EZ-Form

Power Management Company Energy Consumption History Form

Step 1.  In order for us to provide you with an Energy Xpress Quote, we need to learn a little about how your company uses energy.  Please complete the Express Consumption History Form by filling in the blanks below. This form authorizes your utility provider(s) to send us your consumption and credit history, all of which will be kept  confidential.
Sign Up Tip: All the information you need to complete this form is contained in your most recent utility bill.
Step 2. Send this form to us by pressing the Submit button below. If you would like to clear the form to start fresh, press the Clear Form button. If you have any questions, give us a call at 1-585-249-1360.
Your Name:
 Your Company:(as it appears on bill)
E-mail Address:
 Title:
Street Address:
 
Address:  
City or Town: County:
State: Zip:
Company Phone: Fax:
Local Electric utility: Local Gas utility:
Please release the two-year historical consumption and credit information for
the following gas and electric sales account numbers
Natural Gas Accounts
Gas Meter Number 1
Gas Meter Number 2
Gas Meter Number 3
Electricity Accounts
Elec. Meter Number:
Elec. Meter Number:
Elec. Meter Number:
Authorizing Individual: (By typing my name below and submitting this form, I authorize Power Management Company to o btain my 2-year consumption history.)  
If you would prefer to fax this form to us, print this form out; sign and date the form; and fax it to us at 585-249-1361
You can also mail the form to us at: Power Management Co., 1600 Moseley Road, Rochester, NY 14564