meter used to measure solar energy production

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Renewable Portfolio Standard Application Contact Information Renewable Energy Facility Information Name 2819 38th St NW - 12.16 kW Address 2819 38th ST NW Washington, DC 20007 Is this a Residential facility? Yes Is this a community renewable energy facility? No Is this a DC Government facility? No Is this a Federal facility? No Owner Information Name Vanda Berninger Address 2819 38th ST NW Washington, DC 20007 Phone 202-372-5273 Email [email protected] Is the system owned by a third party? No Do you have a Power Purchase Agreement (PPA)? No Operator Information Name Vanda Berninger Address 2819 38th ST NW Washington, DC 20007 Phone 202-372-5273 Email [email protected] Contact Person Information Name Sharene Siddiqui SRECTrade Title Client Services Associate Address 201 California Street, Suite 630 San Francisco, CA 94111 Phone 415-763-7732 Email [email protected] Fuel Information Array Number of Panels Wattage Per Panel Tilt Azimuth 1 38 320.0000 15.0000 180.0000 Fuel Type: Solar Type of Solar Energy Photovoltaic Name of Manufacturer REC Solar Model N-PEAK320W Array Information Total Number of Panels/Modules 38 Rated Capacity 0.0121600000 MW Name of Inverter Manufacturer Enphase Energy Model Number of Inverter IQ 7 Date of Final Approved Interconnection 08/17/2020 Meter used to measure solar energy production Name of Meter Enphase Energy Model Number of Meter Envoy Is Net Metering Used? Yes Is the facility a behind-the- meter (BTM) generator? Yes Required Documentation Required Document Attachment Current Certificate of Good Standing, if applicable, issued by the state in which the business was formed

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Page 1: Meter used to measure solar energy production

Renewable Portfolio Standard Application

Contact InformationRenewable Energy Facility InformationName 2819 38th St NW - 12.16 kWAddress 2819 38th ST NW Washington, DC 20007Is this a Residentialfacility?

Yes Is this a communityrenewable energy facility?

No

Is this a DC Governmentfacility?

No Is this a Federal facility? No

Owner InformationName Vanda BerningerAddress 2819 38th ST NW

Washington, DC 20007Phone 202-372-5273 Email [email protected]

Is the system owned by athird party?

No Do you have a Power PurchaseAgreement (PPA)?

No

Operator InformationName Vanda BerningerAddress 2819 38th ST NW

Washington, DC 20007Phone 202-372-5273 Email [email protected]

Contact Person InformationName Sharene Siddiqui SRECTrade Title Client Services AssociateAddress 201 California Street, Suite

630 San Francisco, CA94111

Phone 415-763-7732 Email [email protected]

Fuel Information

Array Number of Panels Wattage Per Panel Tilt Azimuth

1 38 320.0000 15.0000 180.0000

Fuel Type: SolarType of Solar Energy PhotovoltaicName of Manufacturer REC Solar Model N-PEAK320WArray Information

Total Number ofPanels/Modules

38

Rated Capacity 0.0121600000 MWName of InverterManufacturer

Enphase Energy

Model Number of Inverter IQ 7Date of Final ApprovedInterconnection

08/17/2020

Meter used to measure solar energy productionName of Meter Enphase Energy Model Number of Meter Envoy

Is Net Metering Used? Yes Is the facility a behind-the-meter (BTM) generator?

Yes

Required Documentation

Required Document Attachment

Current Certificate of Good Standing, if applicable, issued by the state inwhich the business was formed

Page 2: Meter used to measure solar energy production

One copy of U.S. Department of Energy, Energy Information AdministrationForm EIA-860, if rated capacity is > 1.0 MW

Certificate of Authorization to Conduct Business in the District of Columbia, ifapplicable

Documentation of authority to sign on behalf of Applicant 2819 38th St NW - Schedule A.pdf

Final Interconnection Approval () 2819 38th St NW - COC.pdf

Other

Required Document Attachment

Electronic Signature Affidavit of General Compliance: I certify, under penalty of perjury, that the information provided on this application is true,

complete and accurate, to the best of my knowledge.

Electronically signed by: Sharene Siddiqui

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SCHEDULE A Generator  Owner’s  Consent

The undersigned on behalf of the Generator Owner, ____________________________,1 represents  to  PJM  Environmental  Information  Services,  Inc.  (“EIS”)  that:

1. I/we am/are the Generator Owner who holds legal title to the Generating Unit(s)designated below.

2. I/we, the Generator Owner, (check one)

Hereby grant authority and permission to Account Holder, __________________________________,2 to create and trade all Certificates associated with the following Generating Unit(s), which Certificates shall also be registered to the GATS account(s) of the Account Holder.

Hereby elect to create and trade all Certificates associated with the following Generating Unit(s) within my own GATS account.

3. I/we, the Generator Owner, further represent that I/we have not granted similar authorityor permission to any other subscriber or account holder for use in the GATS or anysimilar system.

4. I/we, the Generator Owner, understand that this Consent supersedes any and allConsents that have been submitted prior to the Date specified herein. Any and all priorConsents will be considered null and void and the assignment of rights terminated.

5. The assignment of rights that occurs within this Consent does not absolve the GeneratorOwner from upholding any contractual obligations that exist outside of GATS.

6. By executing this Consent the Generation Owner represents it does not have anycontractual obligations that would preclude the execution of this Consent.

Generating Unit Name and Address Optional: [Generating Unit Size/System Size]

PJM MSET ID or EIA Plant Code and Generator Identifier (as applicable)

GENERATOR OWNER3

________________________________

Name: ________________________________

Title: ________________________________

Date: ________________________________

SRECTrade,+Inc.

SIGN+HERE+—>

Vanda Berninger

2819 38th St NW Washington DC 20007

Vanda Berninger

8/19/20

Cindy McCabe
Stamp
Sharene Siddiqui
Owner
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�pepco A PHI Company

DISTRICT OF COLUMBIA CUSTOMER NET ENERGY METERING CONTRACT

(Facilities of 1000 Kilowatts or less)

The Green Power Connection™ Team Pepco A PHI Company

(202) 872-3419 - Phone(202) 872-3228 - FAX

[email protected]

(Send via Email, FAX, or Mail to Pepco, GPC Team) • . . 1h .

Mailing Address: Mail Stop 7642, 701 9 St. NW, Washington, DC 20001

DC NEM Contract 1 FINAL May 2014

DocuSign Envelope ID: AE8C8813-0260-4AF5-9C95-9551594E71C1

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VANDA BERNINGER

2819 38TH ST NW

(202) 372-5273

[email protected]

IQ7 60-2-US

VANDA BERNINGER

2819 38TH ST NW

2819 38TH ST NW

ENPHASE

55022541316

PHOTOVOLTAICAC: 9.12; DC: 12.16

4/13/2020

7/12/2020

DocuSign Envelope ID: AE8C8813-0260-4AF5-9C95-9551594E71C1

Page 6: Meter used to measure solar energy production

In consideration of the agreements hereinafter set forth, the parties agree as follows:

ARTICLE I: DEFINITIONS

The following terms shaU have the following meanings under this Contract:

"Billing Period" or uBilling Month" is the period of time (approximately thirty (30) days) between the recording of metered energy delivered to and received from theCustomer's Generation Facility.

"Ca.pacity" is the maximum output, expressed in kilowatts, of an electric generator under specific conditions designated by the manufacturer, as indicated on a nameplate physically attached to the generator.

"Commission" is the Public Serv ice Commission of the Distrtct of Columbia.

"Competitive Electricity supplier" means a person, including an aggregator. broker. or marketer. who generates electricity; sells electricity; or purchases, brokers. arranges or markets electricity for sale for retail customers: The term excludes the folloWing: (A) Building owners. lessees. or managers who manage the internal distribution system serving such building and who supply electricity solely to occupants of the building for use by the occupants: (B) (1} Any person whO purchases electricity for its own use or for the use of its subsidiaries or affiliates; or (2) Any apartment building or office building manager wtio aggregates electric service requirements for his or her building or buildings, or Who does not: (a) Take title to the electricity; (b) Market electric services to the individually-metered tenants of his or her building; or (c) Engage in the resale of electric service to others; (C) Property owners wllo supply small amounts of power, at cost. as accommodation to lessors or licensees of the property; and (D) A consolidator.

"Customer-generator" means a residential or commercial customer that owns (or leases or contracts) and operates an electric generating facility that: (a) has a capacity of not more than 1000 kilowatts; (b) uses renewable resources, cogeneration, fuel cells, or microturbines; (c) is located on the customers premises; (d) is interconnected with the Electric Company's transmission and distribution facilities; and (e) is intended primarily to offset all or part of the customer's own electricityrequirements.

"Customer's Generation Facility" is all of the Customers plant and equipment, including the Customers generator, inverter, storage devices. and Interconnection Equipment, located on the Customer's side of the Point of Delivery.

"Customer's Interconnection Equipment" is all equipment and facilities owned by the Customer and located on the Customers side of the Point of Delivery installed to interconnect and deliver energy to the Company's system, including but not limited to connection, sWitching, transformation. protective relaying and safety equipment.

DC NEM Contract 3 FINAL May 2014

DocuSign Envelope ID: AE8C8813-0260-4AF5-9C95-9551594E71C1

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"Eligible customer-generator" means a customer-generator whose net energy metering system for renewable resources. cogeneration, fuel cells. and microturbines meets all applicable safety and performance standards.

"Full Retail Distribution Rate" means the per kilowatt-hour distribution charges applicable to the net energy billing customer during the billing period.

"Full Retail Transmission Rate" means the per kilowatt-hour transmission charges applicable to the net energy billing customer during the billing period.

"Generation value" means the product of the applicable SOS kilowatt-hour rate times the number of kilowatt-hours consumed and/or supplied. during the time period(s) associated with such usage and/or supply.

"Net energy metering" means the difference between the kilowatt-hours

consumed by a customer-generator and the kilowatt-hours generated by the customer­generator's facility over any time period determined as if measured by a single meter capable of registering the flow of electricity in two directions.

"Net energy billing" means a billing and metering practice under which a customer-generator is billed on the basis of net energy over the billing period.

"Point of Delivery" is the location where the Customer's Interconnection Equipment and the Company's system are connected.

"Premises" is the Customer's building or part of a building With its appurtenances (as grounds) where the Customer takes service from the Company under a unique account number.

"Prudent Electrical Practice" means those practices. methods and equipment. as changed from time to time. that arc commonly used in prudent electrical engineering

and operations to operate electric equipment lawfully and with safety and dependability and that are in accordance with the National Electrical Code. the Institute of Electrical and Electronic Engineers Code or any other applicable Federal, State and Local government codes, and the Company's construction standards and the Commission"s Interconnection Rules under Chapter 40 of Title 15 of the DCMR. the "District of Columbia Small Generator Interconnection Rules" ("DCSGIR").

"Renewable Resources" means one of the following sources of energy: solar. wind. tidal. geothermal, biomass. hydroelectric facil ities or digester gas.

"Standard Offer Service Provider" means a provider of standard offer service chosen pursuant to Chapter 29 of the Commission's rules.

DC NEM Contract 4 FINAL May 2014

DocuSign Envelope ID: AE8C8813-0260-4AF5-9C95-9551594E71C1

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ARTICLE II: QUALIFICATIONS

It is the purpose of this Contract to set forth rates and conditions for interconnected, parallel operation of Customer owned and operated electric generating facilities (Customer Generation Facility) using Renewable Resources, cogeneration. fue.l cells or microturbines. This Contract is not available for facilities having a total generating capacity of more than 1000 kW at a single Premises. A Customer's Generation Facility must be located on the Customer's Premises and must be intended primarily to offset all or part of the Customer's own electricity requirements. Service is provided under this Contract subject to the provisions listed below.

For the interconnection of a Customer Generation Facility, the Company and the Customer shall follow the interconnection procedures set forth in the District of Columbia Small Generator Interconnection Rules, Chapter 40 of Title 15 of the DCMR, the "District of Columbia Small Generator Interconnection Rules• prior to entering into this Net Energy Metering Contract.

ARTICLE Ill: TERM

The tenn of this Contract shall commence on ______ and shall extend initially for one year and thereafter on a monthly basis, unless tenninated pursuant to the terms herein.

ARTICLE IV: NET ENERGY METERING

Service provided under this Contract is billed under the Customer's normally applicable District of Columbia Schedules "R", ·AE", "RTM�. "GS ND", "GS LV", "GS 3A". "GT LV-, "GT 3A", and "GT 38" for Customer-Generators who meet the requirements set forth in D.C. Code§ 34-1501 (15) and 1518; the Company's Standard Net Metering Contract; and the Commission's Net Energy Metering Rules adopted in Order No. 15837, issued June 11. 201 o.

Net Energy Billing applies only to kilowatt-hour usage charges. Net energy biUing customers are responsible for all other charges applicable to the customer's rate dass and recovered through fixed amounts or over units other than kilowatt-hOurs, including customer and/or demand charges as applicable.

The application of this Rider to Schedules "RTM", "GT LV-. "GT-3A", and "GT-38" sh;ill bP. on thP. h;isis of P.oP.rgy inflow or 011tflow during P.-'ll'.h TimP. of llsP. prir.ing pP.riort rather than on the total monthly energy registration.

Billing for Net Energy Metering Customers with Competitive Suppliers

Monthly Generation and Transmission Service - Credits or charges shall be calculated by the Supplier at the rate specified in the agreement between the Customer­Generator and the Competitive Electricity Supplier.

DC NEM Contract 5 FINAL May 2014

6/01/2020

DocuSign Envelope ID: AE8C8813-0260-4AF5-9C95-9551594E71C1

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Monthly Distribution Service Charges - If the meter has registered net inflow of electricity for the billing month, the Customer-Generator shall be billed for the net inflow at the appllcable full retail rate for Distribution Services.

If u,e 111ele1 has reyislere<.111el uutnuw ur elec:L1icity ru, u,e 1.Jilli11y 111u11lll, a11u u,e Customer's generating facility has a capacity of 1 oo kilowatts or less, a dollar value credit shall be calcu lated by applying the full retail rate for Distribution Service excluding surcharges to the net outtlow. This credit shall be applied to the next monthly bill and to subsequent monthly bills, if necessary. until fully exhausted.

If the meter has registered net outflow of electricity for the billing month. and the Customer-Generator's generating facility is greater than 100 kilowatts in size, there shall be no credit for Distribution Service for the net outflow.

Billing for Net Energy Metering Customers with Standard Offer Service {SOS)

Monthly Generation Service - If the meter has registered net inflow of electricity for the billing month. the Customer-Generator shall be billed for the net inflow at the applicable sos rate for Generation Service.

If the meter has registered net outflow of electricity for the billing month, a dollar value credit shall be calculated by applying the full SOS rate for Generation Service to the net outflow. This credit shall Ile applied to the next monthly bill and to subsequent monthly bills. if necessary. until fully exhausted.

Monthly Transmission and Distribution Service Charges - If the meter has registered net inflow of electricity for the billing month, the Customer Generator shall be billed for the net inflow at the applicable full retail rates for Transmission and Distribution Services.

If the meter has registered net outflow of electricity for the billing month. and the Customer's generating facility has a capacity of 1 oo kilowatts or less, a dollar value credit shall be calculated by applying the full retail rate for Transmission and Distribution Service excluding surcharges to the net outflow. This credit shall be applied to the next monthly bill and to subsequent monthly bills, if necessary, until fully exhausted.

If the meter has registered net outflow of electricity for the billing month. and the Customer-Generator's generating facility is greater than 100 kilowatts in size, there shall be no credit for Transmission and Distribution Service for the net outflow.

ARTICLE V: INTERCONNECTED EQUIPMENT

The Customer is responsible for all costs associated with the installation and connection of its generating equipment. The Customer shall provide and maintain in good working order automatic protective equipment in compliance with the Institute of Electrical and Electronics Engineers, lnc.'s IEEE Standard 1547 ("IEEE 1547"} and Sections 4002--4008 of the DCSGIR. The Company shall conduct the appropriate Level

DC NEM Contract 6 FINAL May 2014

DocuSign Envelope ID: AE8C8813-0260-4AF5-9C95-9551594E71C1

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of Review of the automatic protective equipment in accordance With Sections 4004-4007 of the DCSGIR to detem,ine whether such equipment is fit for use with Pepco's system.

ARTICLE VI: I NTERCONNECTED OPERATION

Interconnection With the Company's system requires the installation of protective equipment. A Customer's Generating Facility must be in compliance with IEEE 1547 and the DCSGIR to receive Net Energy Metering service under this Contract_ The Customer's equipment must be installed and configured in accordance with IEEE 1547 and Sections 4002-4008 of the DCSGIR to ensure that parallel operation ceases per the IEEE 1547 and DCSGIR requirements during Company system outages affecting the Customer's location. The Customer's Generating Facility must meet the applicable requirements of the National Electrical Code and the applicable requirements of the applicable standards issued by the Institute of Electrical and Electronic Engineers and the Underwriters Laboratories.

If the Customer fails to comply With any requirement of this Article of the Contract, the Company may terminate the Customer's service from the Company's electric system. In this event. the Customer wiU be provided With an opportunity to enter into a new net metering contract by (1) providing the Company with a notarized statement explaining the cause of the violation and evidence that the cause of the initial violation has been remedied in such a manner as to prevent its recurrence, including copies of all inspections pertom,ed on the Customer's Generation Facility; (2) fully re­qualifying With all provisions of the Commission's Rules and the net metering contract; and (3) fulfilling any reasonable requirements established by tne Company to ensure that the Company's system is adequately protected from future Violation of the Article. If the Customer and Pepco are unable to resolve any disputes as to whether the Customer has met each of the requirements to enter into a new net metering contract, the Customer may file an informal complaint with the Commission.

ARTICLE VII: METERING

The Company shall furnish, install, maintain and own all metering equipment needed for measurement of the energy supplied and received. The Company will provide one or more meters capable of "Net Energy Metering•, i.e. a meter that can register the flow of energy both from the Customer to the Company (out-flow) and from the Company to the Customer (in-flow),

ARTICLE VIII: ACCESS

Please see Access under the Level 1 Interconnection Request Application Fom, and Agreement or Right of Access under the Level 2-4 Standard Agreement for Interconnection of Small Generator Facilities of the DCSGIR, which are applicable to your generating facility based on its level of review.

DC NEM Contract 7 FINAL May 2014

DocuSign Envelope ID: AE8C8813-0260-4AF5-9C95-9551594E71C1

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ARTICL.E IX: CONTINUITY OF SERVICE

Please see Disconnection under the Level 1 Interconnection Request Application Form and Agreement or Temporary Disconnection under the Level 2-4 Standard Agreement for Interconnection of Small Generator Facilities of the DCSGIR, Which are applicable to your generating facility based on its level of reView.

ARTICLE X: GOVERNMENTAL AUTHORIZATIONS

The Customer shall obtain all governmental authorizations and permits required for operation of the Customer's Generation Facility and shall maintain all required governmental authorizations and permits required for the Customer's Generation Facility during the term hereof. The Customer shall provide copies of any such authorizations, permits and licenses to the Company in compliance with Chapter 40 of Tille 15 of the DCMR. the DCSGIR.

ARTICLE XI: INDEMNIFICATION

Xl.1. Level 1 Indemnification

The parties shall at all times indemnify, defend. and save the other party harmless from any and all damages. losses, claims. including claims and actions relating to injury to or death of any person or damage to property, demand, suits, recoveries, costs and expenses, court costs. attorney fees, and all other obligations by or to third parties, arising out of or resulting from the other party's action or inactions of its obligations under this agreement on behalf of the indemnifying party, except in cases of gross negligence or intentional wrongdoing by the indemnified Party.

XJ.2. Level 2 through 4 ("Level 2-4") Indemnity

XJ.2.1 This provision protects each Party from liability incurred to third parties as a result of carrying out the provisions of this Agreement. Liability under this provision is exempt from the general limitations on liability found in Article 6.2 of the Level 2-4 Standard Agreement for Interconnection of Small Generator Facilities for the DCSGIR.

XJ.2.2 The Parties shall at all times indemnify, defend, and hold the other Party harmless from, any and all damages, losses, claims, including claims and actions relating to injury to or death of any person or damage to property, demand, suits, recoveries. costs and expenses, court costs, attorney fees, and all other obligations by or to third parties. arising out of or resulting from the other Party's action or failure to meet its obligations under this Agreement on behalf of the indemnifying Party, except in cases of gross negligence or intentional wrongdoing by the indemnified Party.

XJ.2.3 Promptly after receipt by an indemnified Party of any claim or notice of the commencement of any action or administrative or legal proceeding or investigation as to which the indemnity provided for in this Article may apply, the indemnified Party shall notify the indemnifying Party of such fact. Any failure of or delay in such notification shall

DC NEM Contract 8 FINAL May 2014

DocuSign Envelope ID: AE8C8813-0260-4AF5-9C95-9551594E71C1

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not affect a Party's indemnification obligation unless such failure or delay is materially prejudicial to the indemnifying Party.

Xl.2.4 If an indemnified Party is entitled to indemnification under this Article as a result of a claim by a third party, and the indemnifying Party fails. after notice and reasonable opportunity to proceed under this Article, to assume the defense of such claim, such indemnified Party may at the expense of the indemnifying Party contest, settle or consent to the entry of any judgment with respect to, or pay in tun, such claim.

x1.2.s If an indemnifying Party is obligated to indemnify and hold any indemnified Party ham,less under this Article, the amount owing to the indemnified person shall be the amount of such indemnified Party's actual loss. net of any insurance or other recovery.

ARTICLE XII: ASSIGNMENT

This Contract shall not be assigned, pledged or transferred by either party without the written consent of the non-assigning party, which consent shall not be unreasonably Withheld. All assignees, pledgees or transferees shall assume all obligations of the party assigning the Contract. If this Contract is assigned without the written consent of the non-assigning party. the non-assigning party may terminate the Contract.

ARTICLE XIII: BREACH; TERMINATION

Except for termination of this contract pursuant to the second paragraph of Article VI, if the Customer at any time fails to meet any of the other requirements set forth in this Contract, Pepco may immediately tem1inate the Contract. The Company shall not be liable to the Customer for damages of any kind resulting from a tem1ination pursuant to this paragraph.

ARTICLE XIV: WAIVER

Any waiver at any time by either party of its rights with respect to a default under this Contract, or with respect to any other matters arising in connection with this Contract, shall not be deemed a waiver with respect to any subsequent default or other matter.

ARTICLE XV: MODIFICATION

No modification to this Contract shall be valid unless it is in writing and signed by both parties hereto.

ARTICLE XVI: APPLICABLE LAWS

This Contract is made in accordance with the laws of the District of Columbia and shall be construed and interpreted in accordance with the laws of the District of

DC NEM Contract 9 FINAL May 2014

DocuSign Envelope ID: AE8C8813-0260-4AF5-9C95-9551594E71C1

Page 13: Meter used to measure solar energy production

Columbia. The effective Net Energy Metering rules of the Commission are applicable to this Contract.

ARTICLE XVII: INTEGRATION

The terms and proVisions contained in this Contract between the Customer and the Company constitute the entire Contract between the Customer and the Company for Net Energy Metering and shall supersede all previous communications, representations, or agreements, either verbal or written, between the Customer and the Company regarding Net Energy Metering

ARTICLE XVIII: INTERPRETATION

If any inconsistency exists between any provision in Artides I through XVII of this Contract, Pepco may in its sole discretion choose which provision shall control.

ARTICLE XIX: SEVERASILITY

The invalidity of any provision of th is Contract shall not affect the validity or enforceability of any other provision set forth herein.

IN WITNESS WHEREOF. the parties hereto have caused this instrument to be executed, all as of the day and year first above written.

Potomac Electric Power Company

Sy:

Title: _____________ _

Date:

Net Metering customer

By:

Title: _____________ _

Date:

DC NEM Cootract 10 FINAL May 2014

Homeowner

DocuSign Envelope ID: AE8C8813-0260-4AF5-9C95-9551594E71C1

4/17/2020

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DocuSign Envelope ID: 774212E2-D307-40F2-B1DF-06B36B6BD36D

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VANDA BERNINGER2819 38TH ST NW

Washington DC 20007(202) 372-5273

[email protected]

DocuSign Envelope ID: 774212E2-D307-40F2-B1DF-06B36B6BD36D

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2819 38TH ST NWWashington DC 20007

IQ7 60-2-US12.16 12.16

9.12 9.12

REC 320N-PEAK - 320 W

IQ7 60-2-US

38

DocuSign Envelope ID: 774212E2-D307-40F2-B1DF-06B36B6BD36D

55022541316

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6/30/2020

Customer Account Number: 55022541316

DocuSign Envelope ID: 774212E2-D307-40F2-B1DF-06B36B6BD36D

Homeowner 4/24/2020

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DocuSign Envelope ID: 774212E2-D307-40F2-B1DF-06B36B6BD36D

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DocuSign Envelope ID: 774212E2-D307-40F2-B1DF-06B36B6BD36D

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DocuSign Envelope ID: 774212E2-D307-40F2-B1DF-06B36B6BD36D

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DocuSign Envelope ID: 774212E2-D307-40F2-B1DF-06B36B6BD36D

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Small Generator Facility Interconnection

Certificate of Completion Form1

Interconnection Customer Contact Information

Name: ________________________________________________________________

Mailing Address: _______________________________________________________

City: ___________________State:__________ Zip Code: ______________________

Telephone (Daytime): __________________ (Evening): ________________________

Facsimile (FAX) Number: ______________ Email Address: ______________________

Equipment Contractor Name:

Name: _______________________________________________________________

Mailing Address: _______________________________________________________

City: ___________________State:__________ Zip Code: ______________________

Telephone (Daytime): ___________________ (Evening): _______________________

Facsimile (FAX) Number: ______________ Email Address: ______________________

Final Electric Inspection and Applicant Signature

The Small Generator Facility is complete and has been approved by the local electric inspector having jurisdiction. A signed copy of the electric inspector's form indicating final approval is attached. The Interconnection Customer acknowledges that the Small Generator Facility is not ready for operation until receipt of the final acceptance of an approval by the Electric Distribution Company (“EDC”) as provided below.

Signed: ________________________________ (Signature of Interconnection Customer)

Date: __________________________________Printed Name: ____________________________Title: ____________________________________

Check if copy of signed electric inspection form is attached [ ]

Vanda Berninger

Washington DC 20007

2819 38th St NW

202-372-5273

[email protected]

Ipsun Power

9504 Poplar Leaf Ct.

Fairfax VA 22031

866-484-7786

[email protected]

Homeowner

DocuSign Envelope ID: 25982643-19C5-4CC5-AEBD-D16B8286928F

Vanda Berninger

8/14/2020

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Acceptance and Final Approval of Interconnection Installation(for EDC use only)

The interconnection installation is approved and the Small Generator Facility is approved for operation under the terms and conditions of the District of Columbia Small Generator Interconnection Rules and a duly signed and executed Interconnection Agreement.

EDC waives Witness Test: [ ] (Initial) Yes (__________) No (__________)

If not waived, date of successful Witness Test: ________ Passed: (Initial) (________ )

EDC Signature: _____________________

Date: _______________________

Printed Name: ______________________

Title: ______________________________

1The interconnection shall not be deemed complete and ready for operation until the interconnection customer has completed this form, secured the necessary attachments and signatures, returned a copy to the EDC at the EDC's designated address, and received a final signed approval form from the EDC.

DocuSign Envelope ID: 25982643-19C5-4CC5-AEBD-D16B8286928F

cac

08/17/2020

Connie Christopher

Account Coordinator

/ERM

/EBONY R MYRICK

/ASSOCIATE ACCOUNT REP

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tYdcra On-Site Inspection Record

Government of the District of Columbia Department of Consumer and Regulatory Affairs

Inspections and Complianc e Administra tion 1 HlO 4th Street SW. Washington. DC 20024 I 202-442-4400 I dcra .dc.gov

Property Address:

Site Representative:

Historic Property? yes NO (NOTI:: Thi'd Porty Companies cannot inspect Historic Properties.)

Third Party Inspection Company? DYES NO Company Name:

Inspection Type (IVR Code) I DATE \ INITIALS AND BADGE/ ID # Check reauired insnections I APPROVE I DISAPPROVE

Reauired? A WALL CHECK MAY BE REQUIRED TO BE APPROVED BY DCRA'S ZONING ADMINISTRATION

Footing (160)

Foundation (130)

Slab / Under Floor ( 178)

Framing / Pre-Cladding ( 100)

-,:, co CD <;; Energy (110) 3 5 ::. z 'llcG) Fire Rated Assembly(140 and/or

1701

Final (170)

Req uired?

I -,:, CD ,, 3 ;ij ::.m 'lie

Req uired?

7J (1)

Unit Number:

Phone#:

Parent Building Permit:

Company Certification#:

Inspection Type (IVR Code) Check required insoections

Reauired? Ground Work (400)

I -,:, Rough-in (410) -,:, r-CD C 3~ - · co ;z Rnal (430)

G)

Gas Line/ Gas Test (485)

Required?

I D Rough-in (360) ~p;\ 3~

D Final (380) 'lie()

Required?

i~ D Ground Work (225)

Rough-io, (215)

' /

~ al(200) )>

~r-TPF (230)

Reauired?

I ::, Building Rnal (715)

-a () Elevator Certificate Verified 3 (1) 0 (") - Boiler Inspection Verified :5·0 ::,

D Zoning Use (7 45) "'

Text A. B. C or D to (202) 849-7694. How would you rote the

inspection process? A) Very Good B) Good C) Poor D) Very Poor

DATE INITlALS AND BADGE/ ID # APPROVE DISAPPROVE

-~ ¾ M'2.0"ZX

Construction hours In the District of Columbia are Monday - Saturday from 7:00 am - 7:00 pm. Customers must apply for an afterhours permit to work beyond these legal construction hours. A full list of no construction holidays can be found on our website at:

dcra.dc.gov /page /no-constructlon-allowed-holldays. \/ER l.6 ll'ebruory 2018)

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