Large Customer Connection Enquiry Form

of 6 Large Customer Connection Enquiry Form (For the Connection of Loads and Generators) Please complete all Mandatory Fields * and as much detail as possible to ensure Energex can meet your requirements. When completed, please attach and e-mail this form to lcc@energex.com.au *Enquiry from Customer Customer s Consultant Customer s Builder Customer s Electrician Applicant Details *Applicant Name (Please print) *Company Name (If applicable not trading name) *Site Name or Reference *ABN or ACN (If applicable) NMI *Business Phone Number Mobile Number *E-mail *Postal Address Postcode Select preferred application form delivery method (if required) Email Post Contestability (Alternative Control Services) The National Electricity Rules allow customers to construct, design and own their connection assets where the works are considered a dedication connection. A dedicated connection is one in which no other customers will be connected to. These assets may also be gifted (at no cost) to Energex. Energex may also be able to offer a quote to construct and design these assets. Specific rules covering the materials, auditing, construction and design may apply and are available for download from the Energex website. http://www.energex.com.au/service_providers/technical_docs/asp/technical_documents.asp Energex at its own discretion will determine the Network Coupling Point i.e. the point at which the Network connects to the Connection Assets. Further information can be found on the Energex website or by contacting our Call Centre on 13 12 53.

of 6 Consultants Details (Energex Accredited) Contact Name (Please print) Company Name (If applicable) ABN or ACN (If applicable) Business Phone Number Mobile Number E-mail Postal Address Postcode Select preferred application form delivery method (if required) Email Post Please choose from the following options. Quotes for services will be provided when available and will only be indicative in nature at this stage. *Option 1 *Option 2 *Option 3 *Option 4 Customer design, construct and own Energex design, construct and own Customer design, construct and Energex own Unsure at this stage Please note that all Network (used by more than one customer, including future use) will continue to be designed, constructed and owned by Energex Property and Enquiry Information Details *New Connection *Customers Business Name *Contact Person Name/s *Email Site Name *Street Address *Upgrade to Existing Connection *Estimate of Total Project Cost *ABN Number Phone Number *RP Description/Lease No. *Suburb Additional details on location i.e. restrictions, environmental, cultural, etc. Is the registered owner of the property the applicant? Yes No If No, please enter name of registered owner

of 6 *Type of Connections Load Connection Generator *New Connection Load >1MV.A+ (If you require a new connection to either a new premises, property or equipment above 1MV.A) *New Generator Connection up to 400kW (If you require a connection for generation plant up to 400kW) *New Generator Connection 400kW+ (If you require a connection for generation plant above 400kW) *New Parallel Generation Agreement (If you have an existing or new connection and require an agreement for a generation system that will not export into the electricity grid but will make a physical connection) *Upgrade Existing Connection or Contract (If you require an upgrade of the existing supply or require modification to an existing contract) *Development (If you require a connection to a development (i.e. You are not the final end user) which has an estimated total consumption of >4GWh or >1MV.A demand) *Other (If your enquiry does not relate to any of the above options, please ensure you describe your enquiry in the area provided on the last page however this form is used generally for generators and large customers only) Please note that if you wish to connect a small photovoltaic system (<=10kW 1-ph or <=30kW 3-ph) telephone our Contact Centre on 13 12 53 as this is not the correct form. *Connection Voltage (kv) *Purpose of Industry / Load *Additional Maps, Site Plans or Diagrams Attached? Yes No General Load Details *Full A/C Demand and Details (e.g. Split System, Chiller etc.) *AS3000 Calc Demand MW kw Amp *Preferred Electrical Substation Indoor Outdoor (ground) Pad Mount Type *Preferred Location of Substation Site Plan attached? Yes No High Rise Developments Total Number of Levels Number of Residential Levels Number of Residential Units Number of Commercial Levels Gross Commercial Floor Area Total Estimated Demand MW kw Amp Other Development Types Type of Plant (eg rolling mill, turbine gas/steam) Network Charges *Are Indicative Network Charges requested at this stage of the enquiry? Yes No *Authorised Demand (highest 30min average demand expected after diversity for a 12 month period) *Energy Consumption (estimated energy consumption in kwh per annum - for generators - energy production) *Anticipated average monthly maximum demand (i.e. the average of all 12 monthly maxima) kw kwh kw *The peak energy as a proportion of total % Anticipated Power Factor *Anticipated Power Factor (at high load) (e.g. 0.85) Power Factor Correction to be Installed? Yes No

of 6 Metering Arrangements *Metering Required HV Metering LV Metering Metering Provider (Responsible person:- responsible for the provision, installation and maintenance of a metering installation) Retailer Details Retailer Name (FRMP: Financially Responsible Market Participant) Registered Participant Registered Participant Reference No. (Embedded Generation >5MWh to be registered with AEMO) Significant / Disturbing Loads (e.g. Harmonics, Large Motors, Welders, Thyristor Drives) Details of Disturbing Loads Significant Load Refer to Attached Detail Yes No Generating Systems (Preliminary Details where applicable) Size Size MW / MVAr MW / MVAr Number of Units Output of Units (kva) Unit: 1-2 - 3-4 - Type of System (e.g. Diesel, Wind, PV, Synchronous Machine) Purpose of Operation Standby Only Co-Generation Commercial Operation / Connection Isolated from Energex Supply Parallel operation (No Export) Parallel Operation (Export) Forecasts Total Hours of Operation per Annum: Maximum Export Demand (kw) to Energex Network: Export Energy (kwh per annum) Supplementary Forms Energex will require more Technical information about the Embedded Generation. Please complete the most appropriate form from the list below and submit with this Enquiry. Form 1060 is mandatory for all Solar PV enquiries. Inc. Form Description F1060 F1552 F1551 F1369 F1554 F1370 Network Connection Application: Embedded Generation (Including Solar PV) Request of PV/Inverter Information Request of Generator Information Request of Motor/Drive Information Request of Load (UPS) Information Request of Furnace/Drive Information

of 6 Connection Construction Timing *Temporary Building Supply Required? Yes No *Maximum Temporary Supply Demand *Required by Date / / *Date Permanent Electricity Supply Required / / *Details of Staging Time Frame and Other Construction Requirements Yes N/A Special Requirements / Future Load Requirements List any special requirements and future load requirements in relation to the connection, (eg N -1, back up supply etc) Other Information / Comments

of 6 Notes You will receive a reply from Energex acknowledging your enquiry within 5 working days of reception. This reply will normally be sent via e-mail and will detail any missing information required before the enquiry can be presented to a Network Connection Manager, failure to provide this information will result in your enquiry being placed on hold. The reply to your enquiry will contain a Work Request number, this reference number is to be used in all future contacts with Energex in regards to this specific project. The reply will also confirm that Energex is the correct Network Service Provider (NSP), if not you will receive further instructions for the relevant NSP for your enquiry. Your enquiry will be processed under the National Electricity Rules (chapter 5); you should take time to understand your responsibilities under this document. A link to Rules can be found on the Energex website www.energex.com.au or at the Australian Energy Market Commission website http://www.aemc.gove.au/rules.php this document is regularly updated. From this enquiry you will receive an enquiry response which will provide an outline of costs, connection method and connection requirements. If you wish to proceed to a connection, an application to connect form will need to be forwarded to Energex with your relevant Work Request number, application fee and additional information.