Electricity Quote Request For small market sites using less than 100MWh (or $25K) per annum

Electricity Quote Request For small market sites using less than 100MWh (or $25K) per annum
Business Information
Company Name*
Address*
Postcode*
State*
ABN*
Company Contact*
Email*
Phone*
Current Electricity Situation
Current Supplier*
Bill Frequency*
National Meter Identifier NMI*
Supply Address for above NMI*
Supply Address for above NMI*
Postcode*
State*
As Above

Option 1Option 2Option 3
Annual Usage in kilowatt hours (kWh)*
Annual Spend $*
Additional NMI at same address
Do you have any additional NMIs at this address or another address?
Number of NMIs at same address above
Number of NMIs at different addresses - must be same entity name
Annual Usage in kilowatt hours (kWh)*
Annual Spend $*
Additional NMI at another address
Additional NMI address
Postcode
State
Annual Usage in kilowatt hours (kWh)*
Annual Spend $*
Identifier
Terms and Conditions of Request

Your obligations

Submitting this form does not mean you have to take up any offer. The response will be in the form of a quote only. All offers for small market electricity supply have a 10 day cooling off period.

Your data

We respect your privacy.The information you submit in this form is collected by Sourced Energy. This information will only be used to enable electricity retailers or Sourced Energy to make you an offer or offers.

You acknowledge

Sourced Energy may receive an introduction incentive fee of up to $150 for a 2 year contract should you take up an offer.

You are an appropriate or approved officer of your organisation to request quotation.

You provide permission

You give permission for Sourced Energy and/or the retailer to contact you with and explain an offer.

Where applicable, you give permission for Sourced Energy to provide your introducing organisation with the status of an offer and its outcome in terms of acceptance.
I understand and accept these terms and conditions
Should be Empty: