Zap Cap Order Form

For a limited time, Tampa Electric is offering Zap Cap Systems^® with FREE installation, a savings of $44.95 (regular installation price $44.95 + tax). Offer valid July 1 through September 30, 2019.

Interested in our Premium Service? Call 877 SURGE 22 (877-787-4322) to learn more about UPS and our bundled package pricing. For surge protection, please complete and submit the order form.

General Information

How did you hear about Zap Cap?

Please select how you heard about Zap Cap.

Marketing Code:

Please enter the Brochure Marketing Code.

Installation Information

Do you have your Tampa Electric account number available?:

Yes

Tampa Electric account number:

Please enter a 12 digit account number starting with the number 2, 3 or 4

Please indicate if you have your Tampa Electric account number.

Please provide the service address where Zapcap will be installed:

Street number:

Please enter a number for your installation street number.

Street direction:

Street name (Main, Oak, etc):

Please enter your installation street name.

Street suffix:

Apartment or lot number:

City / State / Zip:

Please enter your installation City.

Please enter your installation Zip Code.

Total square footage of house:

Less than 2,500 sq. feet

Greater than or equal to 2,500 sq. feet

Don't know

Please select the total square footage of the house.

Is your electric meter accessible to our installers?

Yes, electric meter is accessible

No, electric meter is not accessible

Please select whether your electric meter is accessible or not.

Comments:

Customer Information

First name:

Please enter your First Name.

Last name:

Please enter your Last Name.

E-mail address:

Please enter your Email Address.

Verify e-mail address:

Please verify your Email Address by entering exactly (it's case sensitive) as above.

Home phone:

Please enter your Home Phone Number area code.

Please enter your Home Phone Number suffix.

Please enter your Home Phone Number line number.

Mobile phone:

Please enter your Mobile Phone Number area code.

Please enter your Mobile Phone Number prefix.

Please enter your Mobile Phone Number line number.

Order Information

Zap Cap System^® Basic Package	Price
Installation Charge Includes either the multimedia home office plug-in protector at no additional charge, or upgrade to the deluxe home entertainment plug-in protector for $30.00 (provided at time of installation).	FREE (regular installation cost $44.95 + tax)
Monthly Service Fee	$7.95
Choose ONE of the following plug-in protectors
Multimedia home office plug-in protector Please select a plug-in protector. To help protect your computer, printer, fax and router, choose the multimedia home office plug-in with 8 outlets spaced to accommodate small power supplies.	Free
Or, choose the deluxe home entertainment plug-in protector Please select a plug-in protector. Protecting your TV, DVD or Blu-ray players, stereo equipment and gaming systems is easy with the deluxe home entertainment plug-in. With 8 wide-spaced outlets, extra cable connectors and a 3-foot coaxial cable, you'll have everything you need. (Regularly priced at $79.95 if purchased separately)	Special Offer! $30.00

Optional Products

Now that you have selected one of the above plug-in protectors with the basic Zap Cap Systems package, please consider optional Zap Cap products below to protect additional sensitive electronics in your home.

Remember: All electronic equipment must be plugged into a Zap Cap Systems^® plug-in protector to qualify for the manufacturer's warranty coverage.

Optional Zap Cap Products	Unit Price	Quantity
Single-outlet plug-in protector	$11.95	For bulk purchase of 20+, please call us at 877-SURGE-22.
Multimedia home office plug-in protector	$49.95	For bulk purchase of 20+, please call us at 877-SURGE-22.
Deluxe home entertainment plug-in protector	$79.95	For bulk purchase of 20+, please call us at 877-SURGE-22.
*Subtotal:
*plus applicable sales tax

Your Zap Cap Systems^® fee and applicable sales tax will be conveniently added to your electric bill.

IMPORTANT NOTICE ABOUT YOUR REQUEST: If you do not receive a confirmation e-mail after you have submitted this form, you may have provided an incorrect e-mail address or your spam filter, a system for blocking unwanted e-mail messages, may be switched on.