[City of Santa Barbara] HEAP Incentives Claim

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Step Two: Incentives Claim

HEAP Reservation Number

I am claiming my incentive(s) for the following:

Heat Pump Water Heater

Heat Pump HVAC

Associated Electrical Work

Incentive Recipient Information:Incentive payee can be applicant (SBCE customer) or contractor. If it is the contractor, the contractor is required to pass down the entire incentive amount to customer as shown by line-item deduction shown on project invoice.

Required Documentation:

Date work was completed:

Name of Contractor(s) used: (if self installed, indicate "self")

Total cost of project:

Copy(ies) of itemized contractor invoice(s) for work: (Invoice must show cost of each upgrade separately. If self installed, receipts for equipment and materials used may be submitted.)

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Photo of decommissioned gas/electric water heater or capped gas line:

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Photo of decommissioned gas/electric heater/furnace or capped gas line:

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Copy of Inspection Summary indicating final approval has been issued and project status is "Complete".

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Photo of installed Heat Pump Water Heater:

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Photo of installed Heat Pump HVAC:

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Photo of completed Associated Electrical Work:

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By submitting this claim you acknowledge and agree to the Program Guidelines and Terms & Conditions.

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First Name

Last Name

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I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.

Step Two: Incentives Claim

Full Name

I am claiming my incentive(s) for the following:

Incentive Recipient Name (if different than submitter)

Incentive Recipient Address

Required Documentation:

Copy(ies) of itemized contractor invoice(s) for work: (Invoice must show cost of each upgrade separately. If self installed, receipts for equipment and materials used may be submitted.)

Photo of decommissioned gas/electric water heater or capped gas line:

Photo of decommissioned gas/electric heater/furnace or capped gas line:

Copy of Inspection Summary indicating final approval has been issued and project status is "Complete".

Photo of installed Heat Pump Water Heater:

Photo of installed Heat Pump HVAC:

Photo of completed Associated Electrical Work:

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