Remote Reconnection Form

Owner/Occupant Remote Reconnection Agreement

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This field is for validation purposes and should be left unchanged.
I hereby grant permission to ERTH Power Corporation to remotely reconnect the electricity service at the service address specified below. Please review and confirm the following by checking each box:*
- I have verified the property is safe for reconnection, and that reconnecting the power will not result in any unsafe or hazardous conditions.
- I have ensured all electric stove elements, ovens, kettles, frying pans, clothes irons, hairdryers, and all other similar appliances are turned OFF or unplugged to eliminate the risk of fire when electricity is restored.
- I am the primary person responsible for this property.
- I confirm that there is a responsible person at the property to verify that the remote reconnection is complete.
- I understand that ERTH Power Corporation is relying on these confirmations and that ERTH Power Corporation is not responsible for or liable for any property damage, personal injury, or death, that may occur as a result of this reconnection, whether under legal theories of contract, tort, negligence, strict liability, operation of law or otherwise.
Name*
First Last
Email Address*
Enter Email Confirm Email
Service Address to be Energized:*
Street Address Address Line 2 City Province Postal Code
Confirmation
By submitting this form, I confirm that the property is safe for reconnection.