WATER CONSERVATION REBATE PROGRAM APPLICATION
CUSTOMER INFORMATION/INSTALLATION ADDRESS
*Required
*Required
*Required
*Required
*Required
*Required
*Required
WATER SAVING OPTIONS
Site Type

Select the water saving option chosen:



DEVICE #1
DEVICE #2
DEVICE #3
DEVICE #4

I certify that these toilet(s), smart controller(s), removed turf, and/or air conditioning units were purchased new at retail price and not for resale. I agree that Lake Havasu City may verify the sale, delivery, and installation of the water saving measures identified in this application. I understand that Lake Havasu City does not warrant any of the water saving measures to be free of defects or warrant the quality of the workmanship, and that Lake Havasu City is not responsible for the suitability of the premise for the water saving measures. I further agree to hold harmless Lake Havasu City , its directors, officers, and employees against all loss, damages, expense, and liability resulting from the loss, destruction, or damage to property arising out of, or in any way connected to, the installation of the water saving measures within this application. As a receipt of this rebate, I acknowledge being a beneficiary of the Water Infrastructure Finance Authority Conservation Grant. I have read, understand, and agree to the terms and conditions of the rebate program, including “Qualifications” and sections of this application.

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