LED Lighting Retrofit Rebate Application
Applicant Information
Applicant/Company Name
Contact Name
Email
Phone Number
Address
City
State/Province
ZIP/Postal Code
Facility Information
Facility Name
Facility Type
Facility Address
Project Details
Estimated Project Start Date
Estimated Project Completion Date
Description of Lighting Retrofit Project
Existing Lighting Inventory
Location/Area
Fixture Type
Quantity
Wattage per Fixture
Total Watts
Proposed LED Lighting Inventory
Location/Area
LED Fixture Type
Quantity
Wattage per Fixture
Total Watts
Estimated Costs & Rebate
Total Project Cost
Requested Rebate Amount
Additional Comments