New Commercial Construction Information NameThis field is for validation purposes and should be left unchanged.If a member is unsure of their answer, put "N/A" in the field.Primary Account Holder Name(Required) First Last Cell Phone(Required)Primary Account Holder Email(Required) Business Name (if applicable)Service Address(Required) Address Address 2 City/Town State / Province AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP / Postal Code Parcel Number or Lat/Long if Address is UnknownIs your mailing address different than your service address?(Required)Please only fill out if your service address and billing address are different. Yes No Address Street Address Address 2 City/Town State/Province AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP / Postal Code Date Submitted(Required) MM slash DD slash YYYY General Contractor(Required)General Contractor Phone(Required)Electrical Contractor(Required)Electrical Contractor Phone(Required)General Contractor Email(Required) Electrical Contractor Email(Required) Type of Construction(Required) Commercial Subdivision Multi-unit/Mixed Use Other Service InformationService Size Request 200 amp 320 amp Other (if above 320 amps, please attach load calculations below) Will you need construction temp service? Yes No Additional InformationSupporting DocumentsMax. file size: 10 GB. Consent(Required)The Applicant agrees to be responsible for the electric charges at the location designated above until such time that the Applicant requests and receives discontinuance of service. It is agreed that all bills will be paid by the appropriate due date and failure to do so may result in discontinuance of service. This Application for Electric Service shall constitute a service contract between the Applicant and the Association, a grant of security interests in applicant's future capital credits, and the Applicant agrees to be bound by the Bylaws, Rules and Regulations of the Association. The applicant agrees that any information contained in this request may be used to collect on a delinquent account. The Applicant also agrees to pay late fees (penalty interest) of 1.5% per month on all delinquent charges until paid in full, and agrees to promptly reimburse the Association for all collection costs and attorney's fees incurred by the Association to collect delinquent amounts owed on Applicant's account after default. I agree to the terms of service.(Required)Account Holder Signature (Full Name)(Required)
