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If you purchased a Charging Station, please select an option below If you purchased a Charging Station, please select an option below Purchased a Level 1 EV Charging Station ($50 Rebate per port) Purchased a Level II EV Charging Station ($250 Rebate per port) Purchased a Level III EV DC Fast Charging Station (Max of $1,000 Rebate - call for details)

Level 1 Charger Purchase Date

Level II Charger Purchase Date

Level III Fast Charger Purchase Date

Please enter the make and model of the EV charging station(s)

Please enter the make and model of the EV charging station(s)

Please enter the make and model of the EV charging station(s)

Is the Charger that was purchased for public use? Is the Charger that was purchased for public use? Yes No

Did you purchase a BEV or PHEV for Commercial Use? ($1,500 rebate) Did you purchase a BEV or PHEV for Commercial Use? ($1,500 rebate) Yes No

Make & Model of BEV or PHEV for Commercial Use

Date Purchased

Terms & Conditions: Terms & Conditions: I certify that I have read the following TERMS AND CONDITIONS: All equipment must be new and include original sales receipt indicating items and quantity purchased, date of purchase, purchase location, and price must accompany rebate application. PRE-APPROVAL required before implementation of project with potential rebates over $2,000. Incomplete applications will be not be processed. Disclaimer: Any system upgrades that are necessary to install chargers are the account holders responsibility. MPW does not guarantee that implementation of energy efficiency measures or us of equipment purchased and/or installed under this program will result in reduced energy usage or cost savings. MPW makes no warranties, express or implied, with respect to any equipment purchased and/or installed including, but not limited to, any warranty or merchantability or fitness for purpose. In no event shall MPW be liable for any incidental or consequential damages. By checking this box, you also certify that you have purchased the equipment described in this form and that it has been installed at the service address indicated and that you agree to the terms and conditions set forth in this form.

Upload required files (small image file or PDF) (paid invoice/receipt)File InputChoose FilesNo Files ChosenAccepted file types: jpg, jpeg, jpe, png, pdf. Max. file size: 256 MB

Please confirm: Please confirm: I confirm I am an MPW commercial/industrial electric customer I have attached my sales receipt/invoice and registration to this form. I understand I must have purchased an EV(s) by or before 9/30/24 in the year 2024 to qualify.