California Solar Initiative (CSI) Program

System Description Worksheet

Section A.

Reservation Number (if unknown, leave blank):
Host Customer Name (per Reservation Request Form):
Site Address (Street Address, City, State, Zip):
Name of Person Completing This Form and Title:
Company Name:
Telephone Number:
Email Address:

Section B.

Please provide complete answers to all of the following questions regarding the proposed Project requesting a reservation under the CSI Program.

  1. Is there any existing generation at this Site, including nonfunctioning and/or emergency back-up generation?

Yes No

If yes, does any of this existing generation serve to export electricity for sale, either with an “over-the-fence”, or other wholesale arrangement (e.g., qualifying facility contract)?

Yes No

  1. Describe the location of the major system components on the site (e.g., PV system will be located on the existing administration building’s roof) and attach a copy of a site or plot plan if available.
  1. At what stage of development is this Project currently in and is new building construction or major renovation also involved?

Conceptual planning Signed contract for equipment purchase System installed

New construction Major renovation/facility expansion

  1. What is the estimated date of Project completion (all equipment being claimed as an eligible cost is installed, interconnected, permitted and operational)? Est. project completion date: ____/_____/____
  2. Have the necessary interconnection application(s) already been submitted to the serving local distribution company(s)?

Yes No (estimated date of application: ____/_____/_____)

  1. If the Host Customer will not be the owner of the PV system after it is installed, describe the contractual arrangement between the System Owner and Host Customer, including duration of contract and cancellation policy (attach additional copy of contract).
  1. Does the Host Customer named above have legal ownership of the building and/or property where the proposed PV system will be located?

Yes No

If no, please indicate who does own the building and/or property, the contractual relationship with the
Host Customer and the contract period.
  1. Is the Host Customer or Applicant aware of any plans to potentially sell, transfer or relocate the proposed PV system and/or the buildings or property where the PV system will be located, before the CSI required warranty period ends (i.e., ten years after the system is installed)?

Yes No

If yes, please describe
  1. Will the portion of the Project costs not covered by the CSI rebate require outside financing by the Host Customer?

Yes No

If yes, please indicate the planned source of financing:

____ Seller of System, ____ Government Agency, _____ Commercial Lender, ____ Undecided

  1. Are there other financial incentives with regards to this Project?Examples of other incentives include but are not limited to: other program rebates, grants and gifted equipment.

Yes No

If yes, please describe and attach copies of agreement(s) involved.
  1. Are there any post-sale agreements or contracts anticipated as part of either the sale or lease of this system between either the seller/installer, the system owner and/or the Host Customer which go into effect after the initial sale is made (e.g., cash payment(s) to Host Customer for agreeing to allow seller/installer to use system in a sales or promotion campaign, cash payment(s) to Host Customer if system does not perform to a certain level, anticipated sale of Renewable Energy Credits (RECs) or Green Credits, forgiven loans, performance payments, etc.)?

Yes No

If yes, please describe and attach copies of agreement(s) involved.

I hereby certify that the answers provided to the questions above are complete and accurate to the best of my knowledge. I am signing on behalf of the:

ApplicantHost Customer System Owner

Signature:
Company Name
Date:

Last Printed 12/28/06Page 1 of 2CSI_System_DescriptionNew (2).doc