Application for Utility Connection

Application for Utility Connection

Recitals

WHEREAS Applicant Name: , a person or entity requesting utility service at premises located at Service Address: ;

WHEREAS Utility Provider Name: operates and maintains utility infrastructure and is authorized to provide connection and billing services for the requested utility;

WHEREAS the parties desire to set forth the terms under which Utility Provider will provide connection of the requested utility service and Applicant will accept such service and payment obligations;

Application Details

Account Type: Residential Commercial Industrial

Service Requested: Electric Water Gas Sewer

Scope of Work

Payment Terms

Applicant acknowledges and agrees that prior to connection Applicant must satisfy all payment obligations set forth above, pay any required deposits, and provide proof of any permits or easements required for installation.

Term and Termination

Term Commencement Date: . Term Expiration Date:

Either party may terminate this application/agreement for convenience upon written notice provided at least days in advance. Termination for cause may occur immediately upon material breach by the other party if such breach remains uncured for 10 days after written notice.

Confidentiality

The parties acknowledge that in the performance of connection services each may disclose proprietary or confidential information ("Confidential Information"). Each party agrees to (a) hold Confidential Information in confidence, (b) restrict access to employees and contractors on a need-to-know basis, and (c) not disclose Confidential Information to third parties without prior written consent. Confidential Information does not include information that is publicly available other than by breach of this provision or information independently developed by the receiving party.

Liability; Indemnification; Insurance

Utility Provider will perform connection work in a commercially reasonable manner and in compliance with applicable codes. Applicant shall indemnify and hold Utility Provider harmless from claims arising from Applicant's negligence, failure to obtain required permits, or misrepresentation of site conditions. Utility Provider's liability for direct damages shall be limited to direct costs paid by Applicant for the specific connection work; neither party shall be liable for consequential or punitive damages. Where applicable, Utility Provider shall maintain commercial general liability insurance and workers' compensation insurance as required by law.

Authorization and Certifications

By signing below Applicant certifies that: (a) Applicant is the owner or authorized agent for the Service Address; (b) statements in this application are true and complete; and (c) Applicant authorizes Utility Provider and its agents to access the Service Address for purposes of inspection, installation, maintenance, and disconnection in accordance with applicable law and this agreement.

Applicant understands that knowingly making a false statement in this application may subject Applicant to criminal or civil penalties under applicable law.

Governing Law; Entire Agreement

This application and any resulting connection agreement shall be governed by and construed in accordance with the laws of the State of without regard to conflict of law principles.

This document, together with any attachments or exhibits expressly incorporated herein, constitutes the entire agreement between the parties with respect to the subject matter and supersedes all prior negotiations, representations, and agreements, whether written or oral. Any amendment must be in writing and signed by both parties.

Administrative Information

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