124090369
June 02, 2023
Customer Payment
Coupon
References
Notification # 124090369
Contract # 50082238 V1
E16-PM # 35372280
EOL1-PM # 35372280
Customer # 3533580
City of Stockton
22 East Weber Avenue Room 301
STOCKTON, CA 95202
Customer Payment Summary
424 E 9TH ST, STOCKTON
Please pay the Total Due based upon the payment option(s) you selected on page two of the enclosed Gas and Electric Extension Agreement.
Payment Options Subtotal Total Due
10-Year Refundable Advance Option Gas and Electric $255,861.84 $255,861.84 Non-Refundable 50 percent Discount Option for Gas and
Electric
$135,632.34 $135,632.34
10-Year Refundable Advance Option for Gas and
Non-Refundable 50 percent Discount Option for Electric
$135,632.34 $135,632.34
Non-Refundable 50 percent Discount Option for Gas and
10-Year Refundable Advance Option for Electric
$255,861.84 $255,861.84
Outdoor Lighting Non-Refundable Payment $0.00
Important Payment Information
To complete your contract ONLINE
Follow the instructions provided with your electronic contract Submit payment at https://www.pge.com/contractpayments
To complete your contract BY MAIL
Please make check payable to: PG&E or Pacific Gas and Electric Complete, sign and return the enclosed agreement(s), the SACAC form and the customer payment coupon with your payment
Remit payment and SACAC form to:
PG&E CFM/PPC Department
PO BOX 997340
Sacramento, CA 95899-7340
IMPORTANT MESSAGE
Please review the enclosed information
and total due. This document needs
to be returned with the enclosed
agreements.
If you complete your contract ONLINE,
a copy will be saved to your Customer
Connections Online (CCO) account at
pge.com/cco.
To learn more about PG&E's gas and
electric safety initiatives and resources
please visit pge.com/safety.
Have Questions?
Please Call 1-800-422-0436
ATTACHMENT B
Gas and Electric
Extension Agreement*
* Automated document,
Preliminary Statement, Part A
"PG&E" refers to Pacific Gas and Electric Company, a subsidiary of PG&E Corporation. ©2015 Pacific Gas and Electric Company. All rights reserved.
Form 79-1169
Advice 3579-G/4607-E
March 2015
124090369
For Internal Use
124090369Notification #
50082238Contract #
35372280E-PM #
G-PM #
E-Prior MLX/PM#
G-Prior MLX/PM#
3533580Customer #
1 V
424 E 9TH ST, STOCKTONRe:
June 02, 2023
City of Stockton
22 East Weber Avenue Room 301
STOCKTON, CA, 95202
Dear+$55<%/$&.
We are writing to let you know Pacific Gas and Electric Company (PG&E) will extend its facilities to provide the requested gas and electric service to the project address listed above. PG&E's costs have been developed based on the choices and information provided in your application and may change if you make changes. This letter, including PG&E's tariffs, which are incorporated by reference below, will serve as our contract. As required by the California Public Utilities Commission (CPUC), special facilities will be handled in a sepa rate contract.
Please complete the following four steps to execute this contract. 1 Review the following work responsibilities and cost information.
Work To Be
Done By
GAS MAIN GAS SERVICE ELECTRIC DISTRIBUTION ELECTRIC SERVICE Trench Pipe Trench Pipe Trench Substr. Facilities Trench Substr. Facilities
PG&E X X
Customer X X
GAS ELECTRIC
Total non-refundable project costs $0.00 $15,402.83
Refundable extension costs $0.00 $241,171.75
Allowances (credit) $0.00- $712.74-
Net refundable amount $0.00 = $240,459.00 =
10 YEAR REFUNDABLE OPTION
Net refundable amount $0.00 $240,459.00
Credit for value of design and/or
facilities provided by applicant
$0.00- $0.00-
Total non-refundable project costs $0.00+ $15,402.83+
Total (if you select this option) $0.00 = $255,861.84 = NON-REFUNDABLE 50% DISCOUNT OPTION
Net refundable amount $0.00 $240,459.00
Discount: 50% of Net refundable amount $0.00- $120,229.50- Credit for value of design and/or
facilities provided by applicant $0.00- $0.00-
Total non-refundable project costs $0.00+ $15,402.83+
Total (if you select this option) $0.00 = $135,632.33 = Potential refund per residential lot/unit $0.00 $0.00 Potential reimbursement per service completion
Pressurized or energized system $0.00 $0.00
Not pressurized or energized system $0.00 $0.00
Reimbursement for other work
performed $0.00 $0.00
All amounts include the Income Tax Component of Contribution (ITCC) PG&E is required to charge customers, where applicable.
DEFINITIONS AND
EXPLANATION OF TERMS
(For more detail see rules 15 and 16):
Total non-refundable project costs include costs
for work such as electric trench and excavation,
conduits, inspections, streetlights, conversion from
overhead to underground and contract processing.
Refundable extension costs include costs for
facilities such as electric conductor, transformers
and poles; gas pipe, gas share of distribution trench
and regulators; and meters.
Allowances are a credit against refundable
extension costs. They are based upon the number
of residential units expected to be connected within
the first six months and the expected annual non-
residential net (distribution) revenue from your
project.
Allowances granted under either option are subject
to deficiency billing if the number of residential
units connected or the annual non-residential net
revenue falls below the forecast used to calculate
the allowances.
Net refundable amount is the portion of overall
costs eligible for refund to you based upon
additional residential meters being set or upon
increases in non-residential annual net (distribution)
revenue. A cost-of-ownership charge is assessed
against the Net refundable amount (except for
individual residential applicants) per Rule 15.
Potential refund per residential lot/unit is for
those lots/units for which you did not already
receive an allowance (i.e., units not expected to be
connected in the first six months). Any refunds may
be decreased or eliminated by cost-of-ownership
charges assessed under the provisions of Rule 15.
Potential reimbursement per service completion is
the amount to which a customer may be entitled for
performing certain service connection work PG&E
would otherwise perform when installing service
extensions and are not to be confused with refunds.
Reimbursement for other work performed is
the amount to which a customer may be entitled
for performing certain work (other than service
completions) that normally is PG&E's responsibility.
ATTACHMENT B
Gas and Electric
Extension Agreement*
* Automated document,
Preliminary Statement, Part A
"PG&E" refers to Pacific Gas and Electric Company, a subsidiary of PG&E Corporation. ©2015 Pacific Gas and Electric Company. All rights reserved.
Form 79-1169
Advice 3579-G/4607-E
March 2015
124090369
2 Select one of the following payment options.
#opt1#
10-Year Refundable Option for Gas and Electric
#opt2#
Non-Refundable 50 Percent Discount Option for Gas
and Electric
#opt3#
10-Year Refundable Option for Gas and Non-
Refundable 50 Percent Discount Option for Electric
#opt4#
Non-Refundable 50 Percent Discount Option for
Gas and 10-Year Refundable Option for Electric
Gas
$0.00
$0.00
$0.00
$0.00
+
+
+
+
Electric
$255,861.84
$135,632.34
$135,632.34
$255,861.84
-
-
-
-
Advance
N/A
N/A
N/A
N/A
=
=
=
=
Total Due
$255,861.84
$135,632.34
$135,632.34
$255,861.84
3 Review these important terms and conditions.
This Gas and Electric Extension Agreement is controlled by, and incorporates by reference, PG&E's tariffs, including Gas and Electric rules 2, 15, and 16; the Distribution and Service Extension Agreement-Provisions (Form 62-0982) and the General Terms & Conditions for Gas and Electric Extension & Service Construction by Applicant (Form 79-716), all as approved and authorized by the CPUC. This agreement at all times shall be subject to such modifications as the CPUC may direct from time to time in the exercise of its jurisdiction.
You can view PG&E's tariffs online at pge.com/tariffs or contact the PG&E representative listed below. Additional details underlying the amounts shown in this agreement, as well as the calculation of allowances, refunds or deficiency bills can also be provided by your local PG&E representative. 4 After completing steps 1, 2 and 3 and having checked one, but only one, of the four payment options above, please complete and return the following items to PG&E.
Sign and return this contract as indicated below.
Submit the Payment Coupon with Total Due based on your option selected.
Sign and return the enclosed Statement of Applicant's Contract Anticipated Costs (SACAC) [Form 79-1003] (explanation in box to the right).
Please provide your payment and required forms within 90 days from June 02, 2023. PG&E is not bound by the costs set forth above if payment and the signed forms are not received by PG&E within 90 days.
If you have any questions, please contact Brad Joaquin
at 877-743-7782 or by email at [email protected].
ADDITIONAL INFORMATION
What is the SACAC form
Under PG&E's rules 15 and 16 you have a choice:you can
perform the work yourself, hire a qualified contractor to perform the work or hire PG&E to do the work. We are
required by the CPUC to provide you with PG&E's costs.
This form identifies our cost for the refundable service that is PG&E's responsibility to install. PG&E's costs were
developed based on your choices within the application and may change if you change that choice.
How do I fill out the SACAC?
If you want to do this work yourself or have a qualified contractor do this work, please enter your estimated costs in the section of the SACAC form entitled "Applicant Costs" or check the box in the section entitled "Applicant's Election Not To Provide Costs," sign and return to PG&E. PG&E will send you a revised agreement by return mail only if you choose to provide your estimated costs.
If you want PG&E to do this work, please check the section "Applicant's Election Not to Provide Costs," sign and return the SACAC form along with a check for the Total Due
based on the option you selected above.
You must return the completed SACAC form to PG&E
regardless of who you choose to do the work.
Please follow payment instructions
found on your Payment Coupon.
Pacific Gas and Electric Company
This contract has been reviewed and approved by:
Jennifer Betancourt
Service Planning Supervisor
Customer
Agreed and accepted by:
City of Stockton, A GOVERNMENT AGENCY
Authorized Signatory +DUU\%ODFN
Title &LW\0DQDJHU
Signature #sigMLX#
Date #sigDateMLX#
#titleMLX#
#Form 79-1169#
ATTACHMENT B
124090369
STATEMENT OF APPLICANT'S CONTRACT
ANTICIPATED COSTS.*
Mckinley Park Renovation ProjectProject Name:
424 E 9TH ST, STOCKTONProject Location:
124090369Notification Number:
PM Number(s): (Gas) 35372280(Electric)
APPLICANT COSTS
The following statement must only include the contracted anticipated installed costs of facilities installed by the Applicant that are refundable and that are PG&E's responsibility under its tariffs.
The costs provided by the Applicant must be taken from the Applicant's contract with its contractor. If the Applicant will be performing the work itself, the Applicant must also complete and sign this form.
The Applicant's statement of costs will be compared with PG&E's estimated installed costs of the same facilities, the lower of which will be used to determine the amount subject to allowances and refunds in accordance with the provisions of PG&E's Gas and Electric Rules 15 and 16.
If the Applicant chooses not to provide its costs, it must complete the last section of this form. Until the Applicant either provides the refundable cost from its contract with its contractor (or its own cost, if applicable), or returns this form indicating that it will not do so, PG&E will not proceed with any work on the Applicant's project.
Applicant's statement of costs include: overhead or underground service conductors, poles, service transformers, connection fittings, service pipe, valves, service connections, and other PG&E-owned service equipment, as detailed in Gas and Electric Rule 16.
Applicant's statement of costs DOES NOT include: inspection fees, nonresidential service costs, regulators, or PG&E-owned metering equipment.
Form 79-1003
Tariffs and Compliance
Advice 2458-G-C/2379-E
Decision 03-03-032
Effective: July 1, 2004* Automated document, Preliminary Statement, Part A
GAS ELECTRIC
Residential Service Facilities: Residential Service Facilities:
#applicantCostGas#Applicant: $ #applicantCostElec#Applicant: $ $0.00 PG&E: $0.00 PG&E:
0Number of gas service: 0 Stubs: 0Number of Electric service:
#Form 79-1003#
June 02, 2023
ATTACHMENT B
124090369
GAS ELECTRIC
Gas Distribution Facilities
and Non-Residential Service Services:
Electric Distribution Facilities
and Non-Residential Service Services:
#gasDistFacilities#Applicant: $ #elecDistFacilities#Applicant: $ $0.00 PG&E: $71,611.09 PG&E:
GAS DISTRIBUTION TRENCH
#gasDistTrench#Applicant: $
$0.00 PG&E:
Applicant's statement of costs include: cables, switches, transformers, distribution main, valves, regulators, nonresidential service costs, and other distribution facilities required to complete the distribution line extension, as detailed in Gas and Electric Rule 15 as PG&E's responsibility.
Applicant's statement of costs DOES NOT include: inspection fees, tie-in of system by PG&E, distribution substructures, electric trench, conduits, feeder conduits, or protective structures, as detailed in Gas and Electric Rule 15.
I declare under penalty of perjury that the foregoing is true and correct.
APPLICANT'S ELECTION NOT TO PROVIDE COSTS: (if this option selected, box must be checked) I choose not to provide to the utility my refundable costs for this project as taken from my contract with my contractor, or as performed by myself, and acknowledge that PG&E will use its estimate of the refundable costs for this project in the contract between it and me. #signDateSACAC#Executed on at
(Date) (City)
By:
City of Stockton, A GOVERNMENT AGENCYPrint Applicant Name:
#sigSACAC#Signed:
SignatoryTitle:
#titleSACAC#
Form 79-1003
Tariffs and Compliance
Advice 2458-G-C/2379-E
Decision 03-03-032
Effective: July 1, 2004* Automated document, Preliminary Statement, Part A
#applicantSACAC#
+DUU\%ODFN
ATTACHMENT B
4 4
0 $0.00 Engineering & Administrative Costs
Inspection Fees $0.00 (+)
Others (N/A) $0.00 (+)
Electric Metering $0.00 (+)
Service Tie-In Cost (Energized) by PG&E $0.00 (+)
Including Applicant Design Value of $0.00
$0.00 (+)Service Cost - Applicant installed 0# Services $0.00 (+)0# ServicesService Cost - PG&E installed
$0.00 (=)Total Estimated Cost of Service Subject to Allowance Cost of Service Within Allowance:
less Total Residential Service Allowance
(not to exceed Total Estimated Cost of Service Subject to Allowance) Excess Service Cost
Estimated Service Cost Within Allowance (Total less Excess) Average Cost per Lot or Unit Within Allowance
Excess Service Allowance Applied to Distribution Line Extension Refundable Amount per Lot or Unit:
$0.00 0X $0.00 (-)=
$0.00 =0/$0.00
$0.00 (=)
$0.00 (=)
$0.00
Allowance
- $0.00
Ave. Cost / Unit
$0.00 =
Service Tie-in Cost by Applicant $0.00 (+)
**
Including Net Joint Pole Credit Value of $0.00
June 02, 2023
Applicant: +$55<%/$&.
Project Location/Name 424 E 9TH ST, STOCKTON
Cost Breakdown
Total number of residential lots/units for this project: Total number of non-residential lots/units for this project: Total number of combined meters:
Cost of Services:
Pacific Gas and Electric Company
Detailed Cost Sheet - Electric Distribution
and Service Extension Costs
References
Notification # 124090369
Contract # 50082238 V1
E16-PM # 35372280
EOL1-PM # 35372280
Customer # 3533580
ATTACHMENT B
Allowances
Residential:
Amount Subject to Refund
$74,080.15Engineering & Administrative Costs
Including Applicant Design Value of $0.00
Tie-In of Distribution by PG&E $46,564.43 (+)
Electric Metering (Non-Residential Projects) $2,237.68 (+) Other Taxable charges ( N/A )
PG&E installed - Cost of Distribution Line and Non-Res Svcs.
Applicant installed - Cost of Distribution Line and Non-Res Svcs. $0.00 (+) $194,493.35 (=)
$0.00(+)Inspection Fees
SUB TOTAL
Total Refundable Amount $241,171.75 (+)
$0.00(+)
$71,611.09 (+)
$46,678.40 (+)24%plus ITCC @
$712.75 (-)Less Total Allowances (not to exceed Total Refundable Amount) $240,459.00 Balance: Net Refundable Amount
10 Year Refundable Advance Option
Balance: Net Refundable Amount $240,459.00
$0.00Less Credit for Value of Applicant Design Work
Less Cost of Dist. Line Ext. and Non-Res Svcs. installed by Applicant Less Distribution Substructures by Applicant
Net 10 Year Refundable Advance Option Amount
Non-Refundable Discount Option
Balance: Net Refundable Amount
Less Credit for Value of Applicant Design Work
Less Cost of Dist. Line Ext. and Non-Res Svcs. installed by Applicant Less Distribution Substructures by Applicant
Net Non-Refundable Discount Option Amount
$0.00
$0.00
$0.00
$240,459.00
$240,459.01
$0.00
$0.00
$120,229.50
$0.00
Allowance
X 0
Lots / Units
$0.00 =
24%plus ITCC @ Residential Allowances $0.00 (+)
SUB TOTAL Residential Allowances $0.00 (=)
Non-Residential: $84.84
Net Annual Revenue
/ 0.1476
Cost-of-Service-Factor
$574.79 =
24%plus ITCC @ Non-Residential Allowances $137.95 (+)
SUB TOTAL Non-Residential Allowances $712.74 (=)
less Residential Service Allowance:
( 0
Lots/Units
X $0.00
Ave. Cost / Unit
) + 24%
ITCC
$0.00 =
Total Distribution Line Extension Allowance $712.74(=)
less Discount $240,459.00
Balance
X 0.50
Discount Rate
= $120,229.50 (-)
$0.00(+)Value of Distribution Substructures
Including Net Joint Pole Credit Value of $0.00
ATTACHMENT B
Non-Refundable Payments
Rule 16 Non-Refundable Payments
$0.00 (+)
$0.00
Service Costs Beyond Preferred Service Location
Excess Service Costs
$7,711.67 (+)Service Riser
Value of Service Trench, Conduits & Substructures in the Franchise Area or on 3rd Party Property
$1,810.22 (+)
$0.00 (+)Value of Rule 16 Land Rights Costs
$0.00 (+)
$0.00 (+)Cost of Additional Rule 16 Applicant Design Plan Checks Other Taxable Charges: N/A
$1,700.00 (+)
$1,899.51 (+)
Rule 16 Trench Permits Obtained by PG&E
Inspection Fees
$92.00 (+)Plus Service Trench, Conduits, & Substructures installed by PG&E on Private Property
Inspection Fees (not subject to ITCC) $0.00(+)
$500.00 (+)4 unit(s)Non-Residential Per Meter Charge
Residential Per Meter Charge = 0 unit(s) $0.00(+)
$0.00 (+)Other Non-taxable Charges:
24%Plus ITCC @ $3,149.13 (+)
Total Rule 16 Non-Refundable Amount $15,402.84(=)
Less Service Trench in the Franchise Area or
on & 3rd Party Property installed by Applicant
$0.00(-)Less Rule 16 Applicant Design Work Associated with Excess Rule 15 Non-Refundable Payments
$13,121.40 (=)SUB TOTAL
Inspection Fees $0.00
Re-estimating/Composite Preparation $0.00 (+)
Cost of Additional Applicant Design Plan Checks $0.00 (+) Value of Distribution Conduits $0.00 (+)
Distribution Risers Installed by PG&E $0.00 (+)
Value of Distribution Trench $0.00 (+)
PG&E Land Rights Costs $0.00 (+)
Rule 15 Trench Permits Obtained by PG&E $0.00 (+)
Other $0.00 (+)
SUB TOTAL $0.00 (=)
24%Plus ITCC @ $0.00 (+)
Other Non-taxable Charges $0.00 (+)
SUB TOTAL $0.00 (=)
Less Distribution Conduits Installed by Applicant $0.00 (-) Less Distribution Trench Provided by Applicant $0.00 (-) Total Non-Refundable Electric Rule 15 Amount $0.00(=)
$1,459.70 (-)
$0.00(-)Less Service Costs Beyond Preferred Location by Applicant $0.00(-)Less Excess Service Facilities Installed by Applicant SUB TOTAL $16,862.54 (=)
ATTACHMENT B
Relocation/Rearrangement Inspection Fees
Relocation/Rearrangement Trench Permits Obtained by PG&E Value of Relocation Applicant Design Work
Tie-in/Meter of Relocation/Rearrangement by PG&E
Relocation/Rearrangement Land Rights
Less Relocation/Rearrangement Facilities Installed by Applicant Plus Relocation/Rearrangement - Non Taxable
SUB TOTAL
SUB TOTAL
Relocation / Rearrangement of PG&E Facilities
$0.00(+)
$0.00(+)
$0.00(+)
$0.00(+)
$0.00(-)
$0.00(+)
$0.00(=)
0%Plus ITCC @ $0.00(+)
$0.00(=)
$0.00(+)
Re-engineering/Comp Prep/Add'l AD Plan Checks $0.00 (+) Value of Relocation/Rearrangement Facilities $0.00
Value of Relocation/Rearrangement Conduits & Substructures $0.00 (+) Value of Relocation/Rearrangement Trench & Excavation $0.00 (+) Engineering & Administrative Costs $0.00 (+)
Note: This supplemental detailed cost sheet is for reference only and is not intended for use in place of the actual contract for the project listed. (1) Total Service Allowance not to exceed the Cost of Service (2) 10 Year Refundable and Discount Option credit amounts will be paid upon acceptance of facilities. Credit amounts are subject to future deficiency billing in accordance with the tariff. (3) 10 Year Refundable and Discount Option credit amounts do not offset Other Non-Refundable or Relocation Fees. See Reimbursement Summary for a total of Reimbursements and Credits to be paid upon acceptance of facilities. (4) Inspection Fees (Only Refundable if Applicant's Actual Cost is Used. Applicant's Actual Cost + Inspection Cannot Exceed PG&E's Estimate)
(5) The lower of PG&E's estimated costs or the Applicant's Contract Anticipated Costs (as documented on Form 79-1003 "Statement of Contract Anticipated Costs") will be used to establish the cost of Service and Distribution Line Extension subject to Allowance $0.00(=)Total Relocation / Rearrangement of PG&E Facilities Amount $0.00(-)Less Relocation/Rearrangement Salvage
$0.00 Including Net Joint Pole Credit Value of
Less Value of Relocation Applicant Design Work $0.00(-) Less Trench & Excavation Provided by Applicant $0.00(-) Less Conduits & Substructures Installed by Applicant $0.00(-) D.0405055 Line Extension Costs - Residential $0.00
D.0405055 Line Extension Costs - Non-Residential $0.00
ATTACHMENT B
June 02, 2023
Pacific Gas and Electric Company
Detailed Cost Sheet – Outdoor Lighting Costs
References
Notification # 124090369
Contract # 50082238 V1
E16-PM # 35372280
EOL1-PM # 35372280
Customer # 3533580
Cost Breakdown
424 E 9TH ST, STOCKTONLOCATION:
Outdoor LightingDESCRIPTION OF WORK:
Work Provided by Rate Payers
$201.48 Engineering & Administrative Costs
Outdoor Lighting – Overhead Service & Connection $0.00 (+) Outdoor Lighting - Standard Luminaire(s) & Arm(s) $284.97 (+) Total Amount Provide by Rate Payers $486.45 (-)
Non-Refundable Costs
Re-Engineering, Inspection, Land Rights, Permits $0.00 (+) Outdoor Lighting Excavation, Conduit, Substructures $0.00 (+) Other Costs $0.00 (+)
Subtotal $0.00 (=)
24%plus ITCC @ $0.00 (+)
Outdoor Lighting Customer Poles/Posts, Foundation $0.00 (+) Outdoor Lighting Internal Wire $0.00 (+)
Credits for Applicant Provided Work:
Outdoor Lighting Excavation, Conduit, Substructures by Applicant $0.00 (-) Total Outdoor Lighting Non-Refundable Payment $0.00 (=) Note: This supplemental detailed cost sheet is for reference only and is not intended for use in place of the actual contract for the project listed.
ATTACHMENT B