CERTIFICATE OF INSTALLATION This certificate of installation is a verification that the below named member has complied with the requirements of the DSO Water Heater Energy Efficiency Program. Date of Installation Date of Installation: Date The new water heater is A replacement of a non-electric water\heater ($100) An installation in new construction ($100) A replacement for an electric water\heater ($100) Manufacturer Model Number Capacity in Gallons Warranty Term 1 Year Warranty 2 Year Warranty 3 Year Warranty 4 Year Warranty 5 Year Warranty Lifetime Warranty Other DSO Account Number Name Name Address City/Town State/Province StateAlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederate States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Submit