Common use of Interconnection Customer Signature Clause in Contracts

Interconnection Customer Signature. I hereby certify that, to the best of my knowledge, the information provided in this Interconnection Request Application Form is true. I agree to abide by the Terms and Conditions for Interconnecting a Certified Inverter-Based Generating Facility No Larger than 20 kW and return the Certificate of Completion when the Generating Facility has been installed. Signed: Title: Date: Interconnection of the Generating Facility is approved contingent upon the Terms and Conditions for Interconnecting a Certified Inverter-Based Generating Facility No Larger than 20 kW and return of the Certificate of Completion. Utility Signature: Title: Date: Utility waives inspection/witness test? Yes No Is the Generating Facility owner-installed? Yes No Interconnection Customer Name: Contact Person: E-Mail Address: Address: City: State: Zip: Telephone (Day): Fax: (Evening): Location of the Generating Facility (if different from above) Address City: County: State: Zip: Name: Company: E-Mail Address: Address: City: State: Zip: Telephone (Day): Fax: (Evening): The Generating Facility has been installed and inspected in compliance with the local building/electrical code of Signed (Local electrical wiring inspector, or attach signed electrical inspection): Signature: Print Name: Date: As a condition of interconnection, you are required to send/email/fax a copy of this form along with a copy of the signed electrical permit to (insert Utility information below): Utility Name: Attention: E-Mail Address: Address: City: Fax: State: Zip: Energizing the Generating Facility is approved contingent upon the Terms and Conditions for Interconnecting a Certified Inverter-Based Generating Facility No Larger than 20 kW. Utility Signature: Title: Date:

Interconnection Customer Signature. I hereby certify that, to the best of my knowledge, the information provided in this Interconnection Request Application Form is true. I agree to abide by the Terms and Conditions for Interconnecting a Certified Inverter-Based Generating Facility No Larger than 20 10 kW and return the Certificate of Completion when the Generating Facility has been installed. Signed: Title: Date: Facility’s intended design: Sell All Net Meter If Net Metering, do you intend to keep your current retail rate schedule? Yes No Length of contract term and option under the Cogeneration & Small Power Producer Tariff: Term (Select One): Variable 5-year fixed 10-year fixed 15-year fixed Option (Select One): Option A Option B Interconnection of the Generating Facility is approved contingent upon the Terms and Conditions for Interconnecting a Certified Inverter-Based Generating Facility No Larger than 20 10 kW and return of the Certificate of Completion. Utility Signature: Title: Date: Interconnection Request ID number: Utility waives inspection/witness test? Yes No Is the Generating Facility owner-installed? Yes No Interconnection Customer Name: Contact Person: Address: Location of the Generating Facility (if different from above) City: State: Zip: Telephone (Day): Fax: (Evening): E-Mail Address: Name: Address: City: State: Zip: Telephone (Day): Fax: (Evening): Location of the Generating Facility (if different from above) Address City: County: State: Zip: Name: Company: E-Mail Address: AddressLicense Number: CityDate Approval to Install Generating Facility granted by the Utility: StateInterconnection Request ID Number: Zip: Telephone (Day): Fax: (Evening): The Generating Facility has been installed and inspected in compliance with the local building/electrical code of Signed (Local electrical wiring inspector, or attach signed electrical inspection): Signature: Print Name: Date: As a condition of interconnection, you are required to send/email/fax a copy of this form along with a copy of the signed electrical permit to (insert Utility information below): Utility Name: Attention: E-Mail AddressCompany: Address: City: Fax: State: Zip: Energizing the Generating Facility is approved contingent upon the Terms and Conditions for Interconnecting a Certified Inverter-Based Generating Facility No Larger than 20 10 kW. Utility Signature: Title: Date:

Interconnection Customer Signature. I hereby certify that, to the best of my knowledge, the information provided in this Interconnection Request Application Form is true. I agree to abide by the Terms and Conditions for Interconnecting a Certified an Inverter-Based Small Generating Facility No Larger than 20 kW 10kW and return the Certificate of Completion when the Small Generating Facility has been installed. Signed: Title: Date: Contingent Approval to Interconnect the Small Generating Facility (For Company use only) Interconnection of the Small Generating Facility is approved contingent upon the Terms and Conditions for Interconnecting a Certified an Inverter-Based Small Generating Facility No Larger than 20 kW 10kW and return of the Certificate of Completion. Utility Company Signature: Title: Date: Utility Application ID number: Company waives inspection/witness test? Yes No Is the Small Generating Facility owner-installed? Yes No Interconnection Customer NameCustomer: Contact Person: Address: Location of the Small Generating Facility (if different from above): City: State: Zip Code: Telephone (Day): (Evening): Fax: E-Mail Address: Name: Address: City: State: ZipZip Code: Telephone (Day): Fax: (Evening): Location of the Generating Facility (if different from above) Address City: County: State: Zip: Name: CompanyFax: E-Mail Address: AddressLicense number: CityDate Approval to Install Facility granted by the Company: StateApplication ID number: Zip: Telephone (Day): Fax: (Evening): The Small Generating Facility has been installed and inspected in compliance with the local building/electrical code of Signed (Local electrical wiring inspector, or attach signed electrical inspection): Signature: Print Name: Date: As a condition of interconnection, you are required to send/email/fax a copy of this form along with a copy of the signed electrical permit to (insert Utility Company information below): Utility Name: Attention: E-Mail AddressCompany: Address: City, State ZIP: Fax: State: Zip: Energizing the Small Generating Facility is approved contingent upon the Terms and Conditions for Interconnecting a Certified an Inverter-Based Small Generating Facility No Larger than 20 kW. Utility 10kW Company Signature: Title: Date:

Interconnection Customer Signature. I hereby certify that, to the best of my knowledge, the information provided in this Interconnection Request Application Form is true. I agree to abide by the Terms and Conditions for Interconnecting a Certified Inverter-Based Generating Facility No Larger than 20 kW and return the Certificate of Completion when the Generating Facility has been installed. Signed: Full Name: Company Name Title: DateWith Company E-Mail Address: Mailing Address: City: State: Zip: Telephone (Day): (Evening): Interconnection of the Generating Facility is approved contingent upon the Terms and Conditions for Interconnecting a Certified Inverter-Based Generating Facility No Larger than 20 kW and return of the Certificate of Completion. Utility Signature: Title: Date: Interconnection Request ID number: Utility waives inspection/witness test? Yes No ELECTRONICALLY FILED - 2025 March 7 4:06 PM - SCPSC - Docket # 2019-326-E - Page 74 of 128 Is the Generating Facility owner-installed? Yes No Interconnection Customer Name: Contact Person: E-Mail Address: Address: City: State: Zip: Telephone (Day): Fax: (Evening): Location of the Generating Facility (if different from above) Address City: County: State: Zip: County: Electrician Name: Company: E-Mail Address: Address: City: State: Zip: Telephone (Day): Fax: (Evening): Date Approval to Install Generating Facility granted by the Utility: Interconnection Request ID Number: ELECTRONICALLY FILED - 2025 March 7 4:06 PM - SCPSC - Docket # 2019-326-E - Page 75 of 128 The Generating Facility has been installed and inspected in compliance with the local building/electrical code of Signed (Local electrical wiring inspector, or attach signed electrical inspection): Signature: Print Name: Date: As a condition of interconnection, you are required to send/email/fax email a copy of this form along with a copy of the signed electrical permit to (insert Utility information below): Utility Name: Attention: E-Mail Address: Address: City: Fax: State: Zip: Energizing the Generating Facility is approved contingent upon the Terms and Conditions for Interconnecting a Certified Inverter-Based Generating Facility No Larger than 20 kW. Utility Signature: Title: Date:: ELECTRONICALLY FILED - 2025 March 7 4:06 PM - SCPSC - Docket # 2019-326-E - Page 76 of 128

Interconnection Customer Signature. I hereby certify that, to the best of my knowledge, the information provided in this Interconnection Request Application Form is true. I agree to abide by the Terms and Conditions for Interconnecting a Certified an Inverter-Based Small Generating Facility No Larger than 20 kW 10kW and return the Certificate of Completion when the Small Generating Facility has been installed. Signed: Title: Date: (For Company use only) Interconnection of the Small Generating Facility is approved contingent upon the Terms and Conditions for Interconnecting a Certified an Small Generator 10 kW Inverter Process 4 Inverter-Based Small Generating Facility No Larger than 20 kW 10kW and return of the Certificate of Completion. Utility Company Signature: Title: Application ID number: Date: Utility Company waives inspection/witness test? Yes No Small Generator 10 kW Inverter Process 5 Is the Small Generating Facility owner-installed? Yes No Interconnection Customer NameCustomer: Contact Person: E-Mail Address: Address: City: Location of the Small Generating Facility (if different from above): City State: Zip: Telephone (Day): Fax: Telephone (Evening): Location of the Generating Facility (if different from above) Address City: County: State: Zip: Name: Company: E-Mail Address: Name: Address: City: City State: Zip: Telephone (Day): Fax: Telephone (Evening): E-Mail Address: License Number: Date Approval to Install Facility granted by the Company: Application ID number: The Small Generating Facility has been installed and inspected in compliance with the local building/electrical code of Signed (Local electrical wiring inspector, or attach signed electrical inspection): Signature: Print Name: Date: Small Generator 10 kW Inverter Process 6 As a condition of interconnection, you are required to send/email/fax a copy of this form along with a copy of the signed electrical permit to (insert Utility Company information below): Utility Name: Attention: E-Mail AddressCompany: Address: City, State ZIP: Fax: State: Zip: Approval to Energize the Small Generating Facility (For Company use only) Energizing the Small Generating Facility is approved contingent upon the Terms and Conditions for Interconnecting a Certified an Inverter-Based Small Generating Facility No Larger than 20 kW. Utility 10kW Company Signature: Title: Date:: Small Generator 10 kW Inverter Process 7

Interconnection Customer Signature. I hereby certify that, to the best of my knowledge, the information provided in this Interconnection Request Application Form is true. I agree to abide by the Terms and Conditions for Interconnecting a Certified Inverter-Based Generating Facility No Larger than 20 10 kW and return the Certificate of Completion when the Generating Facility has been installed. Signed: Title: Date: Interconnection of the Generating Facility is approved contingent upon the Terms and Conditions for Interconnecting a Certified Inverter-Based Generating Facility No Larger than 20 10 kW and return of the Certificate of Completion. Utility Signature: Title: Date: Interconnection Request ID number: Utility waives inspection/witness test? Yes No Is the Generating Facility owner-installed? Yes No Interconnection Customer Name: Contact Person: Address: Location of the Generating Facility (if different from above) City: State: Zip: Telephone (Day): Fax: (Evening): E-Mail Address: Name: Address: City: State: Zip: Telephone (Day): Fax: (Evening): Location of the Generating Facility (if different from above) Address City: County: State: Zip: Name: Company: E-Mail Address: AddressLicense Number: CityDate Approval to Install Generating Facility granted by the Utility: StateInterconnection Request ID Number: Zip: Telephone (Day): Fax: (Evening): The Generating Facility has been installed and inspected in compliance with the local building/electrical code of Signed (Local electrical wiring inspector, or attach signed electrical inspection): Signature: Print Name: Date: As a condition of interconnection, you are required to send/email/fax a copy of this form along with a copy of the signed electrical permit to (insert Utility information below): Utility Name: Attention: E-Mail AddressCompany: Address: City: Fax: State: Zip: Energizing the Generating Facility is approved contingent upon the Terms and Conditions for Interconnecting a Certified Inverter-Based Generating Facility No Larger than 20 10 kW. Utility Signature: Title: Date: