Customer Signature. We hereby agree to subscribe to the abovementioned services on the terms and subject to the conditions contained in the Master ICO Agreement and the Service Schedule for the abovementioned services, which terms and conditions shall apply upon Nucleus Connect’s acceptance of this application. We certify that all information provided by us herein are true, correct and complete. Further, we agree that any cancellation of the abovementioned services may result in a charge to us at Nucleus Connect’s prevailing rates. Signature of Authorised Officer Date Company Stamp For Nucleus Connect Use Application Rejected: Reason for rejection: Application Accepted Service ID/s: Work Order No.:
Customer Signature. I hereby certify that: 1) I have read and understand the terms and conditions which are attached hereto by reference and are a part of this Agreement; 2) I hereby agree to comply with the attached terms and conditions; and 3) to the best of my knowledge, all of the information provided in this application request form is complete and true. I consent to permit the PSC and interconnecting utility to exchange information regarding the generating system to which this application applies. Interconnection Customer Signature: Date: _ Printed Name: Title: ………………………………………………………………………………………………… Conditional Agreement to Interconnect Small Generator Facility (for EDC use only) Receipt of the application fee is acknowledged and, by its signature below, the EDC has determined the interconnection request is complete. Interconnection of the small generator facility is conditionally approved contingent upon the attached terms and conditions of this Agreement the return of the attached Certificate of Completion duly executed, verification of electrical inspection and successful witness test or EDC waiver thereof. EDC Signature: _ Date: Printed Name: Title: Level 1 Interconnection Agreement Terms and Conditions for Delaware Interconnection (Lab Certified Inverter-Based Small Generator Facilities Less than or Equal to 10 kW)
Customer Signature. I hereby certify that: 1) I have read and understand the terms and conditions which are attached hereto by reference and are a part of this Agreement; 2) I hereby agree to comply with the attached terms and conditions; and 3) to the best of my knowledge, all of the information provided in this application request form is complete and true. I consent to permit the PSC and interconnecting utility to exchange information regarding the generating system to which this application applies.
Customer Signature. I hereby certify that: (1) I have read and understand the terms and conditions which are attached hereto by reference; (2) I hereby agree to comply with the attached terms and conditions; and (3) to the best of my knowledge, all of the information provided in this application request form is complete and true. Applicant Signature: Title: Date: ………………………………………………………………………………………………………
Customer Signature. Provide the name, title, and signature of the individual completing this form and the date.
Customer Signature. I agree to be bound by the terms and conditions of this Agreement and the applicable Contracts as noted above. Customer Signature: Date:
Customer Signature. I hereby certify that, to the best of my knowledge, all of the information provided in this application is true and I agree to the Terms and Conditions on the following pages: Interconnecting Customer Signature: Title (if Company): Date: Please return this document to: Marblehead Municipal Light Department, XX Xxx 000, Xxxxxxxxxx, XX 00000 Approval to Install Facility (For MMLD use only) Installation of the Facility is approved contingent upon the terms and conditions of this Agreement, and agreement to any system modifications, if required (Are system modifications required? Yes No ). Company Signature: Title: Date:
Customer Signature. I hereby certify that: 1) I have read and understand the terms and conditions which are attached hereto by reference and are a part of this agreement; 2) I hereby agree to comply with the attached terms and conditions; and 3) to the best of my knowledge, all of the information provided in this application request form is complete and true. Interconnection Customer Signature: Title: Date: Conditional Agreement to Interconnect Small Generator Facility By its signature below, the EDC has determined the interconnection request is complete, and that the Small Generator Facility has the Approval to Install. This approval is contingent upon the attached terms and conditions of this agreement, the return of the attached Certificate of Completion duly executed, and the verification of electrical inspection and successful witness test or EDC waiver thereof. EDC Signature: Date: Printed Name: Title: Terms and Conditions for Interconnection
Customer Signature. By signing below I acknowledge that I have read and agree to all terms and conditions outlined in this hire contract and will follow excavator safe work procedures and safe work Australia’s excavation code of practice. Customer Name: Machinery Type: Additional Attachments: Hire commencement Date: Date machinery to be returned:
Customer Signature. We hereby agree to subscribe to the abovementioned services on the terms and subject to the conditions contained in the Master ICO Agreement and the Service Schedule for the abovementioned services, which terms and conditions shall apply upon Nucleus Connect’s acceptance of this application. We certify that all information provided by us herein are true, correct and complete. Further, we agree that any cancellation of the abovementioned services may result in a charge to us at Nucleus Connect’s prevailing rates. Signature of Authorised Officer Date Company Stamp
