Utility Services Electricity Form

UTILITY SERVICES ELECTRICITY FORM

This Utility Services Electricity Form (the Agreement) is entered into by and between:

Provider Name:     Provider Contact:

Customer Name:     Customer Account Name (if different):

WHEREAS

WHEREAS, Provider is duly authorized to supply electrical energy and related metering and billing services to end users within Provider's service territory; and

WHEREAS, Customer desires to receive electric service at the location identified below under the terms and conditions set forth in this Agreement; and

WHEREAS, the parties intend that the rights and obligations created by this Agreement be memorialized in writing and be binding upon their successors and permitted assigns.

SERVICE LOCATION & IDENTIFIERS

SERVICE DETAILS

Service Type: Residential Commercial Industrial

Requested Service Start Date:

SCOPE OF WORK

Provider will deliver electric service and perform routine metering, billing and collection services as described below. Provider's obligations are limited to supply, meter reading, meter maintenance and billing as expressly set forth herein.

PAYMENT TERMS

Customer shall pay Provider for electricity supplied in accordance with the applicable rate plan and the following payment provisions.

Late Payment Fee: If any amount due is not received by Provider within the time specified above, Customer shall pay a late fee equal to of the overdue amount, compounded monthly, or the maximum allowed by applicable law, whichever is less.

Reconnection Fee: Customer shall be responsible for any applicable reconnection fee charged by Provider following termination for nonpayment. Reconnection fee amount:

TERM AND TERMINATION

This Agreement shall commence on Start Date: and shall continue until End Date: unless earlier terminated as provided herein.

Either party may terminate this Agreement for convenience upon providing written notice at least days prior to the effective termination date. Provider may suspend or terminate service immediately for cause, including nonpayment, unauthorized use, tampering with meter equipment, or when continuation of service would create an imminent risk of harm or violation of law.

CONFIDENTIALITY

Each party shall hold in confidence all non-public, proprietary information of the other party disclosed in connection with this Agreement, including but not limited to billing data, load profiles, credit information and technical specifications (Confidential Information). Confidential Information shall not include information that is publicly known or independently developed without use of Confidential Information. Confidential Information shall be used only for the performance of obligations under this Agreement and may be disclosed to affiliates, agents or contractors only to the extent necessary and subject to confidentiality obligations no less protective than those herein.

ACCESS, SAFETY, AND METERING

Customer grants Provider and its authorized representatives reasonable access to the service premises and metering equipment for installation, inspection, maintenance, testing, reading, and disconnection. Customer shall not obstruct access or interfere with meter equipment. Customer acknowledges that tampering with or bypassing metering equipment is unlawful and may result in termination, fines and criminal prosecution.

Authorized on-site contact for access:     Contact Phone:

LIABILITY, INDEMNITY AND FORCE MAJEURE

Provider's liability for claims arising out of or related to this Agreement shall be limited to direct damages and in no event shall Provider be liable for consequential, incidental, punitive or special damages. Customer shall indemnify, defend and hold Provider harmless from third-party claims arising from Customer's negligence, willful misconduct or unauthorized use of service.

Neither party shall be liable for failure or delay in performance to the extent caused by events beyond its reasonable control, including acts of God, labor disputes, acts of government, supply shortages, storms, or other force majeure events. The affected party must notify the other promptly and use reasonable efforts to resume performance.

GOVERNING LAW; ENTIRE AGREEMENT

This Agreement shall be governed by and construed in accordance with the laws of the State of , without regard to principles of conflicts of law.

This Agreement, including any appendices and accepted scopes of work incorporated herein, constitutes the entire agreement between the parties with respect to the subject matter and supersedes all prior oral or written agreements. Any amendment must be in writing and signed by authorized representatives of both parties.

NOTICES AND BILLING CONTACTS

CONSENTS AND AUTHORIZATIONS

Customer authorizes Provider to obtain credit reports and other related information for the purposes of establishing service and determining deposit requirements.

Customer authorizes Provider and its agents to access the meter and service equipment for installation, inspection, testing, maintenance, meter reading and disconnection as reasonably necessary.

Customer elects to enroll in automatic payment (Autopay) and authorizes Provider to charge amounts due to the payment method on file. Enrollment is subject to Provider's policies and may be revoked by Customer upon notice.

ACKNOWLEDGMENT

By signing below, each party represents and warrants that it has the authority to enter into this Agreement, that it has read and understands the terms and conditions herein, and that it shall be bound by this Agreement upon execution.

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