Legal Information Document

Distributed Generation Interconnection Application

Legal Information Document

The information provided in this document will be used to draft (or revise) the Interconnection Service Agreement for the distributed generation system. Please ensure that the information provided is acceptable for use in a legally-binding contract and is sufficient for issuing financial invoices/receipts.

1) / This legal information is being submitted:
Accompanying a new application To update an existing application
If this is an update, please provide the application number(s):
2) / Host Account:
a)Account number with the generation equipment behind the meter:
b)Legal name of the Host Customer:
c)Is the Host Customerthe customer of record (i.e. named on the electric utility bill) for the account listed above?
Yes No
d)If the Host Customer is requesting Net Metering Service, does the Host Customer information on the Schedule Z (in MA) or Schedule B (in RI) match the information above?
Yes No N/A (not net metered or Schedule Z/B not submitted yet)
3) / Host Customer Details:
a)Type of organization for the Host Customer (as listed in question 2):
Residential Customer Limited Liability Corporation 501(c)(3)
Municipality Governmental Entity Other:
b)Complete address of the principal place of business/residence for the Host Customer:
c)Contact information for any notices that must be issued to the Host Customer
Attention:
Street Address:
City:
State: Zip:
Phone Number:
Email:
4) / Is the Host Customer the same legal entity as the Interconnecting Customer (i.e. owner/operator of the generation equipment)? Yes No
If No, fill out question 5. National Grid will provide an Interconnection Service Agreement (Exhibit G) to be signed by the Interconnecting Customer and a Retail Customer Agreement (Exhibit H) to be signed by the Host Customer.
If Yes, skip to question 6.National Grid will provide an Interconnection Service Agreement (Exhibit G) to be signed by the entity that is both the Interconnecting Customer and the Host Customer.
5) / Interconnecting Customer Details:
a)Legal name of the entity that will own and/or operate the generating system:
b)Type of organization for system owner/operator:
Residential Customer Limited Liability Corporation 501(c)(3)
Municipality Governmental Entity Other:
c)Complete address of the principal place of business/residence for the system owner/operator:
d)Contact information for any notices that must be issued to the system owner/operator:
Attention:
Street Address:
City:
State: Zip:
Phone Number:
Email:
6) / Invoice Instructions:
a)Invoice(s) related to this interconnection should be sent to:
Interconnecting Customer
Host Customer
ElsewherePlease provide additional information below in parts b & c.
b)Additional instructions for invoices related to this interconnection application:
c)Contact Information for Invoice(s):
Attention:
Street Address:
City:
State: Zip:
Phone Number:
Email:
7) / Change of Interconnecting Customer:
a)Has the legal name of the Interconnecting Customer changed since the Interconnection Service Agreement was last amended (or since the application was submitted if the Interconnection Service Agreement has not been executed)?
Yes No(skip question 7b)
b)Has the Interconnecting Customerprovided National Grid with appropriate notice as required by the Interconnection Tariff describing the transfer of system ownership and responsibilities to the new Interconnecting Customer?
Yes No

8) Landowner Details:

a)Is the location of the proposed property and generationowned or operatedby either the Host or the Interconnecting Customer? Yes No

If No, fill out part 8b.The landowner must fill out and sign a Landowner Consent Agreement (Exhibit I), which will be provided as part of the Interconnection Service Agreement.

If yes, do not fill out part 8b.

b)Contact informationfor the Landowner:
Attention:
Street Address:
City:
State: Zip:
Phone Number:
Email:

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