Government of Canada
Symbol of the Government of Canada

 ecoENERGY

Payment Request Form: Solar Water Heating System


EcoENERGY for Renewable Heat Program
Renewable and Electrical Energy Division, Natural Resources Canada
Room 150, 615 Booth Street, Ottawa, Ontario K1A 0E
ecoenergyrhp@nrcan.gc.ca  

To qualify for receipt of the incentive offered under the ecoENERGY for Renewable Heat Program, please print clearly when completing this form and submit it to the above address along with your Commissioning Report, Attestation form and copies of paid invoices after the project has been completed. (Ref.: Terms and Conditions and the Contribution Agreement - Article 5).

IMPORTANT: MISSING INFORMATION WILL DELAY THE PAYMENT OF YOUR PROJECT

File Number
Funding Recipient:
     (i.e. business name)
Mailing address:
City:
Postal Code:
Phone:
Fax:
Email:

Other Funding: Since submitting your application, have you applied for, received, or do you expect to receive government funding in support of any part of this project?
No   Yes

If yes, indicate which one(s):
Federal Territorial Provincial Municipal

Program Name Date of Receipt
(dd-mm-yyyy)
Amount

Photographs of installed system:
enclosed     sent by electronic mail to rdjebbar@nrcan.gc.ca

Date system was commissioned: (dd-mm-yyyy)

Estimated Total Project Costs per original application, excluding all taxes: $

BREAKDOWN OF ACTUAL PROJECT COSTS (Excluding all taxes)
Solar Water Heating System Component (Do Not Include Used Equipment) Supplier's Name Invoice Number Cost (excluding all taxes)
Collectors
Collector rack and/or support components
Solar heat exchanger(s)
Solar heat storage equipment
Heat transfer fluid, piping and pipe insulation fromcollectors to the auxiliary heater
Pump(s)
Solar system controller
Photovoltaic components used to power solarpump(s)
EQUIPMENT COST SUBTOTAL
Solar Water Heating System Project Soft Cost
Project feasibility, design
Permits (exclusively for solar system installation)
Project management
Installation labour
Shipping
Commissioning
Other (specify):
TOTAL SOLAR SYSTEM COST:
TOTAL SOLAR SYSTEM COST PER m2 OF COLLECTOR AREA:: $ / m2



The Form must be reviewed and signed by the Applicant.