APPLICATION/AGREEMENTTOOPT‐OUTOFTHEINSTALLATIONOFANAMRMETER
Date_________________________,20____
THEUNDERSIGNEDapplicant("Applicant")herebymakesapplicationto,andentersintoanagreementwith,CENTRALHUDSONGAS
&ELECTRICCORPORATION("Company")toOpt‐OutoftheinstallationofanAMRmeterattheirserviceaddresslocatedat
_______________________________________________________________________.ApplicantisCompanycustomertaking
serviceat__________________________________________________________________________.Customeristakingnon‐
demandelectricand/ornaturalgasservicepursuanttoServiceClassificationNos.1or2underP.S.C.No.15–ElectricityandService
ClassificationNos.1,2,6,12or13underP.S.C.No.12–Gas,asbothofthesetariffsmaybemodifiedorsupersededasapprovedby
theNewYorkStatePublicServiceCommission(“Commission”).
ApplicantagreestocomplywiththeprovisionsofthisAgreementandtheRulesapplicabletheretoassetforthintheCompany’s
tariffs,publiclyavailableattheCommission’swebsiteatwww.dps.ny.gov.Inparticular,ApplicantrequeststhattheCompanynot
install,or,ifalreadyinstalled,removeanAMRmeterat_____________________________________________________________
andinstallanon‐AMRelectronicdigitalmeter,orothernon‐AMRmeterapprovedforinstallationforApplicantbytheCommission.
Applicantunderstandsandagreesthattheinstallationofanon‐AMRmetermaycauseApplicanttoincurcostsforwhichApplicant
aloneisresponsible.IftheApplicant’smeterislocatedinsidethepremisesoftheserviceaddress,ApplicantagreesthatApplicant
shallbesolelyresponsibleforallcoststomovetheexistinginsidemetertoanoutsidelocationdesignatedbyCompany.Applicant
andCompanyagreethatCompanyshallnotinstallanon‐AMRmeteruntilanoutsidemeterlocationhasbeenestablished.
Applicantunderstandsandagreesthattheinstallationofanon‐AMRmetercausestheCompanytoincurincrementalcosts
notassociatedwiththeinstallationofanAMRmeter.TheCommissionhasapprovedrecoveryoftheincrementalcostsassociated
withtheinstallationofanon‐AMRmeterthroughfeeschargedtoApplicant.Applicantagreesthatitwillpayallapprovedfees
associatedwiththeinstallationofanon‐AMRmeterastheCommissionmayapproveandamendthefeesfromtimetotime.
Thefeescheduleis:
ServiceFeeFrequency
Meterchangefee,electricmeteronly $49.00 onetime
Meterchangefee,gasmeteronly$89.00onetime
Meterchangefee,electricandgasmeters $114.00 onetime
Theone‐timefee(s)willappearonyourfirstbillafterthenon‐AMRmeter(s)has(have)beeninstalledatyourpremises.Ifyoulater
choosetohaveyourAMRmeterre‐installed,aone‐timere‐installationfeewillapplythatisequaltothefeelistedaboveforthe
AMRmeter’sremoval.
AMRMeter(s)Requestedtobereplaced(checkoneorbothboxes): Electric Gas
CustomerSignature:________________________________________________Date:_________________________________
CustomerName:__________________________________________________________________________________________
10DigitAccountNumber(XXXX‐XXXX‐XX): ____________________________________________________________________
Address:________________________________________________________________________________________________
City:____________________________________________________________State:______ZipCode:_________________
Telephone(Primary):__________________________________Telephone(Secondary):_______________________________
Fax:________
________________________ E‐Mail:_____________________________________________________