EFFICIENCY MAINE COMMERCIAL & INDUSTRIAL PRESCRIPTIVE PROGRAM FUNDING OPPORTUNITY NOTICE (FON) CIP FON-004-2021 - Small Municipality Retrofits ...
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EFFICIENCY MAINE
COMMERCIAL & INDUSTRIAL PRESCRIPTIVE PROGRAM
FUNDING OPPORTUNITY NOTICE (FON)
Small Municipality Retrofits
CIP FON-004-2021
Opening: December 29, 2020
Applications Due: March 31, 2021 by 3:00 pm
Project Completion: June 1, 2021
Small Municipality Retrofits
CIP FON-004-2021
CONTENTS:
Section 1: Funding Opportunity Notice Information and Instructions 3
Section 2: Project Eligibility 4
Section 3: Application Requirements 9
Section 4: Submittal Instructions 10
Section 5: Project Approval and Incentive Offer Process 10
Section 6: Project Completion Process 11
Section 7: Sample Documents 11
Application Documents:
Attachment A (LP1 & HPP2): Project Application Cover Sheet
Attachment B (LP1): FON-004-2021 CLIC Tool
Attachment B (HPP2): Installation Price Quote
Attachment C (LP1&HPP2): Material Price Quote
Attachment D (LP1 & HPP2): Project Installation Commitment
1
– Lighting Project
2
– Heat Pump Project
Sample Documents:
Sample #1: Lighting Project - Approved Scope of work with Terms & Conditions
Sample #2: Heat Pump Project – Approved Scope of work with Terms & Conditions
Sample #3: Lighting Project - Installation Completion & Applicant Acceptance Form
Sample #4: Heat Pump Project - Installation Completion & Applicant Acceptance Form
2
Small Municipality Retrofits
CIP FON-004-2021
SECTION 1: FUNDING OPPORTUNITY NOTICE INFORMATION AND INSTRUCTIONS
1.1 Purpose of Application Request
Through this Funding Opportunity Notice (FON) Efficiency Maine is seeking applications for high-
performance heat pump retrofit and LED lighting retrofit projects in small municipal1 public buildings.
This initiative falls under the Commercial and Industrial Prescriptive Program (CIP). The CIP program will
refer to this opportunity as the Small Municipality Retrofits FON. Funds for these projects are provided
by Efficiency Maine, along with a contribution from The Nature Conservancy (TNC) in Maine. The goal of
this opportunity is to offer enhanced savings incentives in order to accelerate the conversion to efficient
heat pump systems and LED lighting in small municipalities.
1.2 Funding Description
Efficiency Maine is seeking applications for heat pump retrofit and LED lighting projects with the
principal goal of reducing grid-supplied kilowatt hour (kWh) consumption and carbon emissions from
small municipal public buildings in Maine. Funding for heat pump retrofits will be provided through an
Efficiency Maine budget of $160,000, along with a $100,000 contribution from TNC. High-performance
heat pump retrofits will be offered an incentive of $2,600 for each single zone system, capped at three
units for $7,800 or not to exceed 90% of the total measure cost (whichever is less). LED retrofit projects
will have an incentive from Efficiency Maine of $0.32/kWh saved (first year savings only) or capped at
90% of the total measure cost (whichever is less). Final approved incentives from Efficiency Maine and
TNC will be paid out separately.
Incentive Summary
● Heat pump retrofits: $1,600 from Efficiency Maine and $1,000 from TNC per single zone
system, capped at three systems ($7,800) or capped at 90% of the total measure cost;
● LED lighting: $0.32/kWh in first year savings or capped at 90% of the total measure cost
1.3 Parties Informational Webinar
Efficiency Maine will conduct three webinar presentations to inform interested parties on the specifics
of this FON. It is not mandatory but recommended the applicant attend. The webinar schedule appears
below. To participate, register using the link attached to your desired date.
● January 12, 2021 at 8:00 AM - TO REGISTER, CLICK HERE
● January 14, 2021 at 1:00 PM - TO REGISTER, CLICK HERE
● January 20, 2021 at 8:00 AM - TO REGISTER, CLICK HERE
1
“Small municipal” is defined, for the purposes of this FON, as those municipalities with a population of less than
4,000 residents.
3
Small Municipality Retrofits
CIP FON-004-2021
1.4 FON Schedule
Efficiency Maine will accept applications for the Small Municipality Retrofits FON starting on December
29, 2020. Applications are accepted between December 29, 2020 and March 31, 2021. Efficiency Maine
will review the applications and issue incentive offers in the form of a pre-approval offer email to
applicants who meet the criteria within this FON, and as funding allows. Applicants must accept their
pre-approval offers by April 15, 2021. All projects must be completed, and final documentation
submitted by June 1, 2021 in order to be eligible for the incentives.
SECTION 2: PROJECT ELIGIBILITY
2.1 Eligible Heat Pump Retrofit Projects
An eligible heat pump retrofit project includes only the high-performance heat pump measure listed in
section 2.3, in a building type listed in section 2.4. Section 2.5 lists building types that are ineligible.
Eligible building types represent some of the most cost-effective areas where HVAC needs can be
upgraded. The measure must be rated to a Heating Seasonal Performance Factor (HSPF) of 12.5 or
greater. In all cases, projects must pass the CIP program’s cost-effectiveness test. The installed heat
pump must be used as the primary heating and cooling systems for the space or building zone for which
the heat pump is serving. Buildings that heat with natural gas are not eligible for heat pump incentives
through this FON. In addition, all projects must be completed by an Efficiency Maine Qualified Partner
(QP) or licensed self-installer; a Qualified Partner can be found by using the QP locator at
https://www.efficiencymaine.com/at-work/qualified-partners/. To use the locator simply put in your ZIP
code and desired radius before selecting “Heat Pumps and Cooling Solutions” in the “Services” menu .
4Small Municipality Retrofits
CIP FON-004-2021
2.2 Eligible Lighting Projects
An eligible lighting retrofit project includes only the interior and exterior LED measures listed in section
2.3 associated with the building types listed in section 2.4. A total of 13 measure types can be used for
this funding opportunity. The selected spaces represent some of the most cost-effective areas where
lighting can be upgraded. Lighting products must be certified under the applicable ENERGY STAR® or
DesignLights Consortium standards for each measure type. In all cases, projects must pass the CIP
program’s cost-effectiveness test. Specifically, as described in Section 3, applications must include a
completed Small Municipal Retrofit Cost-effective Lighting Investment Calculator (or Small Municipal
Retrofit CLIC tool), which will help guide applicants towards the creation and planning of an eligible
measure(s) under this FON. In addition, all projects must be completed by an Efficiency Maine Qualified
Partner (QP) or identified self-installer; a list of Qualified Partners can be found by using the QP locator
at https://www.efficiencymaine.com/at-work/qualified-partners/. To use the locator simply put in your
ZIP code and desired radius before selecting “Lighting Solutions” in the “Services” menu. The QP
installer or product supplier will be able to fill out the CLIC tool.
2.3 Eligible Measures
Heat Pump Retrofit
Minimum
Measure Code HSPF Description
DHPCR 12.5
High-Performance Mini-Split Heat Pump System
● Includes up to three single-zone systems.
● Must have a minimum HSPF of 12.5.
5Small Municipality Retrofits
CIP FON-004-2021
Interior Lighting
Measure Code Description
Recessed, Surface and Pendant-Mounted LED Downlight
S21
● Includes recessed, surface or pendant-mounted ceiling and downlights.
● Must be qualified by ENERGY STAR® - See the following link for a complete list of
qualified products:
www.energystar.gov/productfinder/product/certified-light-fixtures/results
LED Interior Luminaires
● Common recessed, suspended, or surface-mounted fixtures intended to provide
ambient lighting in settings such as office spaces, schools, retail stores, and other
S51 commercial environments.
● Must be listed on the DesignLights Consortium’s Qualified Products List with a
minimum Standard classification with the Primary Use of 1x4, 2x2 and 2x4
Luminaires for Ambient Lighting of Interior Commercial Spaces – see the following
link for a complete list of qualified products: www.designlights.org/search
LED Retrofit Kits for Interior Luminaires
● Integrated-style kits are troffer retrofit kits that replace all reflectors and optical
systems of existing luminaries.
● Linear-style kits are tube-shaped or strip-style retrofit kits for troffers. These
products do not replace the optical systems and leave the basic form of the
S52 existing luminaire intact.
● Does not include tube-style, linear replacement lamps in settings such as office
spaces, schools, retail stores, and other commercial environments.
● Must be listed on the DesignLights Consortium’s Qualified Products List with a
minimum Standard classification with the Primary Use of Linear or Integrated
Retrofit Kits for 1x4, 2x2 and 2x4 Luminaires – see the following link for a complete
list of qualified products: www.designlights.org/search
6Small Municipality Retrofits
CIP FON-004-2021
LED High/Low Bay Fixtures
● Pendent or surface-mounted fixtures specific for indoor high ceiling spaces.
● Must be listed on the DesignLights Consortium’s Qualified Products List with a
minimum Standard classification with the Primary Use of High-bay, Low-bay or High-
S61 bay Aisle Luminaires – see the following link for a complete list of qualified products:
www.designlights.org/search
LED Retrofit Kits for High/Low Bay Fixtures
● Integrated-style kits that replace all reflectors and optical systems of existing
luminaries. Does not include screw-in lamps intended as HID replacements.
S62
● Must be listed on the DesignLights Consortium’s Qualified Products List with a
minimum Standard classification with the Primary Use of Retrofit Kits for High-bay
or Low-bay Luminaires for Commercial and Industrial Buildings – see the following
list of qualified products: www.designlights.org/search
LED Stairwell/Passageway Luminaires
● Corner- or surface-mounted luminaires that provide lighting in stairwells and
S71 passageways
● Luminaires must include integral controls or operate off of remote sensors.
● Controls must revert luminaires to lower-power, lower-light output state when no
occupants are in the vicinity.
LED Linear Ambient Luminaires
● Recessed, suspended, or surface-mounted fixtures, no wider than 12", intended to
provide ambient lighting in indoor spaces. May be designed to be installed end-to-
end to create long chains.
S81 ● May be described as direct, indirect, semi-direct, semi-indirect, or general ambient.
● Must be listed on the DesignLights Consortium’s Qualified Products List with a
minimum Standard classification with the Primary Use of Direct Linear Ambient
Luminaires or Linear Ambient Luminaires w/Indirect component – see the following
link for a complete list of qualified products: www.designlights.org/search
7Small Municipality Retrofits
CIP FON-004-2021
LED Retrofit kits for Linear Ambient Luminaires
● Retrofit kits for "strip" luminaires and other types of linear ambient luminaires.
● Do not employ existing lamp holders for "pin" bases.
S82
● Must be listed on the DesignLights Consortium's Qualified Products List with a
minimum Standard classification – with the Primary Use of Retrofit Kits for Direct
Linear Ambient Luminaires – see the following link for a complete list of qualified
products: www.designlights.org/search
Exterior Lighting
LED Retrofit Kits for Exterior Luminaires
● Integrated-style kits that replace all reflectors and optical systems of existing
luminaires Does not include screw-in lamps.
● Must be listed on the DesignLights Consortium’s Qualified Products List with a
S8 minimum Standard classification with the Primary Use of Retrofit Kits for Outdoor
Pole/Arm-mounted Area, Roadway or Decorative Luminaires, Full-Cutoff Wall-
Mounted Area Luminaires, Parking Garage or Fuel Pump Canopy Luminaires – see
the following link for a complete list of qualified products:
www.designlights.org/search
LED Outdoor Area Fixture
● Typical street lights or parking lot lights. Does not include utility pole-mounted
fixtures.
S11 ● Must be listed on the DesignLights Consortium’s Qualified Products List with a
minimum Standard classification with the Primary Use of Outdoor Pole/Arm-
mounted Area and Roadway or Decorative Luminaires – see the following link for
a complete list of qualified products: www.designlights.org/search
LED Wall Packs
● Typical walkway or security lights, affixed to a building wall.
S13 ● Must be listed on the DesignLights Consortium’s Qualified Products List with a
minimum Standard classification with the Primary Use of Outdoor Full-Cutoff
and Semi-Cutoff Wall-mounted Luminaires – see the following link for a
complete list of qualified products: www.designlights.org/search
8Small Municipality Retrofits
CIP FON-004-2021
LED Canopy Flood
● Canopy luminaires for vehicular and pedestrian areas.
● Ceiling mounted luminaires for use outdoors or in locations open to elements.
S17 ● Must be listed on the DesignLights Consortium’s Qualified Products List with a
minimum Standard classification with the Primary Use of Parking Garage or Fuel
Pump Canopy Luminaires – see the following link for a complete list of qualified
products: www.designlights.org/search
Spot Lights
● Directional luminaires intended to highlight objects and areas in outdoor
lighting. Does not include LED screw-in lamps.
S23 ● Must be listed on the DesignLights Consortium’s Qualified Products List with a
minimum Standard classification with the Primary Use of Landscape/Accent
Flood and Spot or Architectural Flood and Spot Luminaires – see the following
link for a complete list of qualified products: www.designlights.org/search
2.4 Eligible Buildings
● Community center
● Fire station
● Police station
● Public safety buildings (combined fire and police services)
● Public works facility (office, garages, bus garages)
● Town hall
● Town libraries
● Town sewer districts (lighting projects only)
● Town water districts (lighting projects only)
2.5 Ineligible Buildings
● Outbuildings - (i.e. sport, storage, playground)
● Schools
● Pump stations
● Modular (non-permanent) structures
SECTION 3: APPLICATION REQUIREMENTS
Each applicant must submit the documentation listed below to be considered for project funding under
this opportunity. If multiple municipal buildings within a municipality wish to participate in the FON,
each building would be considered a separate project and therefore each building would require its own
application and be subject to these requirements. The list of required documentation follows:
9Small Municipality Retrofits
CIP FON-004-2021
Heat Pump Projects:
1) Attachment A: FON Project Application Cover Sheet
2) Attachment B: Heat Pump Installation Price Quote
3) Attachment C: Material price quotes of each product by unit cost and total costs
4) Attachment D: Installer Commitment Form
Lighting Projects:
1) Attachment A: FON Project Application Cover Sheet
2) Attachment B: Completed “Small Municipal Retrofit” CLIC tool with all ancillary cost itemization
3) Attachment C: Material price quotes of each product by unit cost and total costs
4) Attachment D: Installer Commitment Form
SECTION 4: SUBMITTAL INSTRUCTIONS
Project applications must include all materials (Attachments A through D) as requested in Section 3 and
are to be emailed to CIP@efficiencymaine.com by the program applicant. The email subject line must
include “CIP FON-004-2021”.
If there are questions throughout the process, applicants are encouraged to speak with a Qualified
Partner (using the locator tool described in section 2.1) or to contact the Program Team at (207) 213-
6247 or CIP@efficiencymaine.com.
SECTION 5: PROJECT APPROVAL AND INCENTIVE OFFER PROCESS
For applications received by the deadline listed in section 1.4, Efficiency Maine will review the data
submitted to ensure accuracy. Efficiency Maine reserves the right to conduct pre-inspections at project
sites and/or to request additional information during the review process. A representative from
Efficiency Maine may schedule site inspection visits through the point of contact listed in the FON
Project Application Cover Sheet (Attachment A), during the pre-inspection period as listed in section 1.4.
Once Efficiency Maine completes its review, it will make a formal incentive pre-approval offer through
an “Approved Scope of Work” emailed to the applicant and the installer. The Approved Scope of Work,
Sample #1 (Lighting Projects) and Sample #2 (Heat Pump Projects) will be sent to the applicant and will
indicate the approved project incentive, pending project completion. If the applicant wishes to accept
this incentive offer, the applicant and the installer (QP) must sign the Approved Scope of Work and
return it via email to the contact listed in Section 4. Section 1.4 indicates the deadline for accepting the
Approved Scope of Work with the pre-approval incentive offer.
Efficiency Maine will confirm receipt of an applicant’s acceptance of the pre-approval incentive offer via
email to the contacts listed on Project Application Cover Sheet (Attachment A) and the Installation
Contractor as listed on Installer Commitment form (Attachment D). Only at this point the applicant may
10Small Municipality Retrofits
CIP FON-004-2021
proceed with material ordering/purchasing and installation in accordance with the Approved Scope of
Work. Each pre-approved offer will be sent from Efficiency Maine to The Nature Conservancy for project
and budget tracking.
SECTION 6: PROJECT COMPLETION PROCESS
Upon completion of all work as outlined in the Approved Scope of Work (see section 1.4 for project
completion deadline), the applicant and the installing contractor must sign and return the Customer
Project Acceptance Form (See Sample #3: Lighting Project and Sample #4: Heat Pump Project) to the
email address listed in Section 4. Efficiency Maine will conduct a final project review and process the
applicant’s incentive(s). Once the final project review has been completed, Efficiency Maine will provide
The Nature Conservancy with final documentation at which time they can process and send their
portion of the project incentive. The Nature Conservancy will mail a check to the address listed in the
FON Project Application Cover Sheet (Attachment A). Efficiency Maine reserves the right to conduct a
post-installation inspection during the final project review. A representative from Efficiency Maine will
schedule site inspection visits through the point of contact listed in the FON Project Application Cover
Sheet (Attachment A) during the project inspection period as listed in section 1.4. Efficiency Maine will
conclude all approved incentive payments by June 30, 2021.
SECTION 7: Sample Documents
Sample #1: Lighting Project - Approved Scope of work with Terms & Conditions
Sample #2: Heat Pump Project – Approved Scope of work with Terms & Conditions
Sample #3: Lighting Project - Installation Completion & Applicant Acceptance Form
Sample #4: Heat Pump Project - Installation Completion & Applicant Acceptance Form
11ATTACHMENT A (LP&HPP)
PROJECT APPLICATION COVER SHEET
Efficiency Maine
Commercial & Industrial Prescriptive Program
Funding Opportunity Notice
Small Municipality Retrofit Projects
CIP FON-004-2021
This application is for (check one): Lighting Project Heat Pump Project Both
Primary Municipal Contact Name: Title:
Municipality: Phone:
Fax:
Mailing Address: Email:
City: State/Prov: Zip:
Alternate Municipal Contact Name*: Title:
Municipality: Phone:
Fax:
Mailing Address: Email:
City: State/Prov: Zip:
*Complete this section if you wish to designate a point of contact for project coordination & inspections.
AUTHORIZED SIGNATURE
I, the undersigned, am authorized to commit my organization to this project application.
Signature: Printed Name:
Title: Municipality:
Date: Phone/email:
Required Application Documentation (Checklist)
Attachments Heat Pump Project Lighting Project
A Project Application Cover Sheet Project Application Cover Sheet
B Heat Pump Installation Price Quote Small Municipal Retrofit CLIC tool (Excel format)
C Material price quotes Material price quotes
D Project Installation Commitment Project Installation CommitmentATTACHMENT B (HPP)
INSTALLATION PRICE QUOTE
Efficiency Maine
Commercial & Industrial Prescriptive Program
Small Municipality Heat Pump Retrofit Projects
CIP FON-004-2021
Installer (must be a Qualified Partner):
Company Name: QUOTE#:
Street Address: Quote Date:
City, State, Zip:
Phone:
Email:
Quoted for:
Customer Name:
Address:
City, State, Zip:
Description of work to be performed
Item Itemized Labor Chost Quantity Unit Price Amount
1 Labor X hours at $XX.XX/hr $0.00
2 Travel Expenses (if any) $0.00
3 Service Fee (if any) $0.00
4 Other: $0.00
5 Other: $0.00
6 Other: $0.00
Subtotal: $0.00
Tax (if any): $0.00
Notes - Instructions Total Cost: $0.00
Authorized by:
Signature:ATTACHMENT C (LP&HPP)
MATERIAL PRICE QUOTE
Efficiency Maine
Commercial & Industrial Prescriptive Program
Small Municipality Retrofit Projects
CIP FON-004-2021
SUPPLIER: QUOTE:
Company Name: Quote Date:
Street Address:
City, State, Zip:
Phone: List only the lighting products as specified
Email: in the FON-004-2021 Cost-effective
Lighting Investment Calculator and/or
SOLD TO:
Customer Name: eligible high performance heat pump
Addres: models.
City, State, Zip:
Measure Measure High
Total
Item Product Number Quantity Code Code Performance Item Description Unit Price
Amount
(Interior) (Exterior) Heat Pump
1 $0.00
2 $0.00
3 $0.00
4 $0.00
5 $0.00
6 $0.00
7 $0.00
8 $0.00
9 $0.00
10 $0.00
11 $0.00
12 $0.00
13 $0.00
14 $0.00
15 $0.00
16 $0.00
17 $0.00
18 $0.00
19 $0.00
20 $0.00
21 $0.00
22 $0.00
23 $0.00
24 $0.00
25 $0.00
26 $0.00
27 $0.00
28 $0.00
29 $0.00
30 $0.00
Subtotal: $0.00
Authorized by: Tax:
Signature: Total Cost: $0.00ATTACHMENT D (LP&HPP)
PROJECT INSTALLATION COMMITMENT
Efficiency Maine
Commercial & Industrial Prescriptive Program
Funding Opportunity Notice
Small Municipality Retrofit Projects
CIP FON-004-2021
Please complete one or two of the sections below
Heat Pump Installation by an Efficiency Maine Qualified Partner
AUTHORIZED SIGNATURE
I, the undersigned, commit to complete the proposed project by June 1, 2021
Signature: Printed Name:
Organization: Phone:
Date: email:
Lighting Installation by an Efficiency Maine Qualified Partner
AUTHORIZED SIGNATURE
I, the undersigned, commit to complete the proposed project by June 1, 2021
Signature: Printed Name:
Organization: Phone:
Date: email:
Installation by Licensed Paid Staff Personnel
AUTHORIZED SIGNATURE
I, the undersigned, commit to complete the proposed project by June 1, 2021
Signature (Employee): Printed Name:
Municipality: Phone:
Date: email:(Sample #1 - LP)
COMMERCIAL & INDUSTRIAL PRESCRIPTIVE LIGHTING SOLUTIONS
MUNICIPAL LIGHTING RETROFIT APPLICATION
SCOPE OF WORK TERMS AND CONDITIONS Approved
Cost-effective Lighting Investment Calculator (CLIC) CIP FON-004-2021
Facility Name: Town ABC
Qualified Partner #1: Supplier Company A
Qualified Partner #2: Installer Company X
Facility Name: Town Office
Installation Address: 123 ABC Road
City: Augusta State: Maine Zip: 04330
Reference Number: CLIC59901
Terms and Conditions
This Proposed Scope of Work Form is submitted in accordance with the Funding Opportunity Notice (FON) as issued through
the Efficiency Maine Commercial & Industrial Prescriptive Program. When executed by the Parties and submitted with CIP
FON-004-2021, constitute agreement to the following Terms & Conditions:
1. APPLICANT ELIGIBILITY REPRESENTATIONS.
Applicant represents that the following statements are true:
a. Applicant is a non-residential customer of electric utilities in the State of Maine,
b. Applicant’s primary business function is not to generate power to be sold into a power market,
c. Applicant has the authority to contract for retrofit work in the Facility in connection with the Measures listed,
2. AGREEMENT AS TO THE MEASURES. Applicant agrees to have an Installation Contractor perform retrofit work at the
Facility in connection with the Measures identified on the attached Section C to this Scope of Work. In consideration of
the Contractor’s performance of such work, Applicant agrees to pay Installation Contractor for Measures installed at the
Facility, based on the Estimated Costs listed on said Section C for the number of completed units for each Measure upon
receipt of invoice; provided the Contractor may collect a deposit from Customer prior to performing such work, in which
case the final invoice shall be net of such deposit.
3. AGREEMENT AS TO INCENTIVE AMOUNTS.
a. Subject to the other terms of this Scope of Work, Applicant's obligation to pay for the installation and measures shall
be reduced by an amount (the “Incentive”) provided under the Efficiency Maine CIP FON-004-2021, which amount shall be
equal to $0.32 per 1st years saved kWh or capped at 90% of the measure cost.(Sample #1 - LP)
4. INSTALLATION REQUIREMENTS.
a. Services to be provided this Scope of Work shall in no way include work by the Installation Contractor in connection
with the correction of apparent or hidden safety issues or code violations. Installation Contractor shall not perform work
where, in its sole discretion, it is determined such safety issues or code violations exist.
b. The Applicant agrees not to reinstall any of this equipment or transfer it to any other party for installation.
Applicant agrees that it will not alter, modify or discontinue use of the Measures without prior written approval from
Efficiency Maine and that Measures will be used for their rated useful life.
c. Applicant agrees to permit Efficiency Maine (or any designated agent) to access the Facility before, during or after
installation of the Measures at times reasonable convenient to Applicant, project inspections and evaluations.
d. Notwithstanding Applicant’s ownership of all installed improvements, Efficiency Maine shall be deemed the owner
of, and shall hold exclusive right, title and interest in and to any electric system capacity credits and environmental credits
that may be associated with the Measures, and Efficiency Maine can sell, transfer and otherwise dispose of these credits in
any manner authorized by law or regulation. By accepting an Incentive, Applicant expressly and irrevocably conveys all
such rights and credits to Efficiency. In no event shall activity associate with any such energy or environmental credits
result in interference with the Applicant’s sole discretion to operate Measures as approved in the Approved Scope of
Work.
5. LIMITATION OF LIABILITY; INDEMNIFICATION
a. In no event shall Efficiency Maine, nor any of their respective trustees, officers, directors, shareholders, affiliates,
employees, agents, or contractors be liable to the Applicant or anyone claiming through Applicant, for any special,
consequential, or incidental damages, including lost profits or lost business opportunities, or for any damages in tort
(including negligence) caused by or resulting from any activities in connection with or associated with this Scope of Work or
the Efficiency Maine Prescriptive Program.
b. The Applicant shall protect, indemnify, and hold harmless Efficiency Maine, and their respective trustees, officers,
directors, shareholders, affiliates, employees, agents or contractors (each, an “Indemnified Party”) from and against all
liabilities, losses, claims, damages, judgments, penalties, causes of action, costs and expenses (including, without limitation,
attorney’s fees and expenses) incurred by or assessed against an Indemnified Party arising out of or relating to the
Applicant’s performance or non-performance of obligations under this Scope of Work or the installation and operation of
the Measures.
c. Nothing herein shall be construed to waive, release, or diminish any statutory or common law immunities of
Efficiency Maine as a governmental entity, all of which are expressly retained.
6. WARRANTIES
a. Installation Contractor warrants to Applicant that all equipment and materials installed as part of the Project are
free from defects in title, material, workmanship and installation, and shall conform to Efficiency Maine Prescriptive
Program specifications. Such warranty shall not expire before the later of the applicable manufacturer warranty period (if
any) or one (1) year from the date of installation. If such warranty is breached, Contractor shall, at its expense, either repair
or replace (at its option) the equipment or materials to remove the defect and/or establish such conformity, as applicable.
b. Neither Efficiency Maine nor any agent of, endorses, guarantees, or warrants any particular manufacturer or
product, and provides no warranties, express or implied, for any product or services. Efficiency Maine expressly disclaim all
warranties relating to the Measures. The Applicant’s reliance on warranties is limited to any warranties that may be
provided directly by Contractor or equipment suppliers.
c. Neither Efficiency Maine nor any agent of, are responsible for assuring that the design, engineering and
construction of the Facility or installation of the Measures is proper or complies with any particular laws, codes, or industry
standards, nor for the accuracy or inaccuracy of any energy assessment findings or anticipated energy savings. Neither
Efficiency Maine nor any agent of make no representations of any kind regarding the results to be achieved by the
Measures or the adequacy or safety of such measures.(Sample #1 - LP)
7. PUBLICITY OF APPLICANT PARTICIPATION
By accepting an Incentive, the Applicant understands that Efficiency Maine reserves the right to disclose certain information
about the Applicant’s participation in the Efficiency Maine Prescriptive Program, including, but not necessarily limited to,
the Applicant’s name and address, the Incentive amount, projected energy savings as well as other non- proprietary
business information.
8. CUSTOMER MUST PAY ALL TAXES
Incentives received by the Applicant may be taxable by the federal, state, and local government. The Applicant is
responsible for determining any tax obligations and declaring and paying all such taxes. Recipients of Incentive payments
must provide their tax identification number to Efficiency Maine for payment processing. Incentive award payments in
excess of $600 made to unincorporated entities will be reported on IRS Form 1099-MISC.
9. MISCELLANEOUS
a. This Scope of Work constitutes the full agreement among Applicant and Installation Contractor (collectively, the
“Parties”), and supersedes any prior discussions, understandings and agreements, whether oral or in writing.
b. Paragraph headings are for the convenience of the Parties only and are not to be construed as part of this Scope of
Work.
c. If any provision of this Scope of Work is deemed invalid by any court or administrative body having jurisdiction,
such ruling shall not invalidate any other provision, and the remaining provisions shall remain in full force and effect in
accordance with their terms.
d. In the event of any dispute concerning this Scope of Work, or any other requirement of the Efficiency Maine
Prescriptive Program, resolution will be governed in all respects by the laws, statutes, and regulations of the United States
of America and of the State of Maine. Any legal proceeding against the State regarding this agreement shall be brought in
State of Maine administrative or judicial forums. The Applicant consents to personal jurisdiction in the State of Maine.
e. Applicant and Installation Contractor expressly acknowledge that Efficiency Maine or a designated agent of, are
each an intended third-party beneficiary of this Scope of Work with full power to enforce the terms of this Scope of Work.
By signing below, the Parties agree the Measures listed in Section C shall be installed by the Installation
Contractor. The Applicant shall pay the Installing Contractor as described herein following Completion and
Acceptance of Measures.
Participating Customer Date
Installing Contractor Date(Sample #1 - LP)
Section B. Summary of Project Financials and Energy Savings
Estimated Annual kWh Savings: 20,161
Average cost per kWh: $0.15
Estimated Annual Energy Cost Savings: $3,024.08
Estimated Monthly Energy Cost Savings: $252.01
Total Labor Costs: $2,698.75
Total Material Costs: $8,275.00
Total Ancillary Costs: $2,000.00
Total Project Costs (including tax): $12,973.75
Section C. List of Measures
Estimated Est. Cost to
Measure Description Location Qty Labor Cost Material Cost Total Cost Incentive Customer
LED 2x4 Recessed Fixture(SAMPLE #2 – HPP)
COMMERCIAL & INDUSTRIAL PRESCRIPTIVE HVAC SOLUTIONS
SMALL MUNICIPALITIES HEAT PUMP RETROFIT
SCOPE OF WORK & TERMS AND CONDITIONS Approved
CIP FON-004-2021
Municipality Name: Town of Anywhere
Qualified Partner #1: Supplier Company A
Qualified Partner #2: Installer Company X
Facility Name: Town Library
Installation Address: 123 ABC Road
City: Augusta State: Maine Zip: 04330
Reference Number: 000000
Terms and Conditions
This Proposed Scope of Work Form is submitted in accordance with the Funding Opportunity Notice (FON) as issued through
the Efficiency Maine Commercial & Industrial Prescriptive Program. When executed by the Parties and submitted with CIP
FON-004-2021, constitute agreement to the following Terms & Conditions:
1. APPLICANT ELIGIBILITY REPRESENTATIONS.
Applicant represents that the following statements are true:
a. Applicant is a non-residential customer of electric utilities in the State of Maine,
b. Applicant’s primary business function is not to generate power to be sold into a power market,
c. Applicant has the authority to contract for retrofit work in the Facility in connection with the Measures listed,
2. AGREEMENT AS TO THE MEASURES. Applicant agrees to have an Installation Contractor perform retrofit work at the
Facility in connection with the Measures identified on the attached Section B to this Scope of Work. In consideration of
the Contractor’s performance of such work, Applicant agrees to pay Installation Contractor for Measures installed at the
Facility, based on the Estimated Costs listed on said Section B for the number of completed units for each Measure upon
receipt of invoice; provided the Contractor may collect a deposit from Customer prior to performing such work, in which
case the final invoice shall be net of such deposit.
3. AGREEMENT AS TO INCENTIVE AMOUNTS.
a. Subject to the other terms of this Scope of Work, Applicant’s obligation to pay for the installation and Measures
shall be reduced by an amount (the “Incentive”) provided under the Efficiency Maine CIP FON-004-2020, which amount
shall be equal to $1,600 per zone, with a maximum of three zones. The Nature Conservancy will add on an additional
incentive of $1,000 per zone, to bring the maximum incentive of three zones to $7,800.
b. Notwithstanding 3(a) above, Efficiency Maine reserves the right to limit the amount of Incentives on a municipality
which amount shall be up to $4,800, or limited to 90% of total project cost.
c. TNC upon written notice from Efficiency Maine will pay an additional $1,000 incentive for up to three single zone
systems (up to $3,000)(SAMPLE #2 – HPP)
4. INSTALLATION REQUIREMENTS.
a. Services to be provided this Scope of Work shall in no way include work by the Installation Contractor in connection
with the correction of apparent or hidden safety issues or code violations. Installation Contractor shall not perform work
where, in its sole discretion, it is determined such safety issues or code violations exist.
b. The Applicant agrees not to reinstall any of this equipment or transfer it to any other party for installation.
Applicant agrees that it will not alter, modify or discontinue use of the Measures without prior written approval from
Efficiency Maine and that Measures will be used for their rated useful life.
c. Applicant agrees to permit Efficiency Maine (or any designated agent) to access the Facility before, during or after
installation of the Measures at times reasonable convenient to Applicant, project inspections and evaluations.
d. Notwithstanding Applicant’s ownership of all installed improvements, Efficiency Maine shall be deemed the owner
of, and shall hold exclusive right, title and interest in and to any electric system capacity credits and environmental credits
that may be associated with the Measures, and Efficiency Maine can sell, transfer and otherwise dispose of these credits in
any manner authorized by law or regulation. By accepting an Incentive, Applicant expressly and irrevocably conveys all
such rights and credits to Efficiency. In no event shall activity associate with any such energy or environmental credits
result in interference with the Applicant’s sole discretion to operate Measures as approved in the Approved Scope of
Work.
5. LIMITATION OF LIABILITY; INDEMNIFICATION
a. In no event shall Efficiency Maine, nor any of their respective trustees, officers, directors, shareholders, affiliates,
employees, agents, or contractors be liable to the Applicant or anyone claiming through Applicant, for any special,
consequential, or incidental damages, including lost profits or lost business opportunities, or for any damages in tort
(including negligence) caused by or resulting from any activities in connection with or associated with this Scope of Work or
the Efficiency Maine Prescriptive Program.
b. The Applicant shall protect, indemnify, and hold harmless Efficiency Maine, and their respective trustees, officers,
directors, shareholders, affiliates, employees, agents or contractors (each, an “Indemnified Party”) from and against all
liabilities, losses, claims, damages, judgments, penalties, causes of action, costs and expenses (including, without limitation,
attorney’s fees and expenses) incurred by or assessed against an Indemnified Party arising out of or relating to the
Applicant’s performance or non-performance of obligations under this Scope of Work or the installation and operation of
the Measures.
c. Nothing herein shall be construed to waive, release, or diminish any statutory or common law immunities of
Efficiency Maine as a governmental entity, all of which are expressly retained.
6. WARRANTIES
a. Installation Contractor warrants to Applicant that all equipment and materials installed as part of the Project are
free from defects in title, material, workmanship and installation, and shall conform to Efficiency Maine Prescriptive
Program specifications. Such warranty shall not expire before the later of the applicable manufacturer warranty period (if
any) or one (1) year from the date of installation. If such warranty is breached, Contractor shall, at its expense, either repair
or replace (at its option) the equipment or materials to remove the defect and/or establish such conformity, as applicable.
b. Neither Efficiency Maine nor any agent of, endorses, guarantees, or warrants any particular manufacturer or
product, and provides no warranties, express or implied, for any product or services. Efficiency Maine expressly disclaim all
warranties relating to the Measures. The Applicant’s reliance on warranties is limited to any warranties that may be
provided directly by Contractor or equipment suppliers.
c. Neither Efficiency Maine nor any agent of, are responsible for assuring that the design, engineering and
construction of the Facility or installation of the Measures is proper or complies with any particular laws, codes, or industry
standards, nor for the accuracy or inaccuracy of any energy assessment findings or anticipated energy savings. Neither
Efficiency Maine nor any agent of make no representations of any kind regarding the results to be achieved by the
Measures or the adequacy or safety of such measures.(SAMPLE #2 – HPP)
7. PUBLICITY OF APPLICANT PARTICIPATION
By accepting an Incentive, the Applicant understands that Efficiency Maine reserves the right to disclose certain information
about the Applicant’s participation in the Efficiency Maine Prescriptive Program, including, but not necessarily limited to,
the Applicant’s name and address, the Incentive amount, projected energy savings as well as other non- proprietary
business information.
8. CUSTOMER MUST PAY ALL TAXES
Incentives received by the Applicant may be taxable by the federal, state, and local government. The Applicant is
responsible for determining any tax obligations and declaring and paying all such taxes. Recipients of Incentive payments
must provide their tax identification number to Efficiency Maine for payment processing. Incentive award payments in
excess of $600 made to unincorporated entities will be reported on IRS Form 1099-MISC.
9. MISCELLANEOUS
a. This Scope of Work constitutes the full agreement among Applicant and Installation Contractor (collectively, the
“Parties”), and supersedes any prior discussions, understandings, and agreements, whether oral or in writing.
b. Paragraph headings are for the convenience of the Parties only and are not to be construed as part of this Scope of
Work.
c. If any provision of this Scope of Work is deemed invalid by any court or administrative body having jurisdiction,
such ruling shall not invalidate any other provision, and the remaining provisions shall remain in full force and effect in
accordance with their terms.
d. In the event of any dispute concerning this Scope of Work, or any other requirement of the Efficiency Maine
Prescriptive Program, resolution will be governed in all respects by the laws, statutes, and regulations of the United States
of America and of the State of Maine. Any legal proceeding against the State regarding this agreement shall be brought in
State of Maine administrative or judicial forums. The Applicant consents to personal jurisdiction in the State of Maine.
e. Applicant and Installation Contractor expressly acknowledge that Efficiency Maine or a designated agent of, are
each an intended third-party beneficiary of this Scope of Work with full power to enforce the terms of this Scope of Work.
By signing below, the Parties agree the Measures listed in Section B shall be installed by the Installation
Contractor. The Applicant shall pay the Installing Contractor as described herein following Completion and
Acceptance of Measures.
Participating Customer Date
Installing Contractor Date(SAMPLE #2 – HPP)
Section B. List of Measures
Estimated
Est. Cost to
Measure Description Location Qty Labor Material Combined
Total Cost Customer
Cost Cost Incentive
Single Zone Heat Pump – 9,000 BTU/hr Library offices
2 $1000.00 $5,857.50 $6,857.50 $5,200.00 $1,657.50
Single Zone Heat Pump – 15,000 BTU/hr Checkout area 1 $500.00 2,579.50 $3,079.50 $2,600.00 $479.50(Sample #3 - LP)
COMMERCIAL & INDUSTRIAL PRESCRIPTIVE LIGHTING SOLUTIONS
MUNICIPAL LIGHTING RETROFIT APPLICAITON
Installation Completion & Applicant Acceptance Form
Cost-effective Lighting Investment Calculator (CLIC) CIP FON-004-2021
Facility Name: Town ABC
Qualified Partner #1: Supplier Company A
Qualified Partner #2: Installer Company X
Facility Name: Town Office
Installation Address: 123 ABC Road
City: Augusta State: Maine Zip: 04330
Reference Number: CLIC59901
This Project Acceptance Form ("Form") when signed, signifies the project approved from the application
submitted in response to CIP FON-004-2021 and part of the Commercial & Industrial Prescriptive Lighting
Solutions Program has been completed. The Form is to be executed in connection with the installation of energy
efficiency retrofit measures by the Participating Qualified Partner and the above listed Facility ("Parties"). This
Form, together with the Scope of Work, constitute the full Agreement between the Parties.
By signing below, the Parties confirm the measures initialed in Section B of this Form (below) have been
installed in the specified quantities and that associated equipment is operational. Additionally, by signing
below, the Qualified Partner certifies that all applicable permits have been obtained and all hazardous and
nonhazardous materials have been disposed of in accordance with federal, state and local regulations.
The Applicant must review and initial each row in Section B. Both the Installing Contractor and the Applicant
must sign, and return this document as outlined in FON CIP-004-2021 Section 4.1. The project incentive will not
be paid until the signed/initialed Form is received by the date outlined in CIP FON-004-2021 Section 1.4.
Participating Customer Date
Participating Qualified Partner Date
Efficiency Maine Representative Date(Sample #3 - LP)
Section B. List of Measures
Quantity Initials to
Measure Description Location Installed Accept
LED 2x4 Recessed Fixture(Sample #4 – HPP)
COMMERCIAL & INDUSTRIAL PRESCRIPTIVE SOLUTIONS
MUNICIPAL HEAT PUMP RETROFITS
CIP FON-004-2021
Installation Completion & Applicant Acceptance Form
This Project Acceptance Form ("Form") when signed, signifies the project approved from the application
submitted in response to CIP FON-004-2021 and part of the Commercial & Industrial Prescriptive
Program has been completed. The Form is to be executed in connection with the installation of energy
efficiency retrofit measures by the Participating Qualified Partner and the below listed Facility ("Parties").
This Form, together with the Scope of Work, constitute the full Agreement between the Parties.
By signing below, the Parties confirm the measures initialed in Section B of this Form (below) have
been installed in the specified quantities and that associated equipment is operational. Additionally, by
signing below, the Qualified Partner certifies that all applicable permits have been obtained and all
hazardous and nonhazardous materials have been disposed of in accordance with federal, state and
local regulations.
Both the Installing Contractor and the Applicant must sign, and return this document as outlined in FON
CIP-004-2021 Section 4.1. The project incentive will not be paid until the signed/initialed Form is
received by the date outlined in CIP FON-004-2021 Section 1.4.
CUSTOMER INFORMATION
Customer Name:
Physical Installation Address: City: State: Zip Code:
Contact Name/Title:
Email Address: Telephone:
HEATING & COOLING VALIDATION
By signing below, I confirm the single zone heat pump system(s) has been installed and:
(check boxes)
o I confirm the equipment as listed in Section B has been installed
o I have received system operation training
o I have received equipment manuals
o I certify that the system provides primary heating and cooling to the spaces served by the installed equipment
Customer Signature Date(Sample #4 – HPP)
This equipment (listed below) has been installed in accordance with manufacturers specifications and is
operating as designed.
Section B. List of Measures
Estimated
Est. Cost to
Measure Description Location Labor Material Combined
Qty Total Cost Customer
Cost Cost Incentive
Single Zone Heat Pump – 9,000 BTU/hr Library offices
2 $1000.00 $5,857.50 $6,857.50 $5,200.00 $1,657.50
Single Zone Heat Pump – 15,000 BTU/hr Checkout area 1 $500.00 2,579.50 $3,079.50 $2,600.00 $479.50
Qualified Partner Signature DateYou can also read
