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Residential Rebate Form

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Preliminary Information Who bills for your water? *

Customer Information
Contact Name*

Account Number

If you live in a condo or apartment building, you will need to contact your manager for the account number.

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Federal Tax ID No.
Customer Type*
Phone number*  -  - 

No Email Address?

If you do not have an email address, you will not be able to apply online. Please call 303-893-2444 for assistance.

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Confirm Email Address*
Number of Occupants

Mailing Address
Unit No.
Rebate information
Purchase Date*

Rebate Type

Please check the box next to the type of eligible product rebate you are applying for:
Full list of eligible products and models.

WaterSense certified toilet

Up to $75. Must purchase WaterSense-labeled 1.28 gallon per flush toilet by Dec. 31, 2015, to qualify, and apply within 90 days to receive rebate.

Rotary/high-efficiency irrigation nozzles

$3 per nozzle. One-time rebate per 10 years. Minimum of 10 nozzles, maximum is 100.

Clothes Washer

Limited to one per customer every 10 years. The last day to purchase is Sept. 30, 2013; You must submit your rebate application within 90 days of the purchase date.

WaterSense Certified smart irrigation controller

Limited to one per residence. $75 per residence.

WaterSense certified toilet

Up to $100. WaterSense-labeled toilets that use an average of 1.1 gallons per flush (GPF) or less are eligible. Models that flush 1.28 GPF or dual flush toilets with a 1.6 GPF option do not qualify.

Product Type
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*Rebates subject to change at any time.

Installation Address

Unit No.


How will you be sending us a copy of your receipt (proof of payment)? Receipt copy must include:
  • Purchase date
  • Brand and model
  • Price of each item
  • Proof that it was paid in full
Tip: Take a photo of your receipt with your smartphone and email it to yourself for easy upload

  • File types allowed to upload: jpg, jpeg, pdf, tif, and gif
  • File size limit: 5 MB
  • Maximum number of file allowed to upload: 5 files
  • Upload multiple files by browsing to each individually

Customer Feedback
How did you hear about our program?

What is your primary reason for participating in this program?

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