Energy Unite Integration Services Natural Gas Utilities Registration Form

Gas Utilities Registration

Please complete a separate form for each property to be registered.
PLEASE NOTE:

This for is specifically related to the owner of the property whom is the only person/entity that can be registered as the account holder. This does not include any of sectional title properties for example 104 On Creek, City Centre , 65 on Park etc.

If the property does not have an exisitng connection to the gas network kindly complete the following form: Gas Connection Application
Classification
Primary Contact
Name & Surname

NameSurname
Passport / ID No.
Copy of ID/Passport/Company Registration

Browse Files
(Please attach copy of passport/ID) Cancelof
Company
Company Name
Company Reg No.
VAT No.
Address where service is required

Street Address

Unit Nr | Estate Name

CityState / Province

Postal / Zip Code
Billing address ( if different from Service address)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Proof of address

Browse Files
(please attach proof of address, not older than 3 months) Cancelof
Domicilium citandi et executandi
Primary Email
example@example.com
Cell Number Primary

Country CodeArea CodePhone Number
Alternative Contact Person

NameSurname
Alternative Email
example@example.com
Alternative Cell Number

Country CodeArea CodePhone Number
Occupation Date

YearMonthDay
4 digit year, 2 digit month, 2 digit dayDate
TERMS AND CONDITIONS:

1. This agreement is entered into between ENERGY UNITE INTEGRATION SERVICES (PTY) LTD (“2021/699879/07”) and the Customer as defined herein above.

2. The Customer hereby indemnifies ENERGY UNITE INTEGRATION SERVICES (PTY) LTD and/or the appointed contractors and/or its owners, employees and/or agents against any claim whatsoever which may be made in respect of any loss, damages, death or other injury arising out of any activity carried out by ENERGY UNITE INTEGRATION SERVICES (PTY) LTD, excluding any damages occasioned by gross negligence attributable to ENERGY UNITE INTEGRATION SERVICES (PTY) LTD, herein after referred to as 'The Service Provider”'.

3. I agree to the following:

3.1 To allow reasonable access with prior notice where possible to The Service Provider to the premises to install and/or maintain the metering equipment;

3.2 To promptly pay the invoice rendered by The Service Provider within 7 (seven) calendar days from date of invoice, on the tariffs determined and adopted by the Home Owners Association and/or Body Corporate.

3.3 If there is a dispute on the account, same must be raised in writing within 5 (five) calendar days from receipt of the invoice, failure which the invoice will be deemed and accepted as correct and will be payable as set out in 3.2 above.

3.4 In the event of failure to pay the Service Provider may disconnect the gas supply upon 7 (seven) calendar days written notice. For this purposes the consumer agrees that the gas supply is not an essential service and may be disconnected.

3.5 I consent to legal fees and collection fees on attorney and own client scale in the event of breach of payment.

4. I/we select the indicated address on the face hereof as my domicilium citandi et executandi, for purposes of all notices and processes arising out of this agreement and undertake to provide proof of residence upon demand and inform the Firm forthwith of any amendments to my domicilium citandi, failing which I shall be bound by my representations in that regard and unable to avail myself to prejudice suffered as a consequence thereof.

5. Protection of Personal Information Act (“POPI”) /We hereby grant consent to the use of my personal information for purposes of the above service.
Additional Comments
Verify Primary E-mail Address
Should be Empty: