Request for Outdoor Lighting

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First

Middle

Last

Phone Number

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Sumter EMC Account Number

Desired Lighting

Would you like to connect an existing light on your property?

Yes

If there is no outdoor light currently on your property, please provide a brief description of where you would like the light placed.

CONDITION OF SERVICE: Sumter Electric Membership Corporation will furnish, install, and maintain all necessary equipment, including replacement of lamps, globes, photoelectric control, and supply electric energy to operate the light(s) from dusk to dawn. Service calls will be made only during normal business hours.

For a minimum of 12 months, I agree to pay a monthly charge determined by the current outdoor rate for the number of lights on the property. After that time, this agreement may be cancelled by either party. Thirty (30) days notice is required for cancellation.

By submitting this form, I agree to have Sumter EMC install the selected outdoor lighting for the account and address listed above.

Complete Signature

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