Current Open Forms

2. Indoor Air Quality Rebates Application

   Rebates for Qualified Town of Erie Utilities Residential Customers

4. To qualify for a rebate, you must meet all of the following requirements: Applicants must be a Town of Erie utilities customer with a current, non-delinquent account. Must be purchased between January 1, 2023 and December 31, 2023. Appliances must be for use at a Town of Erie service address. Indoor air purifiers and radon mitigation systems must be installed and used at an Erie service address. Residents can receive both a Radon Mitigation System (1) and Stand-alone Indoor Air Purifier (2) rebates. Qualified fixtures or appliances: Radon mitigation system installation requires a permit and inspection from the Town of Erie. Please submit approved permit along with final paid invoice of installation. Installers are required to possess a current Town of Erie contractor's license. Air purifiers must meet the minimum requirements: HEPA filter (99% efficiency rate of capturing particles as small as 2 microns); EPA Energy Star Certified; UL or ETL listed.

8. First and Last Name*
10. Installation Address*
12. Water Account #*
    Account has to be in good standing (no negative balance)
14. Account # belongs to*
    -- Select One --Homeowner/LandlordTenant
16. Daytime Phone*
18. Email Address*
20. Mailing Address*
    (If different than installation)
22. Address 2
24. City*
25. Zip Code*
27. County of Qualified Address*

    1. Boulder
    2. Weld
29. 
30. 
32. Radon Mitigation System
34. Number of Radon Systems Purchased*
    -- Select One --N/AOne

    Limit 1 system per address.

35. Hiring a Contractor
    Tips for Hiring a Contractor
37. What is the name of your contractor?*
38. Was a Town of Erie permit and inspection received?*
    -- Select One --YesNo
39. Would you recommend your contractor?
    -- Select One --YesNo
41. When was your home built?*
43. Stand-alone Indoor Air Purifier
45. Number of Indoor Air Purifiers Purchased*
    -- Select One --OneTwo

    Limit 2 units per address.

47. HEPA Filter*

    Documentation required.

    1. Yes
    2. No
48. EPA Energy Star Certified*

    Documentation required.

    1. Yes
    2. No
49. UL or ETL listed*

    Documentation required.

    1. Yes
    2. No
51. Receipt(s) & Document Upload Below

    **Required**

53. Receipts*
54. Approved Town of Erie Permit & Inspection (Radon)
56. Air Purifier Specifications (HEPA; Energy Star; UL / ETL)
57. Additional Documentation
59. You rebate will be issued as credit to your water bill within one billing cycle.
    If you are a renter or you pay your HOA for your water bill, please contact rebates@erieco.gov after rebate submission.
61. Affidavit
63. I swear or affirm under penalty of perjury under the laws of the State of Colorado that (check one): I am a United States citizen and/or I am lawfully present in the United States pursuant to Federal law. I understand that this sworn statement is required by law because I have applied for a public benefit. I understand that state law requires me to provide proof that I am lawfully present in the United States when asked as well as submission of a secure and verifiable document. I may also be required to provide proof of lawful presence. I further acknowledge that making a false, fictitious, or fraudulent statement or representation in this sworn affidavit is punishable under the criminal laws of Colorado as perjury in the second degree under Colorado Revised Statute 18-8-503 and it shall constitute a separate criminal offense each time a public benefit is fraudulently received. By signing this form, I certify that I purchased the fixtures or appliances as stated above and plan to install it (them) at the address indicated above within the Town of Erie service area.
65. Electronic Signature*
66. Date*
    Date
68. How did you hear about the Water Efficiency Rebate Program*

    1. Town of Erie website
    2. Bill Insert
    3. Media (newspaper, radio)
    4. Friend/family member
    5. Retailer
    6. Social media
    7. Erie.Earth
    8. Town event
    9. Google
70. Subscribe to be notified first!
    Click here

    For more information regarding Sustainability programs, rebates, and more!

72. Radon Mitigation Systems
    Radon Mitigation Systems
Leave This Blank:


74. 1. Receive an email copy of this form.
75. Email address

    This field is not part of the form submission.

76. Submit Submit and Print

* indicates a required field