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On Grid Residential Solar Application

This document is an application for a residential solar electric system through UNS Electric. It collects information about the customer, proposed solar PV system specifications, rebate and payment options. If approved, UNS will perform annual inspections to ensure safe and efficient operation of the system. The customer authorizes payment of rebates to the installing contractor to offset system costs.

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87 views3 pages

On Grid Residential Solar Application

This document is an application for a residential solar electric system through UNS Electric. It collects information about the customer, proposed solar PV system specifications, rebate and payment options. If approved, UNS will perform annual inspections to ensure safe and efficient operation of the system. The customer authorizes payment of rebates to the installing contractor to offset system costs.

Uploaded by

sandyolkowski
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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ACC APPROVED 4/10/08

UNS ELECTRIC, INC.


ON-GRID
RESIDENTIAL SOLAR ELECTRIC APPLICATION

Customer Information

Name ____________________________________________________________________________________
Street Address _____________________________________________________________________________
City ________________________ , State __________ Zip Code _________________________________
Mailing Address (If different from above) _______________________________________________________
Daytime Phone Number ________________________________ Cell Number _________________________
E-mail Address:________________________________________ Account Number ______________________
Operating Agent if different from Customer _______________________________________________________

Solar - PV System Information

Module Supplier Name _____________________________ Nameplate DC Rating ________________watts


Module Manufacturer _______________________ Type ___________ Quantity of Modules ______________
Module Warranty _______________years. (Copy of warranty must be on file with UNS Electric, Inc.)
Inverter Make and Model Number _____________________________________________________________
Inverter Warranty years. (Copy of inverter warranty must be on file with UNS Electric, Inc.)
Total Cost ___________________ PV Cost _________________ Labor Cost _____________________
Estimated Installation Date (Must be completed within 180 days) ______________________________________

System Qualifications
The system must meet the requirements outlined in Attachment A and Attachment B of the On-Grid Residential
Solar Up Front Incentive or Attachment A of the Performance Based Incentive Agreements.

Rebate Calculation – Office Use Only

Rebate Calculation: Nameplate Rating DC Watts x Quantity of Modules = System Size (DC
Watts) _______________.

UFI Calculation for residential projects with a 10 year inverter warranty.


Rebate Calculation: System Size (DC Watts) x $3.00 = _______________________
Rebate Calculation for Self-Install: System Size (DC Watts) x $3.00 x 70% = ___________

1
ACC APPROVED 4/10/08
UFI – Residential BIPV 5 kW DC or less
Rebate Calculation: DC Watts (System Size) x $________ x 90% = (UFI)

PBI Calculation for residential projects with less than a 20 year module warranty or less than a 10 year inverter
warranty or for residential projects with a BIPV system over 5 kW DC .

Term of REC Agreement _____ 10 YR/$.202 _____ 15 YR/$.187 _____ 20 YR/$.180


Estimated annual energy production of system kWh x PBI amount $/kWh = PBI
Will payment be assigned to the installer or dealer of the qualifying solar system? _ _ Yes __ No

UNS Electric’s rebate cannot be more than 60% of system cost. Customer must pay at least 15% of system cost.

Customer Reservation Bid


Customer may elect to use maximum PBI payback listed in the Project Incentive Matrix of the RECPP or choose
a smaller PBI amount that will be more competitive in the period ranking system.

Project Information

Has a City/County Permit been secured? Yes No


Is this an application for Net Metering: Yes No (Net metering applies to systems 10 kW AC or less)
Does this installation meet all ACC Interconnection/REST requirements? Yes No

Installer Information

Installer/Dealer Name _______________________________________________________________________


Business Address __________________________________________________________________________
Arizona Registrar of Contractors (AZROC) License Information
AZROC License Number ________________ Class _____________ Expiration Date _________________
Contractor’s License ____________________ Class ____________ Expiration Date __________________

Assignment of Payment
I authorize UNS Electric, Inc. (UNS Electric) to issue, on my behalf, my full rebate to the following installer/dealer
as payment toward the cost and/or installation of my PV system. I acknowledge that the payment made to the
below named installer/dealer satisfies the financial obligation to me in connection with the Agreement signed by
myself and UNS Electric.

Installer/Dealer Name _______________________________________________________________________


Contact Person ____________________________________________________________________________
Business Address __________________________________________________________________________
Customer Signature __________________________________________ Date _________________________

2
ACC APPROVED 4/10/08
Inspection Authorization

UNS Electric will perform an annual inspection on your system, and at its option, may perform periodic
inspections to ensure it is operating efficiently and safely.

Authorization Agreed 
Authorization Denied 

There are animals in the yard that the Program Inspector needs to be aware of: Yes No

Please return completed application and Renewable Energy Purchase Agreement to:

UNS Electric, Inc.


Energy Services Department
PO Box 3099
Kingman, AZ 86402-3099

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