Industrial Facility Retrofit Incentive Application
Applicant Information
Applicant Name
Date
Organization Name
Title/Position
Address
City
State/Province
Zip/Postal Code
Phone
Email
Facility Information
Facility Name
Facility Address
City
State/Province
Zip/Postal Code
Facility Type
Manufacturing
Processing
Warehouse
Other
Facility Size (sq. ft.)
Project Details
Project Description
Equipment/Systems to Retrofit
Planned Start Date
Planned Completion Date
Estimated Total Project Cost
Requested Incentive Amount
Energy Impact
Estimated Annual Energy Savings (kWh or other units)
Baseline Energy Consumption
Expected Post-Retrofit Energy Consumption
Supporting Documents
Attach Quotes, Specs, or Other Documentation
Certification
By submitting this application, I certify that the information provided is accurate and complete.