CONTRACT 4941A Other" SOUTHERN CALIFORNIA
E D I S O N" 2015 Direct Install Program'
An EDISON INTERNATIONAL &C ,p16Y Partner Authorization Form
Please review, complete, sign and submit this form authorizing an SCE - approved Consultant to perform the services outlined below.
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Customer Name Service Account Name
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Contact Name / Title _) Service Address _f_d
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This Customer Authorization Form is entered into by the Customer listed above in connection with Southern California Edison's (SCE) Third Party
Implemented Turnkey Program (Program).
I, (use 'Contact Name' listed above) a e esentative of Customer, am duly authorized to sign this
_. _ ._
Authorization on behalf of Customer. Customer hereby authorizes ................................................. = (Consultant) to conduct an Energy
Survey of Customer's facility and to replace and /or install energy efficiency equipment "recommended by Consultant as a result of the Energy Survey
(collectively, the "Work"), Customer understands that Consultant has been pre- approved by SCE to perform the Work and that the Work will be performed
at no cost. Customer agrees that all of the Work shall be subject to all terms and conditions of this Authorization and of the Program.
Customer agrees to provide Consultant reasonable access to Customer's facility for the Work, including the Energy Survey and replacement and /or
installation of the recommended energy efficiency measures. Customer further agrees to provide SCE and Consultant (or other SCE consultants)
reasonable access to Customer's Facility for all inspections or verifications of such Work as may be required by SCE in its sole discretion.
Customer acknowledges that SCE will provide up to $10,000 in services and equipment per Service Account for accounts with demands of 0 -99 kW, or up
to $15,000 per Service Account for accounts with demands of 100 -199 kW. Project caps subject to change. Program funding is limited and is available on
a first -come, first - served basis until funding is depleted or the Program is terminated.
Customer must meet the following requirements to be eligible for the Program: (1) Facility site must be a nonresidential active SCE customer and the
facility must be located within SCE's service territory; (2) SCE Customers must pay the Public Purpose Programs Charge ( "PPP ") on the SCE electric
meter where the Work is to be performed; (3) Customer certifies that Customer has not and will not receive any funds from any other energy conservation
program funded by the PPP for the same energy savings components installed under this Program; and (4) Customer and all Work must meet all other
Program requirements, terms and conditions;
Customer acknowledges that connected load at Customer's facility may increase if the Work involves replacing burned out or missing lamps.
Customer hereby agrees that SCE makes no warranty, expressed or implied, with respect to the Work, including without limitation the implied warranties
of merchantability and fitness for a particular purpose. Customer agrees to hold harmless SCE, its officers, directors, affiliates and employees, from and
against any and all liability, damages, losses, claims, demands, actions, costs, including attorneys' fees and expenses and all court or arbitration or other
dispute resolution costs, or any of them, resulting from, arising out of, or in any way directly connected with Work performed by Consultant. Customer
hereby agrees to hold the Consultant solely responsible for any and all claims, losses, liabilities, damages and expenses, including attorneys' fees and
costs, which Customer may incur as a result of the Work. Customer is solely responsible for ownership of the equipment and services under the Program.
Items installed are warranted by Consultant for one year.
Customer agrees that SCE may provide Customer's contact information to Consultant (and other SCE consultants) for the exclusive purpose of carrying
out the Work and the Program. Customer acknowledges that Consultant has been authorized to contact Customer only with regard to performing the
Work, and that any other services, installations, improvements or equipment provided to Customer by Consultant have not been authorized by SCE, and
SCE assumes no responsibility therefore,.
By signing below, I acknowledge that SCE will reimburse the installing contractor for services performed pursuant to the Program and that this expense
will be charged to the Program budget allocated to my City or County. I also acknowledge that any energy savings associated with the Work done
pursuant to this Program will not count toward the Customer's tier level advancement in the Energy Leader Partnership Program, The funding for this
Program is limited. The Program is offered in conjunction with SCE's Commercial Direct Install (DI) program, All terms and conditions of the Commercial
Direct Install program apply to Customer and the Work to be performed pursuant to this Program.
AGREED AND ACCEPTED:
Customer Signature _ �, .�� '. .__..... tw,_ _________ _________ �_. �.......__... ........._________..._wa. -. -.e.
SShighf�ng & ^n I tI I L U��
EleCh'cd 1 .r �,,,c
APPROVED AS TO FORM:
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� CITYATTOR\EY City-Clerk d
Direct Install Program is funded by California ratepayers and administered by SCE under the auspices of the Califorr�digthQg�{gptp�iprsion. For further
information, please contact SCE at (800) 736 -4777. e.• �I jyl V � �vl s uull IILLf(VV
N R -402 -V 1 -0913
White - SCE Canary - Vendor Goldenrod - Customer C -5608
(lifi ft Dired Ins ta I I a I ion P myram: - Survev Worksh cc t Cndate 08101115
Rooin Destoilplion Dal.e� 1.0/30/2.015 By� Js
Bltsmess.";arne. Jos yu Senior Celitcl SA,"': 3000006090 ID
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Set vice Accouirit Name L11 Segundo, City of Rate GS-2 Op I lotu s: fl60
S:!4 ' Ad'drow 331 Shelldon St Ei Segiffido, 90245
Cott lau Name Ifol,'w1d; hi file Posiltion 1,K5 i Aijalyst karigij;tge English
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