New Customer Registration Form

SERVICE
CONTRACT
Customer Details:
Contract Type*
Full Name*

First NameLast Name
Company Name*
Full Name 2

First NameLast Name
Phone Number*
Please enter a valid phone number.
Do you want to receive your Bills electronically?*

YesNo
Email*
example@example.com
Emergency contact

First NameLast Name
Emergency contact phone number
Please enter a valid phone number.
Current employer
Employer phone number
Please enter a valid phone number.
Service Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is your mailing address the same as Service Address?*

YesNo
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Have you previously been a customer of the Berwick Electric Utility?*

YesNo
Previous service address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you own or rent?*

OwnRent
A deposit equal to the estimated charges for two months’ service is required prior to connection, in addition to a $20.00 connection charge which is included on your first month bill.

Contact the Finance Administration Coordinator at berwickelectric@berwick.ca for the deposit details prior to service connection date.
Landlord's Name*

First NameLast Name
Service Date (Please note, you cannot select weekends or holiday dates)*
Please provide a minimum of 2 ID references below

Health Card NoDriver's LicenceOther
Health Card No*
Driver's Licence*
Other*
Application for Service
I, the undersigned hereby apply to the Berwick Electric Commission for electric service and I agree to accept and pay for such service according to the rates, rules, and regulations of the Berwick Electric Commission.
Signature*

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Signature 2

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CONDITIONS OF CONTRACT - BERWICK ELECTRIC COMMISSION

DEPOSITS: When required, each service applicant shall deposit a sum equal to the estimated charges for two months' service with the Commission. The deposit shall be held by the Commission as collateral security for the payment of bills, and when the customer ceases to use the service and pays all bills, the deposit shall be returned. The rate shall be equal to the Royal Bank of Canada's average prime rate for the month of January of the same year minus 2.75%. You can pay your deposit by e-transfer at berwickelectric@berwick.ca please list your name service address, and date of hook up in your e-transfer message.

CONNECTION CHARGE: A connection charge of $20.00 shall be payable for the initial connection of any electric service and for reconnection after disconnection at the customer's request or for non-payment of bills.

PAYMENT OF BILLS: Bills shall be rendered to each customer at intervals of not more than two months and shall be payable within thirty days after the date rendered. Yoi can pay your Berwick Electric bills by e-transfer at admin@berwick.ca

DISCONNECTION FOR NON-PAYMENT OF BILLS: The Commission shall have the right to discontinue service if a bill remains unpaid more than forty-five days after the date rendered. Each customer shall pay the regular connection charge.
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Customer Details: