Sign Up for Service: Commercial Application
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Federal Tax ID # or TIN:
Requested Service Address:
Requested Service City:
Please use the format xxx-xxx-xxxx.
Billing Address (if different):
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Local Contact Person:
Please use the format xxx-xxx-xxxx.
Owner of Building:
Is there currently a meter at this location?
Existing CCEC Meter Number (if known):
Your business has the option of signing up for Cass County Electric's Automatic Payment Plan. With AutoPay, your business can pay your electric bill without ever writing a check! Under this plan, your business will receive a monthly bill statement for your records. Then, on the due date (approximately 10 days after you receive your bill), Cass County Electric will automatically deduct from your business's checking account the total amount due. This plan enables you to save time and money by avoiding the hassles of traditional bill payment. Also, by signing up for the Automatic Payment Plan, your business will receive a
Would your business like to sign up for the Automatic Payment Plan?
If you want to sign up for the Automatic Payment Plan, please fill out the following information about your business's checking account.
Name(s) of all Account Holders:
I authorize Cass County Electric Cooperative, Inc. (hereinafter called the Corporation) and my bank to debit my account identified above for all sums that Corporation may request the bank to charge. I agree that neither the Corporation nor the bank nor any other bank nor any clearinghouse shall have any responsibility for the correctness of any charges, and that any disputes involving the frequency or amount of the charge shall be handled by directly with the Corporation. Should there be any amounts withdrawn from my account by the Corporation which is not due and owing to the Corporation, the Corporations sole obligation shall be to restore the amounts, if any, wrongfully charged by the Corporation against my account. Under no circumstance shall the Corporation or any bank be responsible for any consequential or special damages resulting from any such wrongful withdrawal from my account, including without limitation, any claim for wrongful dishonor of other obligation drawn on my account. This authority is to remain in full force and effect until after you have received written notification from me of its termination.
Security Deposit Information
will be required of all commercial service applicants. The amount of the deposit will be based upon previous or estimated usage at the location in question and shall be equal to no less than a two month average use, with a minimum of
200, as determined by the cooperative. If the service is new, the deposit will be based on a comparable business determined by the cooperative. The deposit amount is denoted on the first bill and due at the time the bill is due. It will be kept until the service is discontinued.
The undersigned (hereinafter called the "Applicant") hereby applies for electric service from Cass County Electric Cooperative, Inc. (hereinafter call the "Corporation") and in consideration of the acceptance of this application, agrees with the terms and conditions found on the reverse side of this application:
Terms and Conditions
1. You agree to purchase from us all of the electrical energy use on the property referred to on the reverse side of this document and will pay for all electric energy used by you in accordance with the rate schedules adopted by our Board of Directors from time to time and subject to the provisions of the Public Utility Regulatory Policy Act of 1978, which amount will not be less than the minimum amount determined by the Board of Directors. 2. You will grant us at our request the necessary easements to serve and supply electric power to you. You grant to us the right of access to your property for purposes of service, installation and repair of electrical facilities. 3. You agree to be bound by and shall have all the rights and privileges granted to members under our Articles of Incorporation and Bylaws. You shall also be bound by all rules and regulations as may be adopted by our Board of Directors from time to time. 4. You understand that a connection fee of $15 will be charged on your first billing statement. 5. You understand that certain customers may be responsible for line extension fees. 6. You agree with our right and remedies for non-payment in accordance with our policy manual. 7. You understand that our policies are subject to change. Any policies which you receive at the time of this application are the policies in effect at the time of the application. You agree to be bound by all policies in our Policy Manual as amended. These policies which affect your involvement in and patronage of Cass County Electric Cooperative are available upon request. If you have elected to receive a lump sum payment for your patronage equity in the cooperative: A. You will continue to own the patronage equity allocated to you by Cass County Electric Cooperative according to our bylaws and policies unless both of the following conditions exist: (i)Your membership with us terminates; (ii)at the time of termination the total patronage equity allocated or estimated to be allocated to you by us (prior to the application of any discount) totals $250 or less. B. If at the time your membership with us terminates, the total patronage equity (prior to the application of any discount) allocated or estimated to be allocated to you by us is $250 or less, your patronage equity in Cass County Electric Cooperative, including any unallocated patronage equity which becomes allocable to you as a result of your business with us prior to termination, will be automatically transferred, assigned and conveyed to us without any further documentation. C. In exchange for your allocated and unallocated patronage equity, we must pay you, and you accept as payment in full, a discounted portion of patronage equity previously allocated or estimated to be allocated to you at the time of termination, determined under our existing policies, who elects to be paid a lump sum in exchange for their patronage equity in Cass County Electric Cooperative, with the date of your termination used under the applicable policy. D. We will make payment to you by crediting all or a portion of the balance owed to you against any amount due by you to us, by check sent to your last known address, or by any electronic funds transfer authorized by you. 8. You certify that all information on the reverse side of this document is complete and accurate. 9. The acceptance of this application by us shall constitute an agreement between Cass County Electric Cooperative and you upon the term hereinabove set forth. 10. If you have provided us a mobile (cellular) phone number: A. You represent that the phone number provided belongs to you, and not a family member or other third party. B. We and our agents and contractors may contact you concerning the status of your account, current or planned disruptions to your electric service or other cooperative business by, among other means, calls or texts to a mobile number you provided us through use of an automatic telephone dialer. C. We may leave a rerecorded and/or text message in connection with any authorized communication we initiate to your mobile number.
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1. Number of meters to transfer
2. Additional address
3. Other information/comments
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