When a company determines they wish to take advantage of the opportunity to replace their conventional lighting with LEDs, this form is to be completed. This information is required for submission to utilities to receive rebates and also for managing inspections and shipment of LEDs.

Is there a forklift or lift gate on site?     YesNo

Please Attach a copy of your Utility Bill ( Acceptable File Types: pdf, jpg ) ( Max File Size: 2MB )