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updated 1.27.15 Page of Window Incentive Worksheet (Please have your window contractor complete the following information) Contractor Information: Business Name: Business License Contact Person: Phone Number: Mailing Address: Street Address / Unit Number City Zip Code Job Date: Invoice Paid Date: Customer Information: Name: Phone Number: Installation Address: Street Address / Unit Number City Zip Code Worksheet: *SHGC = Solar Heat Gain Coefficient Qty Dimensions U-Factor *SHGC Mfg. Model # Location TOTAL QUANTITY OF ELIGIBLE WINDOWS INSTALLED: TOTAL COST OF WINDOWS INSTALLED: (If additional space is required, please print additional copies of this worksheet, number the pages, and submit together) Installer’s Signature Date ANAHEIM PUBLIC UTILITIES HOME INCENTIVE PROGRAMS SIGN