Smart Irrigation Controller Rebate Program

Smart Irrigation Controller Rebate
SC #
A WaterSense® labeled Smart irrigation controller will adapt to local weather and water with precision. Watering schedules will be set up to water your landscape. For more information on smart irrigation technologies, a series of publications can be found at http://edis.ifas.ufl.edu/entity/topic/series_smart_irrigation_controllers.

Maximum rebates range from $200 - $350. Please contact your utility for a more precise number.
Program Qualifications

Active water customer of participating utility in Polk County (go to SavePolkWater.org or call your utility)Homeowner will replace a standard irrigation controller with a WaterSense® labeled Smart Irrigation ControllerHomeowner has a 3-month average of at least 14,000 gallons of water used each month (will be verified by utility) and at least 12 months of consumption history.Controller will be installed, working, and in a proper location with an operating rain sensor at the time of inspection. A rain sensor may be provided if necessary. System will be programmed to irrigate only on permitted watering days.
Steps to Apply
1. Contact your utility to verify funding is available. The utility may issue a reservation number at that time.
2. Homeowner will purchase and install the WaterSense® labeled Smart Irrigation Controller.
3. Homeowner will send this application with the receipt of the WaterSense® labeled Smart Irrigation Controller.
4. Utility will contact homeowner once the application has been received to set up an inspection time. Inspection will include time clock, rain sensor, and sprinkler settings.
5. After the inspection has been completed, a rebate will be issued.
Applicant Information:
Utility*
Billing Account #
Business name (if applicable)
Last Name*
First Name*
M.I.
Street Address*
Unit #
City*
Zip Code*
Relationship to property*
U.S. Phone
Email*
example@example.com
Mailing Address (if different from above)
Building/Property Information: Please select*

Single Family (With HOA)Singe Family (Without HOA)Multi-Family/ApartmentCommercialHOA Common AreaOther
If Multi-Family/Apartment is selected, how many Units?
Does the property currently have Wi-Fi?*

NoNo
Does the property currently have a programmable irrigation system?*

YesNo
How many days per week is the property currently irrigated?*
Estimated square footage of irrigated area*
Agreement of Terms and Conditions
The Utility may deny any application that does not meet program requirements. The undersigned expressly agrees that the Utility may inspect all items submitted for the Smart Irrigation Controller Rebate Program and is replacing an old controller with a new WaterSense® labeled controller. The undersigned further agrees to hold the Utility and/or Polk Regional Water Cooperative against all loss, damage, expense, and liability resulting from the loss, destruction of damages to property arising out of or in any way connected with the installation of the Smart Irrigation Controller. The Utility reserves the right to alter this program at any time. Funding for the rebate program is limited to available resources. Rebates are processed based on the date fully completed applications are received. The acceptance of a submitted application does not evidence funds are then available for the rebate program. For further questions, please contact your utility.

I have read, understand, and agree to the terms and conditions of this rebate program.
Signature*

Clear
Date*

MonthDayYear
Date
For Official Use Only
Reservation #
Application

ApprovedDenied
Reviewed by
Reason for denial
Date controller was installed

MonthDayYear
Date
Date of inspection

MonthDayYear
Date
Type of controller installed
Is the new controller WaterSense Labeled?

YesNo
Customer was educated on controller with a focus on conservation features?

YesNo
Controller works at the time of inspection?

YesNo
Irrigation is free of leaks and broken heads?

YesNo
Total cost
Customer cost
Utility Cost
District cost
Verified that the controller’s automatic shut off is working?

Yes No
Date to accounting

MonthDayYear
Date
Amount of Rebate
Rebate check sent

MonthDayYear
Date
By
Check #
Should be Empty:

Smart Irrigation Controller Rebate

Applicant Information:

Agreement of Terms and Conditions

For Official Use Only