New Construction

New Service Information

Contact Name(Required)

First Last

Best Contact Phone #(Required)

Secondary Phone (Optional)

Email(Required)

Billing/Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

Name of Service Property Owner(Required)

First Last

Existing or Previous GCEA Member(Required)

Yes, Currently

Yes, Previously

Is the Address of Service different from your mailing address?(Required)

Yes

Does not have an address yet

Address to be Serviced

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

County(Required)

Subdivision

Parcel Number(Required)

Section, Township, Range

Lot Number(Required)

Filing

Block

Road, Highway, Street property is located on or near

Type of Service(Required)

New Construction

Relocate

Upgrade

Select Phase

Single Phase - 120/240 volt

Three Phase (If Available)

Requested Amperage(Required)

Style(Required)

Underground

Overhead

I don't know

Type of Building(Required)

Residential

Commercial

I Don't Know

Please Provide a Detailed Description of your Project(Required)

Include any Information that you think will be relevant to us.

Contractor Authorization

I, the undersigned, give authorization for the following individual to act on my behalf for any contact with Gunnison County Electric Association during the process of installing my new electric service or upgrading my electric service. I give permission to Gunnison County Electric Association to release service information and related documents concerning my new electric service or upgrade of my service to my representative. I accept full responsibility for the decisions made by my representative and agree to hold Gunnison County Electric Association harmless in regard to said decisions. Any necessary documents will be executed by me and not by my representative.

Company Name

Contractor Name

Contractor Mailing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Contractor Phone

Contractor Email Address