qualify your project

Requester Information
required fields*
Request Submitted By*     Title
 Date (MM-DD-YYYY)
Company

 Phone*
 		 Email*
 


Client Contact Information

Client Name*
 		 Contact Title
Address*
 
City*
 		 State*
 		 Zip*
 
Phone*
 		 Fax
 Email


Facility Information


Operating Hours
Office (I)
 Production (E)
 WHSE (X)
Sq. Footage*
 		 Type of Facility*
 
Sales Tax
%		 Utility
 Rebate
 kWh Rate

Is there a budget approved for the lighting upgrade? Yes No

Is this project being bid by others? Yes No

Do they have multiple locations? Yes No

Is the space temperature controlled? Yes No

*Approximately how many existing fixtures are there at the site?

 

*What is the primary type of fixture?    


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