Request a Complimentary Energy Assessment

Your Name *

Company Name *

Service Type *
Natural GasElectricityBoth

Annual Volume *

Personal Message to Active Business Services

*By checking here
I request and authorize my local distribution company (“Utility”) to release my historical usage and billing information to Active Business Services. Active Business Services will use this information to evaluate the electricity/natural gas usage patterns of my account(s). This authorization in no way binds me to the purchase of electricity/natural gas from Active Business Services. The authorization is in effect for 60 days from the date this form is received by my Utility.