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2. Title II Compliance

   In accordance with the requirements of Title II of the Americans with Disabilities Act (“ADA”) of 1990, the Fair Employment & Housing Act (“FEHA”), the Rehabilitation Act of 1973 (as amended), Government Code section 11135 and other applicable codes, the City of Modesto (“City”) will not discriminate against individuals on the basis of disability in the City’s services, programs, or activities. For more information, please visit the City of Modesto website.

6. Name*
7. Email Address*

   Providing an Email address will speed up the response time to your application.

9. Address*
10. Alternate Mailing Address

    If your mailing address differs from your physical address please provide it here.

12. City*
13. State*
14. Zip Code*
16. Phone Number*
20. Are you the Property Owner?*

    1. Yes
    2. No
21. Have you previously applied for this rebate?*

    1. Yes
    2. No
22. Type of Property*

    1. Residential
    2. Commercial
24. Where did you learn about the rebate?*
26. NOTE: Tenants: Participation requires written approval from property owner/property manager.
27. Please indicate the date of the last rebate
    Please indicate the date of the last rebate
29. Receipt for new Clothes Washer*
33. Rebate Information
    • The rebate value cannot exceed the actual cost of the clothes washer.
    • An original itemized dated sales receipt is required to qualify for the rebate.
    • Application must be received within 60 days of the dated sales receipt.Limit of 1 washer rebate per account per every 5 years.
    • Compliance with attached guideline is required.

37. Program Guidelines and Participation Section

    Who Qualifies?

    • City of Modesto customers who pay a water utility bill to the City of Modesto
    • Customer accounts that are in good standing
    • Tenants who provide written approval from the property owner or property manager.

    Timeline

    • Program applies to clothes washers purchased during the current fiscal year (July 1 through June 30).
    • Rebate application must be submitted within 60 days of sales receipt.
    • The qualifying clothes washer must remain at the installation site for a minimum of six months after installation.

    Clothes Washer (Qualifying for rebate)

    • New clothes washer must be an Energy Star label appliance which meets Consortium for Energy Efficiency (CEE) standards for energy and water consumption standards.
    • Qualifying units must have a water factor of 5 or less
    • The list of eligible clothes washers and washer rebate values is subject to change.

    Rebates

    • Clothes washer installation, new construction, accessories, and taxes do not qualify.
    • Rebate checks will be mailed within 8 weeks after completing the rebate process.
    • Rebate amount cannot exceed the purchase price of a new clothes washer.
    • Rebates are limited to one per household within a five (5) year period.

    Application and Rebate Approval or Denial

    • On-site compliance verification may be required.
    • The original itemized dated sales receipt for the new clothes washer is required (copies not accepted). Scanned original will be accepted via only submittal only.
    • Incomplete, incorrect or unsigned applications cannot be processed. We will contact you with any discrepancies and may require you to submit a new application.
    • Customer must fulfill all program guidelines in order to be eligible for rebates.
    • The rebate application must be submitted within 60 days of sales receipt.

    Other Considerations

    • The Rebate Program is not responsible for materials lost by mail.
    • Rebates are processed on a first come, first served basis.
    • Funding for this rebate program is limited to available resources.
    • Rebate amounts are subject to change without notification.
    • This program shall at all times be subject to change or termination without prior notice.
    • Clothes washers that are leased, rebuilt, rented, received from warranty or insurance claims, exchanged, won as a prize, or have had new parts installed in an existing unit do not qualify for a rebate.
41. Terms and conditions
    The City of Modesto may deny any application that does not meet program requirements. The undersigned expressly agrees that the City may inspect all items submitted for the High Efficiency Clothes Washer Rebate Program. The City does not guarantee the performance of any clothes washer; does not warrant any clothes washer or installation to be free of defects, the quality of the workmanship, or the suitability of the premises or the clothes washer for installation. The undersigned further agrees to hold harmless the City of Modesto against all loss, damage, expense and liability resulting from the loss, destruction or damage to property arising out of or in any way connected with installation of the clothes washer. The City reserves the right to alter this program at any time. Funding for this rebate program is limited to available resources. Rebates are processed on a first come, first served basis.
43. Electronic Signature*

    1. I have read, understand, and agree to the terms and conditions of this rebate program.
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45. Submit

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