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270 6TH ST JEA SOLAR PANEL APPLICATION JEA APPLICATION FORM FOR INTERCONNECTION OF RENEWABLE GENERATION SYSTEMS (TIERS 1 AND 2) The JEA Net Metering Policy is intended to facilitate generation from customer-owned renewable energy sources to offset up to all of the customer's energy requirements. Interconnection to JEA's distribution grid requires advance application approval by JEA and a properly executed standard interconnection agreement with JEA. The application approval and the interconnection agreement must be obtained prior to initiating installation or construction of the customer-owned renewable generation system. 1. CUSTOMER INFORMATION n Customer Name(JEA account holder): JEA Account M()f�(j�+"1 Address:1 7 Vim '. City: state�zip: 3aa3'3 System Location (if different from above): Customer Phone#132-32)•l2q"� Fax p: Other JJ: Customer EmaihJ \j ebcKQ QtY mk . uwi 2. SYSTEM INFORMATION Type of Renewable Generation System(RGS), please check one: 211residential 0 Commercial Size of RGS, please check one: 01"er 1-10 KW or less OTier 2—Greater than 10 KW but less than or equal to 100 KW Tier 2 systems may require the utilization of other engineering groups within JEA, which may or may not incur additional customer costs,depending on the services required. Renewable system source type: Ef1olar(PV) 0 Wind 0 Bi�$°,.mass� 0 Other System Manufacturer(s): :aJu y(L. Inverter Manufacturer: tt Number of Inverters: Are Inverters UL 1741 Listed? Byes 0 No Inverter Location: Manual Disconnect Switch Location: If solar: Number of Panels: Panel Location: Panel Manufacturer: _ .I kink Manufacturer DC Gross Output Power Rating of System in kW(total): Annual energy production of the generation system to be installed (kWh per year): Customer annual energy usage(kWh in the last 12 months,estimate if new structure): 14 40 C2 To determine your annual energy usage please login to jea.com and go to My JEA Utility Tracker, For a new structure please attach detail of the calculation of your estimate. Are energy storage devices included in the design of the generation system? 0 yes BHro If'Yes",what is the total capacity in kWh of the storage devices? In order to qualify for a net metering interconnection to JEA's distribution grid the customer's generation system must have a gross power rating that does not exceed 90%Of customer's utility distribution service rating and does not result in annual energy(kWh)sent to the JEA grid that exceeds the customer's annual energy(kWh)obtained from the JEA grid. My JEA Utility Tracker is not available to customers with photovoltaic systems. May 22,2015 Gage 1 of 3 JEA APPLICATION FORM FOR INTERCONNECTION OF RENEWABLE GENERATION SYSTEMS (TIERS 1 AND 2) 3. CONTRACTOR INFORMATION Installation Contractor: AIA SOLAR CONTRACTING,INC License# CVC56771 Contractor Address: 10418 New Berlin Road, Unit 223 City: Jacksonville state: FI Zip: 32226 Email: info@alasolar.com Contractor Phone#: 804.468-7861 Fax#: Other# 4. HARDWARE AND INSTALLATION COMPLIANCE 1. The system hardware shall be in compliance with: a) UL 1741,Inverters, Converters,and Controllers for Use in Independent Power Systems b) IEEE Standard 1547-2003,Interconnecting Distributed Resources with Electric Power Systems 2. The system shall be installed in compliance with: a) All relevant articles of the National Electric Code(NEC)and subsequent revisions b) All local building and electrical codes. An electrical permit is required. c) JEA Electric Systems Procedure ES 20202 902 DG Facilities. S. INSPECTION The following items will be inspected/tested: 1. A manual disconnect switch (lockable) must be placed within 5 feet of the revenue meter (or as deemed acceptable by JEA inspector)so it can be accessed at anytime. 2. If the disconnect switch is located away from the meter, a permanent sign must be mounted next to the meter stating the location of the disconnect switch.The sign must be 6"X 6" minimum with red background and 3/8"minimum white lettering. 3. A JEA provided sign stating "NOTICE: RENEWABLE GENERATION SYSTEM DISCONNECT" must be permanently mounted at the manual disconnect switch location. 4. The manual disconnect switch will be opened and the inverter(s) will be observed going offline. If micro-inverters are used, the AC disconnect switch cover and the main service panel cover will be opened/ removed by homeowner or contractor, and the wiring will be visually inspected. Owner is responsible for having covers and/or panels removed for inspection. Upon successful completion of the inspection, the meter shop will be notified so that a two register meter can be installed at the customer's facility. Warning: Do not leave the renewable generation system energized until the new two register meter is installed by JEA.The current meter may reverse register direction and activate anti-theft signals to JEA. 6. DOCUMENTATION Contractor to provide The following documents must be provided with this application: C r to Initial �+ Site survey clearly showing location of Renewable Generation System, Inverter, and Manual Disconnect Switch Documentation of inverter UL 1741 Listing or compliance to UL 1741 Completed W-9 with original signature(name must match JEA account name) May 22,2015 Page 2 of 3 JEA APPLICATION FORM FOR INTERCONNECTION OF RENEWABLE GENERATION SYSTEMS(TIERS 1 AND 2) 7. JEA NET METERING POLICY The entire JEA Net Metering Policy can be found at jea.com. As the owner of this system and by signature, I have received, read and understand this application, the JEA Net Metering Policy and have signed the supplied Department of Treasury's Internal Revenue Service Form W-9, "Request for Taxpayer Identification Number and Certification." V Signed: Name (Print): Name must match wit) JEA account holder name Date:T 11116 May 22,2015 Page 3 of 3 JEA Renewable Generation Interconnection Agreement Tier 1 & 2 Net Metering This Agreement is made and entered into this day ofT_qn_t_, 20� , by and between ��pc p(iQ, (hereinafter called "Customer"), located at a70 L� G n Florida, Zip Code:527A and JEA, a body politic and corporate,with a business address of 21 W. Church St.,Jacksonville, FL 32202. Customer and JEA shall collectively be called the "Parties". The physical location/premises where the interconnection is taking place is: Sbrn WITNESSETH Whereas, JEA, operates an electric distribution system serving Duval County and surrounding areas; Whereas, Customer has made a written Application to JEA, to allow connection of an Customer-Owned Renewable Generation system for any length of time to the distribution system at the location listed above;and Whereas, JEA desires to provide interconnection of Customer-Owned Renewable Generation under conditions which will insure the safety of JEA customers and employees, reliability and integrity of its distribution system; NOW, THEREFORE, for and in consideration of the mutual covenants and agreements herein set forth,the parties hereto covenant and agree as follows: Section 1. Definitions "Customer-owned renewable generation" means an electric generating system located on a customer's premises that is primarily intended to Offset part or all of the Customer's electricity requirements with renewable energy that is generated using one or more of the following fuels or energy sources: hydrogen,biomass,solar energy,geothermal energy,wind energy,ocean energy, waste heat,or hydroelectric power. "Green Tags" shall mean any and all renewable energy credits (RECs), renewable energy certificates (RECs), benefits, environmental attributes, emissions reductions, offsets, and allowances, however entitled, attributable to the generation of electricity from the customer owned-renewable generation and its displacement of conventional energy generation. "Gross power rating" (GPR) means the total manufacturer's AC nameplate generating capacity Of an on-site customer-owned renewable generation system that will be interconnected to and operate in parallel with JEA distribution facilities. For inverter-based systems, the GPR shall be calculated by multiplying the total installed DC nameplate generating capacity by .85 in order to account for tosses during the conversion from DC to AC. March 20,2013 Page 1 of 8 "Net Metering"means a metering and billing methodology whereby customer-owned renewable generation is allowed to offset the customer's electricity consumption on-site. "Renewable Energy"means electrical,mechanical,or thermal energy produced from a method that uses one or more of the following fuels or energy sources:hydrogen,biomass,solar energy, geothermal energy,wind energy,ocean energy,waste heat,or hydroelectric power, "Renewable Generation System"means electric generating system located on a customer's premises that is primarily intended to offset part or all of the customer's electricity requirements with renewable energy. Tier 1 Net Metering— 10 kW or less Tiff 2 Net Metering—greater than 10 kW and less than or equal to 100 kW Section 2.Scope of Agreement 2.01. This Agreement defines the terms and conditions under which JEA and Customer agree to interconnect Customer-Owned Renewable Generation of 100 kW or less to JEA's electric system. Section 3. Interconnection Application 3.01. In order to commence the process for interconnection of the customer-owned renewable generation system, Customer shall complete and submit to JEA a Standard Interconnection Application (a copy of which is attached hereto as Attachment A, and incorporated in the Agreement by this reference). Section 4. Applicable Codes and Standards 4.01. Prior to operating in parallel with JEA's electric system,Customer shall certify that the customer-owned renewable generation equipment, its installation, its operation and its maintenance shall be in compliance with the following standards: a. IEEE-1547 (2003) Standard for Interconnecting Distributed Resources with Electric Power System; b. IEEE-1547.1 (2005) Standard Conformance Test Procedures for Equipment Interconnection Distributed Resources with Electric Power Systems; c. UL-1741 (2005) inverters, Converters, Controllers and Interconnection System Equipment for Use with Distributed Energy Resources. d. The National Electric Code, state and/or local building codes, mechanical codes and/or electrical codes; C. The manufacturer's installation,operation and maintenance instructions. March 20,2013 Page 2 of 8 4.02. Customer may be requested to provide a copy of the manufacturer's installation, operation and maintenance instructions to JEA. Section 5. Inspection Requirements 5.01. Prior to commencing parallel operation with JEA's electric system, Customer shall have the customer-owned renewable generation system inspected and approved by the appropriate code authorities having jurisdiction. Customer shall provide a copy of this inspection and approval to JEA. 5.02. Prior to and after operation of the customer-owned renewable generation in parallel with JEA's electric system, authorized JEA representatives may inspect the customer-owned renewable generation system to verify that it is and continues to be in compliance with the standards and codes contained in this Agreement. 5.03. JEA shall provide Customer with as much notice as is reasonably practicable; either in writing, email, facsimile or by phone as to when JEA may conduct inspection and/or documentation review. Upon reasonable notice, or at any time without notice in the event of an emergency or hazardous condition, JEA shall have access to Customer's premises for any reasonable purpose in connection with the performance of the obligations imposed by this Agreement,or,if necessary,to meet JEA's obligations to provide service to its customers. 5.04. In no event shall any statement, representation, or lack thereof, either express or implied, by JEA, relieve the Customer of exclusive responsibility for the Customer's system. Specifically, any JEA inspection of the customer-owned renewable generation system shall not be construed as confirming or endorsing the system design or its operating or maintenance procedures nor as a warranty or guarantee as to the safety, reliability, or durability of the customerowned renewable generation equipment. JEA's inspection, acceptance, or its failure to inspect shall not be deemed an endorsement of any customer-owned renewable generation equipment or procedure. Section 6. Net Metering 6.01. JEA will allow customer-owned renewable generation up to 100 kW under the JEA Tier I &2 Net Metering Policy. This JEA net metering policy is primarily intended to facilitate generation from renewable energy sources to offset part or all of the customer's energy requirements. Section 7. Electric System Protection Requirements 7.01. Customer certifies that the customer-owned renewable generation equipment includes an interactive inverter or interconnection system equipment that ceases to interconnect with JEA upon a loss of JEA power. The inverter shall be considered certified for interconnected operation if it has been submitted by a manufacturer to a nationally recognized March 20,2013 Page 3 of 8 testing laboratory (NRTL) to comply with UL 1741. The NRTL shall be approved by the Occupational Safety&Health Administration(OSHA). Section 8. Modifications and/or Additions to the Customer-Owned Renewable Generation System 8.01. It is the Customer's responsibility to notify JEA of any change to the GPR of the customer-owned renewable generation by submitting a new application for interconnection specifying the modifications at least 600_days prior to making the modifications. 8.02. If Customer adds another customer-owned renewable generation system which (i) utilizes the same JEA-interactive inverter for both systems; or (ii) utilizes a separate JEA - interactive inverter for each system, then Customer shalt provide JEA with 60 days written notice of the addition. Section 9. Gross Power Rating 9.01. The customer-owned renewable generation most have a GPR that does not exceed 900/6 of the Customer's TEA distribution service rating at the Customer's location. Section 10. Administrative Requirements 10.01. Customer must execute this Agreement and return it to JEA prior to beginning parallel operations with JEA's electric system. Subject to an approved inspection, including installation of acceptable disconnect switch, this Agreement shall be executed by JEA within 60 calendar days of receipt of completed required documentation and returned to the customer. 10.02. Once JEA has received Customer's written documentation that the requirements of this Agreement have been met and the correct operation of the manual switch has been demonstrated to a TEA representative,JEA will install the required net metering meter. Section 11. Customer Insurance Requirements 11.01. JEA strongly recommends that the customer maintain property, liability and worker's compensation insurance for customer-owned renewable generation. Section 12. Customer Equipment 12.01. Customer is responsible for the protection of its generation equipment, inverters, protection devices, and other system components from damage due to normal and abnormal operations that occur on JEA's electric system in delivering and restoring system power. Customer is also responsible for ensuring that the customer-owned renewable generation equipment is inspected, maintained, and tested regularly in accordance with the manufacturer's instructions to ensure that it is operating correctly and safely. Such inspection should occur after large storms have traversed Customer's location and after connection with JEA's system has been restored. March 20,2013 Page 4 of 8 Section 13. Manual Disconnect Switch 13.01. Customer shall install, at customer's sole expense a manual disconnect switch of the visible load break type to provide a separation point between the AC power output of the customer-owned renewable generation system and any Customer wiring connected to JEA's electric system such that back feed from the customer-owned renewable generation system to JEA's electric system cannot occur when the switch is in the open position. The manual disconnect switch shall be mounted separate from the meter socket on an exterior surface adjacent to the meter. The switch shall be readily accessible to JEA and capable of being locked in the open position with a JEA padlock. When locked and tagged in the open position by JEA, this switch will be under the control of JEA. The switch shall meet all applicable local and national electrical codes for the installed renewable generation system (AGS) system. The switch shall be permanently labeled with three inch high letters clearly stating "JEA (name of RGS). DISCONNECT'. If the switch is mounted out of sight of the meter, permanent mounted instructions must be posted at the meter clearly stating the location of the disconnect switch. 13.02. JEA may open the switch, isolating the customer-owned renewable generation system (RGS), without prior notice to Customer. To the extent practical, however, prior notice shall be given. If prior notice is not given, JEA shall at the time of disconnection leave a door hanger notifying the Customer that the RGS has been disconnected, including an explanation of the condition necessitating such action. The switch will be re-closed by JEA as soon as practical once the conditions causing the disconnection cease to exist. Typical conditions which may require the switch to be opened include,but are not limited to: > JEA electric system emergencies or maintenance requirements. > Hazardous conditions existing on JEA's electric system due to the operation of the Customer's RGS generation or protective equipment as determined by JEA. > Adverse electrical effects(such as power quality problems)on the electrical equipment of JEA's other electric consumers caused by the RGS as determined by JEA. 13.03. On termination of services pursuant to this Agreement, JEA shall open and padlock the manual disconnect switch and remove any additional metering equipment related to this Agreement. At the Customer's expense,within 10 working days following the termination, the Customer shall permanently isolate the customerowned renewable generation and any associated equipment from JEA's electric supply system, notify JEA that the isolation is complete,and coordinate with JEA for return of JEA's lock. Section 14. Metering Equipment 14.01. JEA will furnish, install, own and maintain metering equipment capable of measuring the flow of kilowatt-hours (kWh) of energy. The Customer's service associated with the cusmmerowned renewable generation will be metered at a single metering point and the metering equipment will measure energy delivered by JEA to Customer, and also measure energy delivered by Customer to JEA. Customer agrees to provide safe and reasonable access to the premises for installation of this equipment and its future maintenance or removal. March 20, 2013 Page 5 of 8 Section 15. Renewable Energy Credits Pursuant to the JEA Net Metering Policy: 15.01. For customer-owned renewable generation up to 100 M Customer may retain the green tags. Customer shall offer JEA a fust right of refusal before selling or granting to any third party the right to the green tags associated with its customerowned renewable generation that is interconnected to the JEA electric distribution system. Section 16. Indemnification 16.01. Customer agrees to indemnify, defend and hold bamdess JEA, its subsidiaries or affiliates, and their respective employees, officers and directors, governing boards, successors, and assigns against any and all liability, loss, damage, cost or expense, including attorney's fees, which JEA, its subsidiaries, affiliates, and their respective employees, officers and directors, governing boards, successors, and assigns may hereafter incur, suffer or be required to pay by reason of negligence on the part of the Customer under the obligation of this Agreement. This indemnification shall survive the term of this Agreement for events that occurred during the Agreement term. Section 17. Assignment 17.01. Customer shall not have the right to assign its benefits or obligations under this Agreement without JEA's prior written consent and such consent shall not be unreasonably withheld. If there is a change in ownership of the customer-owned renewable generation, Customer shall provide written notice to JEA at least 30 days prior to the change in ownership. The new owner will be required to assume in writing Customer's rights and duties under this Agreement, or execute a new Standard interconnection Agreement. The new owner shall not be permitted to net meter or begin parallel operations until the new owner assumes this Agreement or executes a new Agreement. Section 18. Lease Agreements and Retail Purchase of Electricity 18.01. Customer may contract with a third party for the purchase, lease, operation, or maintenance of an on-site renewable generation system under terms and conditions that do not include the retail purchase of electricity from the third patty. Customer shall provide JEA a copy of the lease agreement for any leased interconnection or generation equipment. Customer shall not enter into any lease agreement that results in the retail purchase of electricity, or the retail sale of electricity from the customer-owned renewable generation. Notwithstanding this restriction, in the event that Customer is determined to have engaged in the retail purchase of electricity from a party other than JEA, then Customer shall be in breach of this Agreement and may be subject to the jurisdiction of the Florida Public Service Commission and to fines/penalties. March 20,2013 Page 6 of 8 Section 19. Entire Agreement 19.01. This Agreement supersedes all previous agreements and representations either written or verbal heretofore made between JEA and Customer with respect to matters herein contained. This Agreement,when duly executed, constitutes the only Agreement between parties hereto relative to the matters herein described. Section 20. Governing Law&Tariff 20.01. This Agreement shall be governed by and construed and enforced in accordance with the laws, rules and regulations of the State of Florida and JEA's Tariff as it may be modified,changed, or amended from time to time. 20.02. This Agreement incorporates by reference the terms of the JEA Electric Documentation Volume 1 filed with the Florida Public Service Commission by JEA, including associated technical terms and abbreviations, general rules and regulations and standard electric service requirements (as may be applicable) as amended from time to time. To the extent of any conflict between this Agreement and such Electric Documentation Volume 1, the Electric Documentation Volume 1 shall control. 20.03. JEA and Customer recognize that the Florida Statutes and/or the Florida Public Service Commission Rules, including those Rules directly addressing the subject of this Agreement, may be amended from time to time. In the event that such statutes and/or rules are amended that affect the terms and conditions of this Agreement, JEA and Customer agree to supersede and replace this Agreement with a new Interconnection Agreement which complies with the amended statutes/rules. 20.04. Customer agrees to furnish JEA with an IRS Form W-9 at the time that the contract is executed. Customer understands that JEA is required to,and will report the dollar value of,the kWh credits for the electricity that the customer sells to JEA on IRS Form 1099- MISC. Customer further understands that these credits may be subject to U. S. Federal Income Tax. 20.05. Customer also understands that JEA will bill,and that the customer is liable for, all applicable State and local Utility Taxes on the net amount of electric power that the customer purchases from JEA. Gross Utility Taxes are reduced by the credits that the customer receives for selling power back to JEA. If the amount of power sold back to JEA is greater than the amount of power purchased from JEA for any given month then taxes will be based only on the Customer Charge. Customer cannot receive a net credit for state or local taxes. March 20,2013 Page 7 of 8 IN WITNESS WHEREOF, Customer and JEA have executed this Agreement the day and year first above written. 'TEA Approved as to Form By: Title: Office of General Counsel Date: CUSTOMER By: tgna ) 441: rceu� (Print Name) (Title, if Corporation) t `11:W 14 (11a1-1 (Customer Account Number) Date: _ Ulu ( ILO March 20,2013 Page 9 of 8 Form W'9 Request for Taxpayer Give Form to the (Re".Cars moer 20141 Identification Number and Certification I6Qd to IR . 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The number shown on this form is my corned taxpayer identification number(or I am walking for a number to be issued to me);and 2. 1 am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been nom) by Me Imemal Revenue Sensate ORS)that I an,Subject to backup withholding as a result of a failure to report all Interest or dividends,or(c)the IRS hes notified me that I am no longer SubjeR to backup withholding;and 3. 1 am a U.S.olden or other U.S.person(defined!belowg and 4.The FATCA oode(S)entered on this form(if any)motoring that I ah exempt from FATCA reporting is coned. Coruscation InebtleNpns.You must cross out item 2 above if you have been notified by the IRS that you are ounemly subject to backup withholding because you have failed to report all interest and dividends on your tax return.For real estate hurls actions,item 2 does not apply.For mortgage interest paid,acoulakion or abandonmant of secured property,cancellation of debt,wntribubons to an mdivehall retirement so ingement(IRA),and generally,payments other than interest and dividends.you are not required to sign the certifcation,but you must provide your coned TIN.Sae the instructions on page 3. Here S'9wore of ua person. theys. (a�l � Le General Instructions •Fotm,n99 awme mn9ape imaesq.,o9B-E lawerrc Ion,„,mry,,ope-T Secure wwercw are to toe ational Revenue Cone unlwe otting For antl. 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N n ^ O P � O 2 w oA nN O ry V V j D m N � r r F m � Microinverters Enphase M250 The delivers increased energy harvest and reduces design and installation complexity with its all-AC approach. With the M250. the DC circuit is isolated and insulated from ground. so no Ground Electrode Conductor(GEC) is required for the microinverter.This further simplifies installation. enhances safety, and saves on labor and materials costs. The Enphase M250 integrates seamlessly with the Engage' Cable. the Envoy- Communications Gateway and Enlighten . Enphase's monitoring and analysis software. enphase SA• :s