Outdoor Lighting Application

Service Desired(Required)

Install New Light(s)

Change Existing Light(s)

Name on DES Account(Required)

First Last

Responsible Person (if different)

First Last

Daytime Phone(Required)

DES Account Number

Install Address

Street Address City

Bill Address

Street Address Address Line 2 City State ZIP Code

Comments

Consent(Required)

The undersigned ("Applicant") submits this Application and Contract for Outdoor Light Service ("Contract") for outdoor dusk-to-dawn ("light") to be furnished by Dickson Electric System ("Dlstributor''). This Contract shall be binding upon Applicant's heirs, devisees, successors, administrators, assigns, and representatives. All fees and terms are subject to modification, adjustment, or replacement at any time.

Application Fees - Non Refundable - payment by cash or check to DES must be made before Order Is Issued to:
- Apply for New Light: Install $25 Application Fee (per application, covers any quantity of lights to Install).
or
- Apply to Change Existing Light: $50 Change Fee (per fixture to change model or relocate fixture).

Location and Construction - Distributor's Engineer will meet with Applicant to stake out location for Installation of light(s) on existing or new DES pole only (not Applicant-owned or meter pole), which must be within 150 feet of an existing transformer, typically completed within four weeks after Application and payment of all charges. Engineer will advise Applicant of construction charges to pay by cash or check to DES prior to Installation.

Note: Underground electric service may affect the costs and/or ability to install outdoor lights.

Aid to Construction Charges $200 Install per Pole for New Light (when existing pole not available for light), plus any additional amounts for equipment, transformers, poles, or service lines required to bring service to new or relocated light location

Equipment and Maintenance - Applicant acknowledges that lights, poles, and construction materials are leased equipment, and remain the property of Distributor. Applicant agrees to reasonably protect the light from damage, and shall be held financially responsible for intentional or avoidable damage to light. Applicant agrees to notify Distributor when the light falls to burn, and Distributor will complete repairs in a timely manner.

There are no refunds for the time the light is not operating.

Lease Term - Applicant agrees to a 24-month lease term for each new light, beginning the date that light is installed. After term expires, Contract shall automatlcally renew and continue to bill on a month-to-month basis unless terminated by Applicant or Distributor. Contract is transferrable to new property owners or business tenants. If light service is cancelled or removed by Applicant during the 24-month lease term, Distributor will bill Applicant for remaining months using the rate in effect at the time of cancellation.

Removal - Light may be turned off, or light and pole removed, at any time by Distributor upon Applicant's failure to pay the charges set forth herein, or upon changes to the service by Applicant or Distributor.

Billing - Each light and added pole will be billed to Applicant's regular monthly electric service billing. Changes to existing light model or poles added or removed will be adjusted on Applicant's bill effective the date of completion and pro-rated for the billing month. Rates are set forth by TVA In Outdoor Lighting Schedule LS-Part B for Rated kWh and Facility charge, and any applicable addendum at the time of billing. Light models and monthly rates are subject to modification, adjustment, or replacement at any time upon agreement by Distributor and TVA.

Monthly Rate November 2024:

Each Pole added for outdoor light, Pole model, $1.50
Light Emitting diode (white) - 9,408 Lumens, 71w LED model, $8.91
Light Emitting diode (white) - 17,122 Lumens, 138w LED model, $13.61
Light Emitting diode (white) - 16,268 Lumens, 128w LED Flood model, $17.95

This Dickson Electric System does not discriminate on the basis of race, color, sex, age, handicap, religion, or national origin.

By signature below, Applicant accepts and agrees to the terms and conditions defined herein and in the attached DES Operating Policies and Procedures Outdoor Light Guidelines hereby incorporated as a part of this Contract.

I hereby verify the information to be true and complete and agree to the terms and conditions. I understand that by typing my full name and pressing the Submit button, this form submission will be stamped with today’s date and authorized by me as if I had signed my signature.

Applicant Signature (Full Name)(Required)

Name

This field is for validation purposes and should be left unchanged.