Heat Pump Rebate Application | Mountain Parks Electric, Inc

Mailing Address
PO Box 170
Granby, CO 80446-0170

970-887-3378
memberservices@mpei.com

Heat Pump Rebate Application

Please fill in the required information below.

Member Owner Contact Information

Full Name

Email Address

Installation Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Account Number:

Application Date:

Date Equipment Installed:

Consumer Type:

System Type:

System Type Replacing:

Number of Units:

Accounts may be eligible for more than once rebate depending on project scope or building type and will be handled on a case-by-base basis.

Air Source Ducted

Outdoor Brand Name:

Series Name:

Outdoor Unit Model Number:

Indoor Unit Model Number:

Furnace Model Number:

Cold Climate:

Heating Capacity:

Heating Capacity Calculation (in Tons):

Size (total installed tons):

SEER:

SEER2 (if available) :

HSPF:

HSPF2 (if available):

Air Source Ductless/Mini Split

Product Manufacture:

Series Name:

Brand Name:

Product Model Number:

Cold Climate:

Heating Capacity:

Heating Capacity Calculation (in Tons):

Manually Enter Heat Pump Information:

Size (total installed tons):

SEER:

SEER2 (if available) :

HSPF:

HSPF2 (if available):

Air-to-Water

Product Manufacture:

Product Model Number:

Size (total installed tons):

Ground Source

System Type Replacing:

Product Manufacture:

Product Model Number:

Size (total installed tons):

EER

COP

Terminal Unit

Product Manufacture:

Product Model Number:

Size (total installed tons):

SEER:

SEER2 (if available) :

HSPF:

HSPF2 (if available):

Is this a Controlled ETS Backup Heat?

Yes

Equipment Cost:

Upload Any Supporting Documents for Your Rebate Request in the Slots Below (Receipts, Pictures, etc.)

Upload Slot A:

Upload Slot B:

Upload Slot C:

Upload Slot D:

Upload Slot E:

One file only.
100 MB limit.
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Mountain Parks Electric, Inc.

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