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Xce/Energyd
<br />OVERHEAD SERVICE FORM
<br />In consideration of Northern States Power Company, a Minnesota corporation ( "Xcel Energy "), extending its
<br />facilities to make 277/480 volt, THREE phase, FOUR wire overhead service available
<br />to (Customer) CITY OF LITTLE CANADA
<br />at (Service Address) 380 LITTLE CANADA RD (City) LITTLE CANADA, MN 55117
<br />the sum of Five Thousand Seven Hundred Forty Seven dollars & Ninety Four Cents Dollars ($ 5,747.94
<br />will be paid to Xcel Energy by (if other than above) CITY OF LITTLE CANADA
<br />Address (it other than above) 515 LITTLE CANADA ROAD EAST City LITTLE CANADA, MN 55117
<br />In accordance with the following terms:
<br />RELOCATE P13 POLE WHICH IS LOCATED BY SAINT JOHN'S CHURCH. PRICE DOES NOT INCLUDE ANY
<br />RESTORATION, OVERTIME, AFTER HOURS, AND /OR WEEKEND WORK. PRICE IS SUBJECT CHANGE IF
<br />SCOPE OF WORK CHANGES.
<br />Credit Approval:
<br />Receipt of the above amount hereby acknowledged on behalf of Xcel Energy by Dan Odegard
<br />The undersigned Customer understands that such payment will give Customer no ownership interest in said facilities
<br />and said facilities shall at all times remain the sole property of Xcel Energy. Customer's and Xcel Energy's rights and
<br />obligations with respect to the facilities and the services provided through the facilities are subject to additional terms
<br />and conditions as provided in the General Rules and Regulations and /or in the Rate Schedules of Xcel Energy's
<br />Electric Rate Book for Customer's specific service, as they now exist or may hereafter be changed, on file with the
<br />state regulatory commission in the state where service is provided.
<br />The undersigned Customer agrees to pay the cost of relocating any portion of said overhead facilities from the
<br />Company's designated location needs.
<br />Dated this % ' °/ day of /
<br />Customer: Print Full Name CITY OF LITTLE CANADA
<br />Signature i i2 // > (,)C,
<br />Xcel Energy Rep: Print Full Name /
<br />Signature
<br />, .,,...Ole * M 4. 4».41,.4 4 »., ...... «..,,.11 « ».. « «.0 0» 4.1.. ».»., «000. «0000.,.... «. «.0...., .14111. «.4....., » ...............
<br />$ Specific service location or route $ 5,747.94 Relocation of overhead lines
<br />$ Excess distribution construction $ Three phase service requested
<br />where single phase is adequate
<br />$ Excess service extension $ Specific service voltage requested
<br />$ Temp. svc. KVA $ Other, explain
<br />Phase
<br />Less than one year
<br />More than one year
<br />Transformers required
<br />J�J
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<br />Xcel Energy Representative
<br />Construction $ 5,747.94
<br />Form 17 -2758
<br />Xcel Energy Work Order 11866289
<br />Removal $ Total $ 5,747.94
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