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: ELECTRONICALLY FILED - 2019 April 22 5:05 PM - SCPSC - Docket # 2019-130-E - Page 60 of 115 Interconnection Request ID number: Utility waives inspection/witness test? Yes No ELECTRONICALLY FILED - 2019 April 22 5:05 PM - SCPSC - Docket # 2019-130-E - Page 61 of 115 Is the Generating Facility owner-installed? Yes No Interconnection Customer Name: Contact Person: E-Mail Address: Address: City: State: Zip: County:

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: ELECTRONICALLY FILED - 2019 April 22 5:05 PM - SCPSC - Docket # 2019-130-E - Page 60 of 115 Interconnection Request ID number: Utility waives inspection/witness test? Yes No ELECTRONICALLY FILED - 2019 April 22 5:05 2020 November 17 4:39 PM - SCPSC - Docket # 2019-130326-E - Page 61 67 of 115 196 DEC/DEP Application - Attachment 1 Docket No. 2019-326-E Is the Generating Facility owner-installed? Yes No Interconnection Customer Name: Contact Person: E-Mail Address: Address: City: State: Zip: County: