FortisBC Dual Fuel Heating System Rebate Program

Agreement of terms and conditions for contractor incentive program
In order to participate in the contractor incentive program, please read the terms and conditions and complete the form below

Contractor legal business name
Technical Safety BC number (must start with "LGA" and must be 7 digits)
Important: your LGA number is used to process your contractor incentives. Please ensure it is accurate.
Must be 10 . Currently Entered: 0 .
Phone number Phone number - ### - ### ####
Email address (a confirmation email and program communications will be sent to this address)
Mailing address Mailing address
Street Address Address Line 2 City Province Postal code Country
Authorized signatory signature

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date / MM / DD YYYY
Name of authorized signatory Name of authorized signatory First Last
Position/title of authorized signatory
Are you a member of FortisBC’s Trade Ally Network (TAN)?

Are you a member of FortisBC’s Trade Ally Network (TAN)? Yes No
Are you a member of the Home Performance Contractor Network?

Are you a member of the Home Performance Contractor Network? Yes No
If your contact information changes, please email us
Contractor declaration

Contractor declaration I warrant and represent I meet the contractor eligibility requirements set out above and accept and agree to the terms and conditions. I further agree FortisBC may collect and use my information (including personal information), whether provided by me, obtained during site visits, or contained in, or forming part of, any documents submitted by a customer, and disclose the information to affiliates, contractors, representatives, agents and funding partners to process, administer and evaluate the Program and the incentives and to monitor and assess compliance with these terms and conditions. FortisBC may contact me by phone or email to administer, verify compliance with, and evaluate my participation in the Program.
Registration for mobile commissioning app

Registration for mobile commissioning app I agree to FortisBC registering me for the mobile commissioning app, and I consent to FortisBC using my information (including without limitation my email address) for this purpose. (Registration is required to be eligible to receive the $300 incentive.)
Emails from FortisBC

Emails from FortisBC I agree to receive emails from FortisBC containing news, updates and promotions regarding FortisBC’s products, services and programs.
Note: You may withdraw your consent at any time. For more information, visit fortisbc.com/privacy.