Motor & Variable Speed Drives Application 2016 Retrofit .

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Motor & Variable Speed Drives Application2016 Retrofit ProgramThe Retrofit Program is designed for commercial andindustrial customers to help replace aging, inefficientequipment and systems with energy efficient technologies.The Retrofit Program provides a customer with incentivesand technical services that will facilitate the installation ofpremium efficient equipment. Call National Grid to arrangea convenient time to perform an inspection of the existingequipment or systems.Prescriptive Retrofit Application & InstructionsFor Replacement of Operating Equipment1. Is your project eligible? Equipment shall be new and shall be installed in a commercial, industrial, institutional, educational, or municipal buildingwithin National Grid’s electric service territory2. Is the equipment you intend to buy eligible? Product types listed in this form are eligible for prescriptive incentives. However, other measures not listed here may beeligible for custom incentives using the Custom Retrofit Application3. Pre-Approval requirements: Contact your National Grid representative before purchasing and installing the equipment To see if the energy efficient measure (EEM) qualifies for an incentive:i. Review the Terms and Conditions governing the program, then submit a completed application form with an authorizedsignatureii. Submit a copy of the Manufacturer’s technical specification sheets (“cut sheets”) for each type of eligible equipment tobe purchasediii. Once pre-approved, a “pre-approved incentive letter” will be issued4. Installation and incentive requirements: Once pre-approved, purchase and install the qualifying equipment within twelve (12) months of National Grid’s pre-approval Return the required information to your National Grid representative within 30 days of the installation:i. A copy of the completed and signed pre-approval applicationii. If there is a change in equipment, please submit a new manufacturer’s technical specification sheet (“cut sheet”) for eachtype of eligible equipment purchasediii. A copy of your invoice indicating Proof of Purchase must indicate type, size, make, and model number of the equipmentand date of purchase and installationiv. At the post-installation verification, the customer is required to sign the post-installation customer acknowledgementsection of the original applicationProgram details:This incentive program covers applications created on or after January 1, 2016. Details of this Program, including incentivelevels, are subject to change without prior notice. Contact National Grid for the latest program details.Motor & Variable Speed Drives 2016 Retrofit Program RI1-800-787-1706 / Fax: 1-315-460-9803Page 1 of Rev. 12/14/201540 Sylvan Road, Waltham, MA 02451-1120

Motor & Variable Speed Drives Application2016 RetrofitALL FIELDS ON THIS PAGE ARE REQUIRED TO COMPLETE YOUR APPLICATION.CUSTOMER/ACCOUNT HOLDER INFORMATIONCOMPANY NAMECONTACT PERSONINSTALL SITEPHONEAPPLICATION DATEFAX NUMBEREMAIL ADDRESSSQUARE FEET (COVERED BY THIS APPLICATION)STREET ADDRESSCITYSTATEZIPMAILING ADDRESS (IF DIFFERENT)CITYSTATEZIPELECTRIC COMPANY NAMEELECTRIC ACCOUNT NUMBER (OR COPY OF ELECTRIC BILL)GAS COMPANY NAMEGAS ACCOUNT NUMBER (OR COPY OF GAS BILL)BUILDING TYPE (PLEASE PLACE “X” IN APPROPRIATE BALLOT BOX) ASSEMBLY AUTOMOTIVE BIG BOX COMMUNITY COLLEGE DORMITORY FAST FOOD FULL SERVICE RESTAURANT GROCERY HEAVY INDUSTRIAL HOSPITAL HOTEL LARGE REFRIGERATED SPACE LARGE OFFICE LIGHT INDUSTRIAL MOTEL MULTI STORY RETAIL MULTIFAMILY HIGH-RISE MULTIFAMILY LOW-RISE OTHER: RELIGIOUS K-12 SCHOOL SMALL OFFICE SMALL RETAIL UNIVERSITY WAREHOUSEPAYMENT METHOD (PAYEE MUST SUBMIT A W-9 FORM)PAYMENT TO: CUSTOMER VENDOR/INSTALLERCHECK PAYABLE TO:CUSTOMER — TAX ID# (REQUIRED)VENDOR/INSTALLER — TAX ID# (REQUIRED IF RECEIVING INCENTIVE)CUSTOMER COMPANY TYPE:VENDOR COMPANY TYPE: INC. NOT INCORP. EXEMPT INC. NOT INCORP. EXEMPTVENDOR INFORMATIONAUTHORIZED VENDOR/INSTALLERCONTACT NAMESTREET ADDRESSCITYPHONEEMAIL ADDRESSSTATEZIPDATE AUTHORIZED VENDOR/INSTALLER SIGNATURE (NOT APPLICABLE IF CUSTOMER IS PAYEE.)XCUSTOMER ACCEPTANCE OF TERMSPRE-INSTALLATIONANTICIPATED COMPLETION DATE I CERTIFY THAT ALL STATEMENTS MADE IN THIS APPLICATION ARE CORRECT TO THE BEST OF MY KNOWLEDGE AND THAT I HAVE READAND AGREE TO THE TERMS AND CONDITIONS ON THE BACK OF THIS FORM.DATEPRINT NAMEAUTHORIZED SIGNATUREXPOST-INSTALLATION I CERTIFY THAT I HAVE SEEN THE ENERGY EFFICIENCY MEASURES THAT HAVE BEEN INSTALLED AND I AM SATISFIED WITH THEIR INSTALLATION.DATEPRINT NAMEMotor & Variable Speed Drives 2016 Retrofit Program RI1-800-787-1706 / Fax: 1-315-460-9803AUTHORIZED SIGNATUREXPage 2 of Rev. 12/14/201540 Sylvan Road, Waltham, MA 02451-1120

ELIGIBILITY REQUIREMENTSPrescriptive Incentives will be provided for the installation of Variable Speed Drives (VSD) from 1-150hp for ONLY the installation typesoutlined in Table 1:f. Boiler Feed Water Pump [FWP]a. Supply Fan on constant volume supply air handlerg. Water Source Heat Pump Circulation Pump [WHP]and VAV packaged HVAC unit [SFA]h. Heating Hot Water Pump [HWP]b. Return Fan on constant volume return air handleri. Process Cooling Pump [PCP]and VAV packaged HVAC unit [RFA]j. Process Exhaust and Make-up Fan [PE] (non VAV system)c. Boiler Draft Fan [BDF]k. Water Supply or Waste Water Pump [WSP]d. Cooling Tower Fan [CTF]e. Chilled and Condenser Water Distribution Pump [CWP]All other VSD applications MUST file a Custom ApplicationVSDs must be controlled by an automatic signal in response to modulating air/water flows. The VSD speed must beautomatically controlled by differential pressure, flow or temperature. Applicants must demonstrate significant loaddiversity that will result in savings through motor speed variation.NOTE: The following VSD applications are NOT eligible for prescriptive incentives under this application:5. Two-speed cooling tower fans,1. Forward curve fans with inlet guide vanes,6. VSD used as two-speed control of fan or pump,2. Variable pitch vane-axial fans,7. VSD used to mitigate over-sized motor installation.3. Replacement of previously failed VSD,4. VSD used for balancing,Motors must be new NEMA-Premium, inverter-duty rated, 3 phase, 1-150 hp, open drip proof (ODP) or totally enclosed fan cooled(TEFC), 1200, 1800, or 3600 RPM motors. Motors must operate a minimum of 2,000 hours annually and meet/exceed the minimumefficiency levels listed in the tables below.Minimum Efficiency Levels — Open Drip-Proof (ODP) MotorsNEMA Nominal EfficiencySize (HP)11.52357.51015202530405060751001251501200 RPM 82.5% 86.5% 87.5% 88.5% 89.5% 90.2% 91.7% 91.7% 92.4% 93.0% 93.6% 94.1% 94.1% 94.5% 94.5% 95.0% 95.0% 95.4%1800 RPM 85.5% 86.5% 86.5% 86.5% 89.5% 91.0% 91.7% 93.0% 93.0% 93.6% 94.1% 94.1% 94.5% 95.0% 95.0% 95.4% 95.4% 95.8%3600 RPM 77.0% 84.0% 85.5% 85.5% 86.5% 88.5% 89.5% 90.2% 91.0% 91.7% 91.7% 92.4% 93.0% 93.6% 93.6% 93.6% 94.1% 94.1%Minimum Efficiency Levels — Totally Enclosed Fan-Cooled (TEFC) MotorsNEMA Nominal EfficiencySize (HP)11.52357.51015202530405060751001251501200 RPM 82.5% 87.5% 88.5% 89.5% 89.5% 91.0% 91.0% 91.7% 91.7% 93.0% 93.0% 94.1% 94.1% 94.5% 94.5% 95.0% 95.0% 95.8%1800 RPM 85.5% 86.5% 86.5% 89.5% 89.5% 91.7% 91.7% 92.4% 93.0% 93.6% 93.6% 94.1% 94.5% 95.0% 95.4% 95.4% 95.4% 95.8%3600 RPM 77.0% 84.0% 85.5% 86.5% 88.5% 89.5% 90.2% 91.0% 91.0% 91.7% 91.7% 92.4% 93.0% 93.6% 93.6% 94.1% 95.0% 95%Motor & Variable Speed Drives 2016 Retrofit Program RI1-800-787-1706 / Fax: 1-315-460-9803Page 3 of Rev. 12/14/201540 Sylvan Road, Waltham, MA 02451-1120

M E A S U R E I N F O R M AT I O NVSD installation information form is required for all BDF, PCP, PE & WSP installations. Attach invoices, product specification sheets and otherrelevant documentation to this application. Variable Speed Drives (VSDs) installed in process applications, waste water or municipal watersupply applications may use the Custom Application process, which requires detailed energy savings calculations.Table 1: Select VSD Installation TypeBDFBoiler Draft FanHWPHot Water Circ PumpRFAHVAC Return Air FanBEFBuilding Exhaust FanMAFMake-up Air FanSFAHVAC Supply Air FanCTFCooling Tower Fan(Single Speed only)PCPProcess Cooling PumpWHPWS Heat Pump Circ LoopCWPChilled / Cond Water PumpPEProcess Exhaust andMake-up FanWSPWater Supply orWaste Water PumpFWPBoiler Feed Water PumpTable 2: Select VSD SizeHorsepower11.5235IncentiveHorsepower 1,200 1,200 1,200 1,200 3,4507.510152025IncentiveHorsepower 3,450 3,600 4,350 5,400 6,1503040506075Incentive 7,650 8,400 8,850 12,900 14,400HorsepowerIncentive100125150 16,500 16,500 16,500Table 3: Controlling ParametersDPDTPressure DifferentialOTHTemperature DifferentialOther SpecifyTable 4:  From Tables 1, 2 & 3 above, fill in using one line for each VSD & Motor.Attach specification sheets and invoice copies to this applicationInstallationType(Table 1)VSD & MotorHorsepower(Table 2)ControllingParameter(Table 3)Motor Type(ODP orTEFC)MotorSpeedNEMANominalEfficiencyAnnualHours ofOperationAlternateor Backup?Location/DesignationRequestedIncentiveper VSD(Table Attach a separate list for additional unit(s)Open Excel FileTotal Requested Incentive (this page) I M P O R TA N T V S D I N F O R M AT I O NVSDs can be sensitive to over-voltages that occur when power factor correcting capacitor banks on the utility power system are switched on. A minimum3% series reactor (inductor, choke) is strongly recommended on the drive AC input connections based on the horsepower of the VSD to be installed. In someinstances your supplier may find it necessary to install 5% reactors and, rarely, additional filtering devices to meet acceptable current and voltage harmonicdistortion requirements.If your power factor is less than 0.8 (80%), we recommend that you consider power factor correction concurrent with the installation of drives.The use of VSDs which incorporate pulse width modulation (PWM) may produce over-voltages which may cause premature failure of AC induction motors notrated for use with an inverter. We recommend that when installing PWM drives, you consider utilizing inverter rated motors.Motor & Variable Speed Drives 2016 Retrofit Program RI1-800-787-1706 / Fax: 1-315-460-9803Page 4 of Rev. 12/14/201540 Sylvan Road, Waltham, MA 02451-1120

VSD INSTALLATION INFORMATION FORM (REQUIRED FOR ALL BDF, PCP, PE, & WSP INSTALLATIONS)Equipment Information(Example: Feedwater Pump #1; Condenser Water Pump #1)Fan or Pump ID(s) (Use list of application types from page four, Table 1, or describe other)Device Code: Type of area(s) served by fan(s) or pump(s): Equipment served by the fan(s) or pump(s): If fan, note type:(centrifugal, forward curve, backward curve, axial, etc)Fan or Pump Nominal HP(if multiple motors, list individual HP’s)Nominal HPNameplate motor efficiencyFan or Pump Manufacturer:Model:Full Load Design Conditions: Flow(CFM, GPM) PressureExisting Controls:(discharge damper, inlet guide vanes, outlet control valve, bypass valve, etc.)Existing Set Point:(inches static, feet of water, PSI, other?)(inches static, feet of water, PSI, other?)Operating HoursThe fan or pump operates the following hours: (Example: 0600 to turdaystoSundaystoSundaystoNumber of shifts per weekday:Number of shifts per weekend day:Motor LoadOption 1: (retrofit): Measured input power under full load:kW, (true RMS power)Option 2: (retrofit): Measured current and voltage under full load:AmpsLoad calculation Volts XAmps XOption 3: (retrofit or new): Estimated Fan or Pump Load:PF Power FactorVolts0kWkW%, Estimated PowerIf estimating load, provide description, assumptions and formula used to calculate power: Proposed OperationsThe proposed VSD will be automatically controlled to maintain the following set points:Flow(CFM, GPM, other?)Pressure(inches static, feet of water, PSI, other?)Other? (describe): Table 5: Estimated VSD speed in future operationsSummerPercent LoadWeekdayWinterWeekendWeekdayWeekend90% to 100%80% to 90%60% to 80%20% to 60%Totals (100%)Motor & Variable Speed Drives 2016 Retrofit Program RI1-800-787-1706 / Fax: 1-315-460-9803Page 5 of Rev. 12/14/201540 Sylvan Road, Waltham, MA 02451-1120

VSD INSTALLATION INFORMATION FORM (REQUIRED FOR ALL BDF, PCP, PE, & WSP INSTALLATIONS)Table 6: ECM Motor TableECM MotorsQuantityCFM RatingLocationElectronically Commutated Motors (ECM)For Fan Powered Boxes & Fan Coils orHVAC Supply Fans onlyDollarsRequested Incentive Dollars 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0TotalNOTE: The PA’s reserve the right to disqualify entries that are incorrect.Motor & Variable Speed Drives 2016 Retrofit Program RI1-800-787-1706 / Fax: 1-315-460-9803Page 6 of Rev. 12/14/201540 Sylvan Road, Waltham, MA 02451-1120

VSD INSTALLATION INFORMATION FORM (REQUIRED FOR ALL BDF, PCP, PE, & WSP INSTALLATIONS)Table 8: ECM Motor InventoryNOTE: Calculated incentive amount is subject to change.Total Quantity:Official incentives will be communicated by therespective Program Administrator in the form ofa pre-approval letter.Total Requested: 0.00#QuantiyCFM RatingLocation / DesignationExample2300Office 201 and Office 2930NOTE: For ECM Motors on Fan Powered Boxes & Fan Coils ONLY, provide a list detailing the associated HVACThese programs are funded by the energy efficiency charge on all customers’ utility bills, in accordance with Rhode Island law.Motor & Variable Speed Drives 2016 Retrofit Program RI1-800-787-1706 / Fax: 1-315-460-9803Page 7 of Rev. 12/14/201540 Sylvan Road, Waltham, MA 02451-1120

TERMS AND CONDITIONS1. IncentivesSubject to these Terms & Conditions, the Program Administrator will pay Incentives to Customer for the installation of EEMs.2. Definitions(a) “Customer” means the customer maintaining an account for service with the Program Administrator, and who satisfies the Program eligibility requirements established by theProgram Administrator.(b) “EEMs” are those energy efficiency measures described in the Program Materials or other Custom Measures that may be approved by the Program Administrator.(c) “Facility” means the Customer location served by the Program Administrator where EEMs are to be installed.(d) “Incentives” means those payments made by the Program Administrator to Customers pursuant to the Program and these Terms and Conditions.(e) “National Grid” means [Massachusetts Electric Company d/b/a National Grid, Nantucket Electric Company d/b/a National Grid or The Narragansett Electric Company d/b/aNational Grid, as applicable].(f) “Program” means the energy efficiency program offered by the Program Administrator to Customers.(g) “Program Administrator” means National Grid.(h) “Program Materials” means the documents and information provided by the Program Administrator specifying the qualifying EEMs, technology requirements, costs and otherProgram requirements, which include, without limitation, program guidelines and requirements, application forms and approval letters.3. Application Process and Requirement For Program Administrator Approval(a) The Customer shall submit a completed application in the form specified by the Program Administrator. Submission of a completed application does not alone entitleCustomer to participation in the Program. Program Administrator reserves the right to reject any application, prior to pre-approval, for any reason whatsoever. In addition, atthe Program Administrator’s discretion, the Customer may be required to provide the Program Administrator with a copy of the detailed specifications and scope of work, aswell as an analysis of the savings and/or demand reduction, for the EEMs proposed for approval. Customer will upon request by the Program Administrator provide a copyof the as-built drawings and equipment submittals for the Facility after EEMs are installed. This analysis shall be prepared by a Professional Engineer licensed in the statewhere the Facility is located to the extent required by the Program Administrator or by applicable law, regulation or code.(b) The Program Administrator will review the Customer’s application and supporting documentation to determine the energy savings and demand reduction potential. TheProgram Administrator reserves the right to reject or modify any calculations, based on the Program Administrator’s own analysis.(c) The Program Administrator is not obligated to pay any Incentives unless the authorized representative of the Program Administrator issues an approval letter regarding theEEMs proposed by the Customer, and any necessary pre- and post- installation verification activity is successfully completed by the Program Administrator. The ProgramAdministrator’s approval letter shall state the maximum approved Incentive amount and the date by which the EEMs must be fully installed and operational to qualify forIncentive payments. The Program Administrator may also require the Customer to execute additional agreements, or provide other documentation regarding the proposedEEM installation and Incentive payment(s).(d) The Customer will have no right to receive, and the Program Administrator will have no obligation to pay, Incentives for any EEMs that have not been approved in writing inadvance by the Program Administrator, unless the Program Materials state that such prior approval is not required. Further, the Program Administrator is not obligated to payIncentives for projects which were pre-approved but are determined to not comply with Program requirements after installation is complete.(e) The Program Administrator reserves the right to approve or disapprove of any application or proposed EEMs.(f) The Program Administrator will only pay incentives for the specific EEMs listed on the front of the application. If the customer has received an Upstream incentive for ameasure listed on this form, the customer is not eligible to receive an additional incentive for the same measure.4. Pre- and Post-Installation Verification and Follow-Up Visits(a) The Program Administrator is not obligated to pay any Incentives until the Program Administrator has performed a satisfactory pre-installation inspection (unless the ProgramMaterials state such pre-inspection is not required) and post-installation verification of the installation. If the Program Administrator determines that any EEMs were notinstalled in accordance with these Terms and Conditions, the Program Materials and the Program Administrator’s approval, the Program Administrator shall have the rightto require modifications before having the obligation to make any Incentive payments. At its discretion the Program Administrator may also withhold payment of Incentivesuntil it has been verified that the Customer has received, as appropriate, final drawings, operation and maintenance manuals, and operator training, and the ProgramAdministrator has received documentation detailing the installation of the EEMs in accordance with these Terms and Conditions, the Program Materials and the ProgramAdministrator’s approval.(b) Program Administrator reserves the right to make a reasonable number of follow-up visits to the Facility during the twenty-four months following the actual completiondate noted on the customer report. Such visit(s) will occur at times mutually agreed upon by Program Administrator and Customer. The purpose of the follow-up visits is toprovide the Program Administrator with an opportunity to review the operation of the EEMs and not to impact on the

Motor & Variable Speed Drives 2016 Retrofit Program RI Page 1 of 9 Rev. 12/14/2015 The Retrofit Program is designed for commercial and industrial customers to help replace aging, inefficient equipment and systems with energy efficient technologies.

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