West Kentucky Rural Electric Cooperative Corporation

New Construction Agreement

Instructions for Electric Service Applicants

This form is for service that requires construction of a powerline to a location. Scroll down to fill out this form.

For service to an existing service location, click here.

Complete this form, read and sign the Electric Service Agreement at the bottom, then submit the form by clicking the "Submit Form" button at bottom. You will receive an email with instructions once you submit your application.

Member Information

*Member/Legal Business Name:
*Primary Phone:
*Is the primary a mobile phone?:
Secondary Phone:
Is the secondary a mobile phone?:
Please note that by providing your cell phone number, you are giving the cooperative permission to text you about important, account-related information (outages, balance due, etc.) and in emergency situations.
*Email:
*Preferred Method of Communication:

Service Location

*Physical Address:
*City:
*Zip Code:
*County:
Subdivision:
Lot:
Gate Code:
GPS Coordinates:

Mailing Address

The Mailing Address is the same as the Service Address.

*Maliing Address:

*Mailing City:

*Mailing State:

Mailing Zip Code:

Membership Information

*Are you an existing member of WKRECC?:
f you are an existing member, provide your current Member Number:
Member Number:
If you are not a current Member, there will be a $5.00 Membership Fee required.

*Complete Applicable Information

Your social security number will be used to verify your identity. If you choose not to provide your SSN, a government-issued photo ID must be presented in person.
Social Security Number:
Driver's License Number:
Driver's License State:
Federal Tax ID Number is required if member is a business.
Federal Tax ID Number:

Deposit Requirements

A deposit may be required. Your utility credit check may be used to determine deposit requirements. This will not affect your existing credit score. All accounts with an unsatisfactory credit check will require a deposit, and staff will let you know what your options are once they process your application.

Predominant Use of Electricity

*Select Predominant Use of Electricity:

For Residential, Complete this Section.

Residential Type:
For Other Personal Residential Use, indicate use. Example: residential water well, personal shed, personal hunting cabin, gate, etc.
Other Residential Use:

For Farm or Ranch Business, Complete this Section.

Type of Farm or Ranch Use:
If Irrigation, Pivot or Water Well then indicate HP:
If Farm Building, indicate use:
If Other Farm Use, indicate use:

For Commercial or Industrial Use, Complete this Section.

Indicate type of Commercial Use. Example: office, pump jack, manufacturing plant, etc.
Commercial Use:

For Other Use, complete this section.

Indicate Other Use. For example church, school, cemetery, etc.
Other Use:

Does your account need to be placed on the Life Support Registry?
Account on Life Support Registry?:
Physician's note required. It is the applicant's responsibility to obtain and submit the appropriate documentation. Without all forms, your account will not be placed on the registry.

Construction Details

*Type of Construction:
*Main Disconnect (Amps) New:
Main Disconnect (Amps) Existing:
If primary meter, enter PME.
New Meter Location:
If available, provide New Meter GPS Coordinates.
GPS Coordinates:
Please indicate if you need temporary power during construction.
Need temporary power:
If you need temporary power, describe needs and location.:

Do you want info on a security light?:

Service Voltage and Main Disconnect Size

Primary:
Secondary:
Secondary Voltage:
Note: 120/208 3 Phase 4 Wire Wye - Service is limited to 100kVA transformer on the pole. 277/480 3 Phase 4 Wire Wye - Service is limited to three (3) 100kVA transformers on the pole.

Electrician Information

Electrician/Engineer Name:
Phone Number:
Email Address:
License Number:

Residential Facility Information

Select a Facility and provide, below, the information indicated in parenthesis for the facility chosen. For example, if House is selected then provide the number of square feet and the number of rooms.
Facility:
Facility Details:
Are other facilities connected to the meter? (ie. pool, barn, outside lighting, etc.) If so, then describe in the text box below.
Residential - Other Facilities:

For Irrigation Accounts

In the Irrigation Motor text box below, provide informtation about electric motors. For each type of motor used, indicate 1 or 3 phase, horsepower and quantity. For Example: 1 phase 2.5 HP Qty 5 3 phase 5.0 HP Qty 3
Irrigation Motor Information:

For Commercial Business

Hours of Operation per Day:
Building Size (sq. ft.):
Information on Structure and/or Connected Load:

TERMS AND CONDITIONS
The undersigned (hereinafter called the "Applicant") hereby applies for membership in, and agrees to purchase electric energy from West Kentucky Rural Electric Cooperative Corporation (hereinafter called the "Cooperative") upon the following terms and conditions:

1. MEMBERSHIP FEE
The Applicant will pay to the Cooperative the amount specified in the Cooperative's Bylaws which, if this application is accepted by the Cooperative, will constitute the Applicant's membership fee. upon termination of service after the term of contract and upon settlement of final billing, the membership fee will be refunded to the Applicant or, at the option of the Cooperative, be applied against the final billing for electric service. In the event the Cooperative is unable to furnish service to the Applicant, the membership fee will be returned to the Applicant.
2. PAYMENT
The Applicant will purchase from the Cooperative or self-generate all electric energy used on the premises described herein and will pay therefore monthly at rates to be determined from time to time in accordance with the Bylaws of the Cooperative. The Applicant will pay the minimum bill provided on the Rate Schedule for his service classification, regardless of the number of kilowatt hours consumed. The Cooperative reserves the right to discontinue service to the premises described herein upon non-payment for any services or products or for any other obligations which shall from time to time become due and payable.
3. DELIVERY POINT
The connectors(s) utilized to dead-end the Cooperative's supply conductor shall constitute the delivery point and all service equipment, wiring and appurtenances beyond said connectors(s), with the exception of the Cooperative's meter, shall be installed and maintained by the Applicant. The Cooperative assumes no duty or liability for any service equipment, wiring or appurtenances not installed by it, or for any injury to persons or property resulting from service equipment, wiring or appurtenances installed by the Applicant. The Applicant hereby releases and agrees to hold the Cooperative, it's officers, directors, employees and agents harmless from any and all claims for injuries to persons or property beyond the above defined delivery point.
4. BYLAWS, RULES AND REGULATIONS
The Applicant will comply with and be bound by the provisions of the Articles of Incorporation and Bylaws of the Cooperative, as amended and revised, and such rules and regulations as may from time to time be adopted by the Cooperative. The Cooperative is a regulated utility and has in its own right established rules and regulations. All the rules and regulations referred to herein, as well as its Bylaws and Articles of Incorporation, as amended and revised, are made a part of this application, incorporated by references as it fully copied herein and will supersede and prevail over any inconsistent terms of this Membership Application/Agreement.
5. PERSONAL LIABILITY
The Applicant, by paying a membership fee and becoming a member, assumes no liability or responsibility for any debts or liabilities of the Cooperative, and it is expressly understood that under the law his private property is exempt from execution for any such debts or liabilities.
6. CONTINUITY
The Cooperative shall use reasonable diligence to provide the Applicant with a constant and uninterrupted supply of electric power and energy; but if such supply shall fail or be interrupted or become defective through act of God, or the public enemy, or by accident, strikes, labor troubles, or by action of elements or inability to secure rights-of-way, or other permits needed, or breaker or fuse operation, or any other cause beyond reasonable control of the Cooperative, the Cooperative shall not be liable therefore.
7. TERM
The acceptance of this application by the Cooperative shall constitute an agreement between the Applicant and the Cooperative and the contract for electric service shall continue from the date service is made available by the Cooperative to the Applicant, and thereafter until cancelled by either party to the other. This section of the application does not apply to the right of the Cooperative to terminate this agreement for non-payment of bills or for violation of any of the rules and regulations, Bylaws, or Articles of Incorporation as herein referred to in Paragraph (4) of the application.
8. SUCCESSION
This agreement may be assigned by the Applicant only with the consent of the Cooperative but shall be binding upon and inure to the benefit of the successors, legal representatives, heirs, devisees, and assignees of the respective parties hereto.
9. CONSENT TO OCCUPY
The Membership Application/Agreement shall constitute an irrevocable license to the Cooperative to construct, operate, maintain, aerially inspect using a manned or unmanned aircraft system (UAS) including drones and repair electric lines and any other electric or communications infrastructure on, over or under the real estate of the Applicant and running with the land applicable to all successors in title, including the right of the Cooperative in its discretion to cut, trim, doze, mow, and/or use herbicidal chemical spraying on trees, shrubbery or other vegetation deemed necessary by the Cooperative to properly and adequately clear and maintain right-of-way in accordance with policy and procedure established by the Cooperative's Board of Directors or management and further including the right of the Cooperative to provide service to the member himself or to other members and customers of the Cooperative and to ingress and egress as may be necessary or convenient to the extension of said service.
10. DEPOSIT
The Cooperative may require from the applicant at any time a deposit in accordance with policy and procedure established by the Cooperative's Board of Directors or management prior to service connection as a guarantee of payment of current bills. Such deposit may be refunded after final bill has been paid or may be applied against any underpaid billing, at the Cooperative's option, upon discontinuance of service.
11. ALTERATIONS
No agent or representative of the Cooperative has the power to amend, modify, alter, or waive any of the provisions of this contract or any of the general terms and conditions relating not herein contained. Any promise, agreements, or representations made by any agent or representative of the Cooperative not herein set forth shall be void and of no effect.

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Member Signature

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Date: (MM/DD/YYYY)

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Commercial / Corporate Signature Authority

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Name of Person Signing

Commercial/Corporate Title

Date: (MM/DD/YYYY)

If Commercial / Corporate signature is other than President, Vice President, Partner, or Owner, proof of signature authority may be required.

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