Solar Power and Energy Efficiency Program

Participation Authorization

Yes, we are interested in considering procuring solar energy and/or energy efficiency services through the Municipal Electric and Gas Alliance ("Alliance"), a program of the New York State Association of Counties. In signing below, we are indicating our consent and authorization:

  1. For our electric and/or gas utilities to provide data (which will be kept confidential) about our energy usage and costs that may be requested by the Alliance, its consultants (EnergyNext, Inc.), and/or selected suppliers;
  2. For the Alliance to include our name listed as a potential solar power purchaser or energy efficiency customer of one or more suppliers selected by the Alliance through competitive bidding.

We understand that the execution of this Authorization is NOT a commitment by this organization, nor an obligation to contract for solar energy or energy efficiency services through or in conjunction with the Alliance. No commitment or obligation will be required until an offer and agreement is presented and accepted by us.

1. Basic Contact Information

Municipality*:
Address:
City:
State:
Zip:
Contact person 1):
Title:
Phone:
Fax:
E-mail:*
Contact person 2):
Title:
Phone:
Fax:
E-mail:
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2. Electrical Needs


  1. Total number of buildings/facilities we would consider for the program
  1. Total approximate square footage of facilities we would consider for solar and/or energy efficiency measures is (information may be available from insurance policies)
  1. Total budget for electricity in FY2010 is approximately:
  1. For all energy (including natural gas and oil):
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3. Electrical Supplier Information


Electric Utility
Electric Supplier
(Only if it is a company other than your local utility)