Portfolio Energy Credit Application For Renewable Energy System Generators NAC 704.8901 — 704.8937

Legal Name of Owner/Applicant (Company Name)

Telephone Number E-Mail Address

Mailing Address

City

State Zip

Name of Designated Representative

Telephone Number E-Mail Address

Mailing Address

City

State Zip

Name of Facility Contact (Person Reporting Production)

Telephone Number E-Mail Address

Mailing Address

City State Zip

Portfolio Energy Credit ApplicationFor Renewable Energy System GeneratorsNAC 704.8901 – 704.8937

Legal Name of Owner/Applicant (Company Name)

Telephone Number E-Mail Address

Mailing Address

City State Zip

Name of Designated Representative

Telephone Number E-Mail Address

Mailing Address

City State Zip

Name of Facility Contact (Person Reporting Production)

Telephone Number E-Mail Address

Mailing Address

City State Zip

Portfolio Energy Credit Application For Renewable Energy System Generators NAC 704.8901 — 704.8937

Generator Information

Facility/Generator Name

Physical Location of Facility

City

State Zip

System Type: 0 Solar Electric 0 Solar Thermal (Biomass

❑ Geothermal ❑Wind ❑Other

Explain Other:

Location and Function of Each Meter

Rated Nameplate Capacity (kW):

Commercial Operation Date:

Begin Testing Date:

Estimated Yearly Production (kWh):

Percent of Fossil Fuel used as an energy source (if applicable):

Net Meter Number:

Gross Meter Number:

Primary Meter Number: (Provide documentation for complicated scenarios)

Portfolio Energy Credit ApplicationFor Renewable Energy System GeneratorsNAC 704.8901 – 704.8937

Generator Information

______________________________________________________________________________Facility/Generator Name

Physical Location of Facility

City State Zip

System Type: Solar Electric Solar Thermal Biomass

Geothermal Wind Other

Explain Other: ___________________________________________

Location and Function of Each Meter

Rated Nameplate Capacity (kW): _________________________________________________

Commercial Operation Date: ____________________________________________________

Begin Testing Date: ___________________________________________________________

Estimated Yearly Production (kWh): ______________________________________________

Percent of Fossil Fuel used as an energy source (if applicable): _________________________

Net Meter Number: ____________________________________________________________

Gross Meter Number: __________________________________________________________

Primary Meter Number: ________________________________________________________(Provide documentation for complicated scenarios)

Portfolio Energy Credit Application For Renewable Energy System Generators NAC 704.8901 — 704.8937

1. Attach: a) A copy of each business license and certificate issued by the State of Nevada

and any local government within Nevada authorizing the applicant to conduct business.

b) A map showing the location of the facility. c) An electrical one-line diagram showing the facility's interconnection points

with the local distribution or transmission system and the location of all generation units.

2. Provide documentation demonstrating that the renewable energy system meets the eligibility requirements set forth in NRS 704.7815.

3. Provide documentation of any other trading program this facility trades through.

4. If any information in the application changes, the applicant must notify the Commission and supply updated information within 30 days of the occurrence of the change.

OATH

I, [name of signatory] , on behalf of [name of applicant] declare under penalties of perjury, that in such capacity, I am qualified and authorized to file and verify such application; that I have carefully examined all the statements and matters contained in the application; and that all such statements made and matters set forth therein are true and correct to the best of my knowledge, information and belief. Declarant further states that the application is made in good faith, with the intention of presenting evidence in support thereof in every particular. Declarant further declares that the applicant agrees to submit to the jurisdiction of the Public Utilities Commission of Nevada for the purpose of participating in the renewable energy credit trading program. Furthermore, the declarant declares that the applicant's renewable energy system has not been built with the benefit of any rebates, incentives (i.e., Solar Generations), or any other discounts that have disqualified the applicant from receiving portfolio energy credits.

Printed Name:

Title:

Date:

Signature:

Portfolio Energy Credit ApplicationFor Renewable Energy System GeneratorsNAC 704.8901 – 704.8937

1. Attach:a) A copy of each business license and certificate issued by the State of Nevada

and any local government within Nevada authorizing the applicant toconduct business.

b) A map showing the location of the facility.c) An electrical one-line diagram showing the facility’s interconnection points

with the local distribution or transmission system and the location of allgeneration units.

2. Provide documentation demonstrating that the renewable energy system meets theeligibility requirements set forth in NRS 704.7815.

3. Provide documentation of any other trading program this facility trades through.

4. If any information in the application changes, the applicant must notify theCommission and supply updated information within 30 days of the occurrence of thechange.

OATH

I, [name of signatory] _________________________________, on behalf of [name of applicant]_______________________________ declare under penalties of perjury, that in such capacity, Iam qualified and authorized to file and verify such application; that I have carefully examined allthe statements and matters contained in the application; and that all such statements made andmatters set forth therein are true and correct to the best of my knowledge, information and belief.Declarant further states that the application is made in good faith, with the intention of presentingevidence in support thereof in every particular. Declarant further declares that the applicantagrees to submit to the jurisdiction of the Public Utilities Commission of Nevada for the purposeof participating in the renewable energy credit trading program. Furthermore, the declarantdeclares that the applicant’s renewable energy system has not been built with the benefit of anyrebates, incentives (i.e., Solar Generations), or any other discounts that have disqualified theapplicant from receiving portfolio energy credits.

Printed Name: _____________________________________

Title: _____________________________________

Date: _____________________________________

Signature: _____________________________________