North American Power & Gas, LLC - 11 North Main Street, Norwalk, CT. 06854

North American Power and Gas Customer Worksheet
Date:
 


Did you give the customer a copy of the disclosure label?
Yes or No

Did you give the customer a copy of the terms / rescission document?
Yes or No


North American Power Vendor number?
 

Rep ID:
Customers Telephone Number :
Customers Name on Bill:
Person who will be speaking:

What is the Program Code: CL&P:100 or UIC:018 (check one)

Service Address: Unit #:
City: State: Zip:

CL&P Account No:
Cl&P Service Reference No:
UIC POD No:
NameKey:

 

Billing Address: (if different from service address, above)

Billing Address: Unit #:
City: State: Zip:

 

TPV Verification Code:
(Given by agent by end of customer verification)

NOTES:

 

An Energy Broker will call you shortly to finish the simple third party verification process and be sure you understand everything and have the disclosure information.

Thank you for making the brighter choice.

 

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