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Temporary Service
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Builders & Contractors / Temporary Service: Construction Sites
Temporary Service For Construction Sites

Use this form to request electrical service during construction.

Customer Information
E-mail address:
Our Privacy Policy protects your info
Customer name:
Is this a legally registered name?
Additional customer name (store #, asset#, etc.):
Site address:
Street address (no P.O. Boxes)
City:
State:
Zip:
Example: 12345
Directions to site:
Mailing address:
City:
State:
Zip:
Example: 12345
Federal ID Number:
DUNS Number:
Customer contact name:
Cust. contact day phone:
Example: 123-456-7890
Cust. contact pager number:
Example: 123-456-7890
Cust. contact cell phone:
Example: 123-456-7890
Cust. contact pager e-mail address:
Example: name@company.com
Cust. contact evening number:
Example: 123-456-7890
Cust. contact fax number:
Example: 123-456-7890
Cust. contact e-mail address (if different from above):
Example: name@company.com
Contractor Information
E-mail address:
Example: name@company.com
Contractor name:
Company name:
Contractor mailing address:
City:
State:
Zip:
Example: 12345
Contact day phone:
Example: 123-456-7890
Contact pager number:
Example: 123-456-7890
Contact pager e-mail address:
Example: name@company.com
Contact cell phone:
Example: 123-456-7890
Contact evening number:
Example: 123-456-7890
Contact fax number:
Example: 123-456-7890
Contact e-mail address (if different from above):
Example: name@company.com
Preferred method of contact:
New Construction Details
Requested ready date:
Service type:

Approximate distance from nearest pole with transformer (overhead service) or transformer enclosure (underground service):




Details about new construction request:

Your Safety is Important
Learn what you must know about working safely around electrical facilities.
Safety For Contractors

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