Before Filling Out Your Rebate . - Oklahoma Natural Gas

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OKLAHOMA NATURAL GASENERGY-EFFICIENCY PROGRAMREBATE CHECKLISTBefore filling out your rebate application, please carefully review all requirements and thechecklist below to help expedite the approval process. Rebate applications must be submittedwithin 90 days of equipment installation.INCOMPLETE APPLICATIONS MAY BE DELAYED OR DENIED.You have three options for submitting your rebate application:OnlineVisit OklahomaNaturalGas.com and click on the “I want to.” button at the top of thepage. Select “Complete a rebate application” from the dropdown menu and followthe prompts to complete your application and upload required documentation.EmailComplete and email your application within 90 days of installation to: ONGRebates@OneGas.comMailComplete and mail your application within 90 days of installation to:Oklahoma Natural Gas Energy-Efficiency ProgramP.O. Box 401Oklahoma City, OK 73101-0401Rebate checks will be mailed approximately six to eight weeks after application approval, subject to availabilityof program funds.When submitting a rebate application, make sure: You have an active Oklahoma Natural Gas account. You are submitting your rebate application within 90 days of appliance installation date on yourcontractor’s invoice. The installed equipment meets the minimum efficiency and specific eligibility requirements for therebate. Please review our “Learn More” forms prior to submission at OklahomaNaturalGas.com/Rebates. You have filled in all requested information, including the contractor information (Section 2). You have included all proof of purchase information (Section 4) including:Retailer/Contractor name, address and phone number Itemized list of equipment quantity, description, manufacturer, model number and otheridentifying information, as appropriatePurchase date and price You have signed the “Acceptance of Terms” section of this application (Section 7).

OKLAHOMA NATURAL GASENERGY-EFFICIENCY PROGRAM1. Account and Customer InformationREBATE APPLICATIONResidentialCommercialBuilderProperty OwnerCustomer Name:(As it appears on account)Oklahoma Natural Gas Account Number:Installation Address:City: State: ZIP:Mailing Address:(If different from installation address)City: State: ZIP:Email (preferred):Daytime Phone: Evening Phone:213380656 2611285 00Your account number is located onyour bill. The application cannotbe processed without this numberpresent on this form.CUSTOMER NAME2. Energy-Efficiency RebatesNew Appliance REQUIREDRANGE PROGRAM* 100Natural Gas Range –Freestanding or Slide-inCombined Natural Gas Cooktopand Natural Gas OvenREQUIREDManufacturer NameREQUIREDModel NumberREQUIREDSerial NumberREQUIREDInstall DateYEARSApproximate age of old appliance?Are you replacing an electric appliance? Yes*Customer signature and receipts required for rebate (see Sections 4 and 7)**If you don’t have access to old appliance information, please email ONGRebates@OneGas.com.No

2. Energy-Efficiency Rebates (Cont.)New Appliance REQUIREDCLOTHES DRYER PROGRAM*REQUIREDManufacturer NameREQUIREDModel NumberUp To 400Natural Gas Clothes DryerREQUIREDSerial NumberREQUIREDInstall DateUp To 450ENERGY STAR Certified NaturalGas Clothes DryerYEARSApproximate age of old appliance?Are you replacing an electric appliance? YesNoNew Appliance REQUIREDHEATING SYSTEM PROGRAM* 55095% Efficient N atural GasFurnace or BoilerFurnaceREQUIRED Manufacturer NameREQUIREDModel NumberREQUIREDSerial NumberREQUIREDInstall DateREQUIREDInstall CostREQUIREDBTUCopy of AHRI certificate required.AHRI NumberREQUIREDAFUEYEARSApproximate age of old appliance?REQUIREDLicensed Contractor Company Name:REQUIREDContractor Phone Number:REQUIREDContractor License Number:*Customer signature and receipts required for rebate (see Sections 4 and 7)

2. Energy-Efficiency Rebates (Cont.)Old Appliance REQUIRED **HEATING SYSTEM PROGRAM*Please only check one: 1,950 1,950 2,500 2,500Replacing ElectricResistance Furnace withNatural Gas FurnaceReplacing Electric Heat Pump with Natural Gas Furnace and Air ConditionerReplacing Electric Resistance Furnace with 95% Efficient Natural Gas FurnaceReplacing Electric HeatPump with 95% EfficientNatural Gas Furnace andAir ConditionerNew Appliance REQUIREDFurnaceREQUIRED Manufacturer NameREQUIREDREQUIREDModel NumberREQUIREDREQUIREDSerial NumberREQUIREDREQUIREDElectric ProviderN/AN/AInstall DateREQUIREDN/AInstall CostREQUIREDREQUIREDKW/BTU RatingREQUIREDOPTIONALAHRI NumberCopy of AHRI certificate required.REQUIREDAFUEREQUIREDHeat PumpREQUIREDManufacturerN/AHeat PumpREQUIRED Model NumberN/AHeat PumpREQUIRED Serial NumberN/AN/AA/C ManufacturerREQUIREDN/AA/C Model NumberREQUIREDN/AA/C Serial NumberREQUIREDN/AA/C Install DateREQUIREDREQUIREDLicensed Contractor Company Name:REQUIREDContractor Phone Number:REQUIREDContractor License Number:*Customer signature and receipts required for rebate (see Sections 4 and 7)**If you don’t have access to old appliance information, please email ONGRebates@OneGas.com.

2. Energy-Efficiency Rebates (Cont.)New Appliance REQUIREDWATER HEATER PROGRAM* 250Natural Gas Tankless WaterHeater (Uniform Energy Factorof .80 or higher) 250Natural Gas Condensing Water Heater (Uniform Energy Factorof .80 or higher)REQUIREDManufacturer NameREQUIREDModel NumberREQUIREDSerial NumberREQUIREDUniform Energy FactorREQUIREDInstall DateREQUIREDInstall CostCopy of AHRI certificate if available.AHRI NumberYEARSApproximate age of old appliance?If applicable:REQUIREDLicensed Contractor Company Name:REQUIREDContractor Phone Number:REQUIREDContractor License Number:Old Appliance REQUIRED **WATER HEATER PROGRAM* 850Replacing Electric Water Heaterwith Natural Gas Water HeaterNew Appliance REQUIREDREQUIREDManufacturer NameREQUIREDREQUIREDModel NumberREQUIREDREQUIREDSerial orm Energy FactorREQUIREDREQUIREDElectric ProviderN/AN/AInstall DateN/AInstall CostREQUIREDOPTIONALAHRI NumberCopy of AHRI certificate if available.REQUIREDIf applicable:REQUIREDLicensed Contractor Company Name:REQUIREDContractor Phone Number:REQUIREDContractor License Number:*Customer signature and receipts required for rebate (see Sections 4 and 7)**If you don’t have access to old appliance information, please email ONGRebates@OneGas.com.

3. Attach Proof of PurchaseREQUIREDPlease include a copy of an itemized receipt and/or invoice with your application. Your retailer or contractor can providethis document for your qualified product. Any applications missing this will be delayed or denied.Proof of purchase must include the following: Retailer/Contractor name, address and phone number Itemized listing of quantity, description, manufacturer, model number and other identifying information as appropriate Purchase date and price4. Review and Submit Your ApplicationCompleted application(s) along with required documentation must be submitted within 90 days of installationusing one of the three options below:OnlineVisit OklahomaNaturalGas.com and click on the “I want to.” button at the top of the page. Select“Complete a rebate application” from the dropdown menu and follow the prompts to complete yourapplication and upload required documentation.EmailComplete and email your application within 90 days of installation to: ONGRebates@OneGas.comMailComplete and mail your application within 90 days of installation to:Oklahoma Natural Gas Energy-Efficiency ProgramP.O. Box 401Oklahoma City, OK 73101-0401Rebate checks are issued within approximately six to eight weeks of a completed and approved rebate application.5. Terms and ConditionsAs you decide whether to participate in Oklahoma Natural’s Energy-Efficiency Program, please review the followingterms and conditions:1. Oklahoma Natural is not responsible for any decision regarding the selection of equipment to qualify for rebatesunder our energy-efficiency programs. OKLAHOMA NATURAL DOES NOT MAKE AND HEREBY DISCLAIMS ANYWARRANTY CONCERNING THE MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE FOR ANYEQUIPMENT CHOICE THE CUSTOMER MAKES. The customer is responsible for the full cost and installation ofany equipment.2. Oklahoma Natural is not responsible for any decision about which licensed and qualified contractor the customerselects. Oklahoma Natural encourages its customers to carefully research and select an Oklahoma licensed plumberor heating, ventilation and air-conditioning (HVAC) contractor to install qualifying equipment. Oklahoma Natural isnot responsible for any damage caused (a) when a contractor enters a customer’s premises or during installation, (b)by poor workmanship or (c) by failure to complete projects. Oklahoma Natural will not intervene in disputes betweena customer and his or her selected contractor. Oklahoma Natural also strongly encourages participating customersto be sure any installation conforms to all applicable codes, permit requirements and manufacturer installationrecommendations and requirements. Oklahoma Natural is not responsible for determining whether a customer’sappliances are installed correctly or safely. In the event you believe an appliance is unsafe or you detect the odorassociated with natural gas, you agree to immediately call 800-458-4251.

5. Terms and Conditions (Cont.)3. The Department of Energy and others provide information on projected energy savingsfor different types of appliances and installations. Oklahoma Natural makes no warrantyconcerning the accuracy of this information or whether the devices the customer selectswill accomplish the projected energy and cost savings.4. Oklahoma Natural requires each customer to present a completed rebate applicationand is unable to process incomplete applications. It is the responsibility of the customerto ensure the contractor has completed and signed the application. Applications andadditional information are available at www.OklahomaNaturalGas.com/rebates. OklahomaNatural reserves the right to verify all information provided. Oklahoma Natural issuesrebates in the form of checks, not utility credits. The Company is not responsible if thedealer/installer or retailer fails to provide accurate information about the amount of arebate or eligibility. Rebate checks will be mailed approximately six to eight weeks afterapproval, subject to availability of program funds.5. This program is available to any Oklahoma Natural current or prospective customer.Rebates are only available to active customers of Oklahoma Natural in an individuallymetered residential home. Only qualified natural gas equipment will be considered fora rebate. Oklahoma Natural encourages each customer to review all program eligibilityand requirements.6. Completed rebate applications will be reviewed and processed by Oklahoma Naturalon a first-come, first-served basis until program funds are depleted. Rebate qualificationsand amounts are subject to change. Rebate funds are limited. Funding guidelines forthese programs may be changed or discontinued at any time without notice. Please checkprogram website for updates at www.OklahomaNaturalGas.com/rebates. As a furthercondition to receiving a rebate, applicant agrees to allow Oklahoma Natural’s designatedrepresentative to enter applicant’s premises to verify installation. Applicant agrees thatthe purpose of this visit is not to assess the adequacy or safety of installation, but merelyto verify that qualifying equipment has been installed.SURVEY QUESTIONS1. How did you hear about the program?TVRadioEmailSocial MediaOnline adMailWord Of MouthOther2. How knowledgeable was yourcontractor about the program?3. Is there any way we could improve ourcommunication about the program?7. This Agreement constitutes and represents the complete and entire agreementbetween the customer and Oklahoma Natural with respect to the subject matter containedherein, and supersedes any prior and contemporaneous agreements, arrangements andunderstandings of the Parties, whether written or oral, which are hereby terminated andof no further force and effect. The terms of this Agreement may not be altered, modifiedor supplemented except by a writing signed by each of the Parties.6. Acceptance of TermsREQUIREDI hereby certify that all information is accurate, including claims of customer and equipment information. My signaturebelow indicates I have read, understand and agree to all terms and conditions on this application and acknowledge thatOklahoma Natural Gas may verify all the information provided.APPLICANT SIGNATURE: DATE:

550 95% Efficient Natural Gas Serial Number Furnace or Boiler If you are replacing a gas appliance, what is the age of the old appliance?_ 1,950 Replacing Electric Resistance Furnace with Natural Gas Furnace 1,950 Replacing Electric Heat Pump with Natural Gas Furnace

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