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PAYMENT INFORMATION – A COMPLETED W9 FORM IS REQUIRED

Checks will be made payable to the Legal Business Entity Name or DBA name listed on the W-9. Payee may be responsible for any tax liabilities that may be associated with the incentive/rebate.

TERMS AND CONDITIONS

Application: This Standard Incentive Request and any additional required documentation must be filled out completely, truthfully and accurately. Only Washington customers of Cascade Natural Gas Corporation (“CNGC”) served on rate schedule 504,505, 511, 570 and 577 are eligible for this program. Customers are advised to retain a copy of this application and any other documentation submitted to CNGC under this program. CNGC will not be responsible for lost documentation pertaining to the rebate request. Work must be installed no later than December 31st of the current calendar year to receive program incentives. All completed incentive requests must be post-marked within the current calendar year to be processed. Please allow six weeks for incentive processing.

Pre-Approval and Verification: Equipment installations may be selected for a post-installation inspection or verification. Should a customer’s equipment be chosen for a post-installation inspection, satisfactory completion of that inspection must occur before payment is issued. This inspection is for the purpose of incentive payment only. No warranty is implied.

Tax Liability: CNGC is not responsible for any tax liability which may be imposed on the customer as a result of payment of any incentives. CNGC is not providing any tax advice, and any communication by CNGC is not intended or written to be used, and cannot be used, for the purpose of avoiding penalties under the Internal Revenue Code (W9).

No Endorsement: CNGC does not endorse any particular manufacturer, contractor or product in promoting the Program. The fact that the names of particular manufacturers, contractors, products or systems may appear on this application does not constitute an endorsement. Manufacturers, contractors, products or systems not mentioned are not implied to be unsuitable or defective in any way.

Safety and Building Codes: Customer is responsible for insuring that all equipment installed and work performed complies with all federal, state, and local safety, building and environmental codes, and any manufacturer instructions.

Property Rights: Customer represents that it has the right to install the energy saving equipment on the property on which the equipment is installed and that any necessary consents have been obtained.

Disclaimer/No Liability: Customer understands that, while CNGC may have provided funding for approved equipment, CNGC is not supervising work performed for Customer, nor is CNGC responsible in any way for proper completion of that work or proper performance of any equipment purchased. Customer assumes the risk of any loss or damage(s) that Customer may suffer in connection with the installation of the Equipment. CNGC does not guarantee any particular energy savings results by its approval of this application, or by any other of its actions.

Eligible Products: Incentives are available to approved customers who reside within CNGC service territory and are commercial or industrial customers. Equipment must meet CNGC energy specifications. These specifications may be found on the web at www.cngc.com and are subject to change. If you, or your contractor, are not sure of the specifications, please feel free to contact CNGC’s Conservation Department before proceeding.

Proof of Purchase: The invoice documentation accompanying the application must itemize the products purchased and/or work performed. This proof of purchase must show (a) the date of purchase and an itemized price paid per item, (b) the size, type, make, model or part number for the products, (c) a description of any installation or other labor charges.

Payment: Incentive will be paid after: (a) installation of the energy saving equipment, verification of the installation of the Equipment, and (b) submission of all required documentation of equipment within the current calendar year.

Incentive Amount: Incentives for energy saving equipment installed as set forth in documentation accompanying this application are limited to the amounts provided on CNGC tariff 302. Each piece of equipment may only receive one incentive. Such amounts are subject to change. Current incentive amounts are identified on CNGC’s website at www.cngc.com. Please contact CNGC with any questions.

Facsimile/Scanned Signatures: Facsimile transmission of an original document, or a scanned original document transmitted to CNGC as an attachment via electronic mail, shall be the same as delivery of the original signed document. At the request of CNGC, customer shall confirm documents with a facsimile transmitted signature or a scanned signature by providing an original document.

By signing the Participation Agreement on the Rebate Application, the participant agrees to the terms and conditions. Participant represents to CNGC that all energy-saving measures have been completed satisfactorily and Participant meets the eligibility requirements shown under the “requirements” section. CNGC and/or its representatives may request access to the property on which energy-saving measures have been completed and/or installed in order to do quality control inspections. Customer understands that CNGC and/or its representatives may review and evaluate the energy savings of the project during and after completion. Participants agree to provide access to the property for the purpose described above. Participant also opts-in to receiving information via mail or email about energy efficiency program offerings and energy saving recommendations and may opt-out of these emails by clicking on the unsubscribe link at the bottom of the emails.

Consent to Release of Customer Information: Participants consent to the release of their customer information (including name, service and mailing addresses, phone number, and account number) by CNGC for purposes of regulatory reporting and to its designated internal or third party representatives for the purpose of (1) issuing applicable conservation or efficiency incentives; (2) verifying completion and/or installation of qualified energy-saving measures, applicable conservation or efficiency incentives.