Request for $$$ Estimate

* Denotes required field

Name * :  Job Title : 
Company * :  Email * : 
Type of Facility :  If Other, please describe : 
Phone * :  Fax : 
Address * :  Address 2 : 
City * :  State * : 
Province (if Canada) :  Zip/Postal Code * : 
Country : 
Company Website :  Electric Utility : 
Account Number(s) :  Facility Sq Ft : 
# of Buildings :  Hours of Operation : 
# of Shifts :  # of Employees : 

What time of day do you reach peak kW demand?
(When are you using the most electricity?) : 

What % of your facility has a/c?

Have you ever participated in a Demand Response Program : 
 Yes
 No

Do you have an energy management system?
 Yes
 No

What % of equipment can you shutdown with advance notice?

List the equipment you can shut down : 

Do you have a generator?
 Yes
 No

Capacity (kW) : 

Load attached (kW) : 


Additional Comments :