GreyStone Power Corporation

Request for Commercial New Service

Location Description
Is service for an existing location or new construction?
*Existing or New Construction?:
If New Construction, enter number of Square Feet, type of heat, select either temporary or permanent meter, and indicate whether or not there will be a construction trailer.
Square Feet:
Type of Heat:
Type of Meter:
Construction Trailer?:

Service Address
*Street:
Unit:
*City:
*State:
*Zip:

*Date Service Required:

Local Contact
*Local Contact Name:
*Local Contact Phone Number:
*Local Contact Email Address:

Business Information
*Name of Business:
dba Name:	if applicable
*Type of Business:
*Business Organization:
*Date Business Started:
*Number of Employees:
*Federal ID #:
*State of Incorporation:
*Sales Tax Status:
If Exempt, please upload tax exempt certificate, below. See "Additional Documents" below.
*Is this business a subsidiary?:
Parent Company Name:
Street Address:
Apt:
City:
State:
Zip:

Mailing Address

Check this box if mailing address is the same as the service address provided above.

Street:

Unit:

City:

State:

Zip:

Comments:

Bill Delivery Method
Choose if you would like a paper copy of your bill (mail) or an e-bill (email).
*Bill Delivery Method:

Accounts Payable
*AP Contact Name:
*AP Phone Number:
*AP Email Address:

Executive Officer
*Name:
*Title:
*Phone Number:
*Email Address:

Authorized Personnel

Persons authorized to connect or disconnect electric service in company name:

Check this box to allow anyone who can recite or supply the entire EIN for the organization to be authorized to complete any and all transactions on the account, including connecting or disconnecting service.

Authorized Person 1

Name:

Title:

Phone Number:

Email Address:

Authorized Person 2

Name:

Title:

Phone Number:

Email Address:

Authorized Person 3

Name:

Title:

Phone Number:

Email Address:

Authorized Person 4

Name:

Title:

Phone Number:

Email Address:

Authorized By:

*Authorized By:

*Title:

*Phone Number:

*Email Address:

Additional Documents

Additional documents are required to complete your application. Information about providing these documents is described in this section.

1. You can provide your own Load Data Sheet or use our online form to create one. If you provide your own Data Sheet you can upload it below, or upload it later. You will receive information in an email about creating or uploading a Load Data Sheet.

Load Data Sheet Upload:

2. If you use a management service Then a Management Agreement is required. You can upload it below or upload it later. You will received information in an email about providing a Management Agreement.

Management Agreement Upload:

3. Articles of Incorporation are required. You must upload it below. An example has been provided here.

*Articles of Incorporation:

4. A Tax-Exempt Certificate is required if you indicated a Sales Tax status of 'Exempt'. If 'Exempt' then you must provide the Certificate below.

Exempt Certificate:

5. A Utility Service Guaranty Bond may be required. You will be notified by email if this is required.

6. An assignment of Certificates of Deposit may be required. You will be notified by email if this is required.

I acknowledge that this application is not complete without additional documents.

I acknowledge that information about providing additional documents will be sent in an email addressed to the Local Contact Email Address listed above.

Other Offers

Check box to enroll; by signing this application, you consent to our partners contacting you in the coming days with offers that may be beneficial to you.

Operation Roundup - Round your bill to the next dollar to donate to worthy charities in our area.

EMC Security - Protect your business at highly competitive rates.

Gas South - GreyStone Members enjoy discounts on natural gas. For more information from our partners at Gas South, please check this box.

Review and Sign Off

The Applicant hereby applies for membership in, and agrees to purchase electric energy from, GreyStone Power Corporation (“the Cooperative”), on the terms and conditions specified below. The Applicant further represents, warrants and/or agrees:

1. CONTRACT FOR ELECTRIC SERVICE – Applicant agrees to comply with this Application and with, as they currently exist or as they are later adopted or amended, the Cooperative’s Governing Documents. As used herein, the “Governing Documents” shall be the Cooperative’s: (a) articles of incorporation; (b) bylaws; (c) service rules and regulations; (d) rate or price schedules; and (e) rules, regulations, and actions adopted, taken, or approved by the Cooperative’s board of directors. The acceptance of this Application shall constitute a contract for electric service between Applicant and the Cooperative, in accordance with the terms specified in the Governing Documents. Applicant warrants that all information in this Application is true and complete and is made for the purpose of having the Cooperative supply electrical service to the service address specified. Copies of the Governing Documents, which are on file in the Cooperative’s principal office at Douglasville and may be available on the Cooperative’s website, have been furnished Applicant or made available to Applicant, and are incorporated into this Application to the same effect as though fully set forth herein.

2. VERIFICATION OF INFORMATION; DEPOSIT – Applicant authorizes the Cooperative to obtain information about Applicant, and to verify any information provided by Applicant, and to make, use or provide credit reports to or from credit reporting agencies and others. Applicant agrees to deposit with the Cooperative such consumer’s deposit as may be required by the Governing Documents. The deposit shall not bear interest. The Applicant authorizes the Cooperative to allocate any payment, deposit or membership fee received from the Applicant to any, or all, of Applicant’s accounts with the Cooperative. Any portion of the deposit(s) that is not applied to payment of bills or other amounts due the Cooperative shall be refunded to Applicant in accordance with the Governing Documents.

3. ENERGY PURCHASES – All central station electric energy used on the premises shall be purchased from the Cooperative and will be paid for in the manner, and at the rates, charges, and fees established in accordance with the Governing Documents.

4. EASEMENTS – Upon being requested to do so by the Cooperative, Applicant shall provide and deliver to the Cooperative grants of easement or right-of-way over, on or under such land owned or leased by the Applicant and in accordance with such reasonable terms and conditions as the Cooperative shall require for the furnishing of electric service to Applicant or other applicants or for the construction, operation, maintenance or relocation of the Cooperative’s electric facilities.

5. RIGHT OF ACCESS – All service lines supplying the Applicant with electric energy and all meters, switches and other equipment constructed or installed by the Cooperative or its agents over, on, or under said premises, shall at all times be the sole property of the Cooperative which shall have the right of access to the said premises at all reasonable times for the purpose of reading meters, right-of-way maintenance, testing, inspecting, repairing, removing, maintaining, or exchanging any or all equipment and facilities.

6. INTERRUPTION OF SERVICE – Although the Cooperative shall use its best efforts to furnish Applicant and its other members with adequate and dependable electric service, the Cooperative cannot, and does not, guarantee adequate or uninterrupted electric service. Applicant shall ensure that all three-phase motors and/or loads shall have overload devices on each of the threephase wires to insure proper protection for the motor. The Applicant acknowledges that electric service may be disconnected, established and restored remotely, and Applicant must ensure all electric appliances, and the premises in general, are rendered in a condition safe to be energized upon receipt of payment, restoration of facilities, or other reason prompting re-initiation of electric service.

7. EQUIPMENT DAMAGES, TAMPERING OR BYPASSING – The Applicant acknowledges that the Governing Documents and Georgia law provide that penalties may be imposed on the Applicant in the event any Cooperative facilities or equipment located on property owned by or leased to Applicant are interfered with, impaired in their operation, by-passed or damaged. Such penalties include, but are not limited to, the Cooperative’s cost of investigation, repairing, replacing, or relocating any such facilities and its loss, if any, of revenues from the failure or defective functioning of its metering equipment.

8. WIRING OF PREMISES – Applicant represents and warrants that all premises served by the Cooperative and owned or occupied by Applicant are, and shall remain, wired in accordance with the specifications of the National Electric Code, any applicable state code or local government ordinances, and with any directives of the Cooperative.

9. CAPITAL CREDITS – The Cooperative is a non-profit cooperative, and may allocate to Applicant patronage capital (“Capital Credits”) in accordance with the Governing Documents. The Applicant authorizes the Cooperative to deduct, recoup, or set-off any amount of Capital Credits that may become payable to the Applicant in partial or full satisfaction of any debt Applicant may have to the Cooperative. The Applicant hereby: (a) grants to the Cooperative a security interest in Applicant’s past, present and future rights to the Capital Credits, and (b) authorizes the Cooperative to file a financing statement perfecting said security interest.

I have reviewed and accept the Terms and Conditions of commercial membership, listed above.

The information on this application is true and correct to the best of my knowledge and by making this application, I agree to be bound by and comply with all of the provisions of the Cooperative's Bylaws and Service Rules and Regulations as the same now exist or hereafter are adopted or amended.

Click here to draw your signature.

Signature of Company Officer

With your mouse, draw your signature. Then click Finish.

Name of Person Signing: