FIRST NAME

LAST NAME

COMPANY NAME

COMPANY LEGAL NAME

BUSINESS PHONE NUMBER

EMAIL

CELL NUMBER

CITY

POSTAL CODE

NATURE OF INQUIRY

--None-- Electricity options for my business Natural Gas options for my business Electricity and Natural Gas options for my business General Inquiry

ESTIMATED GJ

--None-- Unknown Under 2,500 GJ Over 2,500 GJ

ESTIMATED kWh

--None-- Unknown Under 250,000 kWh Over 250,000 kWh

NOTES

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