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By submitting this application electronically, the applicant hereby applies for electric service to be provided by the Cooperative and authorizes the Cooperative to perform a credit check to determine credit-worthiness and establish positive identification. The Cooperative will require a copy of your rental/lease agreement or a purchase agreement. Furthermore, the applicant agrees to pay the applicable connect fees, security deposits based on credit score and be bound by all provisions in the Cooperative's Bylaws and Service Rules and Regulations, along with all applicable laws, rules, regulations, statutes, and ordinances as they may now exist and as they may be modified from time to time.
Any information obtained in connection with the Membership Application and Service Agreement will be used by Choctawhatchee Electric Cooperative for credit purposes only and no information received will be distributed to any third party except in an effort to collect upon the account.
Please complete and submit the following application information. A customer service representative will contact you next business day to complete your application.
By my selection, I declare that the use of electricity at this property is exclusively residential. I understand if the status changes, it is my responsibility to notify CHELCO.
In order to comply with the Federal Trade Commission's Identity Theft Program, Choctawhatchee Electric Cooperative, Inc. requires a credit check as part of identity validation. The undersigned consents to and authorizes CHELCO to obtain a consumer credit report for such purpose.
I give CHELCO permission to communicate with me using my email address.
I understand that if additional facilities must be constructed to serve a requested location, the cooperative will provide me with a Work Proposal and I must pay the required Cost In Aid to Construction (CIAC). Proposals are valid for 90 days, and total CIAC must be paid prior to installation of CHELCO facilities. Any deviation from facilities agreed upon, including but not limited to, changing the closest point of attachment (POA) or changing the facilities from overhead to underground will result in additional CIAC. All facilities installed and maintained by CHELCO, are and will remain the sole property of CHELCO.
GENERAL CONDITIONS and TERMS of AGREEMENT
THIS AGREEMENT SHALL BE ENFORCED IN ACCORDANCE WITH THE LAWS OF THE STATE OF FLORIDA. THE ABOVE INFORMATION IS FOR THE PURPOSE OF OBTAINING CREDIT AND ANY INFORMATION PROVIDED WILL BE USED TO COLLECT UNPAID DEBT.
BY SIGNING BELOW, I APPLY TO CHOCTAWHATCHEE ELECTRIC COOPERATIVE, INC. AND AGREE TO COMPLY WITH THE TERMS AND CONDITIONS CONTAINED ABOVE.
I certify that I am at least 18 years of age and all the above information is correct to the best of my knowledge.