For PUC use only: New Hampshire Public Utilities Commission Date Received 21 S. Fruit St. Suite 10 Concord, NH 03301-2429 603-271-2431 STEP 2 FINAL INCENTIVE REQUEST FORM For Category 2 C&I Solar Projects GREATER Than 100 kw ac and less than or equal to 500 kw ac Step 1 Incentive Pre-Approval MUST be approved by the PUC to approval of Step 2. All program requirements and documentation must be complete and submitted in order to receive approval for an incentive payment. Please submit the completed application and attachments to: Sustainable Energy Division, New Hampshire Public Utilities Commission, 21 S. Fruit St., Suite 10, Concord, NH 03301-2429 ** Because this application requires original signatures, electronic copies will not be accepted. ** CONTACT INFORMATION Business/Entity Name Primary Contact Name Applicant Street City State Zip Facility Installation Address Mailing Address Street City State Zip (if different from Facility Installation Address) 1 2 Email Application # Interconnection Electric Meter Number Date Project Became Operational (Current and Original) (see Step 1approval letter) Current: Original: INCENTIVE CALCULATION FOR PV FACILITIES PV Capacity Eligible Facility Costs (do not include self-install Total PV Capacity (watts AC) (watts DC) labor costs or used equipment costs) 1.a 1.b 1.c $ Use the following calculations: Watts AC (1.a above) x $.55/watt Watts DC (1.b above) x $.55/watt Total Eligible Facility Costs (1.c above) x 25% $ $ $ 1.d Project Incentive Cap Original Incentive Amount Incentive Amount Requested (Lesser amount Requested from1.a, 1.b, 1.c, and 1.d calculations.) (from Step 1 application) $ 175,000.00 $ $
New Hampshire Public Utilities Commission 21 S. Fruit St. Suite 10 Concord, NH 03301-2429 603-271-2431 For PUC use only: Date Received STEP 2 FINAL INCENTIVE REQUEST FORM For Category 2 C&I Solar Projects GREATER Than 100 kw ac and less than or equal to 500 kw ac Step 1 Incentive Pre-Approval MUST be approved by the PUC to approval of Step 2. All program requirements and documentation must be complete and submitted in order to receive approval for an incentive payment. Please submit the completed application and attachments to: Sustainable Energy Division, New Hampshire Public Utilities Commission, 21 S. Fruit St., Suite 10, Concord, NH 03301-2429 ** Because this application requires original signatures, electronic copies will not be accepted. ** CONTACT INFORMATION Applicant Business/Entity Name Primary Contact Name Facility Installation Address Street City State Zip Mailing Address Street City State Zip (if different from Facility Installation Address) 1 2 Email Application # (see Step 1approval letter) Date Project Became Operational Interconnection Electric Meter Number (Current and Original) Current: Original: INCENTIVE CALCULATION FOR PV FACILITIES 1.a Total PV Capacity (watts AC) 1.b PV Capacity (watts DC) 1.c Eligible Facility Costs (do not include self-install labor costs or used equipment costs) $ Use the following calculations: Watts AC (1.a above) x $.55/watt Watts DC (1.b above) x $.55/watt Total Eligible Facility Costs (1.c above) x 25% $ $ $ 1.d Project Incentive Cap Original Incentive Amount Requested (from Step 1 application) Incentive Amount Requested (Lesser amount from1.a, 1.b, 1.c, and 1.d calculations.) $ 175,000.00 $ $