The “Customer” hereby authorizes the local Energy Distribution Company (EDC) to permit authorized “Licensed Electricity and/or Natural Gas Service Suppliers” to directly receive “Customers” most recent twenty-four (24) months electric account kWh, kW, and interval usage data; twenty-four (24) months natural gas account data; and twelve (12) months of payment history for the Account Numbers provided. The authorized “Licensed Electricity and/or Natural Gas Service Suppliers” have the right to use the information provided and to retain the information in its files, and disclose it to any authorized employee, agent, or representative. The authorized “Licensed Electricity and/or Natural Gas Service Suppliers” hereby agrees not to sell or otherwise disclose said information to any third party not authorized in writing by “Customer”, for the purposes of such third party marketing to, or soliciting business from “Customer”.

“Customer” hereby authorizes “Licensed Electricity and/or Natural Gas Service Suppliers” to process this Authorization for credit review and approval. All information provided will be held in strict confidence and used only by “Licensed Electricity and/or Natural Gas Service Supplier” or its affiliates, in making its credit evaluation.

“Customer” hereby grants CQI Associates LLC an “exclusive authorization” as the Customer's representative for the purchase and management of electricity distribution and supply services, natural gas distribution and supply services, and related procurement account enrollment services for a term of thirty-six (36) months starting from the signature date. CQI Associates, LLC is licensed as a buyer’s broker/consultant and a registered business enterprise were required by the State Public Service and/or Utility Commission and related registration authority.

“Customer” hereby authorizes the “Licensed Electricity and/or Natural Gas Service Suppliers” to deal directly with CQI Associates, LLC representatives on any and all matters pertaining to the collection of account data, to receive pricing and receiving Agreements as it pertains to Client's electricity and natural gas procurement information, in order for CQI Associates, LLC to manage and evaluate the electricity and/or natural gas pricing requests. This authorization in no way binds “Customer “to the purchase of a supply services and is to be used for the sole purpose of determining an offer price and selecting a supplier for electricity or natural gas supply services. The applicable CQI Associates, LLC professional service fees will be paid by the selected supplier based on the energy consumed during the term of the contract.

THE UNDERSIGNED HEREBY CERTIFIES THAT THE SIGNATOR IS AN AUTHORIZED REPRESENTATIVE OF THE “CUSTOMER” AND THAT THE INFORMATION PROVIDED HEREIN IS TRUE AND CORRECT AND ACCURATELY REFLECTS THE “CUSTOMER’S” CURRENT BUSINESS CONDITION AND ACCOUNT STATUS.

Participation in the Cooperative REQUIRES continuous membership in the Greater Baltimore Chamber of Commerce during the full term of the Agreement. If your membership is not current, you must bring your account current to participate. Submission of the application for participation in the cooperative does not include fees for membership. If your membership is not current, the application for cooperative participation will not be processed.

The Applicant/Customer understands that this application is for a new or renewal electricity and or natural gas supply services agreement obtained through the affiliate Greater Baltimore Chamber of Commerce, Commercial Energy Purchasing Cooperative and CQI Associates, LLC. Market prices and regulations impact the terms, time, and rates of the supplier offer. The supplier contract offer prices will be based on current market conditions. The current “Standard Offer Rates” are used as the “price to compare” or “benchmark price” to determine if a supplier’s offer is economically viable. A period of time could elapse from the date this Application is submitted and the time when market rates are at a point where a price offer will be recommended that is lower than the current or projected utility company “Standard Offer Rates”.
The Applicant/Customer understands and agrees that as part of the competitive bid process, prospective suppliers will review credit and payment history data to determine if they will serve the designated accounts. The decision on credit and service is at the sole determination of the supplier. The Applicant/Customer assures the Commercial Energy Purchasing Cooperative, CQI Associates, LLC, and the selected supplier that they are not in a current supply services agreement that would prohibit enrollment into the new agreement.

If the customer is in a third-party agreement, all data to include but not be limited to; copies of the current agreement, current invoices, and contract end date has been provided with this Application. The Commercial Energy Purchasing Cooperative and CQI Associates, LLC is not liable for any fees or penalties from Applicants/Customers current or future third-party Electricity and/or Natural Gas Supply Company or the current utility distribution service company.

The Applicant/Customer agrees that they will make a decision on the day contracts are offered to accept or reject the offer. The Applicant/Customer understands that the timeframe could be less than four hours to make the decision. The term “cooperative” is being used to express that the program is an aggregation purchasing program connecting the applicant with a supplier in accordance with the regulations permitting customer choice. The applicable Applicant/Customer Cooperative service charges and CQI Associates, LLC professional service fees will be paid by the selected supplier based on the energy consumed during the term of the contract.

The Commercial Energy Purchasing Cooperative and CQI Associates, LLC requires that “Customers” owners, management, staff, associates, consultants, and contractors shall not disclose the contents or terms of this document and the proprietary information developed and provided by the CQI Associates, LLC to a third-party, except in order to comply with the implementation of this Authorization and any applicable law, order, or regulation.

STOP! Your application is not complete until you upload your most recent utility bill for each energy account you are enrolling and, if applicable, supplier contract. Tax-exempt organizations must include a W-9.

Questions?

Contact Joe Tabeling
joe@cqiassociates.com
Phone: 443-472-3870

Established in 1995
Celebrating 25 Years of Service to Our Clients

CQI Associates, LLC is licensed as a buyer’s broker/consultant in the State of Maryland:
Electricity: License # IR-575; Natural Gas: License # IR-1753 
 CQI Associates, LLC is licensed as a registered buyer’s broker/consultant and registered business in California, Delaware, District of Columbia, Georgia, Illinois, Maryland, North Carolina, Ohio, Pennsylvania, and Texas and a business consultant in Connecticut, Colorado, Florida, New Jersey, New York, and Virginia.

CQI Associates, LLC  |  10729-B Birmingham Way  |  Woodstock, Maryland 21163

The Following Information is to be filled out by Supplier ONLY

THE UNDERSIGNED HEREBY CERTIFIES THAT THE SIGNATOR IS AN AUTHORIZED REPRESENTATIVE OF THE “LICENSED ELECTRICITY AND/OR NATURAL GAS SERVICE SUPPLIER” AND AGREES TO THE CONDITIONS OF THIS AUTHOR IZATION.

On behalf of the “Licensed Electricity and/or Natural Gas Service Supplier,”