Required fields are marked with asterisks (*)

Bulk Metered Multi-Unit Residential Premises Declaration Form for Low Volume or Designated Customers

Mandatory fields are indicated with a red asterisk (*)

The Ontario government has set new commodity prices for electricty, which came into effect on April 1, 2004. This change is an important step toward establishing a two-tier pricing structure in Ontario that more closely reflects the true cost of electricty and encourages customers to conserve.

The conservation threshold is the first 1000 kilowatt hours (winter months) or 600 kilowatt hours (summer months) consumed in any month by residential, low-volume and designated consumers. This conservation threshold will be priced at a lower rate and all consumption above this kWh threshold will be priced at a higher rate.

Pursuant to the Regulation filed under s.79.4 (1)(a) of the Ontario Energy Board Act, 1998, where the account of a low-volume consumer or designated consumer relates to:

a property as defined in the Condominium Act, 1998
a residential complex as defined in the Tenant Protection Act, 1997 or
a property that is owned or leased by a co-operative defined in the Co-operative Corporation Act

The conservation threshold for that consumer is determined based on the number of units within the property or complex. In order to determine the appropriate conservation threshold, consumers must provide a signed declaration attesting to the number of units to which an account relates.

If you are billed by Energy+ Inc. and if you qualify for a conservation threshold, (e.g. because there is more than one unit associated with your account), you must complete this form online or send it to our office by fax/mail as soon as possible. Your account will be adjusted upon receipt of this signed and completed Declaration Form. Any delay in processing, as a result of missing or inaccurate information on the form, may not result in adjustments to previous price plan billing years.

If you have multiple accounts eligible for a higher conservation threshold because there is more than one unit associated with your account, please list each account separately on its own form. Do not include units which are metered or billed separately from the account referenced.

You must advise us in writing if your account ceases to qualify for a higher conservation threshold or if there is a change in the number of units within the property or complex. If you are billed by a Retailer and make the decision to return to Standard Supply with Energy+ Inc., you must complete and return this Declaration Form to Energy+Inc. to maintain your bulk metered multi-unit residential unit status.

Energy+ Inc. Account Number(s):

Account Name(s):

Basis for Qualification:

Number of Units within Property/Complex:

Certification

The following individuals have the authority to provide and certify the accuracy of the information provided on this form and any additional attachments. Please fill out the applicable section.

Corporation's Name:

Name and Title of Authorized Officer:

Phone number of Authorized Officer:

Signature of Authorized Officer:

Clear

Date:

I certify the above information to be true, correct and complete.

Applicant's Name:

Phone Number of Applicant:

Signature of Applicant:

Clear

Date:

I certify the above information to be true, correct and complete.

Partnership's Name:

Partnership's Number:

Partnership's Signature:

Clear

Date:

I certify the above information to be true, correct and complete.

All information submitted in this process will be used by Energy+ Inc. in support of its obligations under the Electricty Act, 1998 and the Ontario Energy Board Act, 1998, applicable Ontario Energy Board Codes and Rules, associated policies, standards and procedures and its license.

It is the policy of Energy+ Inc. to only collect information which is required to serve you efficiently and not disclose your information without your consent except where it is required for billing, settlement and market operation, for law enforcement purposes, for the purposes of complying with legal requirements and for processing of past due account which have been passed to a debt collection agency. For more information about our Privacy Policy, please visit our website at www.energyplus.ca.

This information will be retained by Energy+ Inc. and may be subject to review by the Minister of Finance pursuant to the Ontario Energy Board Act, 1998. Based on the information provided, we may change your account status to a "commercial rate" if six or more units are being declared against one metered service which may potentially increase your total electricity charges.

Any penalty or action resulting from false declaration shall be borne by the customer.

Please submit this form online, or mail as soon as possible to:

GrandBridge Energy Inc.

P.O. Box 1060, 39 Glebe Street

Cambridge, Ontario

N1R 5X6

Attn: Customer Care

Phone Number: 519-621-3530

519-442-2215 1-877-871-2215

Fax Number: 519-621-7420

Form Builder

Bulk Metered Multi-Unit Residential Premises Declaration Form for Low Volume or Designated Customers