PROPERTY OWNER NOTICE AND CONSENT FORM (for Home Charging Station and/or Surge Protector Installation)

Transcription

1 by NRG EV Services LLC PROPERTY OWNER NOTICE AND CONSENT FORM (for Home Charging Station and/or Surge Protector Installation) If you do not own the real property on which the Home Charging Station and/or Whole Home Surge Protector is proposed to be installed (the Property ), this Property Owner Notice and Consent Form (the Form ) must be fully completed, signed and notarized by the owner of the Property (the Property Owner ), and returned to NRG EV Services LLC d/b/a NRG evgo ( evgo ) before scheduling installation. Please allow adequate time during the ordering process to complete any reviews and obtain the signature of the Property Owner (including required notarization) on this Form. evgo recommends that the Property Owner be directly involved in the Home Assessment. Please note that if the Property is subject to a Homeowner s Association (HOA) or other such organization, a separate signed HOA Installation Approval form (available from evgo) is required prior to Installation. PROPERTY ADDRESS (address, unit number, city, state, zip): Unit # CUSTOMER ID #: Dear Property Owner: 1. We have been informed that you are the owner of the Property on which your tenant or resident ( evgo Customer ) desires to order and install (the Installation ) either a Home Charging Station or Whole Home Surge Protector or both (the Equipment ) by an independent, licensed, bonded and insured electrical contractor and/or other licensed subcontractor ( Installer ) for use with his or her electric vehicle or at the breaker panel on the Property. In order to complete the Installation, we require your prior written consent that the work may be performed on your Property and acknowledgment that you have received the notices contained herein. We require that you acknowledge your consent by signing this Form in the space below before a notary public attesting to your signature on this document. 2. Installation of the Equipment will involve modifications to the Property and may require that a permit be obtained from the local permitting authority. Installation will require modifying, altering, changing and/or upgrading the electrical wiring at the Property, and may result in holes, drilling, concrete trenching to lay conduit, drywall patching, painting and other alterations and/or changes to the walls, paint, electrical panel or other parts of the Property. Routine Installation of a Home Charging Station typically includes: Drilling holes in walls and running electrical wiring and conduit to support a 240V circuit from the electrical panel to the Home Charging Station location agreed upon between the evgo Customer and the Installer; Obtaining a permit prior to Installation; Attaching the Home Charging Station securely to an interior garage or exterior wall, or mounting it on an exterior pedestal; Verifying the presence of, and upon request installing, a Level 1 120V plug near the parking area; and Obtaining permitting authority inspection signoff after Installation is complete. Routine Installation of a Whole Home Surge Protector typically includes: Drilling holes in an interior wall and either flush mounting or wall mounting a surge protector next to the main electrical panel; Running electrical wiring and conduit from the surge protector to the electrical panel; and Obtaining permitting authority inspection signoff after Installation is complete. In addition to the above routine Installation steps, depending on the age of the Property, configuration, existing electrical capacity and usage, local requirements and other factors, additional non routine modifications to the Property may be required ( Non Routine Installation ). Non Routine Installation may include, by way of example, upgrading or modifying the electrical panel,

2 concrete trenching to lay conduit, drywall patching, painting or other modifications designed to safely and aesthetically accommodate installation and use of the Equipment. All work is performed by independent, licensed, bonded and insured electrical contractors and other licensed subcontractors. 3. MECHANICS LIEN WARNING It is possible that a mechanics lien may be placed on the Property if the Installer is not paid for the installation work. A mechanics lien is a claim, like a mortgage, made against your property and recorded with governmental authorities. The laws regarding availability of and procedures for mechanics liens vary by state and locality. You should check your state and local laws and consult with an independent attorney if you have any questions regarding mechanics liens. 4. Additional mechanics lien warnings and other notifications may be required under state or local laws that you should be aware of and are hereby incorporated by reference into this Form. Please refer to the Terms and Conditions and Installation Summary available online at or from an evgo representative for more information. 5. If the Property is subject to a lease, rental agreement or other written or verbal agreement between you and the evgo Customer, there may be contractual and/or legal rights, obligations and other considerations including, by way of example and not limitation, landlord/tenant law, real property law regarding fixtures and improvements, maintenance obligations and the like which apply to the proposed Installation. The Property Owner and the evgo Customer are solely responsible for addressing the implications of any agreements between them in connection with the Installation. If you are unsure of your rights and obligations in connection with the proposed Installation on your Property, you should consult with an independent attorney before signing this Form. 2

3 PROPERTY OWNER CONSENT I certify that: I am the Property Owner of the Property located at: [Property Address]; I have read, understand and acknowledge receipt of all of the information and notices set forth or referred to in this Property Owner Notice and Consent Form; I understand and agree that evgo and Installer shall have no obligation to remove the Equipment after Installation; I hereby authorize, approve, consent and give permission to: [Name of evgo Customer] to order installation of, and install, the following Equipment at the Property: ClipperCreek Charging Station SurgeAssure Surge Protector Lite On Charging Station with Surge Protector Other: [Describe] Print Name Date Property Owner Telephone No. _ Signature PLEASE SIGN BEFORE A NOTARY! (SEE NEXT PAGES FOR REQUIRED FORM) Property Owner Address Mailing Address of Property Owner 3

4 STATE OF TEXAS ACKNOWLEDGEMENT FOR INDIVIDUAL. [Name] STATE OF TEXAS ACKNOWLEDGEMENT FOR CORPORATION, the [Name of Officer] [Title of Officer] of, a corporation, [Name of Corporation ] [State of Incorporation] on behalf of said corporation. 4

5 STATE OF TEXAS ACKNOWLEDGEMENT FOR LIMITED PARTNERSHIP, the of [Name of Officer] [Title of Officer], a corporation, the General [Name of General Partner of Limited Partnership] [State of Incorporation] Partner of, a limited partnership, [Name of Limited Partnership ] [State of Formation] on behalf of said limited partnership. RETURN INSTRUCTIONS: Please return a fully completed, executed, and notarized Property Owner Notice and Consent Form to evgo by one of the following: to support@evgonetwork.com Fax to evgo at Mail to NRG EV Services LLC at P.O. Box 3043, Houston, TX Please note that the fully completed, signed, and notarized Property Owner Notice and Consent Form must be returned to evgo before an installation can be scheduled. Thank you! 5