Property Owner Account Preferences DRAFT

Property Owner Account Preferences
This form must be filled out by the shareholder (property owner on title).

Atascadero Mutual Water Company (AMWC) is a mutually owned water company, which means that property owners within our service area are our shareholders. In accordance with the State of California requirements, ALL water service accounts must be maintained in the name of the property owner listed on the title.

AMWC does not open or maintain accounts in the name of tenants or any non-owners, including business owners who may be leasing a commercial property.

NOTE: * indicates a required field
Is this a tenant-occupied property?*

YesNo
Account Type

SFR or Residential CondoCommercial, Industrial, MultifamilyFireline or Landscape
RESIDENTIAL TENANT INFO

AMWC does not collect/maintain personal contact information of tenants or track when tenants move in or out of the property. A paper bill will be addressed to "OCCUPANT" and mailed to the service address each month. Tenants do not have access to the property owner's online account portal; however, they may make payments using the QUICK PAY option available from the home page of our website.
COMMERCIAL INFO

A paper bill will be addressed to the tenant and mailed to the tenant at the address provided. Commercial tenants may have access to the property owner's online account portal only if the owner selects a preference in the Release of Account Information section below.
Do you have a Property Manager or Authorized Representative?*

YesNo
There is no need to fill out this form. If you are only looking for access to Civic Pay where you can manage your account online, click here. CIVIC PAY ACCESS.

SHAREHOLDER INFORMATION
AMWC Account Number:*
Service Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Property Owner Name*
(Shareholder)
Property Owner's Mailing Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Cell Phone*
Alternate Phone
E-mail*

COMMERCIAL BILLING INFORMATION
Name on Commercial Bill
Business Name (If Different)
C/O
Billing Address

Street Address

Street Address Line 2

CityState

Zip Code
Tenant Phone*
Tenant Email
example@example.com

PROPERTY MANAGER INFORMATION

(OR AUTHORIZED REPRESENTATIVE)
Property Manager/Authorized Representative
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Email
example@example.com

CIVIC PAY ACCOUNT ACCESS
CIVIC PAY is a 3rd party payment platform used by AMWC which allows owners or their authorized agents to manage water bills online.
- GENERAL ACCESS: View water usage and payment activity, View and print water bills, sign up for e-bills.
- PRIMARY ACCESS: Can do all of above but will have the added capability of scheduling auto payments with a credit card. ONLY select this option if the property manager/authorized agent or commercial tenant needs to schedule recurring payments.
Does your property manager/authorized representative or commercial tenant need online access to CIVIC PAY account portal?

YESNO
ONLINE ACCOUNT PREFERENCE*

GENERAL ACCESS: I hereby authorize AMWC to release (verbally and/or in writing) information regarding this account and to provide my property manager/authorized representative or commercial tenant with access to AMWC's online payment portal.PRIMARY ACCESS: I hereby direct AMWC to give Primary Access of my online water account to my property manager/authorized representative or commercial tenant. I understand that in doing so, the property manager/authorized representative or commercial tneant will have full control of all online account preferences.

Terms and Conditions
Duplicate Bill*

I hereby authorize AMWC to mail a duplicate water bill directly to the tenant or property manager/authorized representative. I also understand that AMWC does not read the water meter when tenants move in or out. Duplicate billing will begin as of the LAST READ date.
By signing below, I represent and warrant that I am the owner of the property at the service address listed above. I understand and agree that I am fully responsible for all water-related charges provided to the property by AMWC. If I have authorized AMWC to send the original water bill to a property manager, authorized representative and/or tenant, or release account balance information to a property manager/authorized representative and/or tenant, then I further agree to indemnify, defend and hold AMWC harmless from and against any and all actions, claims, demands, damages, settlements and costs, including attorneys’ fees, AMWC may incur as a result of, in connection with, or arising from AMWC’s release of such account information.
Please check:*

I agree to the above Terms and Conditions
Electronic Signature Agreement

By selecting the "I Accept" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual/handwritten signature on this Agreement. By selecting "I Accept" using any device, means or action, you consent to the legally binding terms and conditions of this Agreement. You further agree that your signature on this document (hereafter referred to as your "E-Signature") is as valid as if you signed the document in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature, and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature, or any resulting agreement between you and AMWC. In addition, you are confirming that you are the shareholder authorized to enter into this Agreement.
I Accept*

By checking this box and typing my name below, I agree to the terms and conditions of the Electronic Signature Agreement, and I am electronically signing my application.
First Name*
Last Name*
Date*

MonthDayYear
Date
Should be Empty:

Property Owner Account Preferences

SHAREHOLDER INFORMATION

COMMERCIAL BILLING INFORMATION

PROPERTY MANAGER INFORMATION

CIVIC PAY ACCOUNT ACCESS