CONTRACT 4941K Other SOUTHERN CALIFORNIA Agreement No. 4941 K
EDISON® 2016 Direct Install Program
Partnerships Customer Authorization Form
An EDISON INTERNATIONAL®Company
Please review,complete,sign and submit this form authorizing an SCE-approved Consultant to perform the services outlined below.
Customer Name Service Account Name J Y.a
/
Contact Name, - �"L ''",Ttl Service Account Number,,. / ✓ � '.
Contact Title J'./ 1 t 11Lx'I'-le Service Address
This Customer Authorization Form is entered into by the Customer listed above in connection with Southern California Edison's(SCE)Third
Party ImplementedTurnkey Program(Program).
(use'Contact Name'listed above))/p representative of Customer,am duly authorized to sign
this Authorization on behalf of Customer.Customer hereby authorizes / ` .W..d' (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,after a competitive solicitation, 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 are subject to change without notice.
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 meetthe following requirements to be eligible forthe 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 outthe 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 the Work performed and that this expense will be
charged to the Partnership budget allocated to my City,County or Partnership.Partnership programs may count energy savings associated
with the Worktowards their goal achieve ent.This initiative is limited in funding and is in conjunction with SCE's Commercial Direct Install
(DI)program.All terms and condition the Co mercW Direct Install program apply to Partnerships customers.
AGREED AND ACCEPTED: i
Customer Signature Date
. r
tFES,S 1P�il ',rIXY' p " lM, �i F�""�. ` V ,,✓ d"„,;�A'” p,i.
for r,..wr a scow wa¢awra r V, ', G' o
CITY A ",'° i, w CRILlghling&Electrical FESSCOmpto�lrarrotvdEnarylya FCl Management Cansvifowv ,.¢ „ "j<Y,,t..j.j'��
579 North Brasher Street•Anaheim,CA 92807 921 S.Lake Am,,%pha lot-,Paodana.CA 91101 3850 E.Gilman Street•Long Beach,C ° !
A.9091'5.
www.C&NOMM46"a .eom http.11%s"nerWcomnndea htm www.drngteorn '
Direct Install Program is funded by California ratepayers and administered by SCE under the auspices of the California Public Utilities Commission.
For further information,please contact SCE at(800)736-4777
NR-402-Vl-0913
White-SCE Canary-Vendor Goldenrod-Customer r-gang
A�reement No. 4941 K
utility Direct Installation:Prt3Bralrn- urvev Worksheet UDdatte 01103 7
Room Description: Date: 2/22/2017 By: 1S
Business Name: El Segundo Library SAN: 3000900944 ID: 20081
Service Account Name: El Segundo,City of Rate: GS-2 Op Hours: 2288
SAN Address: I I I W..Mariposa Ave.,El Segundo,90245
Contact Name: Greg Carpenter Position: City Manager Language: English
Business Phone: (310)524-2365 Contact Phone: Segment:HM LO SO L is M LIre GS SCH UNIV CC MISC
Area: 6,500 Volt: 120 Hr. 18 FC: NA Cust Signature: p y
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Agreement No. 4941 K
SCE DIRECT INSTALLATION PROGRAM 2013 SURVEY WORKSHEET
BUSINESS NAME: EI Mundo Public ID#
Library
San:# 3000900944 OP HR. 3848
BUSINESS HOURS: 9a-9p M-Th/10a-5p E-S DATE: 10.30.15
IICONVERTION#S 111- 2L 14L 1 1 2331 I I 1 I I 1 I
LOCATION
1st Floor
Fixtures(Books) 1 11 66 287
RR:M/W 2 4
3rd Flood _ p
Book Storage 2 7 32 V
U
Basement 2 1 4
Stairwell Down 1 2
N
Downstairs
RR:M/W 8 16
i
Meeting Rm. 1 2 Y
Toy&Chair Storage - 5 10
Book Storage 2 ,
Childs Library 24 96
NNII I
TOTAL 3 32 97 0 455 0 0 0 0 0 0 0 0 0 0 0
A/C Working Y/N
SCHEDULE APPT: YES/NO IC,Ma'8°YPE",A dbMUSTI /A✓C A dI LPS'T't..
PREFERRED INSTALL
NOTES:
E-MAIL: @