BM/QT.P09.01.11.

01

CNG TY IN LC BC NINH
IN LC: ...............................................................

BNG K
CNG SUT CC THIT B DNG IN
(Km theo h s mua in)

Tn khch hng: ...........................................................................................................................................................................................................

a ch: ................................................................................................................................................................................................................................
STT

TN THIT B DNG IN

S
PHA
CA
T.B

CNG
SUT
T
T.B
(KW)

S
LNG
T.B

TNG
CNG
SUT
T
(KW)

MC CH
S DNG

THI GIAN S
DNG TRONG
NGY
(T gi n gi)

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Tng cng
1. Gi bn in:
- Cn c mc ch s dng in theo thc t iu tra.
- Cn c h s lin quan n khch hng mua in (giy chng nhn KKD, giy php u t, ).
=> Gi bn in p dng l gi (sinh hot bc thang, sn xut, kinh doanh, ): ................................................................
(Trng hp c nhiu mc ch s dng in: C thm bin bn kho st cc mc ch s dng in)
2. H o m in:
- Cng t loi: ........................................................................... , Im: ........................................ (A), Um:.............................................. (V)
- T s bin dng in (nu c): ....................... /............... (A), T s bin in p (nu c): ....................... / ....... (V)
Ghi ch: Qu khch hng mua in sn xut, kinh doanh, dch v c cng sut ng k s dng cc i
t 80kW hoc my bin p c dung lng t 100 kVA tr ln, phi ng k biu ph ti in hnh ngy.
..............................................

I DIN BN MUA IN

, ngy ............. thng .............. nm 20....

I DIN BN BN IN
GIM C IN LC

CN B IU TRA