Applicant Signature. I hereby certify that, to the best of my knowledge, all the information provided in this Interconnection Request is true and correct. For Interconnection Customer: Date: Systems (including use of IEEE 1547.1 testing protocols to establish conformity) IEEE Std 100-2000, IEEE Standard Dictionary of Electrical and Electronic Terms IEEE Std 519-1992, IEEE Recommended Practices and Requirements for Harmonic Control in Electrical Power Systems IEEE Std C37.108-1989 (R2002), IEEE Guide for the Protection of Network Transformers IEEE Std C37.90.1-1989 (R1994), IEEE Standard Surge Withstand Capability (SWC) Tests for Protective Relays and Relay Systems IEEE Std C37.90.2 (1995), IEEE Standard Withstand Capability of Relay Systems to Radiated Electromagnetic Interference from Transceivers IEEE Std C57.12.44-2000, IEEE Standard Requirements for Secondary Network Protectors IEEE Std C62.41.2-2002, IEEE Recommended Practice on Characterization of Surges in Low Voltage (1000V and Less) AC Power Circuits IEEE Std C62.45-1992 (R2002), IEEE Recommended Practice on Surge Testing for Equipment Connected to Low-Voltage (1000V and Less) AC Power Circuits NEMA MG 1-1998, Motors and Small Resources, Revision 3 NEMA MG 1-2003 (Rev 2004), Motors and Generators, Revision 1 NFPA 70 (2002), National Electrical Code UL 1741, Inverters, Converters, Controllers and Interconnection System Equipment for Use With Distributed Energy Resources
Applicant Signature. I fully understand the attendance and tuition requirements for the Xxxxxxxxxxx Xxxxxx Leadership Development program and agree to fulfill those requirements if selected.
Applicant Signature. I certify that I have read and understood the notices in Section 1 and, that to the best of my knowledge, the information provided on this form is true and correct. Signature of Applicant Date (mm/dd/yyyy)
Applicant Signature. I hereby certify that, to the best of my knowledge, all the information provided in this Interconnection Request Application Form is true and correct. For Interconnection Customer: Signature (Authorized Agent of the Legal Entity) Date: Print Name I, [Authorized Signatory Name], [Title] of [Developer Name], under penalty of perjury, hereby certify that, [Developer Name] or its affiliate has executed a written contract with the landowner(s) noted below, concerning the property described below. I further certify that our written contract with the landowner(s) specifies the agreed rental rate or purchase price for the property, as applicable, and allows [Developer Name] or its affiliates to construct and operate a renewable energy power generation facility on the property described below. This verification is provided to [Utility Name] in support of our application for an Interconnection Agreement. Landowner Name(s): Land Owner Contact information (Phone or e-mail): Parcel or PIN Number: County: Site Address: Number of Acres under Contract (state range, if applicable): Date Contract was executed Term of Contract [Authorized Signatory Name] [Authorized Signatory Name], being first duly sworn, says that [he/she] has read the foregoing verification, and knows the contents thereof to be true to [his/her] actual knowledge. Sworn and subscribed to before me this day of , 201_. [signature] [Authorized Signatory Name] [Title], [Developer Name] ANSI C84.1-1995 Electric Power Systems and Equipment – Voltage Ratings (60 Hertz) IEEE 1547, Standard for Interconnecting Distributed Resources with Electric Power Systems (including use of IEEE 1547.1 testing protocols to establish conformity) IEEE Std 100-2000, IEEE Standard Dictionary of Electrical and Electronic Terms IEEE Std 519-1992, IEEE Recommended Practices and Requirements for Harmonic Control in Electrical Power Systems IEEE Std C37.108-1989 (R2002), IEEE Guide for the Protection of Network Transformers IEEE Std C37.90.1-1989 (R1994), IEEE Standard Surge Withstand Capability (SWC) Tests for Protective Relays and Relay Systems IEEE Std C37.90.2 (1995), IEEE Standard Withstand Capability of Relay Systems to Radiated Electromagnetic Interference from Transceivers IEEE Std C57.12.44-2000, IEEE Standard Requirements for Secondary Network Protectors IEEE Std C62.41.2-2002, IEEE Recommended Practice on Characterization of Surges in Low Voltage (1000V and Less) AC Power Circuits IEEE Std C62.45-1992 (R2002), IEEE Recommended...
Applicant Signature. Date ...... / ....... /.......
Applicant Signature. I hereby certify that, to the best of my knowledge, all the information provided in this Interconnection Request is true and correct. For Interconnection Customer: By (signature): Name (type or print): Title: Company: Date: These terms and conditions for the study of a Small Generating Facility or material modification to an existing Small Generating Facility proposed in the Interconnection Request dated __________(“the Project”)_and submitted by ________________________________________, a __________________ organized and existing under the laws of the State of _____________ (“Interconnection Customer”) sets forth the respective obligations between Interconnection Customer and the New York Independent System Operator, Inc., a not-for-profit corporation organized and existing under the laws of the State of New York (“NYISO”) (hereinafter the “Terms and Conditions”). By signing below, Interconnection Customer confirms its understanding and acceptance of the Terms and Conditions.
Applicant Signature. I hereby certify that, to the best of my knowledge, all the information provided in this Interconnection Request is true and correct. For Interconnection Customer: Date: THIS AGREEMENT is made and entered into this day of 20 by and between , a organized and existing under the laws of the State of
Applicant Signature. If you are a self-employed physician, you may name yourself or your Corporation as Employer)
Applicant Signature. I believe that I am eligible to apply for Sabbatical Leave. The information contained in this application is accurate and true to the best of my knowledge. I agree to abide by the conditions of Sabbatical Leaves as outlined in the Faculty Collective Bargaining Agreement and agree to enter into a written contractual agreement prior to beginning my leave, if approved, and I agree to fulfill the obligations set forth in the Bargaining Agreement and in the written contractual agreement. I understand that failure to fulfill my obligations may result in a forfeiture of salary. Signature of Applicant Date Human Resources verification of eligibility: □ meets eligibility □ does not meet eligibility Has been employed as full-time faculty for 6 continuous academic years without a leave of absence*. Has been continuously employed for 6 continuous academic years since previously granted sabbatical. Date Received by Xxxx of Instruction Recommend Approval Recommend Denial Screening Committee Recommend Approval Recommend Denial Comments: Division Director Recommend Approval Recommend Denial Comments: Associate Xxxx Recommend Approval Recommend Denial Comments: Xxxx of Instruction Comments: Recommend Approval Recommend Denial President Comments: Recommend Approval Recommend Denial Board of Education Comments:
Applicant Signature. (Must sign with Notary) Date:
