Letter of Authorization Utility Company/Customer Billing Data



Authorization Release

I,       (Name)       (Title) of      , (COMPANY) City of     , County of      , State of      , do hereby name Alternative Utility Services, Inc. / Admin Center (CONSULTANT) to act as agent and consultant for me and to perform the following specific powers and functions:

1. To receive billing records, customer service records, usage histories, or other requests as defined below for any and all account(s) under COMPANY’s control or management. Any such request should be treated as if COMPANY had made the request directly.

a) Please release copies of all expired, existing, and future contracts and agreements to CONSULTANT, as per their requests.

b) As required by law, please release copies of disclosures and proposals for all parties of past, present, and future transactions to CONSULTANT, as per their requests.

c) Please submit all pricing and proposals to CONSULTANT, as per their requests.

2. To execute and approve any documents in the name of the Company, in connection with applying for any retroactive billing adjustment refunds/credits, review and/or change of rates/tariffs, and to transact business with respect to Company's utility vendors.

CONSULTANT expressly reserves the right to use such data, retain the data in its files, and disclose it to any authorized employee, agent or representative. CONSULTANT hereby agrees not to sell said billing information.

This LOA authorizes CONSULTANT as our exclusive procurement agent for the services listed below. Signing this form in no way obligates COMPANY to buy deregulated energy from CONSULTANT and no charges will be made to our utility account. Furthermore, CONSULTANT is authorized to negotiate new purchase agreements on behalf of COMPANY but such agreements can only bind COMPANY when executed with an authorized signature from a COMPANY officer.

Electric

Gas

Telecommunications

CONSULTANT is authorized to present this letter as definitive proof of the authority being granted to it, to any applicable commodity provider capable of supplying our energy and/or natural gas needs as indicated above. Should any commodity provider need to verify this appointment please have them call or write to the undersigned. Further, any applicable commodity provider is authorized to rely on this letter of appointment until it is revoked in writing.

This Agreement is the entire agreement between the parties and no previous or contemporaneous oral, written or otherwise indicated agreements shall be of any force or effect. This Agreement may not be modified, amended or altered without the prior written consent of all signatories hereunder.

EXECUTED this the day of , 2013

COMPANY NAME: ______________________________________________________

SIGNATURE: ______________________________________________________

PRINTED NAME: ______________________________________________________

TITLE: ______________________________________________________

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