房主的名字(必需) 第一个 最后的 Mailing Address(必需) 街道地址 地址线2 城市 状态 阿拉巴马州阿拉斯加美属萨摩亚亚利桑那州阿肯色州加州科罗拉多州康涅狄格特拉华州District of Columbia佛罗里达乔治亚州关岛夏威夷爱达荷州伊利诺斯州印第安纳州爱荷华州堪萨斯肯塔基州路易斯安那州缅因州马里兰麻萨诸塞州密歇根明尼苏达州密西西比州密苏里州蒙大拿内布拉斯加州内华达新汉普郡新泽西新墨西哥纽约北卡罗莱纳北达科他Northern Mariana Islands俄亥俄州俄克拉何马州俄勒冈州宾西法尼亚波多黎各罗德岛州南卡罗来纳南达科塔州田纳西州德州犹他州U.S. 属维尔京群岛佛蒙特州维吉尼亚州华盛顿西维吉尼亚州威斯康辛州怀俄明Armed Forces AmericasArmed Forces EuropeArmed Forces Pacific 邮政编码 网站地址(必需) Same as Mailing Address 街道地址 地址线2 城市 状态 阿拉巴马州阿拉斯加美属萨摩亚亚利桑那州阿肯色州加州科罗拉多州康涅狄格特拉华州District of Columbia佛罗里达乔治亚州关岛夏威夷爱达荷州伊利诺斯州印第安纳州爱荷华州堪萨斯肯塔基州路易斯安那州缅因州马里兰麻萨诸塞州密歇根明尼苏达州密西西比州密苏里州蒙大拿内布拉斯加州内华达新汉普郡新泽西新墨西哥纽约北卡罗莱纳北达科他Northern Mariana Islands俄亥俄州俄克拉何马州俄勒冈州宾西法尼亚波多黎各罗德岛州南卡罗来纳南达科塔州田纳西州德州犹他州U.S. 属维尔京群岛佛蒙特州维吉尼亚州华盛顿西维吉尼亚州威斯康辛州怀俄明Armed Forces AmericasArmed Forces EuropeArmed Forces Pacific 邮政编码 REC Account Number(必需) Requirements and Specifications This measure is a conversion from an electric forced-air furnace to a high-efficiency ducted air-source heat pump Air Source Heat Pump 必须 be AHRI-tested and certified; manufacturer claims of “equivalent to AHRI-certified equipment” will not be accepted. Rated as having a HSPF2 and a SEER2 efficiency rating that meets federal minimum standards according to the AHRI certificate. HSPF2 and SEER2 apply to units manufactured after January 1, 2023 based on DOE’s change to the national standard testing methodology. If a unit was manufactured before January 1, 2023, it 必须 meet the current federal minimum efficiency standard for HSPF and SEER per the AHRI certificate. Applicable home types with whole-home centrally ducted systems: Existing construction single-family; Existing manufactured homes (including new manufactured homes once on site for occupancy). Homes with less than 4,500 square feet of heated floor area 五月 qualify for only one heat pump payment. This 五月 be one ducted or one ductless heat pump (DHP) but not both. There are two exceptions to this rule: • When the home has two entirely separate duct systems, the home is eligible for two ASHP payments but no more, even if there are more than two duct systems; • When the home’s ductwork has not been extended to an addition, a DHP 五月 be installed to service the area of the home that does not contain ducts. In this scenario, the home 五月 be eligible for a ducted ASHP and one DHP payment. Homes with greater than 4,500 square feet of heated floor area qualify for up to two heat pump measures and no more provided all other program requirements are met.制造商(必需) 型号(必需) Heat Pump Size (in Tons)(必需) 安装HSPF2(必需) 安装SEER2(必需) Installer name:(必需) 建设规模 & 类型Total Conditioned Square Feet(必需) New Construction?(必需) 是的 No Date System Energized(必需) 月 一天 一年 Existing Heat Source(必需) Do you have a backup heating source?(必需) 是的 No Back-up Heating SystemHeating System Replaced(必需) Strip Heat in Plenum (KiloWatts)(必需) Strip Heat in Plenum (Btu)(必需) 隐藏的Submeter Installed 是的 No 隐藏的Date Submeter Installed(必需) MM slash DD slash YYYY Information Required to Complete Installation Agreement for IncentivesA copy of the sales invoice and the AHRI certificate 必须 be included with this agreement.Upload additional material(必需) Drop files here or 选择文件 马克斯. file size: 499 MB. 同意(必需)I have included a copy of the sales invoice which shows purchase date and installed cost. I have included a copy of the AHRI certificate for the ASHP installed. Member understands that changes to the Air Source system 五月 disqualify it from program participation. Failure to comply with this Agreement will disqualify member from receiving program incentives. Member understands, it is the installer’s responsibility to install the system according to all applicable codes and that Ravalli Electric Co-op is free from liability arising from the installation and/or operation of the system. Ravalli Electric Co-op reserves the right to terminate the program and/or modify the program and incentive levels without notice. Member is responsible for checking with Ravalli Electric Co-op to determine whether the program has been changed or is still in effect. I hereby verify the information to be true and complete and agree to the terms and conditions. I understand that by typing my full name and pressing the Submit button, this form submission will be stamped with today’s date and authorized by me as if I had signed my signature.Member Electronic Signature (Full Name)(必需) 电子邮件This field is for validation purposes and should be left unchanged.