Customer Enrollment Form

Please complete the following information to the best of your ability and review and accept the program terms and conditions prior to submitting.

Required fields are designated with a * and will be highlighted in yellow if not filled in.

Business Name

*Primary Contact

Title

*Telephone with Area Code

*Email

I am a San Diego Gas & Electric customer.  Yes No

Account Number:

Business Address (where service is to be performed)

Street

City

Zip Code:

Type of Business

Age of Building

HVAC Contractor

Contact :Name

HVAC Contractor Telephone

HVAC Contractor Email

*Number of HVAC units on rooftop

Comments

Program Terms and Conditions

Neither the Program, its sponsors, affiliates, nor administrators or officers of the utility are liable for workmanship, damages, or issues arising from contractor performance or non-performance of program services. Participating HVAC contractors are NOT subcontractors to the Program or to the utility. Customers must exercise care and diligence in selecting any HVAC contractor. This program requires that customers allow reasonable access to the site for inspection of services performed. For a list of participating contractors, see http://www.premiumcooling.com/general/contractors.php. Redemption requires valid voucher activation number. Conservation Services Group relies on the accuracy and timeliness of contractors to provide Premium Efficiency Cooling Program sticker numbers for service verification. If a Premium Cooling or AC TIME sticker is present on AC units at this location, we cannot guarantee work has not been performed on this unit, even if the measure information is not found in our system. Any A/C unit with a Premium Cooling or AC TIME sticker is not eligible for program services for five (5) years from the date of service.

Signing up on this form does not reserve or guarantee funds or eligibility. Funding is limited and is allocated based on the tonnage and unit data submitted on this form, subject to site eligibility and available funds. This program ends December 31, 2012 or when funds are no longer available. If funds are available and the site is eligible, a voucher will be sent to the applicant by e-mail and will require customer confirmation to activate. Vouchers expire 90 days from date of issue and cannot be transferred or assigned.

The Premium Efficiency Cooling Program is funded by California utility customers and administered by San Diego Gas & Electric Company® (SDG&E®) under the auspices of the California Public Utilities Commission, through a contract awarded to Conservation Services Group. California customers who choose to participate in this program are not obligated to purchase any additional services offered by the contractor. The trademarks used herein are the property of their respective owners.

  I understand and accept the terms and conditions of the Program and designate payment of program funds for Premium Tune-up Services to the above designated contractor.

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