I-D63 Electric Aggregator Registration

Transcription

1 t1amp6, 4 %rnjs cci> New Hampshire Public Utilities Commission Electric Load Aggregation Application Form OM I-D63 I-Fuc iprthpi;%% Rev Page 1 of 5 This form may be used to: (1) apply for initial registration as an electric load aggregator in New Hampshire, (2) apply for renewal of registration as an electric load aggregator in New Hampshire, and (3) notify the Commission of any changes to information in a previously-filed electric aggregator application form. This form is provided as a convenience forfiling only; you are required to provide all information specified under when applying forinitialorrenewairegistration as an electric aggregatoi butyou are not required to use this form when doing so. Indicate whether this application is for an initial registration orforarenewal. Initial E1 Applicant s General Information Renewal (a) (b) Legal Trade (dth/a) (if applicable) Kobiona LLC 67 West Main St Suite 413 Clinton CT (c) Address. Website Address (if applicable) Provide the name(s), title(s), bus ness address(es), telephone number(s), and address(es) of the applicant, if an individual, or of the applicant s principal(s),1 if the applicant is anything other than an individual. Use additional sheets if your response exceeds the space provided on the form.. Brian Choquette Address bchoquettekobiona.com TelephoneNumber 1 Principals means, for a corporation, any of its officers, directors, or controlling shareholders, for a limited liability company, any of its managers or controlling members, for a partnership, any of its general partners, and for any other business entity, any of its personnel exercising executive functions and any of its controlling equity owners. Ednc Aggegato Reg5ation FormZl6 P

2 Rev. 218/201 8 Page 2 of (d) Toll-Free (if available) Customer Service Contact Manaqinq Partner info<@kobiona.com (e)(1) Customer Complaints Contact Manaaina Partner ivissat@kobiona.com (e)(2) Regulatory Compliance Matters Contact (e)(3) Commission Assessment Payments Contact (1) (g) Separate Attachments: Business Authority and Trade Provide, as a separate attachment, evidence of the applicant's authorization to do business in New Hampshire from the New Hampshire secretary of state by submitting either of the following: (1) a recent printout of the applicant's listing on the N.H. Secretary of State website with the status "In Good Standing" or words of similar import; or (2) a copy of a certificate from the N.H. Secretary of State's office stating that the applicant is authorized to do business in New Hampshire. Provide, as a separate attachment, evidence of the applicant's registration of the trade name, if any, to be used by the applicant in New Hampshire from the New Hampshire secretary of state by submitting either of the following: (1) a recent printout of the applicant's trade name on the N.H. Secretary of State website with the status "Active" and indicating that the trade name is owned by the applicant; or (2) a coov of a certificate from the N.H. Secretary of State's office indicating that the applicant has registered as doina Electrk: Aggregalor Registration Form Z16 Pw

3 Rev. 2/8/2018 Page 3 of 5 business under the trade name. Form Z16 Pw

4 Rev. 218/2018 Page 4 of (h)(1) (h)(2) (h)(3) (h)(4) (h)(5) Statements Regarding Applicant and its Principals Please respond to each of the following questions with either "Yes" or "." Has applicant or any of its principals ever been convicted of any felony that has not been annulled by a court? Has applicant or any of its principals, within the 10 years immediately prior to application, had any civil, criminal, or regulatory sanctions or penalties imposed against it, him, or her pursuant to any state or federal consumer protection law or requlation? Has applicant or any of its principals, within the 10 years immediately prior to application, settled any civil, criminal, or regulatory investigation or complaint involving any state or federal consumer protection law or regulation? Is applicant or any of its principals currently the subject of any pending civil, criminal, or regulatory investigation or complaint involving any state or federal consumer protection law or regulation? Has applicant or any of its principals been denied authorization to provide competitive electricity supply service or electric aggregation service in any other state or jurisdiction? If an affirmative answer is provided to any item above, then provide a detailed explanation of the occurrence and the related circumstances. Use additional sheets as needed (i) Other States Please list other states or jurisdictions in which the applicant currently conducts business relating to the aggregation of electric customers. CONNECTICUT, MAINE, MASSACHUSETT S, RODE ISLAND, NEW YORK ) Statement Regarding Supplier Representation Please respond to the following question with either "Yes" or "." Is the applicant representing any supplier interest? I YES If the response to the preceding question is "Yes," please list the supplier(s) represented. Use additional sheets if needed. CONSTELLATION NEW ENERGY NEXTERA ENERGY FIRST POINT POWER LLC ENGIE INC. SPRAGUE ENERGY DIRECT ENERGY AGERA ENERGY (k) (1) and(m) I Expected Marketing Start Date Provide the date upon which the applicant expects to commence marketing its services to customers in New Hampshire. Attestation and Signature BY SIGNING BELOW, THE APPLICANT REPRESENTATIVE CERTIFIES THAT IT HAS THE AUTHORITY TO FILE THE APPLICATION ON BEHALF OF THE AGGREGATOR AND ATTESTS THAT THE CONTENTS OF THE APPLICATION ARE TRUTHFUL, ACCURATE, AND COMPLETE. 1 4/3/2018 Date ~ - - ~nlfiure of the applicant or its authorized representative Nam~>+"' G? \J 151~ }-- ~ :.#1.r;t.~ ~,..J-,..r Form Z16 Pw

5 Rev. 2/8/2018 Page 5 of 5 Filing Instructions 1) Mail an original and two paper copies of this form and all separate attachments to: Executive Director, NHPUC, 21 South Fruit St., Suite 10, Concord, NH ) a PDF of this form and all separate attachments to: Executive. Director@~uc. nh. gov Electric Aggregator Registratioo FormZ16 Pw

6 - 1 =$1 1 1%1MllSl I il~ll llll'mll"ihl'i- a, x fn Lmkedl n X + ~ Qu;, ks,.rt f- ~ C'11t (i) a n h.go v/onli1e/bu:;ine-ss!n q u i r12/busine:ssinforn'ptic n?b~ ~ ± Ill\ lil :;,,...,,..,, '~" NEW HAMPSHIRE SECRETARY OF STATE '~i DEPARTMENT OF STATE WILLIAM. M. GARDNER ""- 1 ~,, ~ Wekome Strategic Energy Partners llc User ID: jvissat l ast Login: 03/07/ :35 AM '* 0 Monday, April 2, 2018 Business Information Business Details. LOGOUT Business N am e: KOBlONA LLC Busi ness Type: Foreign Limited liability Company Business Creation Date: 03/28/ Date of Formation in Jurisdiction: 03/ 28/ Principal Office Address: 67 West Main St. Suite 412, Clinton, CT, 06413, USA Citizenship/ State of Formation: Foreign/Connecticut Duration: t Stated Business tification Ema il: Business ID: Business Status: Good Standing in State of KOBIONA LLC Formation: Mailing Add ress: 67 West Main St. Suite 412, Clinton, CT, 06413, USA last Annual Repcrt Year: 2018 Next Report Yea r: Phone;;; focal Year End Date: NONE Principal Purpose S. NA!CSCode OTHER / Energy Brokerage and Consulting. NAlCS Subcodc