Regulated Price Plan Election Form

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Choose Your Electricity Rate Plan

If you want to change the Regulated Price Plan (RPP) that applies to the Electricity line on your bill, you can complete and submit this form.

For more information on Time-of-Use, Ultra-Low Overnight and Tiered Pricing and tools to help you decide which price structure is right for you, please visit www.oeb.ca/choice.

Note: You will receive an acknowledgment of your change request within 10 business days. This notification will confirm when your new electricity rate plan takes effect.

Notice of Collection

Personal information is collected on this form by GrandBridge Energy Inc. under the authority of the Electricity Act, S.O. 1998, Chapter 15, Schedule A. The principal purpose for the information we are collecting is to accurately deliver our services to you, billing and collection, and ensuring that we are dealing with only you or individuals you have authorized. Personal information will be used only for the purposes set out in GrandBridge Energy’s Privacy Policy.

If you have any questions about this collection, the ways in which your personal information may be used by GrandBridge Energy or would like further information about GrandBridge Energy’s privacy policies, please contact: Chief Privacy Officer, 39 Glebe Street, Cambridge, ON by phone 1-877-871-2215, or by e-mail at: [email protected].

Regulated Price Plan Election Form

Account Holder Information

Before you begin, make sure that you have a copy of your GrandBridge Energy electricity bill for reference.

Please enter your information exactly as it appears on your GrandBridge Energy bill.

Account Holder Name(Required)

First Last

Account Number(Required)

Service Address(Required)

Street Number Street Name & Unit (if applicable) City Postal Code

Primary Phone Number(Required)

Secondary Phone Number

Email Address(Required)

Choose Your Price Plan

Please choose your desired electricity price plan(Required)

I would like to be billed Time-of-Use pricing

I would like to be billed Tiered pricing

I would like to be billed Ultra-Low Overnight pricing

Note: You will receive an acknowledgment of your change request within 10 business days. This notification will confirm when your new electricity rate plan takes effect.

How Can We Contact You?

Please select a preferred method to contact you about your price plan choice(Required)

Phone

Mail to Service Address

If you would like us to mail communication to an alternate mailing address, please provide the mailing address here:

Authorization and Declaration

Signature of Account Holder(Required)

Date(Required)

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