SAGE Rebate Application

SAGE Rebate Application
Business Information
Business Name
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Payee for Rebate for Recipient Business

Designate to whom the rebate check should be made payable and to where the check should be sent.
Point of Contact for Recipient Business

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Rebates Selection

Check all applicable rebates you’re applying for and describe project under each selection
Energy

Other
Energy Description
All upgrades must be ENERGYSTAR, Xcel Energy certified, or of similar high efficiency. The total combined the Recipient Business may receive for energy rebates is up to 75% of total project cost, capped at $1,500/year.
Water

Other
Water Description
All upgrades should be WaterSense certified or similarly high-efficiency equipment. Each product category is eligible to receive up to 75% of total cost rebated, capped at $500 for each product/item.
Waste
Waste Description
Each item is eligible to receive up to 75% of total cost rebated, capped at $500 for each.
Reusables (Each business is eligible to receive up to 75% of total cost rebated, capped at $1,000 for each)

Other
Reusables Description
Reusables Description - Describe the following:
- Please provide details of what you will be buying with this grant.
- What single-use items would this allow you to reduce? (include an estimate of how much will be reduced over the course of a year or month-to-month)
- Please provide any additional details about what systems you might put in place to maximize success.
Transportation

Other
Transportation Description
Custom Rebate
Describe your custom project that does not fit into the categories above. Please include how this project will reduce the use of natural resources (e.g. energy and water), save your business money, and/or improve the sustainability of your business.

Up to 75% project cost, capped at $1,500 for total project costs.
Upload Receipts/Invoices

Cancelof
Upload Photos/Visual Documentation of Project

Cancelof
Terms and Conditions
Acknowledgement
Click here to view the Terms and Conditions.
Electronic Signature
I agree that the information I have provided in this application is truthful and accurate and that checking this box and entering my information below constitutes a legal and enforceable signature for this application in accordance with the provisions of the provisions of the Colorado Electronic Signatures Act 24-71-101.
Full Name (Including middle initial if applicable)
Address
Email
example@example.com
Date Received

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Hour MinutesAM/PM Option
Application Approved
Approval Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Amount Approved
Project Verified
Amount Paid
Date Paid

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Owner

Bridger Tomlin - Sustainability Associate
Should be Empty:

SAGE Rebate Application

Business Information

Payee for Rebate for Recipient Business

Rebates Selection

Terms and Conditions

Electronic Signature

Owner