Commercial and Industrial - Short Form

The undersigned hereby applies to the Fairport Municipal Commission to supply electric service and agrees to abide by the rates, rules, and regulations adopted by the Municipal Commission. 

You must complete all fields of this form if you are a Commerical or Industrial customer and, 
A) This is not a new building
B) You are not changing service requirements

Requested Service Date:

Service Located at:

Business Type: 

Phone #:      Cell Phone Provider: 

Billing Name:    

Mailing Address (if different):

Taxpayer ID#: 

Sales Exempt Organziation:   No      Yes, must attach completed NYS form ST-121   
  *Used for e-bills and notifications. Please check your spam/junk folder for your first bill.

Your Fairport Electric bill will be subject to a required Consumer Security Deposit. The security deposit will be calculated based on your anticipated service requirements. The deposit amount will be approximately

twice your monthly invoice. The deposit will be refunded after 36 consecutive months of
timely payments. 

· Information requested in this form is designated to assisting us place you in the proper and
most beneficial service classification. We rely on this information in determining your service

· The cost of service may vary under different service classifications. The service classes are as
· Small-Commercial - usage less than 7,500 kWh’s or demand less than 25 kw per month
· Large-Commercial - usage more than 7,500 kWh’s and demand between 25 kw and 500 kw per month
· Industrial - demand greater than 500 kw per month

· One service class may be more beneficial than the other but it is determined based on your usage
and demand.

· Our tariff, as well as service class descriptions, can be found online here.  Our tariff may also be reviewed in our business office located at 31 S Main Street, Fairport, New York 14450. Questions about our service classifications may be discussed with our customer service representatives at (585) 223-0440.

· If your usage or equipment changes in the future, you must notify us of the changes to ensure
proper billing.

· If the information provided is inaccurate or incomplete, the customer may be subject to back
billing on the correct service classification, or may be precluded from receiving a refund for
overcharges based on correct service classification.

Signature(enter full legal name here):