Supplemental Service
Please indicate if you require Temporary or Relocation Service and complete the information requested. Be sure to include a site plan showing the proposed location of the Temporary and/or Relocation Service.
|
q Temporary Service: |
WMS#:__________________ |
|
Date temporary service is needed: _____/______/______ |
|
(For BGE internal use) |
(mm/dd/yy)
Purposeoftemporaryservice:____________________________________________________________________________
Address: _______________________________________________________________________________________________
City:_______________________________________________State:__________________Zip: _______________________
Loadinformation: Electricheat_____________kW A/CUnit_____________Tons Other:___________________
Person responsible for Construction Charges:
Name:______________________________________________________________________Title:
LegalNameofCompany:
Address: _______________________________________________________________________________________________
City:_______________________________________________State:__________________Zip: _______________________
Phone:____________________________________________ Fax:
Email:_____________________________________________ CellPhone:_________________________________________
FederalTaxID#:___________________________________
Person responsible for electric and/or gas monthly Consumption Service Billing:
Name:______________________________________________________________________Title:
LegalNameofCompany:
Address: _______________________________________________________________________________________________
City:_______________________________________________State:__________________Zip: _______________________
Phone:____________________________________________ Fax:
Email:_____________________________________________ CellPhone:_________________________________________
FederalTaxID#:___________________________________
q Relocation Service: |
WMS#:__________________ |
|
Date relocation is needed: _____/______/______ |
(For BGE internal use) |
(mm/dd/yy) |
|
Address: _______________________________________________________________________________________________
City:_______________________________________________State:__________________Zip: _______________________
Descriptionofrelocationworkrequired:____________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
Person responsible for Construction Charges:
Name:______________________________________________________________________Title:
LegalNameofCompany:
Address: _______________________________________________________________________________________________
City:_______________________________________________State:__________________Zip: _______________________
Phone:____________________________________________ Fax:
Email:_____________________________________________ CellPhone:_________________________________________
FederalTaxID#:___________________________________