(Attach Certificate of Registration, Certificate of Incorporation,Memorandum and Articles of Association, Deed of Partnership, Deedof Trust, as applicable)
3.1 State whether Application is a fresh Application or Renewal
3.2 Existing Permits/Licences/Tripartite Contracts
Does the Applicant have an existing Permit or Licence and/or Tripartite Contract issued by the Commission for other systems?
If yes, state the nature of the Permit/Licence/Tripartite Contract, date issued and the Permit/Licence/Tripartite Contract number.
3.3 Refusal, Suspension or Cancellation of Permit/Licence/Tripartite Contract
Has the Applicant ever been refused a Permit/Licence/Tripartite Contract or had its Permit/Licence/Tripartite Contract suspended and/or cancelled by the Commission?
If yes, give details of the refusal, suspension, and/or cancellation.
Please indicate the main business activities the Applicant is currently engaged in.
5.1 Site of the Mini-Grid (State, Local Government Area, Ward, Village)
Local Government Area:
(Attach title document to the land, relevant maps and drawings)
|Type of system||Size in kW|
Location of the Power Plant (geographical coordinates in Degrees, Minutes, Second. e.g. Lat : 9°4'0.00"N - Long : 7°28'60.00"E):
Is the Power Plant new? If no, please state number of years the plant has been in operation
Number of years of operation:
|Type of system||Size of system|
|Type of Lines|
Length of distribution network (indicate geographical coordinates of four reference points)(geographical coordinates in Degrees, Minutes, Second. e.g. Lat : 9° 4'0.00"N Long : 7°28'60.00"E):
Latitude of point 1: Longitude of point 1:
Latitude of point 2: Longitude of point 2:
Latitude of point 3: Longitude of point 3:
Latitude of point 4: Longitude of point 4:
Number of customers:
5.5 Revenue and Sources of Funding
Expected electricity sales [kWh/year]:
Electricity tariff [NGN/kWh or flat rate per W]:
Share Capital contribution (specify foreign or local):
Loan capital (specify source and provide evidence):
The project is not unlawful or contrary to the interest of the Federal Republic of Nigeria, provisions of the Electric Power Sector Reform Act and relevant NERC Regulations. hereby declare that the details stated above are, to the best of knowledge, true and correct.
Dated this day of
THE COMMON SEAL OF THE WITHIN NAMED APPLICANT
Has hereunto been affixed in the presence of:
Sworn to this day of at
NOTARY PUBLIC/COMMISSIONER OF OATHS