Docstoc

Program Contract

Document Sample
Program Contract Powered By Docstoc
					                                                                                                                                             Return Reservation Request Form to:
                                                           California Solar Initiative Program                                           PG&E Solar and Customer Generation - CSI
                                                           Reservation Request Form and Program Contract                                                           P.O. Box 7433
                                                                                                                                                         San Francisco, CA 94120
             Reservation Number:                                                           Date Printed:      7/12/2011


    Instructions: Please confirm you are using the current Reservation Request Form by going to your Program Administrator's website. Refer to the CSI
    Program Handbook for instructions, and include all required attachments with your submittal. Incomplete Reservation Requests will result in a suspended
    application.
    1. Host Customer                                                                     2. Applicant (if not Host Customer)
       Customer/Company Name
                 (As listed on electric bill)
                                                                                               Company Name
                Contact Name                                                                     Contact Name
               Mailing Address (Suite/Apt, Street)                                              Mailing Address (Suite/Apt, Street)
                                                (City, State, Zip)                                                 (City, State, Zip)
                                 Email                                                                     Email
                                Phone                                                                      Phone
                                     Fax                                                                     Fax


    Does the Host Customer have legal ownership of the building and/or property where the proposed PV system will be located?            YES                       NO
    If no, please indicate who owns the building and/or property, the contractual relationship with the Host Customer and the contract period
    3. System Owner (if not Host Customer)                                               4. Contractor
              Company Name                                                                     Company Name
                Contact Name                                                                   License Number

               Mailing Address (Suite/Apt, Street)
                                                (City, State, Zip)                       5. Seller
                                 Email                                                         Company Name
                                Phone                                                          License Number
                                     Fax


    6. Project Site Information
                    Project Type:                  Retrofit
                                                  FALSE                      FALSE
                                                                            New Construction (Non-Residential Only)
                Incentive Type:                   FALSE
                                                   Residential                FALSE
                                                                            Commercial                FALSE
                                                                                                 Government, Non-profit, or Public Entity


                    Site Address (Suite/Apt, Street)

                                                (City, State, Zip)
                               County                                                      Est. Building Sq. Ft.

         Electric Utility Service                                                             Meter Number(s)
           Account Number(s)




    Is there any existing generation at this Site, including nonfunctioning and/or emergency back up generation                         YES      NO

    If yes, describe the type of technology for Existing Generation


    Has this project Site received previous incentives for installed PV generation?                         YES          NO
    Amount                                                    Description




Printed 7/12/2011                                                                           1 of 3                                       3ecc27dc-e2d6-4fcf-b035-961f992b609f.xls
                                                                                                                                                         Return Reservation Request Form to:
                                                   California Solar Initiative Program                                                               PG&E Solar and Customer Generation - CSI
                                                   Reservation Request Form and Program Contract                                                                               P.O. Box 7433
                                                                                                                                                                     San Francisco, CA 94120
               Reservation Number:                                                             Date Printed:            7/12/2011

    7. Project Incentive Calculation and Cost Information
    Enter Estimated Annual kWh and CSI System Size as shown on EPBB Tool at www.csi-epbb.com

          Array Number                Estimated Annual kWh                       CEC-AC (kW)                        Design Factor (%)                            CSI System Size
                   1                                                                                                                                           #VALUE!                  kW
                   2                                                                                                                                            0.000                   kW
                   3                                                                                                                                            0.000                   kW
                   4                                                                                                                                            0.000                   kW

            Total Annual kWh:                        0                                0.000                    Total CSI System Size:                          #VALUE!                  kW
                         Project System Size:            #VALUE!      kW
                   Eligible CSI System Size:             #VALUE!      kW                                       Array Type (Select one):             Fixed System
                          Total Project Cost:                                                        #VALUE!                                        1-Axis or 2-Axis Tracking
             Pro-rated Eligible Project Cost:                  #VALUE!                               #VALUE!                    6a   (Pro-ration to equate costs to Eligible CSI System Size)

                                                                      List all other non-CSI incentive sources and amounts being received for Eligible Project Cost Items. See
    Other Financial Incentives in Addition to CSI                     CSI Handbook for more information.
         Other Incentive Source Name                  Other Incentive Source Type                     Amount
                                                                                                                               #VALUE!
                                                                                                                               #VALUE!
                                                Total Other Incentives Amount: $                                    -          #VALUE!               6b
    Verify Incentives Don't Exceed System Owner's Out of Pocket Expenses
    Total Eligible Project Costs (6a) =                                                              #VALUE!                   #VALUE!               6c
    Total Other Incentive Amount (6b) =                                                       $                     -          #VALUE!               6d
    CSI Rebate Amount (7a) =                                                                  $                     -          #VALUE!               6e
    System Owner Out of Pocket Expenses* =                                                                                     #VALUE!                6f
       * Verification of Amount Shown required prior to CSI Incentive Payment

    Line 6c - 6d - 6e - 6f (if Total $'s is not equal to $1 or zero please contact your
    Program Administrator) =
                                                                                                     #VALUE!                   #VALUE!

    8. Requested Project Type, Rate, and Incentive

    CSI System Size:                            #VALUE!                kW

    CSI Incentive Amount:                                     EPBB (< 50 kW)                                                PBI (> = 50 kW or opt in)
                                                                                      $/watt                   OR                                                $/kWh

    Requested CSI Incentive = $                                                           -         7a                                                                           ≥

    9. Checklist for Other Required Documents
    Please complete this checklist. Refer to the latest version of the CSI Program Handbook for detailed instructions on eligibility and application
    requirements. The purpose of this checklist is to ensure applicants submit the all materials required for the Reservation Request and assist the Program
    Administrator to review the documentation.
                FALSE
            Completed Reservation Request Form and Program Contract with Signature
            Electrical System Sizing Documentation (new/expanded load) for projects >= 5 kW
            Copy of Signed Energy Efficiency Disclosure Form
                   FALSE
            Proof of Energy Efficiency documentation:                                                                                           $          -      $          -
                 Energy Efficiency Audit -or-            Title 24 Report within the last 3 years
            Copy of Signed Commitment Agreement (EPBB Existing Commercial buildings >= 100,000 sq ft and Benchmarking <75. [Proof of
            Benchmarking Documentation Req'd.] )
            Printout of EPBB Tool Calculation (www.csi-epbb.com)
          Certification of tax-exempt status (gov't and non-profit only)
    Additional Required Documents for All Residential Customers and Commercial or Government/Non-Profit/ Public Entities < 10 kW:
            Copy of Executed Agreement of Solar Energy System Purchase and Installation
            Copy of Executed Alternative System Ownership Agreement (If System Owner is Different from Host Customer)
    Additional Required Documents for Commercial or Government/Non-Profit/ Public Entities > 10 kW:
    FALSEApplication Fee (see Section 4.4.1.1 of the CSI Handbook for standardized amount based on system size)                                                         $0
    Additional Required Documents for Non-Residential New Construction (Commercial or Government/Non-Profit/ Public Entities):
            Proof of at least 15% above Title 24 Standards (PERF-1 Form Certificate Signed by a Certified Energy Plans Examiner [CEPE])
            Building Site Plan
            Copy of New Construction Building Permit




Printed 7/12/2011                                                                                 2 of 3                                            3ecc27dc-e2d6-4fcf-b035-961f992b609f.xls
                                                                                                                              Return Reservation Request Form to:
                                          California Solar Initiative Program                                             PG&E Solar and Customer Generation - CSI
                                          Reservation Request Form and Program Contract                                                             P.O. Box 7433
                                                                                                                                          San Francisco, CA 94120
             Reservation Number:                                              Date Printed:       7/12/2011

    10. CSI Program Contract
    Declarations by Host Customer and System Owner:

    By execution of this document, System Owner and Host Customer each certifies that the Project meets all Program eligibility requirements and that the
    System Owner and Host Customer agree to abide by the rules and requirements set forth in the CSI Program Handbook. The undersigned declare under
    penalty of perjury under the laws of the State of California that 1) the information provided is true and correct, 2) the above-described generating system
    is new and intended to offset part or all of the Host Customer’s electrical needs at the site of installation.

    The Host Customer and System Owner are committed to completing this Project, and by signing below, are stating their intent to contract with any
    individual(s) necessary for completion of the Project. The Host Customer is the reservation holder and reserves the right to submit new project
    specifications, including a new Applicant designation, upon withdrawal from the Project and cancellation of this Agreement. The undersigned declare
    under penalty of perjury under the laws of the State of California that 1) the information provided in the Reservation Request Form is true and correct, 2)
    the above-described generating system is new and intended to offset part or all of the Host Customer’s electrical needs at the site of installation.

                                   Host Customer                                              System Owner (if not Host Customer)
                    Signature:                                                           Signature:
                Name Printed:                                                       Name Printed:
                          Title:                                                              Title:
                          Date:                                                               Date:

                                                                Program Administrator
                                               Signature:
                                           Name Printed:
                                                    Title:
                                                    Date:

    Certification by Applicant: Where an APPLICANT has been separately identified on the Reservation Request Form, the Applicant must certify that the
    information provided on the Reservation Request Form is true, accurate, and complete. The Applicant is not a Party to the contract, but certifies under
    penalty of perjury that the information provided on the Reservation Request Form and the CSI Incentive Calculation Worksheet is true, accurate, and
    complete.
                                                                        Applicant
                                               Signature:
                                           Name Printed:
                                                    Title:
                                                    Date:

                                    Once complete, please send to the address below with ALL necessary attachments.
                          Regular Mail Address                                                          Overnight Mail Address
               PG&E Solar and Customer Generation - CSI                                       PG&E Solar and Customer Generation - CSI
                            P.O. Box 7433                                                             245 Market St., MC N7R
                      San Francisco, CA 94120                                                      San Francisco, CA 94105-1797




Printed 7/12/2011                                                              3 of 3                                     3ecc27dc-e2d6-4fcf-b035-961f992b609f.xls

				
DOCUMENT INFO
Description: Program Contract document sample