Utility Interconnection Application

UTILITY INTERCONNECTION APPLICATION

WHEREAS RECITALS

WHEREAS, Applicant desires to install and operate electric generation equipment at the Site for the purpose of producing electric energy and to interconnect such equipment to the Utility distribution system under the terms and conditions set forth in this Application and any resulting interconnection agreement; and

WHEREAS, Utility regulates safety and reliability of the distribution system and requires information and compliance measures from Applicant to evaluate and approve interconnection, and may require modifications, inspections, and fees prior to authorization to operate in parallel with the grid.

WHEREAS, the parties intend by this Application to record the technical, administrative and commercial information necessary for Utility to perform engineering review, inspection, and to execute any subsequent interconnection agreement.

APPLICANT INFORMATION

SITE INFORMATION

Nearest Utility Pole or Transformer ID:

Site Coordinates (Latitude / Longitude): /

SYSTEM INFORMATION

Generator Type (check all that apply): Photovoltaic Wind Energy Storage Fuel Cell Other:

Maximum AC Output (nameplate):   Maximum DC Rating:   Quantity of Inverters:

Service Phase: Single-Phase Three-Phase

Intended Operation: Export to grid Import-only (no export)

Anti-islanding / Protective Devices provided: Yes Protective relay   Local Disconnect Type:

Proposed In-Service Date:

SCOPE OF WORK

ATTACHMENTS

Attachments included with this Application: Single-line electrical diagram Equipment spec sheets Site plan / mounting plan Site photographs Other:

PAYMENT TERMS

Applicant shall pay the following fees associated with review, inspection and interconnection. Fees are due in accordance with the schedule below and are non-refundable unless otherwise stated by Utility.

TERM AND TERMINATION

This Application (and any subsequently executed interconnection agreement incorporating these terms) shall be effective as of the date of Utility acceptance and shall continue until terminated as provided below.

Term Start Date:   Term End Date (if applicable):

Grounds for termination include material breach, failure to pay applicable fees, condition that materially affects system safety or reliability, or failure to permit inspection or required remedial work by Utility. Utility may disconnect the generating facility without prior notice where immediate action is necessary to preserve system safety or reliability.

CONFIDENTIALITY

All information submitted in this Application shall be treated as proprietary by the receiving party to the extent permitted by law. Confidential information does not include information that (a) is or becomes publicly available other than by breach of this provision; (b) is already known by the receiving party; (c) is lawfully obtained from a third party without restriction; or (d) is required to be disclosed by law or regulation. Confidentiality obligations shall survive termination for a period of three (3) years.

GOVERNING LAW

This Application and any resulting interconnection agreement shall be governed by and construed in accordance with the laws of the state or jurisdiction in which the Site is located. Governing jurisdiction:

ENTIRE AGREEMENT

This Application, when accepted by Utility, together with any executed interconnection agreement, attachments, and approved technical documentation, constitutes the entire agreement between the parties with respect to the subject matter and supersedes all prior negotiations and understandings, whether written or oral.

CERTIFICATION AND ACKNOWLEDGEMENT

By submitting this Application, Applicant certifies under penalty of perjury that the information provided is true and correct to the best of Applicant's knowledge, that the proposed installation will comply with all applicable codes and standards, and that Applicant will allow Utility access for inspection and commissioning. Applicant further acknowledges that final authorization to operate in parallel with the Utility system is contingent on satisfactory review, testing and, if required, execution of an interconnection agreement.

Applicant acknowledges and agrees to pay fees, comply with required corrective work, and accept Utility's requirement for equipment testing and protective device settings prior to interconnection.

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