[UTILITY COMPANY NAME]
[UTILITY DEPT. NAME AND CONTACT NAME]
[UTILITY STREET ADDRESS]
[CITY/TOWN], New York [ZIP CODE]
_______________________________________________________________ (the “Property Owner”) is the owner of the above- referenced property (the “Property”).
_______________________________________________________________ (the “Developer”) is the developer of the project identified above.
The Property Owner and the Developer have entered into an agreement authorizing the Developer to use the Property for the purpose of constructing and operating a distributed generation facility. The type of agreement that is in place is indicated below by a check mark.
Property Owner and Developer entered into the agreement on or about _______________
(MM/DD/YYYY)
Terms of Agreement (including options to extend) _______________
(MM/DD/YYYY)
Property Owner
By: _________________________________
Printed Name: _____________________
Title: _______________________________
Date: _______________________________
Property Owner
By: _________________________________
Printed Name: _____________________
Title: _______________________________
Date: _______________________________