Service Request Form Customer InformationCustomer Name(Required) First Last Service Address - Customer(Required) Street Address Town Postal Code (Enter N/A, if unknown) Customer Phone Number(Required)Customer Email Address ContractorCompany Name(Required) Contact Name(Required) Company Address(Required) Street Address Town/City Postal Code (Enter N/A, if unknown) Business Phone Number(Required)Email Address(Required) Who is responsible for the invoice?(Required) Customer Contractor Service Request InformationScope of Work(Required)Panel ChangeMeter Base ChangeAdd or Remove MeterRepairService UpgradeDisconnect for DemolitionATS InstallationNet Meter InstallationNew ServiceIs this an 'Existing Service' or 'New Service'?(Required) Existing Service New Service Is electrical service currently active at the property?(Required) Yes, the property has power No, the property does not have power (disconnected) I'm not sure Location of Disconnect(Required)Meter BaseTransformerOverhead StackPoleExisting Service Details(if applicable)Existing Amperage(Required)60100125200400600>600Existing Service Type(Required)OverheadUndergroundExisting Voltage(Required)120/240V, 1∅120/208V, 3∅347/600V, 3∅Existing Meter Details(Required)SingleGangedCentral MeteringExisting Meter Location(Required)InsideOutsideProposed Amperage(Required)60100125200400600>600Proposed Service Type(Required)OverheadUndergroundProposed Voltage(Required)120/240V, 1∅120/208V, 3∅347/600V, 3∅New Service Details (Non-Existing)Proposed Amperage(Required)60100125200400600>600Proposed Service Type(Required)OverheadUndergroundProposed Voltage(Required)120/240V, 1∅120/208V, 3∅347/600V, 3∅Subdivision Lay-insIf you require multiple service connections within one development, please provide additional information belowList proposed unit/lots, service address, amperageAdditional Information (if necessary)Site Meeting Requested Yes, I would like a site meeting No, a site meeting is not necessary Please provide additional details you believe may be relevant to this projectPlease upload any photos or relevant files Drop files here or Select files Accepted file types: jpg, png, pdf, Max. file size: 64 MB. Email Address of Person Submitting this Request(Required) Enter Email Confirm Email Date Submitted(Required) MM slash DD slash YYYY Name First Last