APPLICATION AND CONTRACT FOR ELECTRIC FACILITIES
WHERE FULL ADVANCE PAYMENT IS REQUIRED
Temporary Service
T
o Southern California Edison:
The undersigned Applicant hereby requests you to deliver electric energy to and for the equipment hereinafter described, at the location shown on the reverse
side hereof, in accordance with the applicable rates and rules of SCE.
In consideration of SCE’s acceptance of this application, and the installation of facilities to supply temporary electric service, Applicant hereby agrees to the
following:
1. SCE has made available for inspection its applicable rates and rules. Applicant agrees to comply therewith, and with any changes or modifications thereof
which may be authorized from time to time by the Public Utilities Commission of the State of California.
2. Applicant’s attention has been directed to the rate schedules applicable to the service herein described, and Applicant has elected to take and pay for service
under Schedule __________ for a minimum period of __________ months. As specified in this schedule, Applicant elects the following optional provisions:
3. Applicant agrees to pay in advance to SCE, prior to the installation thereof, the estimated cost installed plus the estimated cost of removal, less the
estimated salvage of the facilities installed to provide the service herein applied for, which cost is agreed to be the sum of ___________ Dollars
($ ____________ ).
4. The amount of refund upon reclassification of Applicant from temporary to permanent will be made on the basis of the extension rule in effect at the time tem-
porary service is reclassified to permanent. No interest shall be paid on the amount advanced.
5. Applicant hereby grants to SCE a right of way for any electric lines which it may be necessary to build in, on, under or over Applicant’s premises for the pur-
pose of making delivery hereunder. Where Applicant requests facilities which are in addition to, or in substitution for, the standard facilities which SCE nor-
mally would install, the extra cost thereof shall be paid by Applicant.
6. In the event Applicant within the initial 36 months of this contract materially increases or decreases his electric service requirements from those installed
hereunder and a change is made in SCE’s facilities, settlement shall be made for the installation and removal cost of the facilities removed. A new agreement
shall be entered into providing for the modified service required by Applicant.
7. This contract shall at all times be subject to such changes or modifications by the Public Utilities Commission of the State of California as said Commission
may, from time to time, direct in the exercise of its jurisdiction.
8. Where applicable — Contract Demand __________ (kW).
9. Where applicable — Excess Transformer Capacity __________ (kVa).
EQUIPMENT TO BE SERVED PHASE K.V.A. K.W. H.P.
LIGHTING
POWER
Service Voltage _______________________________________ Connected Load ____________________________ Est. Max. Demand _____________________________
Corporate or Individual’s Name ______________________________________________________________
Dated _______________________________________________ D.B.A. _________________________________________________________________________________
By _______________________________________ Title ________________________________________
Witness _____________________________________________ Office of Origin___________________________________________________________________________
Approved and accepted for Southern California Edison Company
By_____________________________________________________________________________________
Manager
SCE CSD 274 REV 4/98 (CW) Printed on recycled paper
A
ZIP CODE
IMMEDIATE PREVIOUS EDISON SERVICE ADDRESS
SERVICE ADDRESS STREET
NAME
DATE EFFECTIVE
CREDIT INFORMATION – FORM OF BUSINESS ORGANIZATION
PROPRIETORSHIP
CORPORATION
GENERALSOLE
PARTNERSHIP
CO-PA RT NE R SH IP OTHER
TYPE OF BUSINESS–PROCESSING, MFG., ETC.
CORPORATE OR INDIVIDUAL’S NAME
DBA NAME BUSINESS TELEPHONE NUMBER
PARTNERS OR CORPORATION OFFICERS
NAME ADDRESS TITLE
TELEPHONE
NUMBER
NAME ADDRESS TITLE
TELEPHONE
NUMBER
SERVICE ADDRESS STREET
SERVICE ADDRESS POST OFFICE
CYCLE DIST BOOK FOLIO CR CD FORMER BUSINESS SERVICE ADDRESS
APPLICANT’S RESIDENCE ADDRESSDEPOSIT NUMBER DEPOSIT AMOUNT
00
100
TELEPHONE
NUMBER
DAT E
APPLICANT’S INITIAL
THIS SERVICE DEPOSIT IS
SUBJECT TO ADJUSTMENT
RET. TO ACCTG. F.S.R. AREA NO.
CREDIT DEPT. APPROVAL DATE WANTED
NEAREST CROSS STREETSCHEDULE
METER ORDER NO. LOAD CHECK
LIGHT
POWER
NEW SET
LOOK-UP NO.
C.W.O. / C.J.O. NO.
D.W.O. NO.
HOURS OF OPERATION
SQUARE FOOTAGE (AS REQUIRED)
ADDITIONAL INFORMATION
ORDER TAKEN
COMPLETED FIELD COMPLETED BKPING
AT BY DATE
BY DATE BY DAT E
ON
CYCLE
DIST (METER NO.)
SUFFIXPREFIX
MO DA
BY SUB
BOOK
FOLIO
CUST. NO.
READ CR. CD DP REQ
BY H.L.
RES RANGE
D.M. RANGE D.M. WTR. H D.M. HEAT D.M. AIR C
APT NO.
SERVICE ADDRESS POST OFFICE
CA
ZIP CODE
6
2
CITY
7
8
MAILING ADDRESS
MAILING ADDRESS
MAILING ADDRESS
00
100
DEPOSIT AMT
OWNER OF PREMISES
SP HND
G
GSP DEM. READ
WT. H HEAT AIR C
D.M. PR. RES
LOC CDINST CD MUL ACC COPIES WO CD
ADDRESS
NAME