HomeMy Public PortalAbout2019/03/28 Idaho Power Commercial Indstrial Lighting RetrofitCommercial - Industrial Lighting Retrofit
Payment Application
�POWER
IDAHO
An IOACOpp Company
Idaho Power Use Only
Received
C. Rep:
APP#:
Customer Information kWh/yr:
Rate:
$/yr:
Customer Name (Organization)
City of McCall
Account Number or Meter Number
86849590
Type
Meter Number
Project/Facility Name
McCall Water
Building Type
Industrial — Large
Project Site Address
1240 Bitterroot Drive
City
McCall
Slate
ID
Zip
83638
Customer Mailing Address (if different)
City
State
Zip
Contact Name
Matt Dellwo
Title
Operator
Phone
;208-315-4250
Fax
E-mail (required)
mdellwo@mccall.id.us
Installation Contractor Information— (must be a licensed electrical contractor, except for screw -in and pin -based LEDs and RWre-lamp).
Company Name
AME Electric
Electrical Contractor License Number
C2854
Mailing Address
3621 Arthur St
City
Caldwell
State
ID
Zip
83605
Contact Name
Mike Tenhlilzen
Title
owner
Phone
208-459-8959
Fax
E-mail (required)
mike@ameelectric.com
Electrical Supplier Information
Company Name
Platt Electric Supply
Contact Name
Ryan Rienstra
Mailing Address
5603 West Bethel Street
City
Boise
State
ID
Zip
83706
Phone
Fax
E-mail (required)
ryansienstra@platt.com
Other (Provide Description) (Example: General Contractor, Engineering Firm, ESCO, etc.)
Company Name
Contact Name
Phone
Fax
E-mail (required)
Lighting Project Details
Start Date
1 /4/2019
Completion Date
4/4/2019
Estimated kWh Savings
77,627
Estimated Incentive
$7,630.79
Estimated Project Cost
$36,500.00
Estimated Annual Energy Savings
$4,410.31
Incentive Check Recipient
I, Customer, designate the Idaho Power incentive check for this project be made payable to the following. Recipient of the Idaho Power incentive check
for this project must complete the Tax ID Number and Official Tax Name boxes below. Customer: please ensure the appropriate box below is marked
for who should receive the incen ive payment.
Customer..
Contractor.'
x
Supplier..
Other..
Legal Name
AME ELECTRIC, INC
Mailing Address
3621 Arthur St. Caldwell, ID 83605
Official Tax Name (Associated with TIN/SSN)
AME Electric, Inc.
Federal Tax ID#
82-0419873
Customer Agreement
the undersigned, declare that I am a duly authorized representative of the owner of the building described above. I further acknowledge
that I have read and agree to comply with the Commercial and Industrial Energy Efficiency Program Terms and Conditions set forth at
http://www.idahopower.com/ways-to-save/savings-for-vour-business/tenns-conditions/ and the Program requirements set forth at
https://docs.idahobower.com/pdfs/enerovefficiencv/business/DroceduresManual.odf I certify that the information provided in this
application is true and accurate and that Idaho Power may verify such information at its sole discretion.
Customer Name
&k I E (1-j1M. V to
Custom, Signature
To Submit Obtain Customer's /� - /
CRR 129.12 (08/15/18)
Deter-
3/ r611 C1
3/21/2019