Lighting Equipment Worksheet - Focus on Energy

MultifaMily EnErgy SavingS PrograM 

ligHting EQuiPMEnt WorKSHEEt 

THIS APPLICATION IS FOR EXISTING BUILDINGS ONLY. 

This application expires December 31, 2013. Return signed, completed application with accompanying worksheet(s) and itemized invoice 

postmarked within 60 calendar days of project installation, but no later than December 31, 2013, unless an earlier date is specified by <strong>Focus</strong> 

on Energy. <strong>Focus</strong> on Energy incentives are subject to change. Please visit focusonenergy.com/multifamily to ensure you are using the most 

current form. This worksheet must be accompanied by a completed Prescriptive Incentive Application. Questions: Call 866.486.0832 

Property Name: 

Installation Address: 

REPLACEMENT LAMPS – CFL, COLD CATHODE, CERAMIC METAL HALIDE AND LED 

n One for one replacement of incandescent only. Other replacements may be eligible for custom incentive. 

n LED products must appear on “ENERGY STAR® SSL Qualified Light Bulbs” list. Lists can be found at focusonenergy.com/business/lighting.aspx. 

n Other lamps including CFL to LED conversions may be considered for custom, please call 866.486.0832 for pre-approval. 

n Rebated lamps may not be used for resale or giveaway-type promotions. 

Screw Base CFL/ 

Cold Cathode Lamps 

<strong>Equipment</strong> Type Specifications and Required Information 

CFL Reflector Flood Lamps 

High Wattage CFL Lamps 

CMH Integral Ballast Lamps 

ENERGY STAR 

LED Replacement Lamps 

ENERGY STAR 

LED Replacement Lamps 

Replace incandescent lamps (up to 100W) with CFL or cold cathode screw-base lamps up to 

32 Watts. 

q Installed in Unit Quantity:________ q Installed in Common Area Quantity:_______ 

Replace 100W or less incandescent with CFL flood lamps with integrated reflector up to 30 

Watts. Screw base CFLs only. 

Replace incandescent lamp (greater than 100W) with high wattage CFL from 33-115 Watts. 

Medium Edison screw base CFLs only. 

Retrofit existing 70-100W incandescent flood or spot lamps with ≤25W Ceramic Metal Halide 

reflector lamp with integrated ballast. 

Replace existing Incandescent Lamp ≤40W 

Wattage Replaced:________ LED Manufacturer/Model: ___________________ 

q Installed in Unit Quantity:________ q Installed in Common Area Quantity:________ 

Replace existing Incandescent Lamp 41W to 120W 

Wattage Replaced:________ LED Manufacturer/Model: ___________________ 


Incentive 

Limited to 50% 

of Cost 

$2/Lamp 1 

$4/Lamp 1 

$5/Lamp 1 

$15/Lamp 1 

$10/Lamp 1 

$15/Lamp 1 

Quantity Total 

1Incentive limited to 50% of the product cost. Some retailers sell lamps which are pre-discounted by <strong>Focus</strong> on Energy. Lamps that have 

received this discount are not eligible for the incentives listed above. 

REDUCED WATTAGE REPLACEMENT LAMPS – LAMP ONLY 

n LAMP ONLY- Intended for replacement of existing lamps with Reduced Wattage alternative. 

n Relamp existing T8 fixtures with CEE listed Reduced Wattage 4' T8 (straight or U shaped) lamps, or Reduced Wattage 8' T8 lamps as listed below. 

n Relamp existing CFL or HID fixtures with Reduced Wattage alternatives as listed below. 

n Unless noted below, these lamp-only incentives may be combined with fixture incentives found in the other sections of this application. 

Incentive 

<strong>Equipment</strong> Type Specifications and Required Information 

Limited to 50% Quantity Total 

of Cost 

4’ T8 Reduced Wattage 

CEE Listed 

8’ T8 Reduced Wattage 

Reduced Wattage CFL 

Pin-Based Lamps 

Reduced Wattage HID 

Direct Replacement Lamps 

Exterior Only 

(does not require new ballast) 

Replace existing 4’ 32W T8 lamps with: 

q 25W 4’T8* q 28W 4’T8* 

*(Cannot be combined with 4’ RWT8 System incentives listed on page 4) 

Replace existing 8’ 59W T8 lamps with : 

q 49W 8’T8 q 50W 8’T8 q 51W 8’T8 q 54W 8’T8 

Replace existing pin-based CFL lamps with Reduced Wattage alternative: 

18W replacement: 

q 14W q 15W 

q 16W 


q 21W q 23W 


q 27W q 28W 


q 33W q 38W 

Replace existing standard HID lamps with Reduced Wattage alternative Pulse Start Metal 

Halide (PSMH) or Ceramic Metal Halide (CMH) Lamps: 

1000W 

replacement: 

q 830W 

400W 

replacement: 

q 330W 

q 360W 

320W 

replacement: 

q 260W 

250W 

replacement: 

q 220W 

q 205W 


q 150W 

q 145W 

$1/Lamp 

$1/Lamp 

$1/Lamp 

$10/Lamp 

MM_MESP_lighting_012913 1 of 7








INTERIOR FIXTURES – CFL AND LED 

n Install permanently wired new fixtures instead of or replacing incandescent fixtures. New fixtures include housing, trim, reflector, lens (plus heat sink, driver and light 

source for LED). 

n Replacement lamps are not eligible for these incentives. 

n All LED product types must match the category of the product listing. 

n Both residential and commercial rated LED products are eligible for these incentives. 

n Qualifying ENERGY STAR rated residential products can be found at http://downloads.energystar.gov/bi/qplist/Light%20Fixtures%20Product%20List.xls?aa52-d397 

n Commercially rated LED products must appear on one of the following qualified product lists: 

n ENERGY STAR qualified product list for Commercial LED Downlights, Porch Light or Accent Lights categories 

n OR the DesignLights Consortium (DLC) qualified product list for Track or Monopoint Directional fixtures 

n OR be listed on the <strong>Focus</strong> on Energy qualified product list for LED Downlights over 19W. 

n Please see focusonenergy.com/business/lighting.aspx for more information. 

n CFL to LED conversions can be considered for custom incentives, please call 866.486.0832 for more information. 

<strong>Equipment</strong> Type Specifications and Required Information Incentive Quantity Total 

Pin-Based CFL Fixtures 

ENERGY STAR Rated LED Porch 

Fixtures 

LED Fixtures 18 Watts or Less 

ENERGY STAR Qualified or 

DLC Listed 

LED Fixtures 19W or Greater 

ENERGY STAR Qualified 

DLC Listed or <strong>Focus</strong> QPL 

Replace incandescent fixtures with permanently wired, 

new fixtures containing pin-based CFL lamps. 

q Installed in Unit Quantity:________ 

q Installed in Common Area Quantity:________ 

Replace 60-100W incandescent with qualified 

LED porch fixture 

Model #_______________________________________ 

Replace 60-100W incandescent with qualified LED fixture: (check one) 

ENERGY STAR 

q Downlight q Accent Light 

Incandescent Wattage 

Removed________ 

Incandescent Wattage 

Removed________ 

DLC listed LED 

q Track or Monopoint Directional Fixture 

Manufacturer/Model #_______________________________________ 


Replace incandescent fixture greater than 100W OR HID fixture of 50W to 100W (Lamp) with: 

(check one) 

ENERGY STAR 

q Downlight 

q Accent Light 

DLC listed LED : 

q Track Fixture 

<strong>Focus</strong> QPL: 

q Downlight 

Manufacturer/Model #_______________________________________ 

$30/Fixture 

$30/Fixture 

$30/Fixture 

$45/Fixture 

LINEAR FIXTURES – 2X4 HIGH EFFICIENCY/LOW GLARE – FLUORESCENT AND LED 

n Install a new High Efficiency/Low Glare 2' x 4' recessed fixture instead of or replacing an existing 2' x 4' recessed troffer fixture containing 3 or 4 F32T8 or F40T12 lamps. 

n Must be a new fixture or complete retrofit unit incorporating advanced lighting distribution and glare control optics. Specular reflector kits are not eligible for this incentive. 

n Please verify product is on approved list at focusonenergy.com/business/lighting.aspx or call 866.486.0832 for pre-approval. Fixture efficiency must be 80% or greater 

and must appear on qualified product list. 

n T8 lamps and ballast must be listed on CEE High Performance or Reduced Wattage T8 list to qualify. T5 fixtures must contain 2 F28T5 lamps (T5HO are not eligible). 

n LED products must be DLC listed LED as “Linear panel (2' x 4' troffer).” 

n LED products must be ≤55W and ≥4000 photopic lumens to qualify for this incentive. 

n DLC listed 2x4 retrofits and linear style replacement lamps do not qualify for this offer but may be eligible for custom incentives. Call 866.486.0832 for more information. 


2 Lamp F28T5 2x4 

High Efficiency Recessed Fixture 

2 Lamp HPT8 or RWT8 2x4 

High Efficiency Recessed Fixture 

DLC listed LED LED 2x4 Troffer – 

Less Than 55W, ≥4000 Lumens 

Fixture Model #________________________ $20/Fixture 

Fixture Model #______________________ Ballast Model #_______________________ 

Lamp Model #_______________________ 

$20/Fixture 










BI-LEVEL STAIRWELL/PASSAGEWAY FIXTURES 

n Replace existing 2 lamp 4’ fluorescent fixture with new linear fluorescent or LED fixture manufactured with fixture-integrated occupancy sensors. 

n New fluorescent fixtures must contain Programmed-Start electronic ballasts and if fixtures contain 4’ lamps, must be CEE listed HPT8 or RWT8 to qualify. 

n LED fixtures must be DLC Listed as “Stairwell or Passageway” category. 

n Must include a passive infrared and/or ultrasonic occupancy sensor with a fail-safe feature (fails in “on” position in case of sensor failure). 

n Fixtures must operate in low-standby light level during vacancy and switch to full light output upon occupancy. The fixture cannot exceed 50% of full wattage during 

unoccupied periods. Fixtures whose settings can be overridden are not eligible. 

n Screw-in lamps are not eligible. 

n Bi-level stairwell/passageway fixtures are not eligible for additional incentives (for Controls, Fixtures or Linear Fluorescent system upgrades). 

<strong>Equipment</strong> Type Specification and Required Information Incentive Quantity Total 

Linear Fluorescent Stairwell or 

Passageway Fixture 

DLC Listed LED Stairwell or 

Passageway Fixture 

Fixture Model #________________________ 

Type: 

q Step or Continuous Dimming Fixture 

q Alternate Lamp Fixture (i.e., 4' lamps in occupied 2' lamp in unoccupied) 

$45/Fixture 


BI-LEVEL CONTROLS FOR LED, INDUCTION, FLUORESCENT, CERAMIC METAL HALIDE, AND PULSE START METAL HALIDE FIXTURES 

n Controls must be occupancy or, occupancy schedule based. 

n Controls types must be dimming, stepped dimming, or hi-lo ballast controls. 

n If a passive infrared and/or ultrasonic occupancy sensors are used to control light level it must have a fail-safe feature (fails in “on” position in case of sensor failure). 

n Fixtures must operate in low-standby light level during periods of low occupancy. The fixture cannot exceed 50% of full wattage during unoccupied periods. Fixtures whose 

settings can be overridden are not eligible. 

n A manufacturer’s spec sheet for all bi-level control components must be submitted with this application. 

<strong>Equipment</strong> Type Specification and Required Information Incentive 

Bi-Level Controls Type of Fixture:______________________ Wattage of Fixture:____________________ 

LIGHTING CONTROLS-OCCUPANCY SENSORS 

n Install ultrasonic or passive infrared sensor. 

n Sensors may control more than one fixture. 

n Rapid or programmed start ballasts are recommended for fluorescent fixtures to extend lamp life. 

Wall-Mounted 

Ceiling-Mounted 

$10/Fixture 

Controlled 

<strong>Equipment</strong> Type Specification and Required Information Usage Incentive Quantity Total 

≤ 200 Watts controlled per sensor Est. Hrs___ $15/Each 

> 200 Watts controlled per sensor Est. Hrs___ $15/Each 

≤ 500 Watts controlled per sensor Est. Hrs___ $30/Each 

501-1000 Watts controlled per sensor Est. Hrs___ $30/Each 

> 1000 Watts controlled per sensor Est. Hrs___ $30/Each 

LED EXIT FIXTURE 

n For specially targeted early replacement only. 

n Incentives are based on the conversion of incandescent or CFL exit signs to new LED exit sign or LED retrofit kits. 

LED Exit Fixtures or Retrofit Kits $10/Sign 

Application 

and Quantity 

q 24/7 Parking Garage:__________ 

q Exterior :___________ 

Total 









4' LINEAR FLOURESCENT – HIGH PERFORMANCE T8 (HPT8) OR REDUCED WATTAGE T8 (RWT8) SYSTEMS 

Replace 4' T12 or upgrade standard T8 system with a 4' High Performance T8 (HPT8) OR 4' Reduced Wattage T8 (RWT8) system. Lamps and ballast must meet the 

guidelines below or system will not qualify for ANY incentive. Please call with any eligibility or product qualification questions prior to initiating project. 

n All components (ballasts and lamps) must be CEE listed. “High Performance T8” and “Reduced Wattage T8” qualified product lists posted at 

focusonenergy.com/business/lighting.aspx. 

n Parking garage fixtures must operate 24 hrs/day to qualify. If fixture is in operation less than 24 hrs/day, call to verify eligibility. 

HPT8 SYSTEM REQUIREMENTS: 

n High Performance T8 systems must contain high lumen, long life F32T8 lamps and be listed on CEE High Performance T8 list. 

n Must be paired with LOW Ballast Factor Range ballast from the CEE “High Performance T8” list only. 

RWT8 SYSTEM REQUIREMENTS: 

n Reduced Wattage T8 systems must contain 25W or 28W T8 (straight or U shaped) lamps and be listed on CEE Reduced Wattage T8 list. 

n Qualified lamps (above) must be paired with either a NORMAL OR LOW Ballast Factor Range electronic ballast from the CEE “High Performance T8” OR “Reduced Wattage 

T8” qualified product lists. 

n This incentive cannot be combined with the Reduced Wattage T8 lamp only incentive on page 1. 

<strong>Equipment</strong> 

Replaced/Upgrade 

4' 1 Lamp T12 or 

Standard T8 System 

4’ 2 Lamp T12 or 






Specifications and Required Information Incentive 

32W HPT8 System with CEE listed LOW Ballast Factor Range Ballast 

Lamp Model#______________________ Ballast Model#______________________ 

RWT8 System RWT8 System with CEE listed NORMAL Ballast Factor Range Ballast 

Lamp type: (check one) q 4' 25W T8 q 4' 28W T8 

Lamp Model# ______________________ Ballast Model# ______________________ 

RWT8 System RWT8 System with CEE listed LOW Ballast Factor Range Ballast 








RWT8 System RWT8 System with CEE listed LOW Ballast Factor Range Ballast. 



















$15/Fixture 

$20/Fixture 

$25/Fixture 

$15/Fixture 

$20/Fixture 

$25/Fixture 

$25/Fixture 

$30/Fixture 

$35/Fixture 

$25/Fixture 

$30/Fixture 

$35/Fixture 

Installation Type 

and Quantity 


q Common Area :___________ 

q In Unit :___________ 



q In Unit :___________ 



q In Unit :___________ 



q In Unit :___________ 



q In Unit :___________ 



q In Unit :___________ 



q In Unit :___________ 



q In Unit :___________ 



q In Unit :___________ 



q In Unit :___________ 



q In Unit :___________ 



q In Unit :___________ 

Total 









DELAMPING Incentive – PERMANENTLY REDUCE THE NUMBER OF 4' FLOURESCENT LAMPS IN UPGRADED FIXTURES 

n This offer is in addition to the 4’ linear fluorescent measures shown on page 4 where the number of fixtures is staying the same pre- and post-retrofit, but one or more 

lamps are permanently removed from the fixture. 

n Overall wattage in each fixture must be reduced and must include system upgrade to HPT8 or RWT8 as listed above. Removal of lamps in non-operational fixtures does 

not qualify. 

n <strong>Focus</strong> on Energy reserves the right to complete a pre-inspection prior to issuing a reservation code. Reservation Code is required before project begins to qualify. 

n Call 866.486.0832 to speak with a program representative to begin the reservation code process. 

Reservation Code__________________________ 

Quantity of 

Lamps in 

Existing 

Fixture 

REPLACE OR RETROFIT 8' T12 FIXTURES WITH 4' HPT8 OR RWT8 SYSTEMS 

n Replace or retrofit standard 8 foot T12 systems with 4' High Performance T8 (HPT8) or Reduced Wattage T8 (RWT8) systems in configurations described below. Please 

read carefully. If fixture configuration is not one for one replacement or differs from line items, please call 866.486.0832 to verify eligibility. 

n All components (ballasts and lamps) must be CEE listed. “High Performance T8” OR “Reduced Wattage T8” qualified product lists posted at 

focusonenergy.com/business/lighting.aspx. 

n LOW ballast factor ballast used to replace 8' HO or VHO systems requires a customer sign off on the light level, see below. 

<strong>Equipment</strong> 

Replaced/Upgraded 

8' 1 Lamp T12 

Replaced with 

2 Lamp 4' T8 System 

8' 2 Lamp T12 

Replaced with 


8' 1 Lamp T12HO 

Replaced with 

2 Lamp 4' T8 S ystem 

8' 2 Lamp T12HO 

Replaced with 


Existing 

Fixture Type 

q T12 Lamp 

q T8 Lamp 

q HPT8 Lamp 

q T12 Lamp 

q T8 Lamp 

q HPT8 Lamp 

8' 2 Lamp T12VHO 

Replaced with 4 Lamp 

4' T8 System 

Quantity of 

Lamps in 

Replacement 

Fixture 

Replacement 

System Type 

q RWT8 

q HPT8 

q RWT8 

q HPT8 

Quantity of 

Fixtures 

Upgraded 

Specification and Required Information Incentive 

CEE listed NORMAL Ballast Factor Range Ballast with: 

q HPT8 32W q RWT8 28W q RWT8 25W 


CEE listed LOW Ballast Factor Range Ballast with: 



CEE listed NORMAL Ballast Factor Range Ballast with: 



CEE listed LOW Ballast Factor Range Ballast with: 



CEE listed Ballast (check one Ballast Factor Range): q HIGH q NORMAL q LOW 

LAMP: (check one) q HPT8 32W q RWT8 28W q RWT8 25W 








LIGHT LEVEL CERTIFICATION (For replacing 8' T12 with low ballast factor T8) 

I agree that the low ballast factor ballast lighting is adequate without the need for additional task lighting. 

Customer Signature: Customer Name (Print): Date: 

Total Number of Lamps 

Removed per Fixture 

$30/Fixture 

$35/Fixture 

$30/Fixture 

$35/Fixture 

$30/Fixture 

$40/Fixture 

$45/Fixture 

Installation Type 

and Quantity 

Incentive Total 

$1/ Lamp removed 

$1/ Lamp removed 



q In Unit :___________ 



q In Unit :___________ 



q In Unit :___________ 



q In Unit :___________ 



q In Unit :___________ 



q In Unit :___________ 



q In Unit :___________ 

Total 









Pole Mounted Fixture Parking Garage Fixture 

LIGHTING FIXTURES – LED, INDUCTION AND PULSE START OR CERAMIC METAL HALIDE (CMH) 

n To qualify for incentive, complete luminaire unit including housing, trim, reflector, lens, heat sink, driver or ballast, and light source must be installed. Retrofit projects 

must replace existing HID fixtures with qualified, complete luminaire unit or hardwired retrofit kit. Manufacturer spec sheet is REQUIRED. 

n LED products must appear on “ENERGY STAR SSL Commercial Qualified Products” list or Design Lights Consortium (DLC) qualified products list, and must be listed within 

the category for which they are being installed. Lists can be found at focusonenergy.com/business/lighting.aspx. 

n Project must result in at least a 40% wattage reduction from existing HID fixtures for ALL LED fixture types. 

n All projects must meet IESNA recommendations for light level and uniformity. 

n Other fixtures may be considered for custom incentives, please call 866.486.0832 for pre-approval. 

n Parking garage fixtures must operate 24 hrs/day to qualify. If fixture is in operation less than 24 hrs/day, call to verify eligibility. 

n Induction fixtures and retrofits must have a five year manufacturer’s warranty. 


EXISTING EQUIPMENT INFO REQUIRED: 

Hours of Operation: Parking garage fixtures must operate 24 hrs/day to qualify. Existing Fixture Type: __________ Existing Wattage: ________ 

Replacing 70-100W HID 

Replacing 150W or 

175W HID 

Replacing 250W HID 

DLC listed LED Parking Garage Fixture or Retrofit (Parking Garage Category listed): 

Manufacturer/Model: ____________________ Installed Wattage: ________ 

Induction Parking Garage Fixture or Retrofit q 35W-55W 


Manufacturer/Model: _____________________ Installed Wattage: ________ 

Induction Parking Garage Fixture or Retrofit q 100W 

Pulse Start or Ceramic Metal Halide Parking Garage Fixture or Retrofit q 100W 


Manufacturer/Model: __________________ Installed Wattage: ________ 

Induction Parking Garage Fixture or Retrofit (Check One): q 120-125W q 150W q 165W 

Pulse Start or Ceramic Metal Halide Parking Garage Fixture or Retrofit q 125W 


Hours of Operation: q Dusk to Dawn Existing Fixture Type: __________ Existing Wattage: ________ 



175W HID 



DLC listed LED Pole-Mounted Roadway or Decorative Fixture or Retrofit 

Manufacturer/Model: ____________________ Installed Wattage: ________ 

Induction Pole-Mounted Fixture or Retrofit q 35W-55W 



Induction Pole-Mounted Fixture or Retrofit q 100W 

Pulse Start or Ceramic Metal Halide Pole Mounted Fixture or Retrofit q 100W 



Induction Pole-Mounted Fixture or Retrofit (Check One): q 120-125W q 150W q 165W 

Pulse Start or Ceramic Metal Halide Pole Mounted Fixture or Retrofit q 125W 



Induction Pole-Mounted Fixture or Retrofit (Check One): q 200W q 225W q 250W 

Pulse Start or Ceramic Metal Halide Pole Mounted Fixture or Retrofit (Check One): 

q 200W q 210W q 220W 

$30/Fixture 

$50/Fixture 

$60/Fixture 

$30/Fixture 

$50/Fixture 

$60/Fixture 

$75/Fixture 









High Canopy Fixture Wall-Pack Fixture 






175W HID 



DLC listed Wall-Mounted LED Fixture or Retrofit 


Induction Wall-Pack Fixture or Retrofit q 35W-55W 



Induction Wall-Pack Fixture or Retrofit q 100W 

Pulse Start or Ceramic Metal Halide Wall-Pack Fixture or Retrofit q 100W 


Manufacturer/Model: ______________________ Installed Wattage: ________ 

Induction Wall-Pack Fixture or Retrofit (Check One): q 120-125W q 150W q 165W 

Pulse Start or Ceramic Metal Halide Wall-Pack Fixture or Retrofit q 125W 



Induction Wall-Pack Fixture or Retrofit (Check One): q 200W q 225W q 250W 

Pulse Start or Ceramic Metal Halide Wall-Pack Fixture or Retrofit (Check One): 

q 200W q 210W q 220W 




175W HID 


Replacing 320W or 400W HID 

Itemized Invoice Attached? q Yes 

DLC listed LED Fuel Canopy or High Canopy Fixture or Retrofit (Fuel Canopy listed): 


Induction High Canopy Fixture or Retrofit q 100W 

Pulse Start or Ceramic Metal Halide High Canopy Fixture or Retrofit q 100W 


Manufacturer/Model: _______________________Installed Wattage:________ 

Induction High Canopy Fixture or Retrofit (Check One): q 120-125W q 150W q 165W 

Pulse Start or Ceramic Metal Halide High Canopy Fixture or Retrofit q 125W 



Induction High Canopy Fixture or Retrofit (Check One): q 200W q 225W q 250W 

Pulse Start or Ceramic Metal Halide High Canopy Fixture or Retrofit (Check One): 

q 200W q 210W q 220W 

Date Installation Was Completed: 

TOTAL INcENTIvE REQUESTED 

(all line items pages 1-7): $ 

$30/Fixture 

$50/Fixture 

$60/Fixture 

$75/Fixture 

$50/Fixture 

$60/Fixture 

$75/Fixture 

APPLICATION SUBMITTAL: Return signed, completed form, worksheets and ITEMIZED invoice(s) to: 

Mail: <strong>Focus</strong> on Energy MESP, 12075 Corporate Parkway, Ste. 100, Mequon, WI 53092 

E-mail: Applications and invoices may also be scanned and e-mailed to MESPapps@focusonenergy.com 

Fax: 262.240.0825 Questions: Call 866.486.0832

Lighting Equipment Worksheet - Focus on Energy

Create successful ePaper yourself

Delete template?

Save as template?