AGREEMENT TO PERFORM TARIFF
SCHEDULE RELATED WORK1
DISTRIBUTION:
Applicant (Original)
Division (Original)
Customer Care (Copy)
REFERENCE:
† Information collected on this form is used in accordance with PG&E’s Privacy Policy. Page 1 of 1 The Privacy Policy is available at pge.com/privacy. Form 62-4527 Advice 4350-G/6050-E 1
Automated Document, Preliminary Statement, Part A February 2021 ____________________________________ (Applicant) has requested PACIFIC GAS AND ELECTRIC COMPANY, a California corporation (PG&E), to perform the tariff schedule related work as located and described in paragraph 3 herein.
PG&E agrees to perform the requested work and furnish all necessary labor, equipment, materials and related facilities required therefore, subject to the following conditions:
1. Whenever part or all of the requested work is to be furnished or performed upon property other than that of Applicant, Applicant shall first procure from such owners all necessary rights-of-way and/or permits in a form satisfactory to PG&E and without cost to it.
2. Customer shall indemnify and hold harmless PG&E, its officers, agents, and employees, against all loss, damage, expense, and liability, resulting from injury to or death of person, including, but not limited to employees of PG&E, Customer, or any third party, or damage to property, including, but not limited to, property of PG&E, Customer, or any third party, arising out of or in any way connected with the Services to be provided under this Agreement, but only in proportion to and to the extent such liability, loss, expense, attorneys’ fees, or claims for injury or damages are caused by or result from the negligent or intentional acts or omissions of the Customer, its officers, employees or agents.
Customer shall pay any costs that may be incurred by PG&E in enforcing this indemnity, including reasonable attorneys’ fees. [Pursuant to Resolution G-3561 of the California Public Utilities Commission the foregoing provision may be modified in agreements with governmental agencies to limit the scope of the indemnity to claims caused by the negligent or intentional acts or omissions of the governmental agency. Such modifications to this Agreement shall be submitted to the Commission for approval through a Tier 1 Advice Letter.]
3. The location and requested work are described as follows: (Describe in detail the materials and facilities to be furnished and/or work to be performed by PG&E. If more space is required, use other side and attach any necessary drawings as Exhibits A, B, C, etc.):
LOCATION:
DESCRIPTION OF WORK:
4. Applicant shall pay to PG&E, promptly upon demand by PG&E, as the complete contract price hereunder, the sum of ____________________________________________________________dollars ($ ___________________)
5. This agreement at all times shall be subject to such modifications as the California Public Utilities Commission may direct from time to time in the exercise of its jurisdiction.
Upon completion of requested work, ownership shall vest in: PG&E Applicant Executed this __________ day of ___________________ 20 ____.
This agreement is effective when accepted and executed by PG&E.
PACIFIC GAS AND ELECTRIC COMPANY
Customer/Company
Authorized by (Print) Authorized by (Print)
Signature Signature
Title Title
Date Date
Mailing Address:
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Exhibit A
Description of Work
Background:
The _______(name of community)________ (“community”) is requesting the replacement of existing overhead electric facilities with underground electric facilities per the Electric Rule 20 tariff.
The community requests that this project be executed as a Rule 20A. As required by the Electric Rule 20 tariff, Utility Underground District (UUD)___(name of UUD)____________ established on ___(date of resolution)____ with the passage of Resolution #______. The boundaries of UUD “___(name of UUD)____” are included as Exhibit B. PG&E has reviewed the boundaries and has verified that one or more of the Electric Rule 20 public interest criteria listed below has been satisfied. ☐ Such undergrounding will avoid or eliminate an unusually heavy concentration of overhead electric facilities;
☐ The street or road or right-of-way is extensively used by the general public and carries a heavy volume of pedestrian or vehicular traffic; ☐ Wheelchair access is limited or impeded in a manner that is not compliant with the Americans with Disabilities Act;
☐ The street or road or right-of-way adjoins or passes through a civic area or public recreation area or an area of significant scenic, cultural, and/or historic interest to the general public; or
☐ The street or road or right-of-way is considered an arterial street or major collector as defined by the California Department of Transportation’s California Road System functional classification system.
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The project forecast is calculated as follows:
$
$
$
$
$
$
$
This forecast of $_________ exceeds the community’s available work credits of $___________. This work credit shortfall (“shortfall”) needs to be addressed before the project can progress. The community is exercising their option pursuant to D.23-06-008, to contribute financially to any Rule 20A project that has insufficient work credits for completion, so that the project can resume and complete. Specifically, the community will be contributing $_________ towards the ____(name of UUD)_____ project.
If after the community contributes to the project to cover the shortfall, and/or the community amasses additional work credits through allowable methods described in Electric Rule 20 Tariff Paragraph A.2.d (“reallocation”) and/or A.2.g (“intra-county donations”), the community is entitled to a refund up to but not exceeding the financial contribution. Intra-county donations must be coordinated through PG&E and requires written approval from the donor to donate their work credits to your community.
Communities have until the completion of construction (CN24 milestone) to request a refund in such circumstances.
Once the project is fully funded, the community cannot make any scope changes that would result in an increase in project cost. Examples include but not limited to increasing the UUD boundaries, adding additional properties, changes in location of electric facilities such as transformers, and/or request for pad-mounted facilities to be changed to subsurface.
If such scope changes are required, the community acknowledges that such scope changes must be funded by the community before they are accepted by PG&E. Funding could be work credits, cash, or a combination of both.
Schedule:
PG&E will make best efforts to budget and resource this project so that the project can be executed expeditiously and efficiently to meet community’s needs. 3 | P a g e
Exhibit C
Additional Terms and Conditions
1. Commission Jurisdiction:
This Agreement shall be subject to all of PG&E’s applicable tariff schedules on file with and authorized by the Commission, defined as California Public Utilities Commission (CPUC), and shall be subject to such changes or modifications as the Commission may direct from time to time in the exercise of its jurisdiction.
2. General Conditions Agreement:
The terms and conditions described in the General Conditions Agreement to Perform Work Pursuant to PG&E Electric Rule 20A (Form 79-1127) signed by PG&E and Community shall apply.
3. Applicable tariffs:
PG&E’s applicable tariffs include, but are not limited to, the following:
- Electric Rule 20: “Replacement of Overhead with Underground Electric Facilities.” - Agreement to Perform Tariff Scheduled Related Work (Form 62-4527)
3. Materials:
The Community has determined that Buy America requirements (Federal Highway Administration, U.S. Department of Transportation, U.S. Code 2022 Title 23, Chapter 3, Section 313) are not applicable for this project and therefore will not be applied.
4. Payment:
Community’s full financial contribution (“Payment”), which is defined as the County’s contribution of $____________ as referenced above, is required prior to scheduling construction.
5. Force Majeure:
PG&E shall not be liable for any delay or failure in performance of any part of this Agreement from any cause beyond its control or without its fault or negligence, such as acts of God, acts of civil or military authority, unanticipated changes to government regulations, embargoes, epidemics, war, terrorist acts, riots, insurrections, fires, explosions, earthquakes, nuclear accidents, floods, strikes, power blackouts (except where caused by PG&E's negligence or willful misconduct), volcanic action, other major environmental disturbances, or unusually severe weather conditions. 4 | P a g e
PG&E shall make a reasonable attempt to affect the Work in a timely and expeditious manner in accordance with good utility practice and consistent with reliability and safety. The Work shall be placed in PG&E's regular schedule for engineering and construction. PG&E reserves the right to reallocate material or labor resources to the construction or maintenance projects which it deems, in good faith and in its sole discretion, necessary for serving the needs of all its customers. PG&E shall reallocate such material or labor resources to again perform work under this Agreement, when, in its good faith opinion, the need to respond to such customer needs no longer exists.
PG&E shall not be liable for any delay in effecting the Work hereunder resulting from such allocation or reallocation of PG&E's resources.