LinkedInThis field is for validation purposes and should be left unchanged.Customer Location / Contact InformationCompany Name(Required)Mailing Address(Required) Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Name of Applicant(Required) First Last Email Address(Required) Individual to be Contacted / Position(Required)Work Phone(Required)Cell PhoneVoltage Desired(Required) 140/240 120/208 277/480 Size Service(Required)AmpsCVEC will provide secondary conductors up to 400 amps for a 120/208 or 120/240 volt service. Services above 400 amps or 277/480 volt services will require a CT rated service and the consumer will be responsible for providing secondary conductors.Number & Size of Consumer Provided Conductors (per Phase) From the Transformer to the Service PanelThree-Phase Load & MotorsTotal Three-Phase Heating/AC(in BTU)KW Rating of Strip Heater(for heat pumps)Total Lighting(in KW)Three-Phase MotorsThree-Phase Motors(Please list each on a separate line.)HPVoltageFull LoadEstimated Hours Per Day of Operation Add RemoveTotalTotal HPTotal VoltageTotal Full LoadTotal Estimated Hours Per Day of OperationAdditional Three-Phase Load(Please specify)Single-Phase LoadIf None, Please Indicate: No Single-Phase Load is being applied for. Total Single-Phase Heating / AC(in BTU)KW Rating of Strip Heater(for heat pumps)Total Lighting(in KW)Single-Phase MotorsSingle-Phase Motors(Please list each on a separate line.)HPVoltageFull LoadEstimated Hours Per Day of Operation Add RemoveTotalTotal HPTotal VoltageTotal Full LoadTotal Estimated Hours Per Day of OperationAdditional Single-Phase Load(Please specify)MiscellaneousType Service(Required) Overhead Underground Do You Own the Land on Which This Service is Located? Yes No Contractor InformationContractor Name First Last Contractor Address Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Contractor Office PhoneContractor Cell PhoneUpload Documents Drop files here or Select files Accepted file types: jpg, png, pdf, Max. file size: 100 MB.
