Current Open Forms

2. Efficiency Rebates Application
   Residential Rebates for Qualified Town of Erie Utilities Residential Customers

4. To qualify for a rebate, you must meet all of the following requirements: Applicants must be a Town of Erie utilities customer with a current, non-delinquent account. Must be purchased between January 1, 2023 and December 31, 2023. Appliances must be for use at a Town of Erie service address. Qualified fixtures or appliances: Smart Irrigation Controllers: WaterSense-labeled smart irrigation controller (1 per household).  Limit 2 toilets. Must be EPA WaterSense labeled, 1.1 gallons or less per flush (if dual-flush, both flushes must be 1.1gpf or less), MaP score of 600 or greater. Limit 2 showerheads. Must be EPA WaterSense labeled, 1.5 gallons per minute or less. Limit 24 high efficiency nozzles from qualified list in application. Limit 2 rain barrels, 55 gallons each. Limit 50% rebate on drip equipment (conversion kit, line, emitters, pressure reducer, etc.). Rebate amount cannot exceed equipment price. 

8. First and Last Name*
10. Installation Address*
12. Water Account #*
    Account has to be in good standing (no negative balance)
14. Account # belongs to*
    -- Select One --Homeowner/LandlordTenant
16. Daytime Phone*
18. Email Address*
20. Mailing Address*
    (If different than installation)
22. Address 2
24. City*
25. Zip Code*
27. County of Qualified Address*

    1. Boulder
    2. Weld
29. Toilet Rebates
31. Number of Toilets Purchased
    -- Select One --OneTwo

    To achieve the $100 Rebate per toilet: Required WaterSense Labeled Toilet, be 1.1 Gallons Per Flush (GPF) or less (if dual-flush, both flushes must be 1.1gpf or less), and have a MaP score of 600 or greater.

32. Research Toilets MaP Score
    MaP Search
34. New Toilet #1 GPF
35. Old Toilet GPF
36. MaP Score
37. Watersense Labeled?
    -- Select One --YesNo
39. New Toilet #2 GPF
40. Old Toilet GPF
41. MaP Score
42. Watersense Labeled?
    -- Select One --YesNo
44. Toilets Recycled

    Recycling Toilets is HIGHLY encouraged and is also rebated! Itemized receipt required.

    1. One
    2. Two
    3. N/A
45. Recycle Toilets Here!
    CHaRM
47. 
48. Irrigation Equipment
50. WaterSense Smart Irrigation Controller

    To achieve $100 rebate: Did you purchase a WaterSense labelled smart controller?

    1. Yes
    2. No
51. WaterSense Product Search
    WaterSense

    Search here for WaterSense labelled products.

52. Controller Make and Model #
54. Purchased 55 (or less) Gallon Rain Barrel(s)

    Up to $50 on each barrel (rebate not to exceed total cost)

    1. One
    2. Two
    3. N/A
56. Qualifying High Efficiency Nozzles**
    -- Select One --Hunter MP RotatorK Rain Rotary NozzleOrbit Eco Stream RotatorRain Bird R-VAN NozzleToro Precision Rotating NozzleToro Precision Spray Nozzle

    $3 rebate per nozzle, up to 24 units, not to exceed purchase price (irrigation assessment required prior to retrofits)

57. Quantity of High Efficiency Nozzles Purchased**
59. Drip Equipment**

    50% rebate not to exceed $100, (drip conversion kit, drip line, drip emitters, pressure reducer and y-screen, 1/4"distribution line, connection fittings, spigot timer, drip valve 15-40 psi). Consider using a certified landscape professional

    1. Purchased
    2. N/A
61. Receipt(s) Upload Below
    **Required**
63. Receipts*
64. Recycled Toilet Receipt
66. Resource Central Slow the Flow Report
67. Receipts
69. You rebate will be issued as credit to your water bill within one billing cycle.
    If you are a renter or you pay your HOA for your water bill, please contact rebates@erieco.gov after rebate submission.
71. Affidavit
73. I swear or affirm under penalty of perjury under the laws of the State of Colorado that (check one): I am a United States citizen and/or I am lawfully present in the United States pursuant to Federal law. I understand that this sworn statement is required by law because I have applied for a public benefit. I understand that state law requires me to provide proof that I am lawfully present in the United States when asked as well as submission of a secure and verifiable document. I may also be required to provide proof of lawful presence. I further acknowledge that making a false, fictitious, or fraudulent statement or representation in this sworn affidavit is punishable under the criminal laws of Colorado as perjury in the second degree under Colorado Revised Statute 18-8-503 and it shall constitute a separate criminal offense each time a public benefit is fraudulently received. By signing this form, I certify that I purchased the fixtures or appliances as stated above and plan to install it (them) at the address indicated above within the Town of Erie service area.
75. Electronic Signature*
76. Date*
    Date
78. How did you hear about the Water Efficiency Rebate Program*

    1. Bill insert
    2. Erie.Earth
    3. Town of Erie website
    4. Media (newspaper, radio)
    5. Friend/family member
    6. Retailer
    7. Social media
    8. Town event
    9. Google
80. Subscribe to be notified first!
    Click here

    For more information regarding Energy Efficiency Audits, Irrigation Smart Controller and/or Rain Sensor Direct Installation Programs, Free Sprinkler Assessments, Garden in a Box Xeriscape Program, Town of Erie Smart Meter Replacement Program, and more!
82. Purchase a Garden In A Box
83. Slow the Flow Irrigation Assessment Signup
84. Town of Erie Smart Meters
Leave This Blank:


86. 1. Receive an email copy of this form.
87. Email address

    This field is not part of the form submission.

88. Submit Submit and Print

* indicates a required field