Snohomish County PUD 4/8/2020 - Laserfiche WebLink

EXHIBIT 2 CUSTOMER AUTHORIZATION TO RELEASE INFORMATION FOR NON-PUD BUSINESS This consent form will allow Snohomish PUD to release customer information as indicated below to a third party for non- PUD business purposes.To authorize third party disclosure,the customer must complete this document in its entirety,and the utility must verify that the individual providing consent matches the name,service address and account number of the customer of record in the utility's customer information system. CUSTOMER INFORMATION: Account Number(s): 222038325 Meter Number(s): 1000142627 Name on Account: City of Everett Name of Representative(if a business): _Tom Hingson Service Address:_3225 Cedar St Everett, WA 98201 Telephone number: 425-257-8939 Email address(if applicable): AUTHORIZATION: I authorize the release of my customer information as follows: Type of information to be released(for example,usage or payment history,payment,contact information): Energy usage/cost, billing history and relevant data Period which the information covers: January 1, 2020 through December 31, 2023 Name of recipient/business: Automated Energy Inc. Address: 4100 Perimeter Center Drive, Suite 115, Oklahoma City, OK 73112 Telephone number or contact information: 405-601-7500 FAX: 405-601-7503 Manner in which information is to be provided(mail,email,pick-up,etc.): SFTP Date(s)for which this release is in effect: January 1, 2020 through December 31, 2023 RELEASE: This consent for information release is at the request of,and on behalf of the customer listed above.Therefore,the Customer agrees to release and hold harmless Snohomish PUD from any liability,claims,demands,causes of action, damages or expenses resulting from: 1)any release of information to the recipient authorized above;(2)the unauthorized use of such information by the recipient;and(3)any actions taken by the recipient with respect to such information. Account Holder Signature: Date: Or Authorized Representative-By my signature above,I attest under penalty of perjury that I have the authority from the holder of the account to authorize the release of information set forth above. This consent form must be signed by the customer or authorized representative listed above,and may be submitted by US Mail,or may be scanned and sent by electronic mail.If scanned and sent by electronic mail,the customer agrees that the scanned image will be considered the valid authorization. For Internal Use: Verified By: Date: Time of Day Pilot Customer Participant Agreement -- Execution Final_March 2,2020 7 of 7