Electricity Broker/Consultant Questionnaire Full Business Name * Main Contact * Phone* Email* Legal Address Street Address Address Line 2 City Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State ZIP Code Website How many years in business under this name and ownership? * Total number of employees and contractors (1099 relationships)? States in which you do business?* What % of your electricity business is in Illinois?* Make Your Selection 0% 20% 40% 60% 80% 100% What % of your electricity business is in Maryland?* Make Your Selection 0% 20% 40% 60% 80% 100% What % of your electricity business is in New Jersey?* Make Your Selection 0% 20% 40% 60% 80% 100% What % of your electricity business is in New York?* Make Your Selection 0% 20% 40% 60% 80% 100% What % of your electricity business is in Pennsylvania?* Make Your Selection 0% 20% 40% 60% 80% 100% What % of your electricity business is in Texas?* Make Your Selection 0% 20% 40% 60% 80% 100% How many annual MWh do you manage in your book of business? Please name the REPs or ESCOs that your organization has current relationships with: What % of your electricity business is booked at 300,000 annual kWh or below?* Make Your Selection 0% 20% 40% 60% 80% 100% What % of your electricity business is booked at 300,001 Annual kWh to 2,000,000 annual kWh?* Make Your Selection 0% 20% 40% 60% 80% 100% What % of your electricity business is booked at 2,000,001 annual kWh or above?* Make Your Selection 0% 20% 40% 60% 80% 100% Please describe any experience you have working with customers in the following areas – energy efficiency, demand response, energy management/building automation, solar, CHP, backup generation or electric vehicle solutions: Your submission has been successfully received. Thank you!
