Community Solar Garden Program Form Application Instructions The completed application and associated forms must be sent electronically to LPEA at: CommunitySolarGardenApp@lpea.coop Community Solar Garden (CSG) applications must be received by LPEA no later than December 31, 2013. The Application Deposit of $50 per kw of planned CSG capacity, and the required formssigned, must be delivered to LPEA s Durango or Pagosa Springs office within 1 week of when the application has been electronically submitted, but in no event later than December 31, 2013. Applicant should plan on making a five minute presentation to the LPEA Board of Directors at one of their regularly scheduled committee or board meetings in one of the two months following this deadline. LPEA s Policy 366 and the CSG Program Requirements were approved on September 18, 2013 by the Board of Directors. The CSG Policy, CSG Application, form CSG Contract and Program Requirements as amended can be obtained on LPEA s website www.lpea.coop, or by visiting LPEA s Durango or Pagosa Springs offices. The CSG must have a nameplate value of greater than 50kW and no greater than 500kW as detailed in the Program Requirements. If you have any questions about these limitations, other program requirements, or filling out this application form, contact LPEA at (970) 382-3511, or via email at CommunitySolarGardenApp@lpea.coop. Version 1.0 1
In addition to filling out the application, please include the following information: Documentation that Subscriber Organization is a legal entity recognized by Colorado law. Executive Summary for the CSG Project including content of the proposal and features of the CSG program offered. General description of the program, the anticipated commercial production date, the predicted monthly energy production, key energy production assumptions used, and any unique aspects or benefits of the project. Details on the percentage of project subscribed as of application submission date, the initial membership costs, and how additional members will be obtained. Description of any LPEA member ownership of the CSG. Demonstration of adequate project financing. Documentation demonstrating ownership and control of the CSG location site. Description of Operations and Maintenance funding through the life of the project. Description and documentation of warranty provisions for CSG equipment. Description of how sufficient funds will be available for equipment replacement or site reclamation at end of project life. Description of steps required and taken to obtain necessary governmental approvals and permits. Description of applicable experience in previous project development. Documentation of LPEA engineering review, including details of any necessary changes to the existing grid needed for the CSG and to be paid by the Subscriber Organization per LPEA s Line Extension Policy. Brief schedule of project development activities and completion dates for engineering, permitting (any zoning or special use permits), construction, and commissioning. Evidence of non-profit Subscriber s good standing with the Colorado Secretary of State, its LPEA account number, and the energy offset its membership in the CSG is projected to provide it. Description of the system including orientation, PV module make and model, inverter make and model, name of online monitoring service and its website address. Description of the Subscriber Organization's method for compiling the required monthly reporting to LPEA as detailed in the Program Requirements. A spreadsheet listing name and LPEA account number of all subscribers committed to date. Any additional information deemed appropriate by applicant that may be helpful in reviewing the CSG application. Version 1.0 2
Community Solar Garden Application La Plata Electric Association, Inc. P.O. Box 2750 Durango, Colorado 81302 As the Community Solar Garden (CSG) Subscriber Organization s primary representative, I attest to the truthful and accurate information provided and submitted for this CSG Application in accordance with La Plata Electric Association (LPEA) Policy 366 Community Solar Garden Program and the approved CSG Program Requirements. The information contained in this application and accompanying documents is for the purpose of obtaining approval from LPEA for the development and operation of a CSG by the Subscriber Organization. The undersigned understands that the information provided herein is used in evaluating the CSG Application, and the undersigned represents and warrants the information provided is true and complete, and that the LPEA Board of Directors may consider the application as continuing to be true and correct until a written notice of change is provided. The CSG Application reviewers and the LPEA Board of Directors are authorized to make all inquiries they deem necessary to verify the accuracy of the statements made herein. As the Community Solar Garden (CSG) Subscriber Organization s primary representative, it is understood that the CSG program and the CSG Program Requirements shall be subject to and conform with contractual obligations of LPEA and all pertinent rules, regulations and laws. Applicant / Subscriber Organization: Application Submission Date: Primary Representative Name: Primary Representative Signature: (Print, sign, and deliver this page with your application deposit.) LPEA Representatives Name (print): LPEA Representatives Signature: Date Application Received by LPEA: Version 1.0 3
Community Solar Garden Contracts & Agreements CSG Contract Interconnection Agreement Engineering Work Order Power Purchase Agreement Renewable Energy Credit (REC) Contract As the Community Solar Garden (CSG) Subscriber Organization s primary representative, I attest to the truthful and accurate information provided and submitted for this CSG Application, including that: All contracts and agreements with LPEA specified above have been reviewed and are acceptable to the CSG Subscriber Organization. All Subscribers have read and agree to the LPEA Board approved Policy 366 Community Solar Garden Program and the CSG Program Requirements. All Subscriptions represent no more than 120% of the Subscribers current annual consumption of electricity for their meter. All Subscribers understand that LPEA shall account for the net metering kwh credit against their electric bill within 30 days after the monthly data report is provided by the CSG Subscriber Organization. Applicant / Subscriber Organization: Application Submission Date: Primary Representative Name: Primary Representative Signature: Version 1.0 4
Applicant Information Applicant / Subscriber Organization: Employer Identification Number (EIN): Applicant Primary Representative: Title: Email Address: Phone #: Address: City & State: Zip: Mailing Address: City & State: Zip: Applicant Secondary Representative: Email Address: Phone #: List three references: Name Phone Email: Address: City/State Zip Name Phone Email: Address: City/State Zip Name Phone Email: Address: City/State Zip Version 1.0 5
Community Solar Garden (CSG) Information Project Name: Site / Service Address: DC Nameplate kw Capacity: Builder/Constructer Name: Phone #: Builder / Constructer Address: Owner Name: Phone #: Owner Address: Operator Name: Phone #: Operator Address: Estimated Commercial Production Date: Estimated Annual Generation of CSG (kwh): Percentage of CSG Subscribed (as of Application Submission Date): % Version 1.0 6