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HVAC Tune Up Rebate Digital Form

HVAC Tune Up Rebate

THE HVAC TUNE-UP REBATE IS DESIGNED FOR AIR SOURCE HEAT PUMPS AND CENTRAL AIR CONDITIONING SYSTEMS. GAS FURNACES ARE NOT ELIGIBLE UNLESS PART OF A CENTRAL AIR SYSTEM.

Please fill out the Tune-Up Rebate application and submit with an itemized receipt showing date of service, total cost for tune-up and a checklist of services performed to UDWI.

Member Name
Member Name
First
Last
Street Address
Street Address
City
State/Province
Zip/Postal
Contractor’s Name
Contractor's Name
First
Last
Contractor’s Address
Contractor's Address
City
State/Province
Zip/Postal
Building Type
Construction Type
Housing Type
Occupancy Status

If the rebate will be mailed to the contractor instead of being claimed by the member, please complete the following section:

Member Applicant Assignment of Payment to Non-Applicant/Contractor/Vendor: By initialing and checking below, I assign the full incentive amount pursuant to this application to the individual or entity designated as “Contractor” listed above and agree that such assignment can only be amended or modified in writing acknowledged by member cooperatives and Hoosier Energy, and further agree to hold harmless and indemnify member cooperatives and Hoosier Energy from any claim made for such incentive amount or from any loss resulting from the payment of the incentive amount to the assignee.

Make rebate payment to Contractor/Vendor
1666 West State Road 54
Bloomfield, Indiana 47424

Hours:  Monday – Friday, 7:30 a.m. to 4:30 p.m.

Office: (812) 384-4446
Toll-Free: (800) 489-7362
©2021 Utilities District of Western Indiana REMC. Member-Owned. Member-Focused.