GRID Alternatives

General SASH Contact Information SASH@gridalternatives.org Toll free: 1--866- 921-4696

Inland Empire Office Phone: 888-496-4743 Phone: 951-272-4743 Central Coast Office Phone: 805-351-3344 Fax: 805-980-5129

Greater Los Angeles Office Phone: 310-324-8146 Fax: 310-388-0288 San Diego Office Phone: 619-239-4743 Fax: 619-923-3361

Oakland Office Phone: 510-652-4730 Fax: 510-225-2585 Fresno Office Phone: 559- 261-4743 Fax: 510-225-2585

Single-Family Affordable Solar Homes (SASH) Application

Instructions: Complete this application, including review and acceptance of the Declarations and Agreements, and submission of all requested documents. If you have any questions, please call GRID Alternatives at the appropriate number listed above.

Applicant Contact Information First Name Street Address State CA Home Phone County Business Phone Zip Code Cell Last Name City Email MI

Household Income Information (List all non-renting residents who claim the property as their primary residence. Attach separate page if more than five household members.). Name (First, Last) Gross Annual Income (most recent available) Homeowner: Household Member #2: Household Member #3: Household Member #4: Household Member #5: Total Household Income:
Total income (1040 - Line 22;1040A - Line 15;1040EZ Line 4)

$ $ $ $ $ $

Homeowner Information ( This section is optional) Ethnicity (circle): Gender: Female White Male Latino/a Asian Black/African American Yes No Other (list) Disabled: Yes No

Senior (62 or older):

Other Documents/Information Required: 1. Most recent available Federal Income Tax Return (Form 1040, 1040A, or 1040EZ) for each member of the household or a certification that they are not legally required to file federal tax returns. 2. Most recent copy of homeowners insurance if available. Otherwise, please provide one of the following items: title or deed or property tax bill or mortgage statement. 3. A copy of your most recent electricity bill. 4. Application for the LIEE and CARE programs, if applicable. 5. Proof that your residence is California Public Utilities Code 2852 compliant.
Declarations and Agreements:

SASH is a program that is part of the California Solar Initiative and funded by California utility ratepayers under the auspices of the California Public Utilities Commission.

By participating in the SASH Program, I understand that:

1. I am aware of the requirements and conditions of receiving funds managed by the California Public Utilities Commission
(CPUC) and agree to comply with all such requirements and California Solar Initiative Program Handbook.

2. SASH is ratepayer funded program that is managed by the CPUC and GRID Alternatives and that my application and all
project information will be available to the CPUC upon their request.

3. Filling out this application does not guarantee participation in the SASH Program, and GRID Alternatives has the right to
deny my participation in the program.

4. There may be a cost associated with the photovoltaic solar generating equipment, depending on my income. GRID staff will
discuss these potential costs before continuing the process toward installation.

5. GRID Alternatives will confirm my income status and property address in an existing public database that tracks statewide
low-income housing data. My personal identification will not be disclosed.

6. As a condition for my eligibility to receive the SASH incentive, I will be required, if eligible, to enroll into the Low-Income
Energy Efficiency (LIEE) Program offered by my electric utility provider. LIEE is a free program that provides a range of energy efficiency measures including lighting, low-flow showerheads, window/door sealing, attic insulation, and refrigerators, among others. I understand that a LIEE contractor will contact me regarding this program to schedule an energy efficiency audit to determine which measures qualify for my home. If those measures are not immediately available, I will be placed on a waiting list. If I decline LIEE services prior to my SASH solar installation, and I am eligible for the LIEE efficiency measures, GRID can decline to install my solar system until LIEE measures are implemented.

7. GRID works with my electric utility provider to enroll me in LIEE and that proof of my income and supporting
documentation may be shared with my utility provider in order to expedite my LIEE enrollment.

8. I must provide all required documents and signatures. 9. I will need to fill out additional required forms and legal documents related to my project. 10. I and other members of my household are encouraged to work on my system installation, other installations, and/or other
GRID Alternatives program activities, under the supervision of a professionally licensed solar contractor. purpose of installing a solar electric system.

11. Trained volunteers, under the supervision of professionally licensed solar contractors, will have access to my home for the 12. The solar electric system, if installed, will not provide electricity when the utility company is not able to supply power (i.e.
during a blackout).

13. I grant GRID Alternatives permission to access my electricity usage history from my electric utility provider's website in
order to calculate the appropriate size of my PV-solar system.

14. The solar electric system, if installed, may reduce my electricity bills, but will not eliminate them completely.
I certify that:

15. I am not in the process of selling my house. 16. I am not currently facing financial insolvency (i.e. bankruptcy). 17. I own the property listed on this application and that it is my primary residence.
Indemnification: To the greatest extent permitted by applicable law, I agree to indemnify, defend, and hold harmless GRID Alternatives, its affiliates, subsidiaries, current and future parent companies, officers, managers, directors, agents, and employees from all claims, dema nds, losses, damages, costs, expenses, and liability (legal, contractual, or otherwise), which arise from or are in any way connected with any: (1) decision, action, or inaction by GRID Alternatives regarding my participation or non-participation in the SASH Program; (2) violation of local, state, or federal common law, statute, or regulation, including but not limited to environmental laws or regulations; or (3) strict liability imposed by any common law, statute or regulation; so long as such conduct, violation, or strict liability (as set forth in (1) - (3) above) arises from or is in any way connected with the SASH Program, including my or any third partys performance or fai lure to perform with respect to the SASH Program, however caused, regardless of any negligence of the GRID Alternatives, their officers, managers, or employees, excepting only such loss, damage, or liability that is caused by the willful misconduct of GRID Alternatives, its officers, managers, or employees. Limitation of Liability: Without limiting the foregoing indemnification, GRID Alternatives shall not be liable to me or any of my respective contractors or subcontractors for any special, incidental, indirect or consequential damages whatsoever, including, without limitation, loss of profits or commitments, whether in contract, warranty, indemnity, tort (including negligence), strict liability or otherwise arising from GRID Alternatives performance or nonperformance of its obligations as Program Manager under the SASH Program.

I declare under the penalty of perjury that the information in this form and the supporting documentation submitted herewith is true and correct to the best of my knowledge. Signature (Applicant):___________________________________ Date:______________

rev 12.16.10