B09_PGE_Project_Contract_122103971_E_CONTRACTPK_Amd1_0001.pdf

122103971

April 27, 2022

Customer Payment Coupon

References Notification # 122103971 Contract # 50060648 V1

E16-PM # 35298209

Customer # 3121615

WHISKEYTOWN NATIONAL RECREATION AREA

14412 KENNEDY MEMORIAL DRIVE

WHISKEYTOWN, CA 96095

Customer Payment Summary

12487 STATE HWY 299 WEST, WHISKEYTOWN

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 $26,922.35 $24,422.35

Non-Refundable 50 percent Discount Option for Gas and Electric

$14,521.92 $12,021.92

10-Year Refundable Advance Option for Gas and Non-Refundable 50 percent Discount Option for Electric

$14,521.92 $12,021.92

Non-Refundable 50 percent Discount Option for Gas and 10-Year Refundable Advance Option for Electric

$26,922.35 $24,422.35

The Total Due for each payment option above includes:

Advance Credit ($2,500.00)

Important Payment Information To complete your contract ONLINE

Follow the instructions provided with your electronic contract Submit payment at 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

Gas and Electric Extension Agreement*

* Automated document, Preliminary Statement, Part A

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Form 79-1169 Advice 3579-G/4607-E March 2015Page 1 of 2

122103971

For Internal Use

122103971Notification #

50060648Contract #

35298209E-PM #

G-PM #

E-Prior MLX/PM#

G-Prior MLX/PM#

3121615Customer #

1V

April 27, 2022

WHISKEYTOWN NATIONAL RECREATION AREA

14412 KENNEDY MEMORIAL DRIVE

WHISKEYTOWN, CA, 96095 12487 STATE HWY 299 WEST, WHISKEYTOWNRe:

JOSH HOINESDear

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 separate 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

Customer

GAS ELECTRIC

Total non-refundable project costs $0.00 $2,121.48 Refundable extension costs $0.00 $24,800.86 Allowances (credit) $0.00 - $0.00 - Net refundable amount $0.00 = $24,800.86 =

10 YEAR REFUNDABLE OPTION

Net refundable amount $0.00 $24,800.86 Credit for value of design and/or facilities provided by applicant $0.00 - $0.00 -

Total non-refundable project costs $0.00 + $2,121.48 + Total (if you select this option) $0.00 = $26,922.35 =

NON-REFUNDABLE 50% DISCOUNT OPTION

Net refundable amount $0.00 $24,800.86 Discount: 50% of Net refundable amount $0.00 - $12,400.43 - Credit for value of design and/or facilities provided by applicant $0.00 - $0.00 -

Total non-refundable project costs $0.00 + $2,121.48 + Total (if you select this option) $0.00 = $14,521.92 =

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.

Gas and Electric Extension Agreement*

* Automated document, Preliminary Statement, Part A

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Form 79-1169 Advice 3579-G/4607-E March 2015Page 2 of 2

122103971

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

$26,922.35

$14,521.92

$14,521.92

$26,922.35

Advance

SEE PMT CPN

SEE PMT CPN

SEE PMT CPN

SEE PMT CPN

Total Due

$26,922.35

$14,521.92

$14,521.92

$26,922.35

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 April 27, 2022. 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 Edward Normand at 530-246-6559 or by email at EIN1@PGE.COM.

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:

Bill Powell

Service Planning Supervisor

Customer

Agreed and accepted by:

WHISKEYTOWN NATIONAL RECREATION AREA, A

GOVERNMENT AGENCY

Authorized Signatory JOSH HOINES

Title Other

Signature #sigMLX#

Date #sigDateMLX#

#titleMLX#

#Form 79-1169#

STATEMENT OF APPLICANT'S CONTRACT

ANTICIPATED COSTS.*

12487 STATE HWY 299 WESTProject Name:

12487 STATE HWY 299 WEST, WHISKEYTOWNProject Location:

122103971Notification Number:

PM Number(s): (Gas) 35298209(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: 0Stubs: 0Number of Electric service:

#Form 79-1003#

April 27, 2022

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: $9,299.19 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:

WHISKEYTOWN NATIONAL RECREATION AREA, A GOVERNMENT AGENCYPrint Applicant Name:

#sigSACAC#Signed:

OtherTitle:

#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#

JOSH HOINES

Cost Breakdown

1Total number of combined meters:

1Total number of non-residential lots/units for this project:

0Total number of residential lots/units for this project:

Cost of Services:

$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:

Applicant: JOSH HOINES

Project Location/Name 12487 STATE HWY 299 WEST, WHISKEYTOWN

$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

April 27, 2022

Pacific Gas and Electric Company

Detailed Cost Sheet - Electric Distribution and Service Extension Costs

References Notification # 122103971 Contract # 50060648 V1

E16-PM # 35298209

Customer # 3121615

Allowances Residential:

Amount Subject to Refund

$6,019.74 Engineering & Administrative Costs

Including Applicant Design Value of $0.00

Tie-In of Distribution by PG&E $4,314.48 (+)

Electric Metering (Non-Residential Projects) $367.29 (+)

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 (+)

$20,000.70 (=)

$0.00(+)Inspection Fees

SUB TOTAL

Total Refundable Amount $24,800.87 (+)

$0.00(+)

$9,299.19 (+)

$4,800.16 (+)24%plus ITCC @

$0.00 (-)Less Total Allowances (not to exceed Total Refundable Amount)

$24,800.86 Balance: Net Refundable Amount

10 Year Refundable Advance Option

Balance: Net Refundable Amount $24,800.86

$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

$24,800.86

$24,800.87

$0.00

$0.00

$12,400.43

$0.00 Allowance

X 0 Lots / Units

$0.00 =

24%plus ITCC @ Residential Allowances $0.00 (+)

SUB TOTAL Residential Allowances $0.00 (=)

Non-Residential: $0.00 Net Annual Revenue

/ 0.1476 Cost-of-Service-Factor

$0.00 =

24%plus ITCC @ Non-Residential Allowances $0.00 (+)

SUB TOTAL Non-Residential Allowances $0.00 (=) less Residential Service Allowance:

( 0 Lots/Units

X $0.00 Ave. Cost / Unit

) + 24%

ITCC

$0.00 =

Total Distribution Line Extension Allowance $0.00 (=) less Discount $24,800.86 Balance

X 0.50 Discount Rate

= $12,400.43 (-)

$0.00(+)Value of Distribution Substructures

Including Net Joint Pole Credit Value of $0.00

Non-Refundable Payments

Rule 16 Non-Refundable Payments

$0.00 (+)

$0.00

Service Costs Beyond Preferred Service Location

Excess Service Costs

$762.24 (+)Service Riser

Value of Service Trench, Conduits & Substructures in the Franchise Area or on 3rd Party Property

$0.00 (+)

$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

$0.00 (+)

$847.83 (+)

Rule 16 Trench Permits Obtained by PG&E

Inspection Fees

$0.00(+) Plus Service Trench, Conduits, & Substructures installed by PG&E on Private Property

Inspection Fees (not subject to ITCC) $0.00(+)

$125.00 (+)1 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 @ $386.41 (+)

Total Rule 16 Non-Refundable Amount $2,121.49 (=)

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

$1,610.07 (=)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 (=)

$0.00(-)

$0.00(-)Less Service Costs Beyond Preferred Location by Applicant

$0.00(-)Less Excess Service Facilities Installed by Applicant

SUB TOTAL $2,121.49 (=)

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