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Customer Name

Legal Business Name

Email Address

Phone Number

Average Monthly kWh Usage

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Start Date

Service Street Address

City

State

Zip Code

How did you learn about JUICE?

Please check all boxes below to initiate your commercial electricity quote:: Please check all boxes below to initiate your commercial electricity quote:: I confirm that I have the authority and authorize JUICE to request and obtain all historical usage associated with this service address. I acknowledge that I have to read, agree, and accept the Terms of Service for service to begin. I understand that I am requesting a quote for my business. I am not entering into a contract and my energy services will not be changed at this time. By checking this checkbox and submitting this application, I understand that a qualified professional from JUICE will be contacting me with a specific quote based on the Business address and historical usage information.