270 6TH ST - JEA SOLAR APPLICATION i - 47
JEA APPLICATION FORM FOR INTERCONNECTION OF RENEWABLE JC%
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
Customer Name (JEA accountv
holder): Alnder Yeats JEA Account #:(SI
Address: IrJD (it- City: A-k\cx .c- .h State FL Zip: ?, 333
System Location (if different from above):
Customer Phone#:'17a-32I* 13 _2) Fax#: Other#:
Customer Email: ,1'3 ea+s Q 0,(\\c \ . CO(YI
2. SYSTEM INFORMATION
Type of Renewable Generation System (RGS), please check one: lsidential E Commercial
Size of RGS, please check one: R'f er 1- 10 KW or less
flier 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:
ti5olar(PV) ❑ Wind ❑ Bio-mass ❑ Other
System Manufacturer(s):
Inverter Manufacturer:
Number of Inverters: Are Inverters UL 1741 Listed? i���'Ye��s ❑ No
Inverter Location: Dal(ler T) jc'�`]P4
Manual Disconnect Switch Location: p
If Solar: Number of Panels: Panel Location: (), - Q„ rock
Panel Manufacturer: 1.�(�l Ja
Manufacturer DC Gross Output Power Rating of System in kW (total): %. b5
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): '-(, L{0O
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? ❑ Yes
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 77,7015
Page 1 of 3
JEA APPLICATION FORM FOR INTERCONNECTION OF RENEWABLE JEA
GENERATION SYSTEMS (TIERS 1 AND 2)
3. CONTRACTOR INFORMATION
Installation Contractor: AlA SOLAR CONTRACTING. INC License # CVC56771
Contractor Address: 10418 New Berlin Road, Unit 223
City: Jacksonville State: Fl Zip: 32226 Email: info@alasolar.com
Contractor Phone #: 904-468-7861 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.
5. 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 any time.
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:
Customer to Initial
C Site survey clearly showing location of Renewable Generation System, Inverter,
and Manual Disconnect Switch
C. 1 Documentation of inverter UL 1741 Listing or compliance to UL 1741
(',Lc•t.) Completed W-9 with original signature (name must match JEA account name)
May 22, 2016 Page 2 of 3
JEA APPLICATION FORM FOR INTERCONNECTION OF RENEWABLE JEA
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."
Signed: ',.
/ Name (Print): Aje--/--c-v,--S-4(`
Name must match wit JEA account holder name
Date: G/E1/ 6
May 22, 2015
Page 3 of 3
A
JEA
Renewable Generation Interconnection Agreement
Tier 1 & 2 Net Metering
This Agreement is made and entered into this Le day of J\A Q , 20 1(.4 , by and
between kt.), thtcLks , (hereinafter called "Customer"), located at
a10 !1 S4 , in ANlantkL ,h , , Florida, Zip Code:322-A 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: SQ►rne.., •
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 losses 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
Tier 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;
e. 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
customer-owned 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 1 &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 60 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 shall provide JEA with 60 days written
notice of the addition.
Section 9. Gross Power Rating
9.01. The customer-owned renewable generation must have a GPR that does not exceed
90%of the Customer's JEA 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 JEA 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 (RGS) 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 customer-owned 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 customer-owned 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 kW. Customer may retain
the green tags. Customer shall offer JEA a first right of refusal before selling or granting to any
third party the right to the green tags associated with its customer-owned renewable generation
that is interconnected to the JEA electric distribution system.
Section 16. Indemnification
16.01. Customer agrees to indemnify, defend and hold harmless 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 party. 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.
JEA Approved as to Form
By:
Office of General Counsel
Title:
Date:
CUSTOMER
By:
( igna e)
(Print Name)
(Title, if Corporation)
C�7(IM (1 s a Li
(Customer Account Number)
Date: Le 1 l LQ
March 20, 2013 Page 8 of 8
Form W-9 Request for Taxpayer Give Form to the
(Rev.December 2014) Identification Number and CertificationsDo
egnot
Department of the Treasury senddetootth.he IRRS.
Internal Revenue Service
1 Name(as shown on your income tax re um).Name is required on this line:do not leave this line blank.
N'tVQndP( eAkS
N 2 Business name/disregarded entity n if different from above
as
rn
m
a3 Checkhappropriate box for federal tax classification:check only one of the following seven boxes: 4 Exemptions(codes apply only to
o L�IndividuaUsole proprietor or ❑ C CorporationS Corporationcertain entities.not individuals:see
o. c single-member LLC 0 Po 0 Partnership ❑ Trust/estate instructions on page 3):
Limited liabilitycompany.Enter the tax classification C=C co Exempt payee code(if any)
.0 ❑ P y ( corporation,S=S corporation.P=partnership)►
0 2 Note.For a single-member LLC that is disregarded.do not check LLC:check the appropriate box in the line above for Exemption from FATCA reporting
c y• the tax classification of the single-member owner. code(if any)
d o ❑Other(see instructions)O' iav:..es to accounts masa nec arsine.re V S;
Address(number.street.and apt.or suite no.) Requester's name and address(optional)
:1 5 a'1 b ( st.
co
6 City.state,and ZIP code
°' Ak \ an-k:\c. beach, FL . 3a3..5
7 List account number(s)here(optional)
•
Part I Taxpayer Identification Number(TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid I Social security number
1 backup withholding.For individuals,this is generally your social security number(SSN).However,for a f
resident alien,sole proprietor,or disregarded entity,see the Part I instructions on page 3.For other ta I _ el _ 0 ct 6 g
entities.it is your employer identification number(EIN).If you do not have a number,see How to get a l l 7
TIN on page 3.
or
Note.If the account is in more than one name,see the instructions for line 1 and the chart on page 4 for Employer identification number
guidelines on whose number to enter. —I I I I I I I I
Part II Certification
Under penalties of perjury.I certify that:
1. The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me):and
2. I am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue
Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am
no longer subject to backup withholding;and
3. I am a U.S.citizen or other U.S.person(defined below);and
4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct.
Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage
interest paid,acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA).anc
generally,payments other than interest and dividends,you are not required to sign the certification,but you must provide your correct TIN.See the
instructions on page 3.
Sign Signature
Here U.S.person f► t/
WI,iiflirre Date b.
(41.41149
General Instructions / •Form 1098(home mortgage interest),1098-E(student loan interest).1098-T
Section references are to the Internal Revenue Code unless otherwise noted. Formon)
•
Future developments. 1099-C(canceled debt)
Information about developments affecting Form W-9(such •Form 1099-A(acquisition or abandonment of secured property)
as legislation enacted after we release it)is at www.irs.gov/fw9.
Purpose of Form Use Form W-9 only if you are a U.S.person(including a resident alien).to
provide your correct TIN.
An individual or entity(Form W-9 requester)who is required to file an information /f you do not return Form W-9 to the requester with a TIN,you might be subject
return with the IRS must obtain your correct taxpayer identification number(TIN) to backup withholding.See What is backup withholding?on page 2.
which may be your social security number(SSN),individual taxpayer identification
number(ITIN),adoption taxpayer identification number(ATIN),or employer 1,Certifyg the filled-out forth.you:
identification number(EIN),to report on an information return the amount paid to 1• that the TIN you are giving is correct(or you are waiting for a number
you.or other amount reportable on an information return.Examples of information to be issued),
returns include,but are not limited to.the following: 2.Certify that you are not subject to backup withholding.or
•Form 1099-INT(interest earned or paid) 3.Claim exemption from backup withholding if you are a U.S.exempt payee.If
•Form 1099-DIV(dividends,including those from stocks or mutual funds) applicable.you are also certifying that as a U.S.person,your allocable share of
•Form 1099-MISC(various types of income,prizes.awards,orrose proceeds) any partnership income from a U.S.trade or business is not subject to the
9 withholding tax on foreign partners'share of effectively connected income.and
•Form 1099-8(stock or mutual fund sales and certain other transactions by 4.Certify that FATCA code(s)entered on this form(if any)indicating
brokers) that you are
exempt from the FATCA reporting,is correct.See What is FATCA reporting?on
•Form 1099-S(proceeds from real estate transactions) page 2 for further information.
•Form 1099-K(merchant card and third party network transactions)
Cat.No.10231X Form W-9(Rev.12-2014)
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The `rnha; a M250 Mirnr;; •-.�:,;:,r delivers increased enemy harvest and reduces design and
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`PODUCT ! VE SIMPLE
- Optimized for nigner-power - No GEC needed for micronrerte•
-nodules -No DC design or String calculation - �'C,•,-. •� ;.
- Maximtzes energy production
- Minmizes impact of shaping. - Easy installation with Engage
dust. aria debris Cable
enphase
-17)'ase• M250 Micronverter 1, DATA
INPUT DATA(DC) M250-60-2LL-S22/S23/824
Recommended input power(STC) 210-300 W
Maximum input DC voltage 48 V
Peak power tracking voltage 27 V-39 V
Operating range 16 V-48 V
Min/Max start voltage 22 V/48 V
Max DC short circuit carer•.t 15 A
Max input current 9.8 A
OUTPUT DATA(AC) 0208 VAC —'"
_ _ 0240 VAC
Peak output power 250 W
250 W
Rated(continuous)output power 240 W
240 W
Nominal output current 1.15 A(Arms at nominal duration) 1.0 A(A rms at nominal duration,
Nominal voltage/range 208 V.183-229 V
Nominal frequency/range 240 V/211-264 V
60.0/57-61 Hz 60.0/57-61 Hz
Extended frequency range' 57-62.5 Hz
Power factor 57-62.5 Hz
>0.95 >0.95
Maximu,^,pmts per 20 A branch circuit
24(three phase) '6(single phases
Maximum output fault current
---__t-__-_ - 850 mA rms for 6 cycles 850 mA rms for 6 cycles
EFFICIENCY _"" ------�
CEC weighted efficiency.240 VAC
96.5%
CEC weighted efficiency.208 VAC 96.0%
Peak inverter efficiency
96.5%
Static MPPT efficiency(weighted,reference EN50530) 99.4 '/o
Night time power consumption 65 mW max
MECHANICAL DATA
Amoient temperature range
-40°C to+65°C
Operating temperature range linternall -40°C to+85°C
Dimensions(WxHxD) 171 mm x 173 mm x 30 mm(without mounting bracket)
Weight
2.0 kg
Cooling
Natural convection-No fans
Enclosure environmental rating
Outdoor-NEMA 6
FEATURES - - ___-_-_ _ ___._�__-W._
Compatibility --
Compatible with 60-cell PV modules.
Communication
Power line
Integrated ground The DC circuit meets the requirements for ungrounded PV arrays in
NEC 690.35.Equipment ground is provided in the Engage Cable. No
additional GEC or ground is required.
Monitoring
Free lifetime monitoring via Enlighten software
Compliance
UL1741/IEEE1547,FCC Part 15 Class B.CAN/CSA-022.2 NO.0-M91,
• 0.4-04,and 107.1-01
F'ea,Jency ranges Ca'-be a°tended beyond nominal it•eduired by the utility
To learn more about Enphase Microinverter technology,
. enphase