Site Installation Address

 
 
 
 
 

 

Mailing Address (if different than Site Installation address)

 
 
 
 
 

 
 

Estimate the approximate size of the home in square feet.

 
 
 
 
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Does your household fall below 200% of the 2024 Federal Poverty Level?


1 Person: $30,120

2 People: $40,880

3 People: $51,640

4 People: $62,400

5 People: $73,160

6 People: $94,680

7 People: $94,680

8 People: $105,440

9 or more: Add $10,760 each

 

 

Please include a copy of contractor’s invoice for proof of installation, including the date installed, appliance specifications, and model numbers.

Drop your files here
 

 

Terms & Conditions

Complete application must be received within 6 months of the installation date to be considered for incentive. Homeowners must comply with all applicable codes and regulations. Available to all active OPALCO members in good standing (no arrears balance). OPALCO reserves the right to inspect installation and will coordinate inspection as applicable. Rebate is cost reimbursement of charges and fees directly related to the purchase and installation of qualifying Ductless Heat Pump units up to $1,500.00 as a fuel-switching incentive only. OPALCO is not responsible for any part of the appliance maintenance, power consumption, or any and all implied warranties (including but not limited to implied warranties or merchantability or fitness for a particular purpose) and shall not be responsible for any representation or promise with respect to the equipment, materials, or labor required for the installation of the appliance on the premises, or the cost of such equipment, materials and labor. Cannot be combined with other OPALCO rebate offerings. Additional conditions may apply. By signing below, the member implies that all information provided is true and accurate to the best of their knowledge.

 

 

Member Signature

 
 
 
mm/dd/yyyy
 
 

 
 

Include cost for equipment, labor, electrical, tax, permit and other (prior to rebate).

 
 
 
 
 
 
 

Include Model No.

 

Include Model No.

 

Include Model No.

 

Include Model No.

 

 

Contractor Signature Release

By signing below, the contractor certifies that this invoice form and all accompanying documents are complete and accurate. The signature certifies that the contractor is licensed, bonded, insured, has been trained by the manufacturer of the installed product and has received project contractor orientation. By signing this, the contractor has read and understood the terms and conditions listed on this form and/or project information on the NW Ductless Heat Pump Project website (www.GoingDuctless.com). It also assumes that installation of all appliances has been done according to all codes and regulations, the contractor is licensed, bonded and insured.

 

Who is the best person to contact?

 
 
 
 
 
 
 
mm/dd/yyyy
 

 

**VOLUNTARY** Demographic Information

Why do we ask? This information helps us access grants and other funding opportunities to better serve you!