BBH Certification and Rebate Claim Form

Required fields are marked with asterisks (*)

Blue Built Home Certification and Rebate Claim form: new multi-residential building

Applicant information

Building owner corporation/partnership/company name

Building owner mailing address

City

Province

Postal code

Primary contact name

Phone number

Information for buildings with units to be Blue Built Home Certified

Building(s)

Up to 3

Building address

Total number of units

Total number of bathrooms

Water billing account number for the building

Add another building Remove building

Collection of personal information

Personal information is being collected and will be used for the purpose of the administration of your participation in the Blue Built Home program.

Personal information, as defined by Section 2 of the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA), is collected under the authority of enter legal authority here; e.g. the Municipal Act, 2001, and in accordance with the provisions of MFIPPA.

If you have questions about this form or the certification requirements, please contact the Blue Built Home Program Coordinator at 519-822-1260 extension 2116, bluebuilthome@guelph.ca or visit bluebuilthome.ca.

If you have questions about the collection, use or disclosure of this personal information please contact the City’s Information and Access Coordinator at 519-822-1260 extension 2349 or email privacy@guelph.ca.

Applicant agreement

I agree to the following:

I have read, understand and agree to the Blue Built Home Program Terms and Conditions

I certify that the identified applicant is the active water account holder and property owner for the identified buildings, upon building occupancy.

I understand that my total rebate is calculated by the allocations per fixture, appliance or system as verified during the final plumbing inspection, and that the City may request proof of purchase or additional site visits to confirm their installation.

I pledge to be water wise, encourage responsible water use by the tenants and uphold the values of the Blue Built Home program.