EmailThis field is for validation purposes and should be left unchanged.Central Florida Electric Cooperative, Inc. (hereinafter called the “Cooperative”) and the undersigned (hereinafter called the “Member”) hereby mutually covenant and agree as follows: 1. The Cooperative herby agrees to furnish and install an outdoor lighting unit on Cooperative owned poles at location(s) agreeable to both parties. The Cooperative shall make all necessary electrical connections and furnish electricity for the operation of the outdoor lighting unit. An installation charge shall be assessed to the Member for poles installed at the Member’s request to be used exclusively for lighting purposes. The Cooperative will operate, maintain and control the operation of lighting units at its own expense. 2. This service will be provided under the terms and conditions agreed to as outlined on the “Application for Membership and Electrical Service.” 3. The Member agrees to pay for this service on a monthly basis at prevailing rates or charges as determined in accordance with the applicable Bylaws and policies of the Cooperative. 4. The Member agrees to notify the Cooperative promptly in the event that any lighting unit does not function properly. 5. The minimum term of this agreement shall be for a period of 24 months and shall continue from billing period until notice of cancellation by either party. If cancellation occurs before the 24-month term ends, the member will be billed for the remainder of the contract.Name(Required) First Last Phone Number(Required)Account Number or Meter NumberPole NumberPlease select your light size(Required) 100w $0.343/day 250w $0.554/day 400w $0.781/day Physical Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Member Consent(Required) I hereby verify the information to be true and complete and agree to the terms and conditions. I understand that by typing my full name and pressing the Submit button, this form submission will be stamped with today’s date and authorized by me as if I had signed my signature.Member Electronic Signature (Full Name)(Required)Date(Required) Month Day Year Untitled