| Invoice # | Today's Date | Company Name | Company Contact | Company Phone | Company Email | Rebate Status | Safety Inspection Date | Purchase/Invoice Date | Safety Inspector’s Full Name | Type of Installation | Total | How many rebates would you like to claim? | Installation Type | Appliance Type | Brand | Model # | Model # | Serial Number | Installation Date | Upload Receipt | Appliance Type | Brand | Model # | Model # | Serial Number | Installation Date | Upload Receipt | Appliance Type | Brand | Model # | Model # | Serial Number | Installation Date | Upload Receipt | Total | Propane Company Name | Propane Marketer Name | Mailing Address | Email Address | Phone Number | Customer / Recipient Name | Customer / Recipient Phone Number | Customer / Recipient Email | Customer / Recipient Address | Customer / Recipient Installation Address | Upload Proof of Purchase: | Name of Builder/Contractor | Upload Spec Sheet for Manufactured Home |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2025-90347320 | 08/21/2026 | Town and Country Gas | Adam Howard | (706) 547-2525 | Email hidden; Javascript is required. | Payment Sent | 08/18/2026 | 08/13/2026 | Tracy Kitchens | Replacement or New Appliance | $400.00 | 1 | Replacement Installation | Propane furnace, or gas pack ($400.00) | Rheem | RGEAYB036AJT081NA | F322601434 | 08/13/2026 | SKM_C45826082114550.pdf | $400.00 | Town and Country Gas | Adam Howard | 402 E Broad St Wrens, Georgia 30833 Map It | Email hidden; Javascript is required. | (706) 547-2525 | John Kitchens | (706) 547-2346 | 20819 Hwy 1 North Matthews, Georgia 30818 Map It | 20819 Hwy 1 North Matthews, Georgia 30818 Map It | SKM_C458260821145501.pdf | ||||||||||||||||||
| 2025-63794097 | 08/21/2026 | Sikes Propane Inc | Daniel Sikes Jr | (912) 367-1151 | Email hidden; Javascript is required. | Payment Sent | 08/20/2026 | 08/20/2026 | DANIEL SIKES | Replacement or New Appliance | $250.00 | 2 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE160e | WA.UA-001994 | 08/20/2026 | Cooktop ($50.00) | FRIGIDARE | FCRG3062ASH | VF55162099 | 08/20/2026 | HPSCAN_20260821193529253_2026-08-21_193617199-1-compressed-12.pdf | $250.00 | SIKES PROPANE INC. | SIKES PROPANE | 1488 GOLDEN ISLES WEST BAXLEY, Georgia 31513 Map It | Email hidden; Javascript is required. | (912) 367-1151 | KOBY MCLAIN | (912) 278-6765 | 1209 MIDWAY CHURCH RD BAXLEY, Georgia 31513 Map It | 1209 MIDWAY CHURCH RD BAXLEY, Georgia 31513 Map It | HPSCAN_20260821193529253_2026-08-21_193617199-1-compressed-13.pdf | |||||||||||||
| 2025-84678677 | 08/24/2026 | Partners Propane of Ga Inc | Kim Ogan | (229) 649-4040 | Email hidden; Javascript is required. | Payment Sent | 08/13/2026 | 08/13/2026 | Luke Ogan | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RHEEM | PROG40S | 0332503122 | 08/13/2026 | B.S.-Miller-Perf-Rebate_0001.pdf | $200.00 | PARTNERS PROPANE GA | JAN WHITLEY | 206 W 6TH AVE BUENA VISTA, Georgia 31803 Map It | Email hidden; Javascript is required. | (229) 649-4040 | B.S. MILLER | (229) 649-1714 | 266 GA HWY 137W BUENA VISTA, Georgia 31803 Map It | 266 GA HWY 137W BUENA VISTA, Georgia 31803 Map It | B.S.-Miller-Perf-Rebate_00011.pdf | ||||||||||||||||||
| 2025-36635458 | 08/24/2026 | Partners Propane of Ga Inc | Kim Ogan | (229) 649-4040 | Email hidden; Javascript is required. | Payment Sent | 08/03/2026 | 08/03/2026 | Luke Ogan | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RHEEM | PROG40 | 0402539385 | 08/03/2026 | Johnny-Lee-Williams-Perf-Rebate_0001.pdf | $200.00 | PARTNERS PROPANE GA | JAN WHITLEY | 206 W 6TH AVE BUENA VISTA, Georgia 31803 Map It | Email hidden; Javascript is required. | (229) 649-4040 | JOHNNY LEE WILLIAMS | (229) 314-3284 | JOHNNY LEE WILLIAMS 1128 MARVIN BELL RD BUENA VISTA, Georgia 31803 Map It | JOHNNY LEE WILLIAMS 1128 MARVIN BELL RD BUENA VISTA, Georgia 31803 Map It | Johnny-Lee-Williams-Perf-Rebate_00011.pdf | ||||||||||||||||||
| 2025-96364705 | 08/24/2026 | Barfield Gas Company, Inc. | Michael Davis | (229) 896-4828 | Email hidden; Javascript is required. | Payment Sent | 08/14/2026 | 08/14/2026 | Caleb Harnage | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE199eP | WE.UA-057023 | 08/14/2026 | REBATE-B.LOVETT-58179.pdf | $200.00 | Barfield Gas Company | Michael Davis | PO BOX 990 PO BOX 990 Adel, Georgia 31620 Map It | Email hidden; Javascript is required. | (229) 896-4828 | BILLY JO LOVETT | (229) 794-3277 | 635 W D STALVEY RD HAHIRA, Georgia 31632 Map It | 635 W D STALVEY RD HAHIRA, Georgia 31632 Map It | REBATE-B.LOVETT-581791.pdf | ||||||||||||||||||
| 2025-59086854 | 08/24/2026 | Barfield Gas Company, Inc. | Michael Davis | (229) 896-4828 | Email hidden; Javascript is required. | Payment Sent | 08/14/2026 | 08/14/2026 | Caleb Harnage | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE199eP | WD.UA-042129 | 08/14/2026 | REBAT-D.TAYLORDEV-58177.pdf | $200.00 | Barfield Gas Company | Michael Davis | PO BOX 990 PO BOX 990 Adel, Georgia 31620 Map It | Email hidden; Javascript is required. | (229) 896-4828 | DIXON TAYLOR CONST DIXON TAYLOR CONST | (229) 506-0082 | 6031 NATURE'S WAY NAYLOR, Georgia 31641 Map It | 6031 NATURE'S WAY NAYLOR, Georgia 31641 Map It | REBATE-B.LOVETT-581792.pdf | ||||||||||||||||||
| 2025-28910915 | 08/24/2026 | Barfield Gas Company, Inc. | Michael Davis | (229) 896-4828 | Email hidden; Javascript is required. | Payment Sent | 08/19/2026 | 08/19/2026 | Caleb Harnage | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE140eP | WG.UA-077833 | 08/19/2026 | REBATE-NEWLIFE-58194.pdf | $200.00 | Barfield Gas Company | Michael Davis | PO BOX 990 PO BOX 990 Adel, Georgia 31620 Map It | Email hidden; Javascript is required. | (229) 896-4828 | NEW LIFE BAPTIST CHURCH NEW LIFE BAPTIST CHURCH | (229) 563-4945 | HWY 76 ADEL, Georgia 31620 Map It | HWY 76 ADEL, Georgia 31620 Map It | REBATE-NEWLIFE-581941.pdf | ||||||||||||||||||
| 2025-71002922 | 08/24/2026 | Sikes Propane Inc | Daniel Sikes Jr | (912) 367-1151 | Email hidden; Javascript is required. | Payment Sent | 08/21/2026 | 08/21/2026 | DANIEL SIKES | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE180e | WC.UA-028211 | 08/21/2026 | HPSCAN_20260824192146598_2026-08-24_192234013-1-compressed.pdf | $200.00 | SIKES PROPANE INC. | SIKES PROPANE | 1488 GOLDEN ISLES WEST BAXLEY, Georgia 31513 Map It | Email hidden; Javascript is required. | (912) 367-1151 | JIMMY SELLERS | (912) 245-8391 | 1771 JIM SELLERS RD BAXLEY, Georgia 31513 Map It | 1771 JIM SELLERS RD BAXLEY, Georgia 31513 Map It | HPSCAN_20260824192146598_2026-08-24_192234013-1-compressed1.pdf | ||||||||||||||||||
| 2025-57026129 | 08/24/2026 | Barfield Gas Company, Inc. | Michael Davis | (229) 896-4828 | Email hidden; Javascript is required. | Payment Sent | 08/17/2026 | 08/17/2026 | Caleb Harnage | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE199eP | WD.UA-072130 | 08/17/2026 | REBATE-L.RENTZ-57854.pdf | $200.00 | Barfield Gas Company | Michael Davis | PO BOX 990 PO BOX 990 Adel, Georgia 31620 Map It | Email hidden; Javascript is required. | (229) 896-4828 | LEVY RENTZ | (229) 560-8113 | 1087 SHADY GROVE RD HAHIRA, Georgia 31632 Map It | 1087 SHADY GROVE RD HAHIRA, Georgia 31632 Map It | REBATE-L.RENTZ-578541.pdf | ||||||||||||||||||
| 2025-35264096 | 08/25/2026 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Payment Sent | 08/20/2026 | 08/20/2026 | Brandon Payne | New Construction | $50.00 | 1 | Cooktop ($50.00) | Kitchen Aid | KFG5330TP50 | RF2913200 | 08/20/2026 | img08252026_0005.pdf | $50.00 | Folger Gas | Stacy Miller | 2660 Tennessee 68 Turtletown, Georgia 37391 Map It | Email hidden; Javascript is required. | (706) 455-3537 | Chris Todd | (706) 273-6368 | Email hidden; Javascript is required. | 3357 Owl Town Road Ellijay, Georgia 30536 Map It | 394 Blackberry Circle Ellijay, Georgia 30536 Map It | n/a | ||||||||||||||||||
| 2025-12776032 | 08/25/2026 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Payment Sent | 08/20/2026 | 08/20/2026 | Brandon Payne | New Construction | $200.00 | 1 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Navien | NPE15052 | 2075W247043 | 08/20/2026 | img08252026_0006.pdf | $200.00 | Folger Gas | Stacy Mullinax | 4955 Appalachian Hwy Blue Ridge, Georgia 30513 Map It | Email hidden; Javascript is required. | (706) 632-7606 | David Massey | (706) 455-6408 | Email hidden; Javascript is required. | 2647 Annette Street Flagger Beach, Florida 32136 Map It | 1990 Big Creek Rd Cherry Log, Georgia 30522 Map It | n/a | ||||||||||||||||||
| 2025-48649425 | 08/25/2026 | Conger LP Gas | Lee Phillips | (229) 386-5574 | Email hidden; Javascript is required. | Payment Sent | 08/03/2026 | 08/03/2026 | Shawn Rousey | Replacement or New Appliance | $400.00 | 1 | Replacement Installation | Propane-Fueled Recirculating Water Heater ($400.00) | Rinnai | REP160eP | PK.UA-111458 | 08/03/2026 | 0375_001.pdf | $400.00 | Conger LP Gas | Lee Mathews | 146 S. RIDGE AVE. TIFTON, Georgia 31794 Map It | Email hidden; Javascript is required. | (229) 386-5574 | Landon Dotson | (229) 848-6654 | Email hidden; Javascript is required. | 416 West 6th Street Tifton, Georgia 31794 Map It | 416 West 6th Street Tifton, Georgia 31794 Map It | 0375_0011.pdf | |||||||||||||||||
| 2025-96579950 | 08/25/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Payment Sent | 08/24/2026 | 08/24/2026 | Cole Truett | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE199eP | WE.UA-056987 | 08/24/2026 | FIRM-3809_1690_260825124336_001.pdf | $200.00 | Conger LP Gas | Richard McCranie | 2310 US Hwy 84 W Suite B Valdosta, Georgia 31601 Map It | Email hidden; Javascript is required. | (229) 469-4250 | Derek Shaw | (229) 561-0082 | Email hidden; Javascript is required. | 1848 W. Marion Lake Park, Georgia 31636 Map It | 3809 Kinderlou Forest Valdosta, Georgia 31601 Map It | FIRM-3809_1690_260825124336_0011.pdf | |||||||||||||||||
| 2025-33790820 | 08/25/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Payment Sent | 08/24/2026 | 08/24/2026 | Cole Truett | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180eP | WF.UA-064163 | 08/24/2026 | PREMIERE-5044_1689_260825124244_001.pdf | $200.00 | Conger LP Gas | RIchard McCranie | 2310 US Hwy 84 W Suite B Valdosta, Georgia 31601 Map It | Email hidden; Javascript is required. | (229) 469-4250 | Premier Southern | (229) 263-1602 | Email hidden; Javascript is required. | 2410 Andover Drive Valdosta, Georgia 31602 Map It | 5044 Hatfield Circle Hahira, Georgia 31632 Map It | PREMIERE-5044_1689_260825124244_0011.pdf | |||||||||||||||||
| 2025-27083952 | 08/26/2026 | Conger LP Gas | Lee Phillips | (229) 386-5574 | Email hidden; Javascript is required. | Payment Sent | 08/24/2026 | 08/24/2026 | Lee Phillips | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180eP | WD.UA-040075 | 08/24/2026 | 0392_001.pdf | $200.00 | Conger LP Gas | Lee Phillips | 146 Ridge Ave S Tifton, Georgia 31794 Map It | Email hidden; Javascript is required. | (229) 386-5574 | Danny Coley | (229) 425-6224 | 190 Osierfield Road Wray, Georgia 31798 Map It | 190 Osierfield Road Wray, Georgia 31798 Map It | 0392_0011.pdf | ||||||||||||||||||
| 2025-52525919 | 08/26/2026 | EverGlo Propane Gas Service Inc | Christy Greene | (229) 439-4540 | Email hidden; Javascript is required. | Payment Sent | 08/18/2026 | 08/18/2026 | Barry Vann | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE199eP | WC.UA-029428 | 08/18/2026 | $200.00 | EverGlo Propane Gas Service Inc | Christy Greene | 2215 GILLIONVILLE ROAD Albany, Georgia 31707 Map It | Email hidden; Javascript is required. | (229) 439-4540 | John West | (229) 317-3110 | Email hidden; Javascript is required. | P.O. Box 746 Edison, Georgia 39846 Map It | 21320 Hwy 37W Edison, Georgia 39846 Map It | |||||||||||||||||||
| 2025-24147815 | 08/26/2026 | BATES GAS COMPANY | CHRSITINE FOWLER | (229) 436-5338 | Email hidden; Javascript is required. | Processing | 08/21/2026 | 08/21/2026 | FLOYD BRANCH | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE160EP | WD.UA-038724 | 08/21/2026 | $200.00 | BATES GAS COMPANY | CHRSITINE FOWLER | 2703 SYLVESTER RD ALBANY, Georgia 31705 Map It | Email hidden; Javascript is required. | (229) 436-5338 | CHRIS MANN | (229) 395-4500 | 4908 MILLSBEE CIRCLE ALBANY, Georgia 31721 Map It | 4908 MILLSBEE CIRCLE ALBANY, Georgia 31721 Map It | chris-mann1.pdf | |||||||||||||||||||
| 2025-87978699 | 08/27/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 08/19/2026 | 08/19/2026 | RICKY JARRELL | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | GE | GP50T08BXR01 | RA602575C | 08/19/2026 | WHITLOCK.pdf | $200.00 | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | JONATHEN WHITLOCK | (910) 554-9481 | 132 AMBLESIDE DR LEESBURG, Georgia 31763 Map It | 132 AMBLESIDE DR LEESBURG, Georgia 31763 Map It | WHITLOCK1.pdf | ||||||||||||||||||
| 2025-55135401 | 08/27/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 08/18/2026 | 08/18/2026 | RICKY JARRELL | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | BRADFORD WHITE | RG250T6X | CB56659157 | 08/18/2026 | WILSON.pdf | $200.00 | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | PAMELA WILSON | (229) 886-5034 | 129 STEWART CT LEESBURG, Georgia 31763 Map It | 129 STEWART CT LEESBURG, Georgia 31763 Map It | WILSON1.pdf | ||||||||||||||||||
| 2025-34133038 | 08/27/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 08/21/2026 | 08/21/2026 | RICKY HUIRAS | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | GE | GP50T08BXR01 | SA603314C | 08/21/2026 | ORTON.pdf | $200.00 | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | FRED ORTON | (229) 432-2059 | 101 LAVENDER LANE LEESBURG, Georgia 31763 Map It | 101 LAVENDER LANE LEESBURG, Georgia 31763 Map It | ORTON1.pdf | ||||||||||||||||||
| 2025-63036840 | 08/27/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 08/12/2026 | 08/12/2026 | CURTIS HUNTER | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RX180IN/P | TL.BA-260952 | 08/12/2026 | ENTZ.pdf | $200.00 | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | JEFF ENTZ | (229) 349-1234 | 158 LONGLEAF DR LEESBURG, Georgia 31763 Map It | 158 LONGLEAF DR LEESBURG, Georgia 31763 Map It | ENTZ1.pdf | ||||||||||||||||||
| 2025-63893909 | 08/27/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 08/14/2026 | 08/14/2026 | royce hunter | Replacement or New Appliance | $400.00 | 2 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RX160IN/P | TG.BA-171320 | 08/14/2026 | SMITH.pdf | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RX180IN/P | TG.BA-169474 | 08/14/2026 | SMITH1.pdf | $400.00 | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | GREG SMITH | (912) 682-7175 | 129 GRAND OAKS CT ALBANY, Georgia 31721 Map It | 129 GRAND OAKS CT ALBANY, Georgia 31721 Map It | SMITH2.pdf | ||||||||||||
| 2025-20699634 | 08/27/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 08/17/2026 | 08/17/2026 | CURTIS HUNTER | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RX199IN/P | WA.BA-006747 | 08/17/2026 | RAINEY.pdf | $200.00 | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | THOMAS RAINEY | (229) 854-9099 | 2534 W DOUBLEGATE DR ALBANY, Georgia 31721 Map It | 2534 W DOUBLEGATE DR ALBANY, Georgia 31721 Map It | RAINEY1.pdf | ||||||||||||||||||
| 2025-36698602 | 08/27/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 08/10/2026 | 08/10/2026 | CURTIS HUNTER | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE160IP | WD.UA-041797 | 08/10/2026 | SKALLA.pdf | $200.00 | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | RUSTY SKALLA | (229) 886-2444 | 293 S BOULEVARD ST SMITHVILLE, Georgia 31787 Map It | 293 S BOULEVARD ST SMITHVILLE, Georgia 31787 Map It | SKALLA1.pdf | ||||||||||||||||||
| 2025-26303409 | 08/27/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 08/03/2026 | 08/03/2026 | RICKY JARRELL | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE199EP | TJ.UA-139181 | 08/03/2026 | MIXON.pdf | $200.00 | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | JOHN MIXON | (229) 894-2650 | 128 MEADOW DR AMERICUS, Georgia 31709 Map It | 128 MEADOW DR AMERICUS, Georgia 31709 Map It | MIXON1.pdf | ||||||||||||||||||
| Invoice # | Today's Date | Company Name | Company Contact | Company Phone | Company Email | Rebate Status | Safety Inspection Date | Purchase/Invoice Date | Safety Inspector’s Full Name | Type of Installation | Total | How many rebates would you like to claim? | Installation Type | Appliance Type | Brand | Model # | Model # | Serial Number | Installation Date | Upload Receipt | Appliance Type | Brand | Model # | Model # | Serial Number | Installation Date | Upload Receipt | Appliance Type | Brand | Model # | Model # | Serial Number | Installation Date | Upload Receipt | Total | Propane Company Name | Propane Marketer Name | Mailing Address | Email Address | Phone Number | Customer / Recipient Name | Customer / Recipient Phone Number | Customer / Recipient Email | Customer / Recipient Address | Customer / Recipient Installation Address | Upload Proof of Purchase: | Name of Builder/Contractor | Upload Spec Sheet for Manufactured Home |
