UTILITIES SERVICE AGREEMENTUtilities Service Agreement • September 6th, 2022
By signing below, Customer agrees to, acknowledges to have read, all the accompanying terms and conditions on the reverse side of this application. Charges are the responsibility of both spouses under Utah law regardless of who signs this application.
UTILITIES SERVICE AGREEMENTUtilities Service Agreement • August 5th, 2020
By signing below, Customer agrees to, acknowledges to have read, all the accompanying terms and conditions on the reverse side of this application. Charges are the responsibility of both spouses under Utah law regardless of who signs this application.
UTILITIES SERVICE AGREEMENTUtilities Service Agreement • March 27th, 2023
THE UNDERSIGNED HEREBY REPRESENTS that he/she is the applicant or an authorized agent for the applicant, and that he/she has the authority to sign this contract for utility services consisting of Waste Water. The applicant agrees to comply with all provisions of Bylaw 1380/22 of Lacombe County, including payment for all utility services supplied by the County to the above service address until such time as the applicant or authorized agent requests in writing or in person that the contract be terminated. It is understood that in the event of late payment or non-payment, in addition to other remedies Lacombe County may have, the amount owing for utilities services shall bear a penalty charge in accordance with the Municipal Government Act and Bylaw 1380/22, and that non-compliance with the provisions of said Bylaw may result in discontinuation of utilities services by Lacombe County. The applicant acknowledges that the failure to receive or the loss of a utility bill will not be accepte
UTILITIES SERVICE AGREEMENTUtilities Service Agreement • March 27th, 2023
THE UNDERSIGNED HEREBY REPRESENTS that he/she is the applicant or an authorized agent for the applicant, and that he/she has the authority to sign this contract for utility services consisting of Water, Wastewater and Garbage Collection. The applicant agrees to comply with all provisions of Bylaw 1382/22 of Lacombe County, including payment for all utility services supplied by the County to the above service address until such time as the applicant or authorized agent requests in writing or in person that the contract be terminated. It is understood that in the event of late payment or non-payment, in addition to other remedies Lacombe County may have, the amount owing for utilities services shall bear a penalty charge in accordance with the Municipal Government Act and the Hamlet of Mirror Water, Wastewater and Garbage Bylaw 1382/22, and that non-compliance with the provisions of said Bylaw may result in discontinuation of utilities services by Lacombe County. The applicant acknowledg
ContractUtilities Service Agreement • July 28th, 2017
UTILITIES SERVICE AGREEMENTUtilities Service Agreement • March 27th, 2023
THE UNDERSIGNED HEREBY REPRESENTS that he/she is the applicant or an authorized agent for the applicant, and that he/she has the authority to sign this contract for utility services consisting of Water and Waste Water. The applicant agrees to comply with all provisions of Bylaw 1381/22 of Lacombe County, including payment for all utility services supplied by the County to the above service address until such time as the applicant or authorized agent requests in writing or in person that the contract be terminated. It is understood that in the event of late payment or non-payment, in addition to other remedies Lacombe County may have, the amount owing for utilities services shall bear a penalty charge in accordance with the Municipal Government Act and Bylaw 1381/22, and that non-compliance with the provisions of said Bylaw may result in discontinuation of utilities services by Lacombe County. The applicant acknowledges that the failure to receive or the loss of a utility bill will not
Lebanon Utilities Service AgreementUtilities Service Agreement • September 2nd, 2015
NOTE: In order for us to service your account or to collect any amounts you may owe, we may contact you by telephone at any telephone number associated with your account, including wireless telephone numbers, which could result in charges to you. We may also contact you by sending text messages or emails, using any email address you provide us. Methods of contact may include using pre-recorded or artificial voice messages and/or the use of an automatic dialing device, as applicable. I/We have read this disclosure and agree t hat Lebanon Utilities (or its representatives) may contact me/us as described above.
UTILITIES SERVICE AGREEMENTUtilities Service Agreement • February 23rd, 2010
By signing below, Customer agrees to, and acknowledges to have read, all of the accompanying terms and conditions on the reverse side of this application.
City of Bellevue BELLEVUE TAX/UTILITIES SERVICE AGREEMENT AND WAIVER OF SECURITY DEPOSITBellevue Codified Ordinance 921.04 and 925.14 Please complete and return this questionnaire within thirty (30) days. Service Address: Date: Please check one:...Utilities Service Agreement • October 28th, 2014
ContractUtilities Service Agreement • October 28th, 2014
City of Bellevue BELLEVUE TAX/UTILITIES SERVICE AGREEMENT AND WAIVER OF SECURITY DEPOSITBellevue Codified Ordinance 921.04 and 925.14 TENANT INDIVIDUAL QUESTIONAIRE Service Address: Acct. No.: Owner’s Name: Address: Phone: Tenant’s Name: Mailing Address: Phone: Employer: Mailing Address: Phone: Tenant’s Name: Mailing Address: Phone: Employer: Mailing Address: Phone: In the last 7 years, have you filed with the Bellevue Tax Department? Yes NoIf yes, under what name? Are you over the age of 18? Yes No Below, list the names of all other adults (over 18) living at this address: SIGNATURES: SOCIAL SECURITY NUMBERS TO AVOID A $50.00 DEPOSIT, PLEASE COMPLETE THIS FORM. THANK YOU.
