2. 
4. Please select the type of application you wish to apply for*

   I want to...

   1. Apply for the Residential High Efficiency Toilet Rebate Program (CVWD-942)
   2. Apply for the Residential Efficient Washing Machine Rebate Program (CVWD-993)
   3. Apply for the Residential Hot Water Recirculation Pump Rebate Program (CVWD-992)
6. Today's Date*
   Today's Date

   Residential High Efficiency Toilet Rebate Program

   About the Program

   Coachella Valley Water District (CVWD) is offering a rebate for High-Efficiency (1.28 gallons per flush or less) toilets for customers living within CVWD’s service area. CVWD will offer a maximum of $100 per toilet and up to $10 for the required recycling of each replaced toilet. Customers will be responsible for installation, submission of sales receipt(s), and submission of recycling receipt(s).  CVWD will reimburse the customer after all program conditions have been met.

   Eligibility 

   1. All applicants must be a CVWD customer and property owner of the residence.  The residence must be located within CVWD’s service area. 
   2. The customer must have an account in good standing with CVWD.   
   3. Receipts and application must be submitted within 90 days of purchase.  The program is not for new construction and is not retroactive to toilets purchased more than 90 days before the application is received.

   Terms and Conditions

   1. Customer must complete and sign a program application. 
   2. The rebate is limited to the number of toilets in a residential unit served by a single water meter, applicable for single family homes, duplexes, triplexes, and four-plexes.
   3. Customer agrees to purchase and install the toilet(s) at customer’s expense.
   4. Receipts and application must be submitted within 90 days of purchase.  The program is not for new construction and is not retroactive to toilets purchased more than 90 days before the application is received.
   5. Qualifying toilets must be high-efficiency models with a rating of 1.28 gallons per flush or less and have an EPA Water Sense label.
   6. The customer agrees to deliver old, inefficient toilet(s) to Desert Recycling Center, or a professional recycling center of their choice, at the customer’s expense and provide a recycling receipt.  Applications submitted without proof of recycling will not be accepted or approved.
   7. Customer must provide original cash register receipt along with the sales invoice, if one is issued, indicating the make and model purchased from a home improvement store or other retail outlet that sells new toilets.  For toilets purchased through a plumber or contractor, the original invoice from the contractor with the make, model, and cost of each toilet stamped “Paid in Full” will be acceptable as proof of payment.
   8. Customer agrees that when all program conditions are met, CVWD shall reimburse an amount up to One Hundred Dollars ($100) per toilet or the cost of the purchase of the toilet, whichever amount is less and will reimburse the cost of recycling of old toilets at an amount up to Ten Dollars ($10) per toilet.  A rebate check will be mailed to the property owner within 60 days.
   9. Customer has read and agrees to the program conditions and the following disclaimer:
   10. Coachella Valley Water District reserves the right to offer this program. By applying for or participating in any component of CVWD’s programs, personal information listed on your application may be subject to disclosure to any member of the public who requests it pursuant to the California Public Records Act.
   11. Coachella Valley Water District administers this program on a first-come, first-served basis, subject to availability of funds and all other applicable program conditions.  By participating in the program, you waive and release Coachella Valley Water District from any and all claims and causes of action arising out of the purchase, installation, or use of the High-Efficiency toilet.  Any claim you may have based upon any defect or failure of the performance of the High-Efficiency toilet purchased by you in conjunction with this program shall be pursued with the retail outlet and the manufacturer or installation contractor.
8. Today's Date*
   Today's Date

   Residential High Efficiency Washing Machine Rebate Program

   About the Program

   Coachella Valley Water District (CVWD) is offering a residential rebate program for installing a new efficient washing machine (list available at www.energystar.gov). Residential property must be within CVWD’s service area. CVWD will offer a maximum of $150 rebate per installed washing machine. Customers will be responsible for providing a completed application, color photo of the installed washing machine, and sales receipt. CVWD will reimburse the customer after all program conditions have been met.

   Eligibility 

   1. All customers must be the CVWD property owner or the account holder of record for the service address. The residence must be located within CVWD’s service area. 
   2. The customer must have an account in good standing with CVWD. 
   3. Customer must install an ENERGY STAR certified washer with an Integrated Water Factor of 4.5 or less, listed at www.energystar.gov, to qualify for a rebate. 

   Terms and Conditions

   1. Customer must complete and sign a program application. 
   2. The rebate is limited to one (1) per household for a single-family dwelling; or one (1) rebate application per unit for a multi-family dwelling duplex, triplex or four-plex. 
   3. Customer agrees to purchase and install an ENERGY STAR certified washing machine with an Integrated Water Factor of 4.5 or less at customer’s expense. Eligible models are available at www.energystar.gov.
   4. Customer must submit 1) application, 2) receipt(s), and 3) color photo showing proof of installation within 60 days of purchase. The program is not for new construction and is not retroactive to washing machines purchased more than 60 days before the application is received.
   5. Customer must provide a cash register receipt along with the sales invoice, if one is issued, indicating the make and model purchased from a home improvement store, or other retail outlet that sells new washing machines. For washing machines purchased through a plumber or contractor, the invoice from the contractor with the make, model, and cost of the washing machine stamped “Paid in Full” will be acceptable as proof of payment. Installations may be subject to site visit inspection.
   6. Customer agrees that when all program conditions are met, CVWD shall reimburse an amount up to One Hundred and Fifty Dollars ($150) per washing machine. A rebate check will be mailed to the applicant within 60 days.
   7. Customer has read and agrees to the program conditions and the following disclaimer: 

   Coachella Valley Water District reserves the right to offer this program. By applying for or participating in any component of CVWD’s programs, personal information listed on your application may be subject to disclosure to any member of the public who requests it pursuant to the California Public Records Act.

    Coachella Valley Water District administers the Residential Efficient Washing Machine Rebate Program on a first come, first-served basis, subject to availability of funds and all other applicable program conditions. This program may be discontinued or modified at any time. By participating in the program, you waive and release Coachella Valley Water District from any and all claims and causes of action arising out of the purchase, installation, or use of the washing machine. Any claim you may have based upon any defect or failure of the performance of the washing machine purchased by you in conjunction with this program shall be pursued with the retail outlet and the manufacturer or installation contractor.

10. Today's Date*
    Today's Date

    Residential Hot Water Recirculating Pump Rebate Program

    About the Program

    Coachella Valley Water District (CVWD) is offering a rebate program for installing a new Hot Water Recirculating Pump for residential customers living within CVWD’s service area. CVWD will offer a maximum of $125 rebate, or the cost of the recirculating pump, whichever is less. Customers will be responsible for providing a completed application, color photo of the installed recirculating pump, and sales receipt. CVWD will reimburse the customer after all program conditions have been met. 

    Eligibility 

    1. All applicants must be a CVWD customer and property owner of the residence. The residence must be located within CVWD’s service area. 
    2. The customer must have an account in good standing with CVWD.   

    Terms and Conditions

    1. Customer must complete and sign a program application. 
    2. The rebate is limited to one (1) per household for a single-family dwelling; or one (1) rebate application per unit for a multi-family dwelling duplex, triplex or four-plex. 
    3. Customer agrees to purchase and install a hot water recirculating pump at customer’s expense. 
    4. Customer must submit 1) application, 2) receipt(s), and 3) color photos of installed pump system within 60 days of purchase. The program is not for new construction and is not retroactive to hot water recirculating pumps purchased more than 60 days before the application is received. CVWD will not reimburse for the cost of installation. 
    5. Customer must provide a cash register receipt along with the sales invoice, if one is issued, indicating the make and model purchased from a home improvement store, or other retail outlet that sells new hot water recirculating pumps. For hot water recirculating pumps purchased through a plumber or contractor, the invoice from the contractor with the make, model, and cost of the pump stamped “Paid in Full” will be acceptable as proof of payment. Installations may be subject to site visit inspection. 
    6. Customer agrees that when all program conditions are met, CVWD shall reimburse an amount up to One Hundred and Twenty-Five Dollars ($125) per hot water recirculating pump. A rebate check will be mailed to the applicant within 60 days. 
    7. Customer has read and agrees to the program conditions and the following disclaimer: 

    Coachella Valley Water District reserves the right to offer this program. By applying for or participating in any component of CVWD’s programs, personal information listed on your application may be subject to disclosure to any member of the public who requests it pursuant to the California Public Records Act. 

    Coachella Valley Water District administers the Hot Water Recirculating Pump Rebate Program on a first-come, first served basis, subject to availability of funds and all other applicable program conditions. This program may be discontinued or modified at any time. By participating in the program, you waive and release Coachella Valley Water District from any and all claims and causes of action arising out of the purchase, installation, or use of the Hot Water Recirculating Pump. Any claim you may have based upon any defect or failure of the performance of the Hot Water Recirculating Pump purchased by you in conjunction with this program shall be pursued with the retail outlet and the manufacturer or installation contractor.

12. Number of Toilets Applying For*
14. Account Number
    First 6 Digits*
15. Account Number
    Second 6 Digits*
17. Property Owner First Name*
18. Property Owner Last Name*
20. Property Address*
22. City*
    -- Select One --Cathedral CityDesert Hot SpringsIndian WellsIndioLa QuintaMeccaNilandPalm DesertRancho MirageSalton CitySky ValleyThermalThousand Palms
23. Zip Code*
24. State*
    -- Select One --California
25. Mobile Number*
27. Mailing Address*
    -- Select One --Same as Property AddressDifferent Mailing Address
29. Mailing Address Line 1*
31. Mailing Address Line 2
33. City*
34. State / Province*
35. Zip / Postal Code*
37. Email Address*
41. Date of Purchase*
    Date of Purchase
42. Manufacturer/Brand Name*
43. Model*
45. Upload Proof of Recycling Receipt*

    Applications submitted without proof of recycling will not be accepted or approved.

47. Upload Proof of Purchase Receipt*

    Sales receipt, cash register receipt or invoice with make, model and cost of the item. If purchased and installed by a contractor invoice must also have stamped "Paid in Full"

48. Upload Proof of Installation*

    Colored photo required

49. Cost*
51. Upload Additional Photos or Receipts
57. How did you hear about this program?*

    1. Agency Website
    2. Neighbor/Friend
    3. Newspaper
    4. Bill Insert
    5. Customer Service Representative
    6. CVWD Presentation
    7. Radio/TV
    8. Social Media
    9. Community Event
    10. Other
61. By typing or signing my name, I certify that I understand the terms and conditions outlined above and that to the best of my knowledge the information I provided is true and correct.*

63. COACHELLA VALLEY WATER DISTRICT

    Post Office Box 1058

    Coachella, California 92236

    (760) 391-9600

    (760) 837-5848 - fax

    
     rev 4/2022

     

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