TN-CET Grant Application 2009

http://www.dsireusa.org/documents/Incentives/TN-CET%20Grant%20Applicatio...

State of Tennessee
Department of Economic and Community Development
Energy Division
Wm. R. Snodgrass TN Tower, 10th Floor
312 Eighth Avenue, North
Nashville, Tennessee 37243-0405
Tennessee Clean Energy Technology Grant Program
APPLICATION FOR GRANT ASSISTANCE

Important Notice: The grant requested herein cannot be used to reimburse you for projects already completed prior to the date of this application. You are not authorized to proceed with any part of the project described herein without the approval of the Energy Division. This application is not an Approval to Proceed and shall act only as a Project Registration and Reservation of Grant Funds Form. Upon receipt of this application, the Energy Division will reserve grant funds in an amount sufficient to cover your project. The Energy Division will also order a free Energy Audit/Design Analysis. If the Energy Audit/Design Analysis shows that the project is feasible and meets required design review criteria, a written Approval to Proceed will be issued. An Approval to Proceed, in writing, is your authorization to begin work on your project. This grant is a “reimbursement grant” which means that you must complete your project and request payment of grant funds from the Energy Division after it is completed. At that stage, additional information will be given to you.

Section A must be completed in its entirety. Complete Sections B and C and attach a copy of your contractor’s proposal. Be sure to sign and date your application.

This Application cannot be submitted online. Return it to the TN Department of Economic & Community Development- Energy Division at 312 Eighth Avenue North-10th Floor, Nashville, Tennessee 37243-0405. Mark “TN-CET Grant” on the outside of the envelope. If you have any questions, contact the Energy Division at in-state, toll-free 1-800-342-1340 or in Nashville, 741-2994.

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
Section A: Applicant/ Company Information

Applicant/ Company Name

Mailing Address (If PO Box, also give actual street location)

____________________________________________________ ____________ ___________
City State Zip County

_________________________________________________ _______________________________
Contact Person Name Phones (Landline and Cell) Fax

______________________________________________ __________________________
Federal Employer ID or Social Security Number Number of Employees When was business established?

Nature of Business (Describe what your firm does)

Type of Business: _____ Regular Corporation _____ Limited Liability Corporation _____ Proprietorship

_____Other (Describe)

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
Continued on Reverse

Section B: Project Information (Complete this section using information obtained from your contractor.
You must attach a copy of your contractor’s proposal.)

Type of Project (Check One): PV (Solar Electric) ________ Wind ________ Solar Water Heating
Hydrogen Fuel Cells _______ Hybrid Lighting _________

Project Location (Where is the project located. If the same as address in Section A, specify “Same”)
______________________________________________________ ________________________________
Address City Zip
Contact at location above: _______________________________________________ Phone:

Please describe the project (Tell what you want to do. We must have this information to complete application):

Estimated Total System Installed Cost (We must have this information to process request):

Anticipated Start Date: ________________ Project Duration: ________________ Completion Date:

Will this system be tied into the electric power grid serving your area (Yes or No)? __________ If “Yes”, name of your electric power supplier:

Who is your primary contractor?

Name of Contractor

Address of Contractor

______________________________________________________ _____________________
City State Zip

___________________________________________________
Contractor Contact Person Name Phones (Landline and Cell)

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
Section C: Building Information

When was this building built? ________________________ Total Building Square Footage:
I hereby apply for a grant under the Tennessee Clean Energy Technologies Grant Program to purchase and install a renewable, clean energy system described in Section B, above. I certify that the information presented on this application, and in any supporting documents, is true and accurate to the best of my knowledge. I further certify that the grant funding received will only be used to fund the project described in Section B.

____________________________________________________ ___________________________
Authorized Signature of Applicant Title Date