2020 – 2021 Bryant Colorado PartnershipPRODUCT REQUEST CHECKLIST

GENERAL GRANT INFORMATION

Grant Title: Bryant Colorado Product Donation

Amount Available to Affiliates: Bryant 912S Multipoise Condensing Gas Furnace (1 per home)

Grant Period: (rolling) through June 30, 2021

How to Apply: This form should be submitted 4 weeks BEFORE the furnace is ready to be installed. A pick-up date will be provided within 7 days of order being approved. Installer may pick up furnace at Bryant locations in Englewood, Denver, Fort Collins, or Colorado Springs, or delivery can be requested. Submit completed form to Tamara Foglio: tamara@habitatcolorado.org.

Grant Requirements: The donor requests that they have the option of volunteering at the worksite, that they be invited to home dedications, and that they be recognized appropriately according to your affiliate’s policies. Invitations and thanks can be sent to Tbrooks@bryantcolorado.com. DO NOT CONTACT BRYANT COLORADO DIRECTLY REGARDING ORDERS; ALL REQUESTS MUST COME THROUGH HFHC.

GRANT CHECKLIST

Affiliate Name: Affiliate Contact Information:

Homebuyer’s Full Name: Full House Address:(serves as Purchas Order # for tracking purposes)

Furnace Size: BTUs: Blower Tonnage:

Installer/Contractor’s Information: Name: email:

Is installation in-kind or discounted?

If no, cost of install:

Bryant 2019 - 2020 Grant ChecklistPage 2

Phone:

Installer will: ☐ Pick up ☐ Delivery needed

Items Due with order:

☐ Signed copy of this checklist

Items Due after installation:

☐ Photograph of installed furnace☐ Photograph of homebuyer and/or home☐ Homebuyer Story

You can upload photographs and homebuyer’s story into your affiliate’s folder at this link: http://bit.ly/BryantPartnership

PLEASE NOTE THERE IS NO FEE OR CHARGE TO ACCESS BRYANT COLORADO’S DONATION

ASSURANCES

______________________________________(affiliate) hereby commits, to the best of its ability, to the following: ☐ The income for the family at the above property is at or below 80% AMI.

☐ Our affiliate has on file a waiver from family giving permission to Habitat for Humanity to use family

pictures and stories in marketing/collateral material, including the website and marketing material

related

to Bryant Colorado.

☐ Bryant Colorado will be invited to volunteer at the worksite.

☐ Bryant Colorado will be invited to the home dedication.

☐ Our affiliate will thank and recognize Bryant Colorado in a timely manner according to our policies.

___________________________________________________Printed name of the Affiliate’s Board or Affiliate Representative

Signature of the Affiliate’s Board or Affiliate Representative Date