Property Assessed Clean Energy Program (PACE) APPLICATION

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Property Assessed Clean Energy Program (PACE) APPLICATION The Solar and Energy Loan Program ("SELF") provides financing for the installation of energy efficient improvements, water efficient improvements, and renewable energy sources that are permanently fixed to real property ("Improvements"). Assessment Contracts and Implementation Agreements will be entered into as provided for in State law. SECTION 1: Eligibility Requirements Applicant(s) is/are legal owner of the property described in the Application (the "Property"). Property is developed and located within St. Lucie County. Mobile homes that are not affixed to real property and subject to secured property tax are not eligible. Property Owner is current on all property taxes for all properties owned in St. Lucie County. Property Owner is current on all mortgage(s). 1 For commercial property; lender has signed the Lender Acknowledgment form for SELF Financing. Property Owner is not in bankruptcy and the property is not an asset in a bankruptcy. 2 There are no federal or state income tax liens, judgment liens, or similar involuntary liens on the property. Improvement costs are reasonable for the scope of the proposed project and to Property value. Requested Financing Amount does not exceed 20 percent of the Assessed Property Value. 3 The lien to value ratio (excluding the Requested Financing Amount) does not exceed 100 percent. Total annual property taxes, plus current assessments, including projected annual SELF assessments due on the property do not exceed 5% of the assessed property value, as determined at the time of approval of the contractual assessment. For further information on eligibility requirements, see the Finance Program Handbook, or contact SELF staff at (772) 468-1818. 1 If property is subject to loan modification because of default or delinquency, additional restrictions may apply. See SELF s PACE Finance Program Handbook. 2 If property owner has been in bankruptcy in the past three years, additional requirements may apply. See Finance Program Handbook for details. 3 Calculation: Sum of all lien balances against the assessed property value is less than or equal to 100%. 1

For Office Use Only [Date Stamp] Received On: File No. By: SECTION 2: Applicant Information PROPERTY OWNER(S) LEGAL NAME(S) AS THEY APPEAR ON PROPERTY TAX RECORDS OWNER 1 OWNER 2 OWNER 3 OWNER 4 PROPERTY OWNER(S) TYPE (Check all that apply) Individual(s) / Joint Tenants / Corporation Limited Liability Company Common Property (Not in Trust) Trust / Trustees / Living Trust Partnership Other (Please Specify) PROPERTY OWNER CONTACT INFORMATION NAME: EMAIL ADDRESS: DAYTIME TELEPHONE NO: PHYSICAL PROPERTY ADDRESS AND ASSESSOR'S PARCEL NUMBER (Site of improvements) STREET ADDRESS CITY STATE ZIP ASSESSOR'S PARCEL NUMBER FOR SUBJECT PROPERTY FL 2

MAILING ADDRESS (If different) MAILING ADDRESS CITY STATE ZIP SECTION 3: Property Information PROPERTY TYPE (Check all that apply) Single Family Residential (1 to 4 units) Industrial Home Owner s Association (HOA/CCRs) Commercial NIACS Code Multi-Family Residential (5 or more units) Commercial Historic District SECTION 4: Proposed Improvement Project Information PROPOSED IMPROVEMENT PROJECT (Attach additional page(s) if necessary) ENERGY ANALYSIS METHOD? HOW IS PROPERTY CURRENTLY HEATED? HOW PROPERTY IS CURRENTLY COOLED? 1. PROPOSED IMPROVEMENT MEASURE NAME TYPE OF IMPROVEMENT (CHECK ONE) (=) NET 2. PROPOSED IMPROVEMENT MEASURE NAME TYPE OF IMPROVEMENT (CHECK ONE) (=) NET 3

3. PROPOSED IMPROVEMENT MEASURE NAME TYPE OF IMPROVEMENT (CHECK ONE) (=) NET TOTAL PROJECT COSTS (Sums from above) (S) (-)LESS REBATE(S) (+)PLUS ESTMI ATED PERMIT FEE(S) (=) NET PROGRAM COSTS/FEES Title Cost - Due when the application review is complete, immediately preceding Title search.) The amount of the title cost is based on the requested financing amount. Contact SELF for estimate. Recording Fee - for Assessment Lien documents and assessment contract. Due at contract signing. Site Inspection Cost - Applicant may request interim payments for projects over 40,000. A final permit for that portion of work in which funds are requested will be required along with the Request for Disbursement form. If an interim payment is requested for a large project, an inspection by SELF staff to verify that 75% of materials are secured on the property will be required. Interest will accrue on the entire assessment amount at the time of the first interim payment. Note: These fees and costs may not be included in the requested financing amount. 4

ITEMIZED ESTIMATED COST OF IMPROVEMENT(S)-DOCUMENTATION REQUIRED* A. Construction contract{s) {bid price for cost of materials and labor less any applicable rebates), excluding permit fees: B. Contingency allowance OPTIONAL [10% of above- single disbursement contracts under 40,000] C. Onsite energy and water survey/analysis costs [Commercial: must obtain free PG&E or equivalent onsite energy analysis]: D. Professional services {Appraisal, drafting, engineering, project management and/or plan preparation costs): E. Permit Fee: Permit included in bid Total: Requested Financing Amount: Minimum proposal amount (line A) is 2500. REQUESTED ASSESSMENT REPAYMENT PERIOD 5 Years 10 Years 15 Years 20 Years Signature: Date: 5