Smart Thermostat Rebate Form Admin Only Indexed

Please enter payee name and address if different from installation information.

If the second thermostat was purchased or installed separatedly, please fill out the form twice.

Please upload the following documents:

• Dated sales receipt

Valid for purchases made 6/1/18 – 12/31/18. All rebate requests must be postmarked no later than 1/31/19. This rebate offer is available to all residential electric utility customers in Vermont. Thermostat purchased must be new (no used or refurbished units). Smart Thermostat must be listed on the Efficiency Vermont qualified products list at the time of purchase and must be installed in Vermont to be eligible for rebate. Unit must be fully installed, connected to the internet via Wi-Fi and activated with the manufacturer prior to Efficiency Vermont issuing a rebate. This rebate may be subject to change without prior notice. This rebate may not be combined with any other Efficiency Vermont offer, including discounted pricing at wholesale locations. Efficiency Vermont reserves the right to conduct field inspections to verify installations. The customer must contribute at least $50 to the pre-tax purchase price of each smart thermostat; therefore, the rebate amount for each qualifying smart thermostat will be the lesser of (a) the applicable rebate listed on this form, or (b) the pre-tax purchase price of the smart thermostat minus $50. For any smart thermostats included in bundled packaging with other products, the $50 minimum customer contribution will be subtracted from the stand-alone smart thermostat price (if available) or the approximate retail value, as determined by Efficiency Vermont in its reasonable discretion. Limitation of liability: Efficiency Vermont does not guarantee the performance of installed equipment expressly or implicitly, and will not be liable for any incidental or consequential damages of any kind in connection with the rebate program or in connection with the installation, implementation, or use of the equipment at the customer’s premises. In accepting these financial incentives, the customer (a) authorizes the release of any smart thermostat usage data, including customer name and address, to Efficiency Vermont and any approved contractor or other vendor providing services under this Efficiency Vermont program; (b) the customer agrees that Efficiency Vermont holds the sole rights to any electric system capacity credits and environmental credits associated with the energy efficiency measures for which incentives have been received; and (c) agrees that Efficiency Vermont may contact the customer to provide information about additional programs and services that Efficiency Vermont may develop related to smart thermostats. Limit two smart thermostat rebates per Vermont residential electric account. Allow up to 60 days for delivery of rebate. Incomplete or missing information will delay processing and payment. For more information, call 888-921-5990.