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Load Information <br /> (ERMU requires information to estimate load and monthly usage) <br /> Hours of operation: Service size (amps) <br /> Square footage of facility: Rewire? ❑Yes-Proposed add'l kW No <br /> Square footage office space ❑ Single Phase ❑ Three Phase <br /> Production/retail space Voltage: <br /> Machinery/equipment description: <br /> ❑ 12 months past electric bills and previous facility square footage(if applicable) <br /> ❑ Electrician contact information: <br /> ❑I am an authorized agent/signer for the business named above. I agree to pay a$20 application processing fee required <br /> for all new Commercial Utility Applications. I understand that a credit check will be completed for the business and the <br /> business owner for sole-proprietorships. I also understand that a Service Agreement must be signed and a deposit will be <br /> required to be paid before service is started. The deposit amount will be outlined in the Service Agreement and shall be up <br /> to and no more than 3 times the highest estimated monthly usage. <br /> Signature Date <br /> Printed Name Title: <br /> Internal Office Use Only: <br /> Estimated monthly bill: Calculated by: Date: <br /> Deposit required: Calculated by: Date: <br /> 2 <br /> 96 <br />