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2. 
3. Attic Insulation Rebate Application

   Homeowner must supply and attach a copy of the installation invoice.  

4. Date*
   Date
6. Qualifications

   To qualify, insulation rebates apply to upgrades on existing homes only.  New construction does not qualify.  

8. Before Installation

   Completed application must be submitted.

9. After Installation

   Invoice and final inspection could be necessary.  Call 503-992-3253 to verify.  

11. ALL MEASURES MUST BE INSTALLED ACCORDING TO BPA'S RESIDENTIAL WEATHERIZATION SPECIFICATIONS & BEST PRACTICE GUIDE.

13. Electric Heat Source*
    -- Select One --Wall Unit, baseboard, ceiling cableForced-Air Electrice FurnaceHeat PumpOther
15. Type of Insulation*
    -- Select One --AtticWall
17. Rebate(s) will not exceed 100% of the installed job cost.
18. Rebate(s) for self-installed measures will not exceed 100% of the cost of materials.
20. Measure Information
    -- Select One --Attic Wall
21. Existing R-Value*
22. Final R-Value*
23. Area (sq ft)*
25. Installation*
    -- Select One --Self-InstalledContractor Installed
26. If work is not completed within three months of application date, customer must reapply for rebate(s). There is no guarantee funds will be availabe or the incentive amount will remain the same.
28. Account Number*
29. Phone Number*
31. First Name
32. Last Name
34. Email Address
36. Address
38. City
39. State
40. Zip Code
42. Reimbursement

    Rebates will be paid when Forest Grove Light & Power has received ta complete rebate application, copies of contractor's final invoice and the work has been inspected and approved by a FGL&P representative.  The contractor's final invoice must include product details, R-Value of existing insulation, R-Value of final insulation, and square footage of added insultation. 

44. Upload Invoice or Receipt*
46. Electronic Signature Agreement*

    Rebate offer(s) may be changed or discontinued at any time by Forest Grove Light & Power.  FGL&P disclaims any warranty, whether expressed or implied, regarding the measure(s) listed on this application for any materials or labor associated with installation, maintenance, repair, or any energy savings associated with use.

    I understand that the measure(s) must be installed to FGL&P specifications and I certify myself or my contractor have reviewed the specifications prior to beginning the work. When selecting a contractor, I understand that it is the homeowners responsibility to request proof of insurance and licensing that meets the statutes and rules of the Oregon Construction Contractors Board.  FGL&P strongly recomments validating qualifications before work begins. 

    I understand the above and certify that I am a customer of Forest Grove Light & Power, that all the information is true, that the measure(s) is/are installed at the address indicated on this application, and this address is within the FGL&P service area.    

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
48. Electronic Signature*
Leave This Blank:


50. 1. Receive an email copy of this form.
51. Email address

    This field is not part of the form submission.

52. Submit Submit and Print

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