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L I P P E R C R E E K, INC. 11850 Kemper Road <br />N N O V AT I V E INFRASTRUCTURE FOR Suite #E • Auburn, CA <br />ELECTRIC AND HYBRID VEHICLES 95603 95603 • 9 (5(5300) 887 887--116674 E)IN <br />* Fax (530) 887-8527 17olwo <br />Reconnect California Grant Outline: <br />(Site Identifier Form) <br />Funded through CEC PON-09-006 <br />ClipperCreek has received grant funding through the California Energy Commission (CEC) to replace and update existing EVSE <br />(Electric Vehicle Supply Equipment) infrastructure to the new SAE J1772 standard. Through the grant funding we are able to offer <br />the replacement and installation of the new SAE J1772 compliant EVSE(s) at no charge to qualified sites. <br />The replacement chargers will be provided by ClipperCreek and the installation work will be done by a certified contractor partnering <br />with ClipperCreek for this program. <br />What the grant covers: <br />- New EVSE (CS-40) to replace existing obsolete infrastructure <br />- Installation of new CS-40 EVSE <br />- Proper disposal of removed/obsolete EVSE <br />If you are interested in taking advantage of this phenomenal opportunity I will need the following information from you. <br />Site Owner/decision maker name and title: <br />Contact Information: <br />Site Address: <br />On Site Contact Name and Phone Number: <br />*Please include site photos if you have them* <br />Thank you for your time. Please provide the above requested information to ClipperCreek in order to move onto the next step of the <br />upgrade process. <br />Upon site approval we will be contacting you to begin the installation process by scheduling a pre install inspection, which will be <br />followed by the installation of your new upgraded EVSE's. <br />Mail To: <br />ClipperCreek, Inc. <br />Attn: Will Barrett <br />11850 Kemper Rd #E <br />Auburn, CA 95603 <br />Email To: <br />Will e,ClipperCreek.net <br />Call in To: <br />530-887-1674 Ex 303 <br />4/4/2011, WPB, Reconnect California Grant-Site Identifier (2).docx <br />Office Use Only: <br />Date entered into install queue: <br />Site ID Number: <br />Page 1 of 1 <br />25F-9