Custom Quote Request

Please fill out the form below with your quote specifications.

"*" indicates required fields

Name*

First Last

Phone Number*

Email*

Project Address*

Street Address Address Line 2 City ZIP / Postal Code

Referral Source*

Choose Your Preferred Service Line*

Please Provide Information About Your Building, Location, or Need*

Car Make & Model*

If other, please describe:*

Type of connector desired*

** For more information on the Chargepoint Homeflex charger, visit https://www.chargepoint.com/drivers/home/chargepoint-home-flex/

Electrical Service Size*

NOTE: You will find this on your "main breaker" which is located at the top of your main panel. IF it is NOT there, it will be located on your Electric Meter on the exterior of your house. Please open the meter box to find the electric breaker which should say "100" "150" "200" etc. and that is your service size.

Meter Main Location*

If other, please describe:

House Panel Location*

If other, please describe:

Ideal Charging Location*

If other, please describe:

Approximate distance from Ideal Charging Location to Panel (In Feet)*

Please consider that electrical circuits don't usually run in a straight line between the panel and the desired charging location due to walls, floors, or outdoor space in between.

Describe the location of your panel in relation to the charging location I.e. Our panel is located on the West exterior side of our home and it shares a wall with the charging location.*

Any picture to help show us the distance between panel & desired charger location