Application for Floating Water Meter

Name *

First Name Last Name

Company or Business Name

Date

Billing Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Location where meter is to be placed *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Service Request Date

Date

President or Legal Representative

Federal Tax ID#

Type of Business

Corporation Partnership Sole Proprietorship

Phone Number *

Area Code Phone Number

Fax Number

Area Code Phone Number

Email *

example@example.com

Driver's License or ID#

State

Date of Birth

Date

DEPOSITS

City Ordinance Sec. A20.02.036 $1,200 Only City Owned Meters are allowed.

CONNECTION FEE

There will be a $20.00 connection fee at the time of initial service.

All water trucks or tanks must be filled with a connection which provides an air gap of at least 6 inches from filler pipe to mouth of tank. Under no circumstances is a truck or tank to be filled from a bottom connection.

Under no circumstances will injection type equipment (for soil stabilization) be attached to a hydrant meter.

BILLING RATE

Minimum monthly charge for 3 inch floating (fire hydrant) meter $184.28 (2,000 gallons included in a minimum charge)

THERE WILL BE A MINIMUM CHARGE OF $184.28 PER MONTH EVEN WITH NO CONSUMPTION.

Consumption over 2,001 to 50,000 gallons will be billed monthly at a rate of $3.80 per 1,000 gallons in addition to minimum monthly charge. Consumption over 50,000 gallons will be billed monthly at a rate of $4.82 per 1,000 gallons in addition to charges mentioned above.

MOVING OF METERS

All meters must be moved by the City of Greenville utility department. Please call (903) 457-2800 at least 24 hours in advance when a meter is to be moved to a new location.

The Applicant, whose signature appears below, applies to GEUS and the City of Greenville Utility Administration Office for some or all of the following services: Electric, Water, Sewer, Garbage, Cable TV, Internet and other services incident thereto, to be supplied at the address herein described, and upon request, at any other local address to which Applicant may move.

The Applicant agrees to pay for said services as bills are rendered therefore, in accordance with the rates, rules and regulations as provided in the City Charter or by City Ordinances as now existing or as may be enacted and in effect at the time of delivery, regardless of who the consumer might be.

The Applicant further agrees to release and discharge said GEUS or the City of Greenville from a liability for damages suffered

(1) by reason of electric or water currently furnished to the premises, or

(2) by reason of interruption, discontinuance or disconnection of service hereunder from any cause other than negligence by GEUS or the City of Greenville or

(3) by reason of the condition, maintenance, location, or existence of any of the facilities, fixtures or systems located on or adjoining the property supplied and by which services are furnished and delivered. Service requests for disconnect will be processed within 48 hours.

Applicant agrees to follow all current or as amended policies and procedures established in the Greenville City Ordinances and GEUS Service Policy. Such policies and procedures can be found on the links provided below.

www.geus.org/pdf/GEUS-Service-Policy.pdf

http://z2.franklinlegal.net/greenville-flp

I understand and agree to the terms and conditions as stated above.

Signature *

First Name Last Name

Date *

Date

Signature *

Clear

Application for Floating Water Meter

Agreement