Step 1 of 6 0% Download the Rebate Request Form (PDF) or fill out the online form. Terms & Conditions References to ‘electric cooperatives’ include Hoosier Energy, its member system electric cooperatives, and their agents, affiliates, and subsidiaries. Eligibility requirements and programs are subject to change or termination at any time, with or without notice, at the sole discretion of RushShelby Energy or Hoosier Energy. Applications will not be processed if required documentation/information is not included. Please read the application carefully and include all information requested. Not submitting requested documents will significantly delay processing and may disqualify your application. Eligibility requirements Program eligibility includes prior participation in rebate programs, with incentive and measure caps specific for each program. Applications in excess of program caps will not be processed. Location for installation must be the primary residence of applicant, and must be served by the electric cooperative. Program parameters All rebated equipment must be new; used or rebuilt equipment is not eligible for an incentive. Rebated equipment must meet all requirements for the manufacturer’s warranty. Incentive items must be installed on the residence associated with the electric cooperative account listed on the application. Rebated equipment must meet the technical specifications listed in the application form. Equipment and eligibility are subject to program-specific requirements. Application procedures and deadlines Rebated equipment must be installed and operational on or after January 1, 2023, and on or before December 15, 2023. All applications become the property of the electric cooperative and will not be returned. Keep a copy for your records. Applications must be submitted within 30 days of the purchase date or by December 15, 2023, whichever comes first. An invoice, and specified program documentation must be included for the application to be considered complete. Ability to confirm installation (right to conduct inspection) Pre-install inspection: RushShelby Energy reserves the right to inspect the program participant’s premises to verify that equipment meeting program qualifications exists prior to providing an incentive, and the program participant agrees to provide reasonable access to the premises for such purposes. Post-install inspection: RushShelby Energy reserves the right to inspect the program participant’s premises to verify that equipment matching the information provided on the program application has been placed in service at that location, and the program participant agrees to provide reasonable access to the premises for such purposes. Post-inspection, the program participant will have 30 days from the request date to submit any additional information requested by RushShelby Energy. Failure to submit requested information may result in application rejection. If any requested inspection finds the program participant or the program participant’s contractor did not comply with program rules and standards, any incentive received must be returned to RushShelby Energy within 60 days of notice of such inspection. RushShelby Energy reserves the right to conduct an additional post-install inspection for program portfolio evaluation, measurement, and verification (EM&V) purposes. Incentives received will not be affected by the results of this inspection. Incentive payments The incentive payment cannot exceed 75% of the total equipment cost. Installation, taxes, and fees cannot be included in the equipment cost. Application approval is not a guarantee of incentive payment. RushShelby Energy reserves the right to withhold payment for products that do not meet the program requirements as determined within its sole discretion. Program funds are limited. Incentives are available on a first-come, first-served basis, subject to application approval. Incentive amounts, thresholds, and offerings are subject to change or termination with or without notice at the sole discretion of RushShelby Energy. RushShelby Energy is not liable for incentives promised to members as a result of a contractor misrepresenting or not verifying the rules of the program. Only RushShelby Energy has the right to approve an application and the incentives. Incentives are paid as a one-time, one-program offer and cannot be combined with incentive payments, rebates, or discount programs from other utility providers. Logo usage Program applicants and program participants may not use any member cooperative, Hoosier Energy, or Team Up logo or name without prior express written permission. Program Disclaimers RushShelby Energy and Hoosier Energy Do not endorse any particular manufacturer, product, or system design by offering these incentives; Will not be responsible for any tax liability imposed on any program participant as a result of the payment of incentives; Do not expressly or impliedly warrant the performance of any installed equipment and hereby disclaim any and all warranties, express or implied, including the warranties of merchantability or fitness for a particular purpose; Are not responsible for the handling, storage, treatment, transportation, or disposal of any waste generated as a result of any measures for which incentives have been applied for and/or received under this program nor any resultant environmental contamination related to the same; Are not liable for any damage caused by the operation or malfunction of the installed equipment; and Do not guarantee that a specific level of energy or cost savings will result from the implementation of energy conservation measures or the use of products funded under this program. Member InformationName(Required) First Last Account Number(Required) Meter Number(Required) Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Email(Required) Phone(Required)Cell PhoneContractor's Name(Required) First Last Contractor's Mailing Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Building Type(Required) Residential: Mobile/Manufactured Residential: Single Family Occupancy Status(Required) Owner Renter Vacant Tenant Landlord Construction Type(Required) New Construction Existing Home Housing Type(Required) Stick-Built or Modular Mobile or Manufactured Home Year Home Was Built(Required) Total Project Invoice Cost(Required) Will Rebate Be Mailed to Contractor Instead of Being Claimed by the Member?(Required) Yes No Member Applicant Assignment of Payment to Non-Applicant/Contractor/Vendor(Required) I assign the full Team Up incentive amount pursuant to this application to the individual or entity designated as "Contractor" listed above and agree that such assignment can only be amended or modified in writing acknowledged by member cooperatives and Hoosier Energy, and further agree to hold harmless and indemnify member cooperatives and Hoosier Energy from any claim made for such incentive amount or from any loss resulting from the payment of the incentive amount to the assignee.Member Electronic Signature (Full Name)(Required) Rebate Type(Required) HVAC Water Heater HVAC InformationHVAC Installation Date (mm/dd/yyyy)(Required) Month Day Year Installation Type: Equipment Must Be Installed in Primary Residence(Required) Replacing Existing A/C or Heat Pump; or New Construction Install (ASHP, MSHP, or GHP Heat Pump Type) Replacing 100% Electric Resistance* (HPRER or DMSHP Heat Pump Type) HPRER Must be Primary Heat Source to Home *Not qualified for 100% Electric Resistance Replacement: Heat pump with electric resistance, space heaters, gas furnace, wood stove, wood pellet, A/C, back-up heatExisting or New Construction(Required) Existing Home New Heat Pump Install New Construction Install Replacing Existing A/C Replacing Existing Heat Pump What Type of Heat is Being Replaced?(Required) Electric Coil Furnace Baseboard Ceiling Cable Other Heat Pump Type(Required) Air Source (ASHP) — $750: Dual/Variable/Multi-Speed Compressor is Required Geothermal Heat Pump (GHP) — $1,500 Electric Resistance Replacement Air Source/Dual Fuel (HPRER) Ductless Mini-Split Heat Pump (DMSHP) Geothermal Heat Pump(Required) Single Speed Compressor Dual/Variable/Multi-Speed Compressor Desuperheater Installed?(Required) Yes No Propane/Gas Back-Up?(Required) Yes No Electric Resistance Replacement Air Source/Dual Fuel(Required) Single Speed Compressor — $800 Dual/Variable/Multi-Speed Compressor — $1,500 Ductless Mini-Split Heat Pump(Required) Single Room Installation* — $300: (Variable/Multi-Speed Compressor is Required) Replacing Existing A/C, HP, or New Construction Electric Resistance Replacement *Single room installation can include room additions or outbuildings. Must be located and serviced by member on account and must be occupied/used year-round (seasonal occupance does not qualify).Replacing Existing A/C, HP, or New Construction Whole-Home, Variable/Multi-Speed Compressor — $750 Electric Resistance Replacement Whole-Home, Variable/Multi-Speed Compressor — $1,500 Does the Heat Pump Have a Gas Furnace? (Dual Fuel) Yes No Gas Furnace Annual Fuel Utilization Efficiency (AFUE) Fossil Fuel Type Quantity of Outdoor Units Installed(Required) Quantity of Indoor Units Installed(Required) Manufacturer(Required) Purchased From:(Required) Heat Pump Equipment Cost (Excluding labor costs)(Required) British Thermal Units (BTUs)(Required) Size (Tons)(Required) Air-Conditioning, Heating, and Refrigeration Institute (AHRI) Seasonal Energy Efficiency Ratio (SEER) Rating(Required) Outdoor Unit Model Number(Required) Outdoor Unit Serial Number(Required) Indoor Unit Model Number(Required) Indoor Unit Serial Number(Required) Installed by:(Required) Building Contractor's Name(Required)HVAC Contractor must indicate on the invoice, whether a single or dual/variable speed compressor was installed. File Upload(Required)AHRI Certificate and Invoice/Receipt (Required) Drop files here or Select files Max. file size: 300 MB. Limit of 2 rebates per household. Rebates for HVAC equipment are available for whole home installations only unless otherwise stated. To receive a rebate, all homeowners must provide AHRI validation for all SEER and EER ratings that can be obtained from the installing heating and cooling dealer. No rebate will be awarded based on HVAC dealer bid specifications, promotional material of dealer, manufacturer, or any other source than AHRI. A certificate of AHRI-certified performance must be submitted. All homeowners must complete this rebate application form and provide proof of purchase to receive any rebate. The cooperative reserves the right to approve, deny, or select the appropriate rebate. The co-op also reserves the right to inspect and verify the installation of equipment receiving a rebate. Water Heater InformationWater Heater Installation Date (mm/dd/yyyy)(Required) Month Day Year Number of Units Installed(Required) Equipment Cost (Excludes Labor)(Required) Manufacturer(Required) Purchased From:(Required) Unit Model Number(Required) Unit Serial Number(Required) Size (Gallons)(Required) Efficiency Rating(Required) Type of Home HVAC(Required) Installed By:(Required) Building Contractor(Required) File Upload(Required)Invoice or Receipt (Required)Max. file size: 300 MB.Note: Rebate available only for Heat Pump or Hybrid Water Heaters, minimum 40 gallons. There is no incentive for electric resistance tank or tankless water heaters. Limit of 2 water heater rebates per household. All homeowners must complete this rebate application form and provide proof of purchase to receive any rebate The cooperative reserves the right to approve, deny, or select the appropriate rebate. The co-op also reserves the right to inspect and verify the installation of equipment receiving a rebate. Agreement & SignatureMember Consent(Required) 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. All rules and requirements of this program have been followed. Applicant has read and agrees to the Residential Rebate Program Terms and Conditions. Applicant is a residential member of RushShelby Energy, and electric cooperative member of Hoosier Energy. The rebated equipment was installed and operational prior to submission of this application. RushShelby Energy is providing the electric service to the installation site address listed on this application. Rebated equipment is installed in the primary residence of the applicant. Applicant understands and agrees that neither Hoosier Energy nor RushShelby Energy assumes any responsibility or liability arising out of or related to applicant's participation in Team Up programs. Applicant will allow inspection of the rebated equipment (if requested). Applicant understands applicant will not receive a rebate if applicant and/or applicant's contractor fails to provide required program documentation. Applicant agrees to purchase power from RushShelby Energy for a period not less than the deemed measured useful life of rebated equipment. Should the applicant receive power from any source other than the electric cooperative, including generation owned by the customer, before the end of the equipment's deemed useful life, the applicant agrees to refund the full amount of the rebate to the distribution cooperative. Applicant gives permission to Hoosier Energy to obtain usage information from their electric cooperative. Applicant understands that Hoosier Energy may use the usage information provided for program evaluation and analysis. If signing in a capacity other than an individual capacity, the individual signing below hereby represents and warrants that they are duly authorized to execute and deliver this application on behalf of the applicant. RushShelby Energy reserves the right to approve, deny, or select the appropriate rebate amount. Member Electronic Signature (Full Name)(Required)
