Utility Billing Service Quote
Name
*
First Name
Last Name
Area Name
*
Which service are we quoting you for?
Sewage
Garbage
Stormwater
Other
What is the water company used for your area?
Do you bill for...
Residential
Commercial
Both
What is the number of accounts in your area?
Do you currently collect sewage in-house or 3rd party
In-House
3rd Party
Who collects your sewage currently?
Do you currently collect garbage in-house or 3rd party
In-House
3rd Party
Who collects your garbage currently?
What is the frequency of your sewage billing currently?
Monthly
Quarterly
Yearly
In regards to sewage, do you bill based on consumption or do you have a flat rate?
Consumption
Flat rate
In regards to sewage, do you have late fees, penalties, or interest? (check all that apply)
Late Fees
Penalties
Interest
Do you have termination agreements / shutoffs?
Yes
No
What is the frequency of your garbage billing currently?
Monthly
Quarterly
Yearly
In regards to garbage, do you have late fees, penalties, or interest? (check all that apply)
Late Fees
Penalties
Interest
When do you anticipate the effective date of change?
1-2 months
3-6 months
6-12 months
12+ months
Email - Where we can send the quote
*
example@example.com
Phone Number - if we have any questions
*
Please enter a valid phone number.
Format: (000) 000-0000.
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