Cooperative Membership Application — New Construction

The undersigned (hereinafter referred to as “APPLICANT”) hereby applies for Membership with the BEARTOOTH ELECTRIC COOPERATIVE, INC. (hereinafter referred to as “BEC”) and acknowledges receipt of a copy of the Amended Bylaws of the Cooperative:

1. The APPLICANT agrees to comply with and be bound by BEC’s Articles of Incorporation, Amended Bylaws, Rules and Regulations, and Policies both as the same now exist or may hereafter be adopted, rescinded, or supplemented by the Board of Trustees.
2. The APPLICANT, if property owner, hereby grants and conveys all necessary and convenient right-of-way, easements, rights of ingress, and egress to BEC to install, furnish, and maintain electric service and facilities to the APPLICANT, which shall include the right to clear right-of-way. APPLICANT, if property owner, agrees to work with and provide an easement to BEC for extending new facilities or relocating existing facilities.
3. The APPLICANT recognizes the right of BEC to measure, collect and transmit usage information for BEC service purposes.
4. The APPLICANT agrees to keep BEC informed of their mailing address until all accrued Capital Credits due them have been repaid. BEC shall have the right to apply any or all of the APPLICANT’S unretired Capital Credits toward the payment of the APPLICANT’S unpaid billing balance(s).
5. In the event the APPLICANT defaults on any charges for electric service, construction, extension, or any other accounts, BEC shall have the right to collect the entire balance of all monies due, and BEC may elect any remedy at law as well as the right to disconnect its electric facilities and lines; in the event of an action at law to enforce collection, the APPLICANT agrees to pay BEC’S attorney fees and court costs.
6. CONTINUITY OF SERVICE: BEC shall use reasonable diligence to provide a constant and uninterrupted supply of electric power and energy hereunder. If the supply of electric power shall fail or be interrupted, or become defective through an act of God, Government authority, action of the elements, public enemy, accident, labor contract disputes, required maintenance work, inability to secure right-of-way or any other cause beyond the reasonable control of BEC, BEC shall not be liable for damages caused thereby.
7. Production or use of electric energy on the APPLICANT’S premises, regardless of the source thereof, by means of facilities, which shall be interconnected with BEC facilities, shall be subject to appropriate Rules and Regulations and policies as shall be adopted from time to time by BEC. Such facilities interconnected with BEC’S facilities shall require an Interconnection Agreement (BEC Policy MR416A www.beartoothelectric.com/mybec/policies) between the APPLICANT and BEC.
8. BY SIGNING, this Application constitutes permission to collect previous credit information to determine payment history.
9. BY SIGNING this Application, the Members of BEC, by dealing with BEC, acknowledge that the terms and provisions of the Articles of Incorporation, Amended Bylaws, Policies, and Rules and Regulations, shall constitute and be a contract between BEC and each Member. Both BEC and the Members are bound by such contract, as fully as though each Member had individually signed a separate instrument containing such terms and provisions. The provisions of the Articles of Incorporation, Amended Bylaws, Policies, and Rules and Regulations shall be called to the attention of each Member of BEC by making them available at BEC’s Red Lodge office and posted on BEC’s website www.beartoothelectric.com.
10. The APPLICANT, by becoming a member, assumes no personal liability or responsibility for any debts or liabilities of BEC, and it is expressly understood that under the law, the APPLICANT’S private property cannot be attached for any debts or liabilities of BEC.
11. The APPLICANT, by becoming a Member, gives consent to BEC to contact you by telephone or by email, with notifications such as delinquent accounts, planned outages, member announcements, etc. Cooperative membership includes a subscription to Rural Montana, the Cooperative monthly magazine provided via USPS, a subscription to the Cooperative eNewsletter provided via the email provided, and access to BEC’s website, www.beartoothelectric.com , Facebook page www.Facebook.com\BeartoothElectric, and all that may hereafter be adopted, rescinded or supplemented by the Board of Trustees.
12. SUCCESSION AND APPROVAL: This Application shall be binding upon and inure to benefit the successors, legal representatives, and assigns of the respective parties hereto. It is agreed that the venue for the enforcement or interpretation of the Agreement shall be Carbon County, Montana.

I have read, understand, and agree to the terms and conditions of service stated in this Application. I hereby verify the information provided to be true and complete.

13. Date I will be responsible for service
    MM slash DD slash YYYY
14. Property description (Check all that apply)
    • New Construction
    • Residence
    • Business
    • Own
    • Rent
15. If Rental, please provide Landlord Name
16. Landlord Phone
17. If Business, please provide Business Name
18. Business EIN #
19. Business Owner/Officer Name
20. Account Holder Legal Name
    First Last
21. Mailing Address*
    Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code
22. Service Location Address*
    Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code
23. Primary Phone*
24. Email
25. Marital Status
    • Single
    • Married
26. Date of Birth
    MM slash DD slash YYYY
27. Color photo ID verification issued by a U.S. or Canada jurisdiction (Check preferred ID type. Copy required.)
    • A valid U.S. or Canada driver license
    • A valid U.S. or Canada passport
28. Drivers License State
29. Drivers License Number
30. or Passport Country
31. Passport Number
32. If Applicant does not hold a valid Driver's License or Passport, please select two optional forms of ID to submit with your application. (Copies required)
    • A certified birth certificate issued by a U.S. or Canada jurisdiction
    • An original U.S. social security card or Canada social insurance card
    • A certified copy of a marriage certificate or license issued by a government jurisdiction
    • A U.S. or Canada driver license or identification card that has been expired for more than one year but not more than five years
33. Employer Name
34. Employer Information
    Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code
35. Employer Phone
36. Add a joint member?*
    • Yes
    • No
37. Joint Member Name*
    First Last
38. Joint Member Primary Phone*
39. Joint Member Email
40. Marital Status:
    • Single
    • Married
41. Date of Birth
    MM slash DD slash YYYY
42. Color photo ID verification issued by a U.S. or Canada jurisdiction (Check preferred ID type. Copy required)
    • A valid U.S. or Canada driver license
    • A valid U.S. or Canada passport
43. Joint Member Drivers License State
44. Joint Member Drivers License Number
45. or Joint Member Passport Country
46. Joint Member Passport Number
47. If Applicant does not hold a valid Driver's License or Passport, please select two optional forms of ID to submit with the application. (Copies required)
    • A certified birth certificate issued by a U.S. or Canada jurisdiction
    • An original U.S. social security card or Canada social insurance card
    • A certified copy of a marriage certificate or license issued by a government jurisdiction
    • A U.S. or Canada driver license or identification card that has been expired for more than one year but not more than five years
48. Joint Member Employer Name
49. Joint Member Employer Information
    Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code
50. Joint Member Employer Phone
51. Location Alerts
    • Medical Alert
    • Net-Meter Location
    • Back-up Generator on Premesis
52. Please Describe Medical Alert
53. Please Enroll Me
    • SmartHub: Online account management system
    • Auto Payment Option
    • Prepay Service
    • Operation Round Up

54. I understand that by enrolling in this program I am giving Beartooth Electric Cooperative permission to round up my monthly bill to the nearest dollar, and the extra cents will be contributed to a fund to help my neighbors with their energy needs.

55. Upload Required Document(s) Here
    Drop files here or Select files

    Max. file size: 100 MB.
59. Primary Account Holder E Signature*
    First Last
    Type full legal name
60. Primary Account Holder Authorization*
    I hereby verify the above information to be true and complete. I understand that by typing my full name above and pressing the Submit button below, this application will be stamped with today's date and authorized by me as if I had signed my Signature.
61. Phone