steam Boiler Incentive Table

    Measure Code

    Incentive/Unit

    Eligibility Criteria - MBtu/h

    Eligibility Criteria - Efficiency

    SB-1

    $2/MBtu/h

    ≤ 300

    ≥ 82% AFUE

    SB-2

    $1/MBtu/h

    301 - 2,500

    ≥ 79% Et

    SB-3

    $1/MBtu/h

    > 2,500

    ≥ 80% Et

    *Qualifying equipment must fit within the appropriate size range for input capacity (MBtu/h)

    *MBtu/h = 1,000 Btu/h

    Natural Gas Boiler Data Collection Table

    Measure Code

    Manufacturer

    Model Number

    Input Capacity (MBtu/h)

    Efficiency (AFUE or Et)

    (A) Count

    (B) Incentive/Unit

    Total Incentive (A x B)

    Add Additional Equipment

    (enter total in 'Individual Measure Incentive Totals')

    Furnace/Boiler Tune-Up Data Collection Table

    Measure Description

    Measure Code

    (A) Count

    (B) Incentive/Unit

    Total Incentive (A x B)

    Furnace Tune-Up

    T-1

    $50

    Boiler Tune-Up

    T-2

    $50

    (enter total in 'Individual Measure Incentive Totals')

    Demand-Control Ventilation Data Collection Table

    Measure Code

    Area of Conditioned Space

    Manufacturer and Model Number

    (A) Count

    (B) Incentive/Unit

    Total Incentive (A x B)

    Ex: HE-6 (DCV)

    2,800 s.f.

    Company xx-xx

    2

    $200/sensor

    $400

    HE-6 (DCV)

    $200/sensor

    (enter total in 'Individual Measure Incentive Totals')

    Natural Gas Water Heater Data Collection Table

    Measure Code

    Description

    Eligibility Criteria

    Size

    (A) Count

    (B) Incentive/Unit

    Total Incentive (A x B)

    WH-5

    Storage Tank Water Heater

    0.80 UEF or 0.80 Et

    ≤ 140 gal.

    $250

    WH-6

    Tankless Water Heater

    0.80 UEF or 0.80 Et

    Any size

    $100

    (enter total in 'Individual Measure Incentive Totals')

    Duct Insulation Data Collection Table

    Measure Code

    Duct Section

    Dimensions of Duct (width x height) (in.)

    (A) Length of Ductwork Insulated (ft.)

    (B) Incentive/ft.

    Total Incentive (A x B)

    HE-4

    1

    $.50/ft.

    HE-4

    2

    $.50/ft.

    HE-4

    3

    $.50/ft.

    (enter total in 'Individual Measure Incentive Totals')

    *Ductwork traveling through uninsulated plenum space only

    *Duct insulation for natural gas-fired heating systems only

    *Insulation R-value of at least 6

    *For existing uninsulated ductwork

    Pipe Insulation Data Collection Table

    Measure Code

    Pipe Section

    Contents of Pipe (domestic hot water; hot water for heating; steam)

    Diameter of Pipe (in.)

    (A) Length of Pipe Insulated (ft.)

    (B) Incentive/ft.

    Total Incentive (A x B)

    HE-3

    1

    $3.00/ft.

    HE-3

    2

    $3.00/ft.

    HE-3

    3

    $3.00/ft.

    (enter total in 'Individual Measure Incentive Totals')

    *Pipe insulation for existing natural gas-fired hot water or steam boiler systems only

    *Insulation R-value > 4

    Accessory Equipment Data Collection Table

    Measure Description

    Measure Code

    (A) Count

    (B) Unit Incentive

    Total Incentive (A x B)

    Wi-Fi Thermostat

    TH-2

    $50

    (enter total in 'Individual Measure Incentive Totals')

    Natural Gas Clothes Dryer Data Collection Table

    Measure Description

    Measure Code

    (A) Count

    (B) Unit Incentive

    Total Incentive (A x B)

    Natural Gas Clothes Dryer

    GD-1

    $50

    (enter total in 'Individual Measure Incentive Totals')

    Individual Measure Incentive Totals

    Rebate cap of $100,000 per project, per program year

    Terms and Conditions

    1. To be eligible for a rebate, Customer understands that: (a) they must have an active meter serviced by National Fuel Gas Distribution Corporation (“National Fuel”) in National Fuel’s Western New York service territory for the installation address and, (b) the product(s) Customer has installed must qualify as described on the Rebate Application Form, incorporated herein by this reference, and be designed and installed to reduce the consumption of the energy distributed to them by National Fuel at the installation address. Customer understands they must complete an application for each installation address. For installations at locations with multiple meters, please attach a separate sheet indicating gas account number and/or meter number with eligible equipment for that account number or meter. All uses herein of the words “install,” “installation” or similar phrases shall mean complete installation such that the subject product(s) is/are fully functional at the time that the rebate application is submitted.

    2. All eligible measures must be installed by a licensed contractor, or a contractor that can supply you with either a Federal ID number, or a Certificate of Insurance, or a Business Certificate.

    3. Customer understands the Conservation Incentive Program Rebate term begins on January 1, 2024. Rebate cap of $100,000 per project, per program year. Resale products, products leased, rebuilt, rented, received from insurance claims, won as a prize, or new parts installed in existing products do not qualify. All applications are processed on a first-come, first-served basis, as received. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. Resubmitted information/documentation is processed on a first-come, first-served basis, based on the new receipt date. This program may be modified or terminated at any time and without prior notice. In the event that the amount of a rebate changes during the course of the program, the installation date will be used to determine product eligibility and rebate amount.

    4. Customer understands that this signed and dated Rebate Application Form, all appropriate Proof(s) of Purchase and other required documentation as referenced in this Application must be sent to National Fuel’s Processing Center to be considered eligible for a rebate.

    5. Customer will allow, if requested, a National Fuel representative reasonable access to the install address to verify the product has been purchased and is installed before a rebate is paid. Customer understands that a rebate will not be paid if they refuse to participate in any required verification. Customer understands that National Fuel may contact the qualifying product vendor and/ or installer, if needed, to verify purchase and/or installation and may provide Customer’s name and/or address to complete such verification.

    6. Customer has installed a qualifying product(s) and understands the energy efficiency level of the qualifying product(s) determines the rebate amount (as defined in the Rebate Application Form). A single gas-fired piece of equipment that provides two functions (e.g., heat and hot water) is only eligible for one rebate, that being the higher rebate amount of the two listed amounts. The rebate amount cannot exceed the purchase price. One furnace/boiler tune-up service rebate per furnace/boiler, per year.

    7. Customer agrees that the selection of qualifying product(s), selection of manufacturer, dealer, supplier and/or installer, and purchase, installation and ownership/maintenance of the qualifying product(s) referenced in this Application are their sole responsibility, and that their manufacturer, dealer, supplier or installer of these products and measures is not an agent or representative of National Fuel. Customer understands that National Fuel makes no representations regarding manufacturers, dealers, contractors, materials or workmanship. CUSTOMER ALSO UNDERSTANDS THAT NATIONAL FUEL MAKES NO WARRANTY WHETHER EXPRESS OR IMPLIED, INCLUDING WITHOUT LIMITATION THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR ANY PARTICULAR PURPOSE, USE, OR APPLICATION OF THE PRODUCTS OR MEASURES. Customer agrees that National Fuel has no liability whatsoever concerning (1) the quality, safety and/or installation of the products or measures, including their fitness for any purpose, (2) the estimated energy savings of the products or measures, (3) the workmanship of any third parties, (4) the installation or use of the products or measures including, but not limited to, effects on indoor pollutants, or (5) any other matter with respect to the National Fuel Conservation Incentive Program. Customer waives any and all claims against National Fuel, its parent companies, directors, officers, employees, or agents, arising out of activities conducted by or on behalf of National Fuel in connection with their application for any rebate(s) under the National Fuel Conservation Incentive Program. Without limiting the generality of the foregoing, none of the above stated parties shall be liable hereunder for any type of damages, whether direct, indirect, incidental, consequential, exemplary, reliance, punitive or special damages, including damages for loss of use regardless of the form of action, whether in contract, indemnity, warranty, strict liability or tort, including negligence of any kind.

    8. Customer is responsible for meeting all program requirements and complying with their state/county/city governments, local conditions, restrictions, codes, ordinances, rules, and regulations concerning this installation.

    9. If Customer’s property is not owned by Customer, Customer is solely responsible for obtaining the property owner’s permission to install the product for which they are applying for a rebate. Customer’s signature on this application indicates they have received such permission.

    10. I understand that National Fuel is not responsible for items lost or destroyed in the mail/transit.

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