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Customer: Representative:
Utility Management Services, Inc.
_________________________________________ a__n_d_i_ts__r_e_p_re__s_e_n_ta_t_iv_e__s_____________________
Name (Printed) Name (Printed)
_________________________________________ _________________________________________
Authorized Signature (if for Company/Organization) Authorized Signature (if for Company/Organization)
P__re_s_i_d_e_n_t_______________________________
_________________________________________ Title
Title
6__3_1_7_O__le__a_n_d_e_r_D__ri_v_e_S__u_it_e__C_,_W__il_m__in_g_t_o_n_,_N__C_28403
_________________________________________ Address
Address
_8_8_8_.8__6_7_.3_2__3_0_____________________________
_________________________________________ Phone
Phone
_A_u_d_i_ts_@__U__ti_lM__a_n_a_g_e_m__e_n_t_.c_o_m________________
_________________________________________ E-mail
E-mail
_________________________________________
_________________________________________ Date
Date
E-Mail, Fax or Mail this Agreement to:
Alabama Power Company
Regulatory Affairs
Attn. Curtis Bowden
Post Office Box 2641
17N-0646
Birmingham, Alabama 35291
G2APCRATEREQ@southernco.com
Fax (205) 257-1613
A signed copy of this Agreement will be returned to Customer and Representative at the email
addresses provided above.
For Alabama Power Company Use Only
____________________________________________________________
Authorized Signature
____________________________________________________________
Name (Printed)
____________________________________________________________
Date
Rev. June 2019
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