To be eligible for a rebate, I understand that: (a) I, or my tenant, must be a customer with an active meter serviced by National Fuel Distribution Corporation (“National Fuel”) in National Fuel’s Western New York service territory for the installation address and, (b) the product(s) I have installed must qualify as described on the Rebate Application Form, incorporated herein by this reference, and be designed and installed to reduce the consumption of the energy distributed to me by National Fuel at the installation address. I understand I must complete an application for each installation address. For installations at multi-family dwellings, a separate application must be completed for each active meter. All uses herein of the words “install,” “installation” or similar phrases shall mean complete installation such that the subject product(s) is/are fully functional at the time that the rebate application is submitted.

All eligible measures must be installed by a licensed contractor, or a contractor that can supply you with either a Federal ID number, or a Certificate of Insurance, or a Business Certificate.

I understand the Conservation Incentive Program Rebate term begins on January 1, 2022. Product purchases and installations made prior to January 1, 2022 do not qualify for a rebate with this form. Resale products, products rebuilt, rented, received from insurance claims, won as a prize, or new parts installed in existing products do not qualify. All applications are processed on a first-come, first-served basis, as received. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. Resubmitted information/ documentation is processed on a first-come, first-served basis, based on the new receipt date. This program may be modified or terminated at any time and without prior notice. In the event that the amount of a rebate changes during the course of the program, the installation date will be used to determine product eligibility and rebate amount.

I understand that this signed and dated Rebate Application Form, all appropriate Proof(s) of Purchase and other required documentation as referenced in this Application must be submitted to National Fuel to be considered eligible for a rebate, and that HomeServe USA will be submitting this form and all documentation on my behalf.

I will allow, if requested, a National Fuel representative reasonable access to the install address to verify the product has been installed before any rebate is. I understand that a rebate will not be paid if I refuse to participate in any required verification. I understand that National Fuel may contact the qualifying product vendor and/or installer, if needed, to verify purchase and/or installation and may provide my name and/or address to complete this verification.

I have installed a qualifying product(s) and understand the energy efficiency level of the qualifying product(s) determines the rebate amount (as defined in the Rebate Application Form). A single gas-fired piece of equipment that provides two functions (e.g., heat and hot water) is only eligible for one rebate, that being the higher rebate amount of the two listed amounts. The rebate amount cannot exceed the purchase price. One furnace/boiler tune-up service available per furnace/boiler, per year.

I agree that the selection of qualifying product(s), selection of manufacturer, dealer, supplier and/or installer, and purchase, installation and ownership/maintenance of the qualifying product(s) referenced in this Application are my sole responsibility, and that my manufacturer, dealer, supplier or installer of these products and measures is not an agent or representative of National Fuel. I understand that National Fuel makes no representations regarding manufacturers, dealers, contractors, materials or workmanship. I ALSO UNDERSTAND THAT NATIONAL FUEL MAKES NO WARRANTY WHETHER EXPRESS OR IMPLIED, INCLUDING WITHOUT LIMITATION THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR ANY PARTICULAR PURPOSE, USE, OR APPLICATION OF THE PRODUCTS OR MEASURES. I agree that National Fuel has no liability whatsoever concerning (1) the quality, safety and/or installation of the products or measures, including their fitness for any purpose, (2) the estimated energy savings of the products or measures, (3) the workmanship of any third parties, (4) the installation or use of the products or measures including, but not limited to, effects on indoor pollutants, or (5) any other matter with respect to the National Fuel Conservation Incentive Program. I waive any and all claims against National Fuel, its parent companies, directors, officers, employees, or agents, arising out of activities conducted by or on behalf of National Fuel in connection with my application for any rebate(s) under the National Fuel Conservation Incentive Program. Without limiting the generality of the foregoing, none of the above stated parties shall be liable hereunder for any type of damages, whether direct, indirect, incidental, consequential, exemplary, reliance, punitive or special damages, including damages for loss of use regardless of the form of action, whether in contract, indemnity, warranty, strict liability or tort, including negligence of any kind.

I am responsible for meeting all program requirements and complying with my state/county/city governments, property owner and/or homeowner’s association requirements (if any) in my area regarding local conditions, restrictions, codes, ordinances, rules, and regulations concerning this installation.

If a tenant, I am responsible for obtaining the property owner’s permission to install the product for which I am applying for a rebate. My signature on this application indicates I have obtained this permission.

I understand that National Fuel is not responsible for items lost or destroyed in the mail/transit.