Fixed Incentive Application Form

Customer Legal Name *

Customer Mailing Address *

Customer City *

Customer Postal Code *

Customer Contact Name *

Customer Contact Phone *

Customer Email Address *

Project Type *

Required to receive the contractor portion of the incentive.

There was no contractor involved in this installation

By filling in the details below, I agree to the terms and conditions applicable to these incentives. I confirm that I have the authority to apply for the incentive on behalf of the recipient(s) and to bind the recipient(s) to the applicable terms and conditions. If I have also claimed a contractors incentive payable by Enbridge Gas, I confirm that I have made the customer aware of this incentive. Where applicable, I confirm the technology meets the Technical Requirements applicable to the measures.

Name (Where Applicant is a corporation, I/we have authority to bind the corporation) *

Date (MM/DD/YY) *

TERMS AND CONDITIONS

All incentive offers are available to Enbridge Gas Inc., Ontario customers. The customer must be the owner of the applicable energy efficient equipment. Enbridge Gas account must be in good standing. Incentive offers available between January 1, 2018 and December 7, 2018 (natural gas equipment must be installed by November 23, 2018). To receive any incentive, a completed Fixed Incentive Application Form and proof of purchase matched to the installation address must be provided to Enbridge Gas no later than December 7, 2018. Enbridge Gas is not responsible for lost mail or mail disruptions. Allow 10 to 12 weeks for delivery of payment. All Fixed Incentives are paid on a per unit basis unless otherwise indicated. Programs and incentives may be subject to change or cancellation without notice at any time. Enbridge Gas makes no representation, warranty or guarantee regarding the projected savings of any energy efficiency measure or performance of installed equipment. Enbridge Gas reserves the right to independently verify application information and confirm installation. Showerhead Incentive applies to the replacement of standard showerheads (with a flow rate of 2.5 GPM or greater) in existing multi-family residential buildings that use natural gas for water heating. Replacement low-flow showerheads must have a flow rate of 1.5 GPM or less. Existing showerhead flow rate testing is required for a minimum of 10% of the total number of residential suites. Additional Terms and Conditions apply. Capitalized terms used in this form, and not otherwise defined herein, have the meaning set out in the Enbridge Gas "Fixed Commercial and Industrial Contractor Incentives" brochure for the calendar year in respect of which this application form is submitted.