Rock Energy Cooperative
Contents
1. For all services NOTE Natural gas service is only available in Illinois M Application filled out completely and signed Keep copy for your records The following must accompany the application for further processing M M M m Sketch of member owned facilities to be included see attached example Attach recorded copy of certified survey map or platted lot and lot corners staked Expose or locate with staking flagging and or other durable marking the physical location of any member owned underground facilities i e wells septic underground tanks fuel lines drain tiles downspouts member owned wires sprinkler systems and yard lighting Appropriate inspection form for electric services completed by the local Electrical Inspector Enclosed Gas Disclosure Statement Illinois only filled out and signed keep H py for your records if applicable Be sure to read your copy of the Residential Electric and Natural Gas Service Application and Agreementt You can estimate line extension costs by using the attached fee schedule Building Site Sketch and Meter Location Requirements A B C Mark a G for your proposed gas meter location with a measurement from the nearest corner of the dwelling Mark an E for your proposed electric meter socket pedestal location with a measurement from the nearest corner of the dwellings Show all decks pools wells septic underground tanks fuel lines drain ti2. Any pipe size larger than four 4 inches cost to be determined at time of project Mains non frost rate Plastic two 2 inch 8 00 per foot Plastic four 4 inch 11 00 per foot Steel any size cost to be determined at time of project All extensions greater than 200 feet cost to be determined at time of project Any pipe size larger than four 4 inches cost to be determined at time of project Mains frost rate Nov 15 April 1 Plastic two 2 inch 12 00 per foot Plastic four 4 inch 16 50 per foot Steel any size cost to be determined at time of project All extensions greater than 200 feet cost to be determined at time of project Any pipe size larger than four 4 inches cost to be determined at time of project Road bore if needed sese eren nnne nnns 15 00 per foot Electric amp of feet x cost foot Gas of feet x cost foot Road bore of feet x cost foot Grand total Rock Energy Cooperative Gas Disclosure Statement IL only Important Notice This Disclosure Statement must be signed dated and returned to Rock Energy Cooperative prior to the natural gas service being turned on at the address below Property Owner Phone Number Address of Gas Meter The above owner is requesting REC turn on the natural gas service at the above address The following are the terms and conditions associated with turning the service on After the meter is
3. Cooperative reserves the right to consider alternate service routes if necessary to avoid contaminated media The member may be held liable for additional costs incurred by the Cooperative if contaminated media is encountered during the installation of service If contaminated media is encountered during the installation or extension of service the Cooperative shall terminate the installation or extension of service and notify the member The member is responsible for reporting the discovery of contamination to the appropriate agencies The member or landowner is responsible for management of any contaminated media generated during the installation of service 7 The Cooperative agrees to furnish and the member agrees to take and pay for utility service in accordance with provisions and rates subject to all applicable rules of the Cooperative including but not limited to terms and conditions on this page hereof until such time as the member discontinues service or elects to make a written application for service under a different schedule Such election however may not be exercised within a one year period from the date of this application 8 Member understands once meters are set billing will begin 9 All property of REC which includes but is not limited to the meter and transformer shall remain the property of REC and shall not be modified or altered in any way Any modification or alteration could be extremely dangerous and is ill
4. Rock Energy Cooperative 2815 Kennedy Road e P O Box 1758 Janesville Wisconsin 53547 1758 608 752 4550 e 866 752 4550 Fax 608 752 6620 www rock coop Dear Prospective Member Thank you for contacting Rock Energy Cooperative for new service Established in 1936 Rock Energy is a not for profit utility distributing safe and reliable electricity and natural gas to more than 27 000 meters across our nine county service area in southern Wisconsin and northern Illinois We are dedicated to providing members with the highest quality service at the lowest possible price This packet contains all the information you need to apply for electric and or natural gas service Details about natural gas installation can be found by visiting www rock coop and clicking on Natural Gas Service Manual in the Energy Management tab Please complete the enclosed application and return it along with the required documents by any of the following means Email NewMember rock coop Fax 608 752 6620 815 389 9100 Mail Rock Energy Cooperative Rock Energy Cooperative P O Box 1758 P O Box 126 Janesville WI 53547 South Beloit IL 61080 Drop off 2815 Kennedy Road 15229 Willowbrook Road Janesville WI South Beloit IL We are looking forward to meeting your energy needs If you have any questions please call us at 608 752 4550 or 866 752 4550 between 7 30 a m and 4 p m weekdays Sincerely Rock Energy Cooperative Instructions for service
5. egal Trench Marking Agreement The Member agrees the Cooperative will dig trench plow or bore on the member s property located at the above address for the installation of utility services Utility rates are based on rough grade construction meaning the Cooperative will backfill and smooth over any excavations that the Cooperative performs Final restoration grass seeding watering and mowing are the member s responsibilities Prior to digging trenching or boring the Cooperative will identify the route of the proposed excavation The Cooperative will notify other utility owners to facilitate the marking of existing underground utilities including electric telephone and cable TV The Member agrees to physically mark the location of any and all owned obstacles that lie underground within ten feet of proposed excavation Such obstacles include but are not limited to septic and sewer systems buried wires for out buildings or decorative lighting and LP gas lines The Member shall mark the location of all of these obstacles with stakes or flags or by painting the ground The Member hereby accepts any and all responsibility for damage to or damage done by striking any such underground obstacle the Member fails to mark or marks incorrectly uoneso JSF pue u23e3IS INS Suipiina JIAN YX amies s mtm m np ap EO noc 0 X 0 2 Mme l r cbe NE Fee Schedule Effective Janua
6. gy Cooperative file Yellow Rock Energy Cooperative staking Pink Member Residential Electric and Natural Gas Service Application and Agreement 1 The applicant s understand s and agree s that prior to installation of underground electric lines or natural gas piping the Homeowner shall have established the final grade of the route and that after installation of the line the grade shall not be increased or decreased more than 6 without the approval of Rock Energy Cooperative REC If applicant is not the Homeowner the applicant is responsible for obtaining such agreement in writing from the Homeowner and providing same to the Cooperative at no expense to the Cooperative 2 Easement Right of Access a The applicant s if also the Homeowner s grant to the Cooperative the right to clear for installation and maintenance of its overhead and or underground electric line or gas piping and to use any necessary equipment in on and across the above described land along highways and along fence lines thereon and to extend such lines along or near property lines of such premises as may reasonably be necessary to extend service to future applicants for such service and to permit the attachment of communication lines and equipment owned by others If applicant is not the Homeowner the applicant is responsible for obtaining such agreement in writing from the Homeowner a
7. ision Name Lot Number City Town Village County Square Footage of Dwelling Dwelling Type Check One Number of Units Single Family Multi Unit Billing Information Who should be billed for electric gas installation Who should be billed for electric gas usage during construction Builder Contractor Homeowner Builder Contractor L Homeowner cU Contractor Information s EE _ Address Fire amp Street City State Zip Daytime Phone Number Evening Phone Number Email Address Electrical Contractor Work Phone Number Cell Phone Number Heating Contractor Work Phone Number Cell Phone Number C o Electric Service Requirements Service Amps Service Type Voltage 100 200 300 Other Overhead Underground 120 240 Other oe Natural Gas Equipment Heating Quantity Water Heater Quantity E RengejQuantiy Quantity Water Quantity BTU s 1 Other Generator Quantity Heate Pool Heater etc Instantaneous BTU s i e Approval and Acceptan LI have read and understand the terms a Homeowner Responsible Party Signature Homeowner Responsible Party Printed Name Accepted by Rock Energy Cooperative REC REC Representative Signature REC Representative Printed Name White Rock Ener
8. les downspouts member owned wires sprinkler systems yard lighting etc Procedures for processing request for service 1 All new applicants are subject to the REC Deposit Policy This will require a soft credit check to determine whether a deposit is required to set up services This credit check will not affect your credit scores If a deposit is required you will be contacted by Member Services and said deposit must be paid before further processing will occur Once deposit is received or if no deposit is required your request for service will be forwarded to the appropriate Co op personnel who will contact you to schedule a field visit 2 Co op personnel will provide you at time of field visit with a copy of an estimated cost for services You will receive an invoice from Billing Dept within 3 5 business days after initial visit This must be paid prior to service being installed Request for Residential Electric and Natural Gas Service Rock ENERGY COOPERATIVE For Office Use Only Gas WO No Member Account No Date Received Electric WO No Rock Energy Cooperative Representative Map Location Homeowner and Site Information New Service Address Fire amp Street City State Zip Existing Mailing Address Fire amp Street City State Zip Daytime Phone Number Evening Phone Number Fax Number Email Address Check One City Town Village Name Subdiv
9. nd providing and same to the Cooperative at no expense to the Cooperative unless same has previously been provided to the Cooperative b The applicant s jointly with other applicants on the same extension shall without cost to the Cooperative maintain a right of way which the Cooperative has the right to clear adequate for the extension and along a route approved by the Cooperative c If requested by the Cooperative the applicant s homeowner shall grant to the Cooperative an easement in recordable form conveying the rights and privileges in a and b above If applicant is not the Homeowner the applicant is responsible for obtaining the easement in writing from the Homeowner and to provide the same to the Cooperative at no expense to the Cooperative 3 The applicant s individually and jointly agree s to indemnify and hold harmless the Cooperative from all claims against the Cooperative because of any injury disease or death sustained by reason of any act omission or negligence of the applicant or any agent employee or subcontractor thereof 4 This agreement shall become effective when acceptance of the application has been signed on behalf of the Cooperative 5 The member is subject to the Cooperative s Deposit Policy 6 The member is responsible for notifying the Cooperative of contaminated media soil groundwater etc that may be present on the premises prior to Cooperative commencing installation or extension of service The
10. ny charges to Rock Energy Cooperative the natural gas service is subject to immediate disconnection Owner Responsible Party Signature Date Member Shut Off Regulator w 9 REC Red Tag N Meter Stop Meter REC Lock s V NI White Copy REC Yellow Copy Member
11. ry 1 2015 This payment schedule will be reviewed and renewed on an annual basis Electric minimum charge 250 00 a Single phase Primary or Secondary non frost rate Overhead and Underground sees seen nennen 10 50 per foot b Single phase Primary or Secondary frost rate Nov 15 April 1 Overhead and Underground sese ennt 17 15 per foot c Multi phase Primary or Secondary non frost rate Overhead and Underground essent 22 50 per foot d Multi phase Primary or Secondary frost rate Nov 15 April 1 Overhead and Underground essent nn 37 50 per foot e Variance considerations The above line extension fees are based on typical conditions should conditions vary the cooperative reserves the right to request alternative measures be sought by the requesting party Additional work by the cooperative as a result in variance shall be billed at the appropriate fee as listed Gas minimum charge 250 00 Services non frost rate Plastic 8 25 per foot Steel 12 80 per foot All extensions greater than 200 feet cost to be determined at time of project Any pipe size larger than four 4 inches cost to be determined at time of project Services frost rate Nov 15 April 1 Plastic 12 75 per foot Steel 19 50 per foot All extensions greater than 200 feet cost to be determined at time of project
12. set the member is responsible to complete the following prior to sending in the Disclosure Statement e Piping completed from the meter to their appliances e Pressure test e External piping painted to protect from corrosion e Pipe passing through wall wrapped without seams or folds e Comply to all plumbing codes e Member underground piping must be preapproved by REC REC will make one 1 trip without charge to turn on the above natural gas service this provision does not include non payment issues Any subsequent trips to the above location beyond the initial service call will be subject to fees and charges Should the above natural gas service fail to pass an REC inspection which will include a gas creep test REC is required to issue a Caution Card In addition REC may require the above owner to furnish a completed and signed Piping Statement and or approval from the County Plumbing Inspector The owner is responsible for any and all costs that result beyond the member s shut off The owner is responsible for removing the member s shut off seal and for all relights at the above address By signing below I understand that I am requesting Rock Energy Cooperative turn on the natural gas service at the above address I understand that Rock Energy Cooperative is not responsible for any and all claims arising from turning on the natural gas service agree to the above terms and conditions further understand that should fail to pay a
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