ELECTRIC THERMAL STORAGE

PROGRAM REQUEST FORM

Xcel Energy account number _______________________________

Name _______________________________________________

2010
Mailing address _ ______________________________________

City___________________________ State_ ______ ZIP_________

Address ETS equipment is installed (if different from above)
Address _ ____________________________________________
City___________________________ State_ ______ ZIP_________
ETS EQUIPMENT INFORMATION
Contractor name _______________________________________
Installation date _ ______________________________________
m New construction m Existing construction m Addition
Limitations ETS & ELECTRIC INCENTIVE PROGRAMS
• Incentives quantities are limited.
• Installation of qualified equipment does not obligate
Xcel Energy to pay an incentive.
• Incentive qualifications and amounts are subject to change
at any time and may be canceled with 60-days notice.
• This Xcel Energy incentive program runs from
Jan. 1 to Dec. 31, 2010.
• Please allow four to six weeks for delivery of your
incentive check.

Room unit _________________________________________ kW

Slab heat (underfloor electric cable) _ _____________________ kW

ETS forced air central furnace___________________________ kW

ETS hydronic central furnace _ __________________________ kW

Off-peak electric boiler & tubing_ ________________________ kW

Other, please specify _________________________________ kW

m Time-of-Use
m With Mini-Peak Interrupter
m With Steffes Power Line Carrier Transmitter
or Comfort Control Relay Panel
m No automatic control P.O. Box 8 © 2010 Xcel Energy Inc.

m Other, please specify _____________________________ Eau Claire,WI 54702-0008

1-800-895-4999
Xcel Energy is a registered trademark
of Xcel Energy Inc.
xcelenergy.com Northern States Power Company –
m Limited Off-Peak Rate Wisconsin, an Xcel Energy Company

09-12-310 12/09 CRS 1894

2010
INCENTIVE PROGRAMS
ELECTRIC THERMAL
STORAGE PROGRAM
Incentives are available for Xcel Energy
residential customers in Wisconsin who install
Electric Thermal Storage (ETS) heating.
ETS ROOM UNITS & ETS
COMFORT PLUS SYSTEMS
• $25 per kW for first 50 kW
• $10 per kW for each additional kW
SLAB HEAT STORAGE &
OFF-PEAK ELECTRIC HYDRONIC
• $20 per kW for first 50 kW
• $5 per kW for each additional kW
Note: Customers must be on Xcel Energy’s
Time-of-Day Rate or Limited Off-Peak Rate
and have an approved automatic control
device installed to qualify for rebates.
To receive incentive:
• Complete attached ETS Program Request Form
• Mail form and a copy of the itemized equipment
invoice to:
Xcel Energy, Electric Products & Services
P.O. Box 8, Eau Claire, WI 54702-0008
ELECTRIC WATER HEATER INCENTIVE
PROGRAM REQUEST FORM
Xcel Energy account number ________________________________
Customer Information (Please print clearly)
Name ________________________________________________
ELECTRIC WATER HEATER Daytime phone _ ________________________________________
INCENTIVE PROGRAM
Installation address
Xcel Energy will pay a incentives to Wisconsin
residential customers who purchase and install
Address _ _____________________________________________
an electric water heater which meets certain
requirements. This incentive is only available in
City___________________________ State_ ______ ZIP__________
areas where natural gas is not available.
Mailing address (if different from above)
• 80-99 gallon - $200
• 100+ gallon - $3/gallon Address _ _____________________________________________
• .91 or greater Energy Factor
City___________________________ State_ ______ ZIP__________
• Must be on Time-of-Day Rate or
Limited Off-Peak Rate
I hereby certify that all information is accurate. I understand that
To receive incentives: Xcel Energy reserves the right to inspect and verify any equipment
• Complete attached Electric Water Heater before issuing incentives.
Incentive Request Form
Customer signature ______________________________________
• Mail form and a copy of the itemized invoice to:
Xcel Energy Date _________________________________________________
Electric Products & Services
P.O. Box 8 WATER HEATER INFORMATION
Eau Claire WI 54702-0008
Installation date_________________________________________
Brand name____________________________________________
Model # ______________________________________________
Size (gallons)___________________________________________
Energy Factor (EF) _ ______________________________________
Rebate amount__________________________________________