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07/14/1981Florida Keys Electric Cooperative Association Inc. SECURITY LIGHT AGREEMENT CN E M1 IN M2 Please Print - One Letter Each Square Last Name First (Joint Memberships - Both First Names) P.O.Street or :._ MC I I I I I I I I 11 1 1,31 1 1 1 City MC State MS Zip Code MZ DO NOT WRITE IN LINES BELOW WD 15 ZD GS7 ER1 T1 KP1 KD1 DD1 RC1 OTHER Street Light /LM1 Membership Deposit Ser/F Rate Tax Multi. DMD Class YA Meter Number Fee Location Account No. Reading Cashier Date Lot: Block: Subdivision: ) NEW ( ) ADDRESS CHANGE ( ) RECONNECTED LIGHT DEPOSIT ( ) PRIVATE ) NO. OF LIGHT ( ) 450 WATT ( ) DISCONNECTED POLE DEPOSIT ( ) COUNTY ) NO. POLES SET ( ) 175 WATT ( ) ACCOUNT CHANGE hereinafter known as Member, hereby applies to the FLORIDA KEYS ELECTRIC COOPERATIVE ASSOCIATION, INC., a Florida corporation, hereinafter known as Cooperative, for security lighting or highway lighting on Cooperative — owned poles at location or locations agreeable to the Cooperative. The Cooperative will make all necessary electrical connections including one pole and one span of wire per light, and furnish the necessary electric current. The Cooperative will operate and maintain such units, and will control the operation by a device of its selection. The Member agrees to pay for the service and provision provided for in the approved Rate Schedule LS, "Outdoor Lighting Service", and to be billed every month for a minimum of rive (5) years. The Member agrees to afford reasonable protection to poles and equipment to the best of the Member's ability. The Installation Deposit may be refunded in full five years after date of this application on evidence of a record of prompt payment during the period. If Member requests removal of security light, the Cooperative reserves the right to remove at its convenience all pole, line and lighting facilities which have been installed under this application. If removal of these facilities is requested by the Member in less than five years from the date of this application, the Member must pay an amount equal to one fifth of an installation deposit for each year or fraction of year between the date of removal and the end of the five year period. Upon the completion of the installation of the facilities by the Cooperative, as provided in this application, it is agreed that if the Member requests any changes in facilities provided for in this application, such changes will be made at the expense of the Member. This application is non -assignable on the part of the Member and is transferable only upon and with the express approval of the Cooperative. IN WITNESS WHEREOF, THIS AGREEMENT is executed in two counterparts, each one of which shall be deemed an original, this the day of A.D., 19 FLORIDA KEYS ELECTRIC COOPERATIVE ASSOCIATION, INC. By: 'Member Address *Clerk or Sec'y Address WITNESS: Date *For a municipality or other corporation, the execution shall be by the President of the Town Council and attest by the Clerk or by the corporation President or Vice President and attest by the corporation Secretary. (To be signed by the owner of the proRgrty in thg,event Member contracting is not the owner, as provided in paragraph 2.) 1/N'E are the owners of the following described property and hereby provide an a ght-of-way on, overPn oss u p perty to t�e FLORIDA KEYS ELECTRIC COOPERATIVE ASSOCIATION, INC. for the purpose establishing poles whessary or instalNng, electrical equipment and facilities which Cooperative is providing under the terms of th ove contract. PROPERTY DESCRIPTION: .. WITNESS — v Owner J