Common Contracts
9 similar Service Application and Agreement contracts
CORBET WATER SUPPLY CORPORATION SERVICE APPLICATION AND AGREEMENTService Application and Agreement • September 19th, 2024
The following information is required by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application of to discriminate against you in any way. However, if you choose not to furnish it, we are required to not the race/ national origin of individual applicants on the basis of visual observation or surname.
SODA WATER SUPPLY CORPORATIONService Application and Agreement Please Print: DATE APPLICANT'S NAME CORPORATION USE ONLYDate Approved: Service Classification: Cost: Work Order Number: Eng. Update: Account Number: Service Inspection Date:Service Application and Agreement • October 24th, 2023
The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname.
SENECA WATER SUPPLY CORPORATION SERVICE APPLICATION AND AGREEMENTService Application and Agreement • September 28th, 2021
The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname. White, Not of Hispanic Origin Black, Not of American Indian or Hispanic Origin Alaskan Native Hispanic Asian or Other Pacific Islander | Male (Specify) | Female
SERVICE APPLICATION AND AGREEMENTService Application and Agreement • August 17th, 2021
PROOF OF OWNERSHIP PROVIDED BY: Warranty Deed - Deed of Trust - Other Recordable Documentation LEGAL DESCRIPTION OF PROPERTY (Include name or number of road, subdivision with lot and block number, 911 address)
CORPORATION USE ONLYService Application and Agreement • November 5th, 2020
White, Not of Black, Not of American Indian or Hispanic Asian or Other Male Hispanic Origin Hispanic Origin Alaskan Native Pacific Islander (Specify) | Female
POTOSI Water Supply Corporation Service Application and AgreementService Application and Agreement • June 21st, 2017
The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname.
BIROME WATER SUPPLY CORPORATION SERVICE APPLICATION AND AGREEMENTService Application and Agreement • November 17th, 2016
The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname.
Rusk Rural WATER SUPPLY CORPORATION SERVICE APPLICATION AND AGREEMENTService Application and Agreement • December 17th, 2015
The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname.
WARREN WATER SUPPLY CORPORATION SERVICE APPLICATION AND AGREEMENTService Application and Agreement • September 29th, 2015
The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname. White, Not of Hispanic Origin Black, Not of American Indian or Hispanic Origin Alaskan Native Hispanic Asian or Other | MalePacific Islander (Specify) | Female
