Customer Data Intake Form

Contractor Business Name:**
Contractor Email:*
End User Customer First Name:**
End User Customer Last Name:**
End User Customer Email:*
End User Customer Phone Number:*
Installation Address:*
City:*
State/Region:*
Zip Code:*
Existing Equipment Type (for AC/HP only):
End User Customer's Utility:*
Existing Equipment Size (Btu/hr) (for AC/HP only):
Distributor Invoice Number:**

* is REQUIRED for the form.

** Please refrain from using "&" in any of the inputs above and use "and" instead.

If you have any questions, please contact us via email or phone listed below.

Email: info@ComfortablyCA.com

Phone: 1 (855) 700-4651

The Comfortably CA Program is funded by California utility customers under the auspices of the California Public Utilities Commission and implemented by CLEAResult under a contract awarded by San Diego Gas & Electric Company (SDG&EŽ) and supported by Pacific Gas and Electric Company (PG&EŽ), Southern California Gas Company (SoCalGasŽ) and Southern California Edison Company (SCEŽ). Customers who choose to participate in this program are not obligated to purchase any additional goods or services offered by the contractor or any other third party. The trademarks used herein are the property of their respective owners. Program funds, including any fund utilized for rebates or incentives, will be allocated on a first-come, first-served basis until such funds are no longer available. This program may be modified or terminated without prior notice.

https://www.comfortablyca.com/