Distributed Energy Resources
AMENDMENT TO EXISTING AGREEMENT
This Amendment No.
(“Amendment”) is entered into by and between Hawaiian Electric Company, Inc. (“Company”) and the “CustomerGenerator” referenced herein, and amends that certain Distributed Energy Resources Agreement (“Agreement”) dated
as stated
herein. As hereby amended, the Agreement is hereby ratified and confirmed and shall remain in full force and effect, subject to all of the terms,
covenants and conditions therein and herein set forth. This Amendment is effective as of
.
This Amendment may be executed in two or more counterparts, each of which is deemed an original but all constitute one and the same instrument
binding all Parties not withstanding that all of the Parties are not signatories to the same counterparts. Signatures may be provided in original (“wet”)
form or by other means intended to preserve the original graphic and pictorial appearance of the signature, such as a photocopy. A copy of a Party’s
signature shall be considered an “original” signature for purposes of this Amendment.
PROGRAM
NEM
CGS
CSS
Agreement ID:
How was the Amendment to Existing Agreement obtained?
Company website
Company representative
Previously provided
Other:
CUSTOMER-GENERATOR
Name:
Electricity Account #:
Service
Address:
TMK:
City:
Zip Code:
Mailing Address:
City:
State:
Daytime Phone:
Email:
Zip Code:
OWNER-OPERATOR
Not Applicable
Name:
Mailing Address:
City:
State:
Zip Code:
Daytime Phone:
ELECTRICAL CONTRACTOR INFORMATION
Electrical Company:
Hawaii License #:
Mailing Address:
City:
State:
Zip Code:
Daytime Phone:
Evening/Cell Phone:
GENERATING SYSTEM CITY & COUNTY PERMIT #: (To be filled out by the company)
I certify that, to the best of my knowledge, all the information provided in this Amendment is true and correct. I will not interconnect and operate
additions to the existing system without prior written approval by Hawaiian Electric.
Customer Generator:
Owner-Operator of
Generating Facility:
Company Approval:
05/2017 V.3
Print:
Sign:
Date:
Print:
Sign:
Date:
To be filled out by the
company
To be filled out by the
company
To be filled out by the
company
Print:
Sign:
Date:
Page 1 of 4
Distributed Energy Resources
AMENDMENT TO EXISTING AGREEMENT
Generating Facility (Modifications to DER System): Please list changes from the existing agreement.
PHOTOVOLTAIC INVERTERS
Inverter Manufacturer
Not Applicable
Inverter Model
(Please list exact model #)
Inverter Size
(Watts)
Quantity (+/-)
Total Change in Rated Inverter Capacity (kW) =
PHOTOVOLTAIC MODULES
PV Module Manufacturer
Not Applicable
PV Module Model
(Please list exact model #)
STC
(Watts)
Quantity (+/-)
Total Change in PV Module STC Capacity (kW) =
ENERGY STORAGE
Energy Storage
Manufacturer
Not Applicable
Model
(Please list exact model #)
Size
(kW)
Charge/Discharge
(kW)
Will the energy storage system be used only as an Emergency Backup System?
Will the distribution grid be used to charge the storage device?
Mode of Operation:
No
Non-export
Yes
Max Capacity
(kWh)
Quantity
(+/-)
No
Yes, charging periods:
Export Coincident with PV
Export Non-coincident with PV
Description:
Existing Rated Generator Capacity =
New Proposed Rated Generator Capacity =
GENERATOR DISCONNECT
Manufacturer
Fused or
Non-fused
Not Applicable
Catalog #
Single Phase or
Type
Three Phase
Rated Amps
Rated Volts
Uses multiple disconnect
Mounting location:
Please include
Application cover form
05/2017 v.3
Updated electrical drawing(s)
Supporting documents for energy storage
(if applicable)
Page 2 of 4
Distributed Energy Resources
AMENDMENT TO EXISTING AGREEMENT
REVISION (if applicable)
ALL revisions are subject to review and may change the status of an application.
Revision Type:
Revised
Capacity:
Change of Equipment - including but not limited
to inverters and modules.
Change in Project Developer**
kW
Is this a proposed
increase in capacity?
Change in Owner/Operator - Adding, removing, or changing 3rd
party owner.
Change in Customer-Generator
NO
YES - please see next page for customer-Generator
acknowledgement of increasing system capacity.
NOTES
The sections below are to be reviewed by the Customer-Generator/Customer or Authorized Signatory*.
Please carefully read and provide your signature on the next page.
GRANT OF AUTHORITY
™™ I hereby appoint and authorize the contractor listed to act on my behalf in all manners relating to my Distributed Energy Resources (DER)
application, including but not limited to, the authority to (i) request, access and receive directly from Hawaiian Electric Company, on my
behalf, all information and documentation relating to my proposed project, and (ii) make decisions and execute agreements, if required,
regarding the proposed project.
™™ This Grant of Authority shall remain in effect until Hawaiian Electric Company receipt of written termination of such Grant of Authority by
Customer or resubmittal of an updated Grant of Authority.
™™ I acknowledge that this authorization is granted for the sole purpose of my application, and for managing questions related to the
system post-installation. Utility service outside of the PV system is not included, unless said information directly affects processing of my
application. I understand that a new form must be submitted if I change my installing contractor.
ACKNOWLEDGEMENTS
™™ The existing meter socket is in sound operating condition, or that it will be by the time permission to operate the proposed system is
granted, and I understand that I am responsible for any upgrades necessary to meet current code requirements.
™™ I understand that proof of insurance may be required prior to execution of the attached program agreement (see the appropriate program’s
Rule or Tariff for specific requirements).
™™ I agree not to interconnect and operate this proposed system without prior written approval from the Hawaiian Electric Companies.
™™ The inverters used for this system will be compliant with all of the Hawaiian Electric Companies’ current requirements and understand that
proof of compliance with these requirements will be necessary prior to the execution of the attached program agreement.
™™ (1) The distributed generation facility shall meet the Hawaiian Electric Companies’ Interconnection Standards stated in Appendix I:
Distributed Generating Facility Interconnection Standard Technical Requirement of Rule 14; (2) the specific characteristics or needs of each
distributed generating facility may change its interconnection requirements; and, therefore, (3) the distributed generation facility may be
subject to additional interconnection requirements that are necessitated by the results of the technical review process.
™™ As the Technical Review of the proposed system may require a no-cost Supplemental Review, I pre-authorize a Supplemental Review.
05/2017 V.3
Page 3 of 4
Distributed Energy Resources
AMENDMENT TO EXISTING AGREEMENT
REVISION ACKNOWLEDGEMENTS
Please complete ONLY when making applicable revisions
For revisions involving change of Project Developer/Installing Contractor ONLY:
I,
confirm I have changed my project developer to and request that all correspondence
regarding my project be forwarded accordingly.
For revisions involving an increase to the proposed system capacity ONLY:
I, confirm I will be increasing my PV system’s proposed capacity to
kW.
I understand that by doing so I may forfeit my current position in the queue and my project might require resubmittal for technical
review. I also understand that approvals that may have been granted previously may no longer be valid.
SIGNATURE
By signing below I certify that, to the best of my knowledge, all the information provided in this submission is true and correct and
agree to the foregoing Grant of Authority and acknowledgements.
Signature of Customer-Generator Customer
or Authorized Signatory*:
Date:
Printed Name:
* The Authorized Signatory on the form is the person signing on behalf of a trust, company, etc. Supporting documentation may be requested.
Please send your Amendment to Existing Agreement with required attachments in one packet to the correct address below.
Hawaiian Electric
Maui Electric
Hawai‘i Electric Light
(MAIL ONLY)
(MAIL ONLY)
(MAIL, EMAIL OR DROP OFF)
All Programs except SIA
Standard Interconnection
Agreement (SIA)
All Programs
East Hawai‘i
Hawaiian Electric
Distributed Energy Resources
P.O. Box 2750, CP12-SE
Honolulu, HI 96840
[email protected]
Hawaiian Electric
Attn: SIA; CP10-SN
P.O. Box 2750
Honolulu, HI 96840
[email protected]
Maui Electric
Renewable Projects
P.O. Box 398
Kahului, HI 96733
[email protected]
Hawai‘i Electric Light
Hawai‘i Electric Light
Hilo Engineering Dept.
Kona Engineering Dept.
54 Halekauila Street
74-5519 Kaiwi Street
Hilo, HI 96720
Kailua-Kona, HI 96740
[email protected]
05/2017 v.3
West Hawai‘i
Page 4 of 4