Service Connect Application

For electrical service, BVEA will need the following application completed and signed. There is a $40.00 connect fee, and we may require a $150.00 deposit for residential service.

In lieu of a deposit, you may have your previous utility company fax over a letter of credit with no negative reporting in the past 12 months to 307-368-0931, your deposit will be waived.

If you have had service with us previously, a business account, or are moving a service, an application is still required.

BRIDGER VALLEY ELECTRIC ASSOCIATION, INC.
MEMBER/SERVICE CONNECT APPLICATION

Applicant

First and Last Name *

Phone Number *

Last 4 of SSN

Date of Birth *

00/00/0000

Service Location Address *

City *

State *

Zip *

Billing Address (if different)

City

State

Zip

Previous Address *

Previous Address City *

Previous Address State *

Previous Address Zip *

Email *

Employer *

Account Type *

Individual Account

Joint Account

Business Account

Spouse/Roommate Name

Spouses Maiden Name

Phone

Date of Birth

It is agreed that all bills will be paid when due. Failure to do so will result in disconnection of service

I agree to pay a reasonable attorney’s fee and other costs of collection after default and referral to any attorney

I certify that the information I have provided is true and accurate and any false statement made constitutes reason for immediate disconnection

I consent to a soft credit check for the purpose of a deposit for service

Employer

Phone

Home Owner Status

Status *

Owner

Renter

Landlord

Phone

Closest Relative Not in Household

Name *

Phone *

Address *

City *

State *

Zip *

Date of Application *

Date of Requested Service Transfer *

Do you want to participate in Operation Roundup?

Yes

No

This program rounds up to the nearest dollar. Average is $6.00 per year and helps people in the BVEA service area.

Interruption and Liability of Electric Service

The Association will endeavor to furnish continuous service, but does not guarantee uninterrupted service and is not liable for any damage which the member may sustain by reason of the failure or partial failure to of the power, failure or reversal of phases, or variation in service characteristics whether caused by accident, repairs, storms, or incurred by the use of any service wiring, connection, instruments service or appliances installed or by or for the member; nor is the Association liable for damages that may be incurred due to the presence of the Association’s property on the member’s premises. In the case of three-phase service required by the member, the installation and maintenance of adequate relays with circuit breakers to protect against single-phase conditions and phase reversal are desirable and their installation and maintenance is the responsibility of the member.

It is agreed that all bills will be paid when due. Failure to do so will result in disconnection of service

I agree to pay a reasonable attorney’s fee and other costs of collection after default and referral to any attorney

I certify that the information I have provided is true and accurate and any false statement made constitutes reason for immediate disconnection

I consent to a soft credit check for the purpose of a deposit for service

I hereby request electric service from Bridger Valley Electric Association, Inc., and herewith make application for membership in said Association. I agree to purchase electric energy from the Association. I agree to be bound by the Articles of Incorporation, the By-Laws and amendments thereto, and such Rules and Regulations as may be adopted from time to time by the Board of Directors.

I understand that if I am required to give a deposit for service, that it will be held for the following.

Consumer, 1 Year. Business, 2 Years.

Deposits will be returned as a credit to the account, with interest, if all payments are made on time during the allotted time frame, or the account is no longer active for the consumer or business.

Applicant Consent *

Applicant Consent - By checking, you agree to the Terms and Conditions of this e-STATEMENT Agreement

Co-Applicant/ Roommate Consent *

Co-Applicant/ Roommate Consent - By checking, you agree to the Terms and Conditions of this e-STATEMENT Agreement