Business Information
Business Name (“Customer”):
DUNS # / Fed. Tax ID:
Contact Name:
Title:
Service Address:
City, State, Zip:
Phone:
Fax:
Email:
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Account Information
Utility
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See attached bills: ☐
Account # and/or POD ID
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Terms:
Customer hereby authorizes Crosslink Advisors LLC d/b/a Crosslink Energy Advisors to serve
as Customer’s exclusive agent for the purpose of assisting Customer in energy-related matters,
including the following: obtaining energy supply offers from retail energy suppliers; evaluating
such offers; and, assisting in contract negotiations between Customer and such retail energy
suppliers. This authorization also includes providing Crosslink access to utility usage and
payment information, as applicable.
This authorization (this “Authorization”) shall commence as of the date hereof and continue until
revoked by Customer in writing.
Sincerely,
_____________________________
Name: Click here to enter text.
Title: Click here to enter text.
Date: 07/13/17