Business Entity Application - Trico Electric Co-Op

Phone

This field is for validation purposes and should be left unchanged.

Date

Trico Member Status*

New Member

Existing Member

Customer Number*

Billing Account Information

Name of Business on Account*

Federal/State tax ID number*

Type of Entity

Commercial

Industrial/Manufacturing

Mixed Use Commercial/Residential

Sole Proprietorship

Partnership

Corporation

Other

Entity - Other

Establishment Date of Business*

Days/Hours of Operation*

Present Mailing Address*

Street Address Address Line 2 City State ZIP Code

Daytime Phone*

Business Phone*

Fax

Accounts Payable Contact Name

Mailing address of new service

Where you will receive the bill at the time of connection.

Street Address Address Line 2 City State ZIP Code

Name and Title of Requestor

Email*

Responsible Contract Signatory

Development Company’s Legal Name Responsible for Contract

Applicant Name

Business Phone

Mailing Address

Street Address Address Line 2 City State ZIP Code

New Construction Information

Street address of new service

Street Address Address Line 2 City State ZIP Code

Township

Range

Section

Development/Subdivision

Unit/Lot #

General Contractor

Phone or Email

Engineer

Phone or Email

Electrical Information

Underground to meter

Overhead to meter

Underground to property line

Overhead to property line

Primary only (backbone)

Not sure

Service Entrance Section (SES) Size

Volts

Type of service:

(i.e. Entrance Monument, Landscape Irrigation, Gates)

Single Building or Custom Home

Multiple Buildings

Strip Mall

Apartments

Commercial Building

Commercial Well

Other

Service - Other

Square Footage of Building(s)/Suites

Will you have gas or propane on site?

Yes

List any loads not part of normal operation:

(i.e. Fire Suppression Pumps)

Total number of metered services required:

Connection Responsibility

Responsible for Connection

Service to Be Connected Under Different Business Name

Will you have tenants

Yes

Date you will require power/service:

Will you require temporary construction power?

Yes

Date you will require power/service for temporary construction

Additional comments by applicant:

Please note the billing account fees:

Billing Deposit or Letter of Credit from present electric company. (See rule 124 & 128 of Trico’s current R, R, & LEP)
$100.00 New Service Establishment Fee plus applicable taxes will be billed on your first bill. (one-time charge)
Fixed Monthly Charge plus applicable taxes, in accordance with the applicable Rate Tariff determined by Trico.

(See rule 109, 139, & 140 of Trico’s current R, R, & LEP)

Please note the billing account fees:

Line Extension Costs all applicable fees (to be determined at a later date) shall be paid to the Cooperative, prior to construction. (See rule 203.D of Trico’s current R, R, & LEP)
A Design Deposit may be required to prepare detailed line extension plans. Such advance will be applied to the final cost. (See rule 201.B of Trico’s current R, R, & LEP)

Agreement to Accept Service

I have read and understand the requirements and my responsibilities regarding the type of service I am applying for, I also understand that I must meet those requirements before Trico can extend electric service to me.

By becoming a member of Trico, you are agreeing to follow the policies, rules and schedules of Trico Electric Cooperative, Inc. A copy of the Rules, Regulations & Line Extension Policies approved by the Arizona Corporation Commission (ACC), 402 W. Congress, Tucson, AZ 85701, (520) 628-5555 is available on-line or upon request.

I hereby apply for electrical service at the above location. I understand that Trico will make service available upon completion of engineering details and duly executed contractual agreement between the parties. This application is valid for 60 days from the above date. I agree to accept service when construction is completed.

The design of your line extension will be based on the Rules, Regulations, and Line Extension Policies of Trico and must factor if existing facilities are capable and able of supplying your service requirement, plus responsibilities of the Cooperative and the Applicant, together with system plans of the Cooperative, to determine the most cost effective design, in the Cooperative’s opinion.

These instructions may not cover all situations. Some situations might require special written agreements or studies.

Signatory’s Printed Name*

Date*

Signature*

Business Service Application - No uploads

Billing Account Information

Responsible Contract Signatory

New Construction Information

Agreement to Accept Service