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4. APPLICANT'S CONTRACT ANTICIPATED COST INFORMATION (to be completed only <br />if installation is performed by a Qualified Contractor/Subcontractor as selected in Section 3 above) <br />Applicant and/or Applicant's Qualified Contractor/Subcontractor understands that for the portion of <br />the Electrical Distribution and/or Service Extension that SCE would normally install, in accordance <br />with SCE's Rule's 15 and/or 16 and the Terms and Conditions Agreement for Installation of <br />Distribution Line Extension by Applicant, the Applicant, prior to performing any work associated <br />with the installation of these electrical facilities, and for the purpose of utility billing and accounting, <br />shall elect one of the following options, and return this form to SCE prior to SCE proceeding with any <br />further work on the Applicant's project. <br />Option 1 Applicant elects to provide SCE with the Applicants Contract Anticipated Costs, which are <br />subject to refund, that are associated with that portion of the new Distribution Line and/or <br />Service Extension normally installed by SCE, and understands that the lower of SCE's <br />estimated refundable cost or the Applicant's Contract Anticipated Costs, which are subject <br />to refund, as submitted below, shall apply to any applicable SCE refunds and allowances <br />provided in accordance with Rule 15 and 16, 1 or <br />Option 2 Applicant elects not to provide SCE with the Applicants Contract Anticipated Costs, which <br />are subject to refund. The Applicant understands that by selecting this option, the Applicant <br />is directing SCE to use SCE's estimated refundable cost for all billing and accounting. <br />Applicant understands the Applicants Cost Information, as described above, and hereby elects the <br />following by initialing the appropriate selection below: <br />Option 1 - Applicants Contract Anticipated Costs $ <br />Option 2 - SCE's Estimated Refundable Costs <br />5. ITCC <br />SCE shall value all trenching, conduit, backfill, street repair, substructures, and encasement, based on <br />SCE's estimate of such items, for the purpose of collecting the applicable governmental taxes (ITCC) on <br />contributions to SCE. <br />6. UTILITY RESPONSIBILITIES <br />Upon receipt of this completed and signed form, SCE shall begin the process of producing theapplicable <br />contracts and forms based on the selection made by the Applicant. <br />7. SIGNATURE <br />I declare under penalty of jury that the foregoi g s t re d correct <br />Applicant's signature: Trh I <br />Applicant's printed name . D,qyr o Gh to, <br />1 <br />Date : 12 k-) <br />i Excludes the estimated costs of work the Applicant cannot perform, such as, work on or in proximity to, <br />energized equipment. <br />Fonn 14-754, New 7/04 <br />