Schedule 1, Commission (Mini Grid ) Regulations, 2019

Regulation 8 (1) a Application form for basic mini-grid licence IMPORTANT NOTES: Your application is incomplete unless all required documents are submitted. SLEWRC reserves the right to verify the accuracy of this information. The basic mini-grid licence, if approved by SLEWRC Commission, will be valid for a duration up to 10 years and may be renewed or extended by the Commission beyond that time following procedure described in these Regulations. In compliance with the SLEWRC Mini-Grid Regulations, 2019I _________________[name of representative] certify that, [name of company] ____________________________________ is intending to construct, install or start to operate a mini-grid system with distribution power not more than 100 kW of distributed power on [date] __________________ and hereby applies for a basic minigrid licence pursuant to the SLEWRC Mini-Grid Regulations, 2019. Penalty. 1.0 PARTICULARS OF APPLICANT AND CONTACT PERSON Name of applicant:........................................................................................ Physical address:......................................................................................... Postal address:................................................................................................. Tel:................................................................................................................... Fax:..................................................................................................................... Mobile phone:................................................................................................ E-mail:............................................................................................................. Website address:............................................................................................ Name of contact person:............................................................................. Mobile phone of contact person:................................................................. E-mail for contact person:............................................................................... 2.0 LEGAL STATUS OF APPLICANT 2.1 Indicate legal status of Applicant (Tick relevant option) A. Sole proprietorship B. Partnership C. Cooperative society D. Company Limited by Shares E. Other (please specify) 2.2 List and particulars of directors: Name Nationality Address Expiry date of tenure 3.0 NATURE OFAPPLICATION 3.1 State whether application is a new application or amended application. 3. 2 Existing Licence Does the applicant have an existing basic or full mini-grid licence issued by the commission for other systems? If yes, state the nature of the licence, date issued and the licence number. 3.3 Refusal, suspension or Cancellation of Licence Has the applicant ever been refused a licence or had its licence suspended and/or cancelled by the Commission? If yes, give details of the refusal, suspension, and/or cancellation. 4.0 MAIN BUSINESS ACTIVITIES OF APPLICANT Please indicate the main business activities the applicant is currently engaged in. 5. 0 DESCRIPTION OF PROJECT 5.1 Site of the mini-grid Village: Ward: Town: City: Chiefdom: District: 5. 2 Generation Solar ............... kW Generation Wind ............... kW Biomass ............... kW Hydro ............... kW Diesel ............... kW Other: ............. ............... kW Total: ............... kWh Storage ......................... ............... kWh Inverters ............................... ...............kW Terminal Voltage ..........................V Rated Frequency .......................... Hz Expected Annual Generation (kWh/year), ......................... kWh/year Location of the power plant (geographical coordinates / GPS): Is the power plant new? If no, please state number of years the plant has been in operation. If yes, please state the expected date of commissioning. 5.3 Distribution Lines Three-phase MV ............ metres Single phase LV ............ metres Three-phase LV ............ metres Total: ............ metres Type of Lines Overhead Underground Concrete ............ poles Wood ............ poles Poles Steel ............ poles Other: ............ ............ poles Total: ............ poles ............... type Transformers ............... kVA ............... number Length of distribution network (indicate geographical coordinates of four reference points) 5.4 Consumers Number of consumers: Residential:........................................ Commercial:...................... Productive/Industrial: ...................... Health Centres:................ Schools:...................... Street lighting: ................. Other (please specify):................................................................................ 5.5 Electricity Sales Expected electricity sales [kWh/year, or number of flat rate, or power price]:............................................... Indicated average electricity tariff [SLL/kWh or flat rate, or per W]:.......................... 6.0 DECLARATION BY THE APPLICANT The project is not unlawful or contrary to the interest of Sierra Leone, the National Electricity Act, 2011, the SLEWRC Act, 2011 and relevant SLEWRC Regulations. I/ we hereby declare that the details stated above are, to the best of my/our knowledge, true and correct. Datedthis....................................day of ........................................................20.................. THE COMMON SEAL OFTHE WITHIN NAMED APPLICANT Name of Applicant Signature Has hereunto been affixed in the presence of: Sign: Sign: Name: Name: Designation: Designation: Sworn to this........................ day of........................ 20...... at........................................... ACCOMPANYINGDOCUMENTATION 1. Completed application form 2. Map with position of power station and distribution network marked using indicators to distinguish low voltage single phase and three phase as well as medium voltage networks 3. Certified copy of business registration or certificate of incorporation, 4. Memorandum and articles of association, deed of partnership or deed of trust, as applicable, 5. Tax & NASSIT registration certificates 6. Proof of technical qualification of electrician (e.g. certificate) 7. A 3 - 5 years Business plan FOR OFFICIAL USE ONLY 1. Date of receipt of application:......................................................................... 2. Fees paid and receipt number:........................................................................ 3. Results of verification for completeness:..................................................... 4. Recommendation of SLEWRC Legal Division:............................................ 5. Recommendation of SLEWRC Head of Electricity:...................................... 6. Decision of SLEWRC:....................................................................................... 7. Issue date of licence:......................................................................................... 8. Expiration date of licence: ................................................................................. 9. Other relevant information: ...............................................................................