Distributed Generation Application

Please complete all fields of this application form.

Distributed Generation Program Applicants must complete and sign the Electric Generator Interconnection and Operating Agreement prior to commissioning of the proposed generating equipment. All equipment installations must comply with the agreement requirements based upon the generator capacity before obtaining Holland BPW approval. Local permits will be required and necessary building and electrical upgrades may be needed in order to satisfy local code requirements before construction begins. Testing and successful operation of the inverters and controls of the generation system to verify successful shut-down of the system upon loss of power will be required by HBPW electric engineering personnel before final commissioning of the system will be granted.

Program participants for Categories 1 and 2 will not require a separate generation meter for their generation system. Program participants for Category 3 may require a separate generation meter.

After you submit the online Distributed Generation Application, we will contact you to discuss all of the requirements. Additional documentation and an Interconnect Evaluation processing fee of $100 are required to advance through the application process. Payment must be submitted with the additional documentation. Only complete submittals will be reviewed.

In some cases, a more in-depth study is needed. In those cases, additional costs may apply.eeded. In those cases, additional costs may apply.

Account Information

I wish to participate in the Holland Board of Public Works Distributed Generation Program for the following account:

Account Number*

Account Name*

Service Address*

City, State and Zip*

Customer Name*

Daytime Telephone*

Alternate Telephone

E-mail*

Customer Type

Please provide the following generator information:

Capacity Rating of the Generator(s) in KW*

Projected Monthly KWh Output of the Generator*

Renewable Energy Source*

Other Renewable Energy Source (please specify)

Please provide the estimated date for generator installation/operation*

Has the Interconnection agreement been completed

Electronic Signature*

Date

Confirm: