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RFP - Request for Proposal

Please complete and Submit the following Request for Proposal form. We will send you the completed RFP.
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Your Business or Entity
Your Name
Your Title
Your Email
ECC Number (if available(7 digits))
I have authority of the business or entity named above to request this information from an LVX company. Yes
No
I am an electrical contractor with an LVX EC Number. I am requesting this proposal on behalf of another business or entity. Yes
No
Site Location Number (if available (20 digits))
1. CUSTOMER INFORMATION
Name of Business or Entity
Authorized Signr Name
Authorized Signer Title
2nd Authorized Signer Name (if required)
2nd Authorized Signer Title (if required)
3rd Authorized Signer Name (if required)
3rd Authorized Signer Title (if required)
Customer Address
Customer City
Customer State
Cistomer Phone
2. CUSTOMER BILLING ADDRESS
Billing Adress
City (of Billing Adress)
State (of Billing Address)
Zip (of Billing Address)
Phone (for Billing Contact)
Fax (for Billing Contact)
Billing Contact Name
Billing Contact Title
Email (for Billing Contact)
3 PREMISES INSTALLATION LOCATION
Name of Building (of Installation)
Address (of Installation)
City (of Installation)
State (of Installation)
Zip (of Installation)
Phone (at Installation Location)
Fax (at Installation Location)
Contact Name (at Installation Location)
Contact Title (at Installation Location)
Contact Email (at Installation Location)
Estimated Square Footage of Installation Premises (all floors)
4. CUSTOMER ELECTRIC UTILITY COMPANY INFORMATION
Customer Electric Utility Company Name
Customer Electric Utility Company Address
City (of Utility Company)
State (of Utility Company)
Zip (of Utility Company)
UTILITY ACCOUNT NUMBER:
PREMISES ELECTRIC NUMBER:
Information from Your Last Electrric Bill:
Month for Billing Statement:
Total Monthly Bill (in dollars)
Kilowatts Used
Cost per Kilowatt (in cents before taxes and fees)