Hydrant Meter Application Form

HYDRANT METER APPLICATION AND SERVICE AGREEMENT

Recitals

WHEREAS, Applicant Name: (hereinafter "Applicant") requests temporary potable water service via a municipal hydrant meter for construction, maintenance, or temporary use; and

WHEREAS, Utility Name: (hereinafter "Utility") is the owner/operator of the public water system and is authorized to provide hydrant meter service under the terms of this Agreement; and

WHEREAS, the parties wish to set forth the terms, conditions, fees, and responsibilities governing issuance, use, and return of the hydrant meter equipment.

Applicant Information

Service Location and Meter Request

Meter Size Requested: 1" 2" 3" Other

Quantity:    Purpose: Construction Street Cleaning Dust Control Other

Requested Start Date:    Requested End Date:

Scope of Work

Describe planned use of hydrant meter, including estimated daily consumption, locations of use, and any required connections. Applicant must include sufficient detail to permit Utility to evaluate meter placement and service conditions.

Fees, Deposits and Payment Terms

Applicant agrees to pay the following fees and deposit prior to issuance of meter. All fees are non-refundable unless otherwise noted.

Payment Terms: Applicant shall be responsible for all water consumption charges measured by the meter, meter rental, and any applicable fees. Utility will invoice Applicant according to the Billing Schedule above. Payments not received by the due date are subject to the Late Payment Fee and may result in suspension of service and recovery costs charged to Applicant.

Responsibilities, Use and Maintenance

Applicant acknowledges and agrees that the hydrant meter and associated equipment remain the property of Utility. Applicant is responsible for proper use, protection from theft or vandalism, and shall not permit meter tampering. Applicant shall immediately report any damage, loss, or malfunction. Unauthorized removal, bypass, or tampering with the meter constitutes grounds for immediate termination and forfeiture of deposit, and may subject Applicant to civil or criminal penalties.

Backflow Prevention: Applicant shall provide or permit Utility to install approved backflow prevention devices as required. Applicant is responsible for inspection, testing, and any associated costs. Failure to maintain required backflow prevention is a material breach.

Indemnity and Insurance: Applicant shall indemnify, defend, and hold Utility harmless from all claims, liabilities, losses, and expenses arising from Applicant's use of water or hydrant facilities, except to the extent caused by Utility's gross negligence or willful misconduct. Applicant shall maintain commercial general liability insurance naming Utility as an additional insured where required by Utility policy and provide proof of insurance upon request.

Term and Termination

Term: This Agreement commences on Start Date: and, unless sooner terminated under this section, continues until End Date: or such time as the meter is returned and all charges are paid.

Termination: Either party may terminate this Agreement for convenience upon providing Notice Period (days): days written notice. Utility may immediately terminate service for nonpayment, meter tampering, public health or safety concerns, or breach of any material term. Upon termination Applicant must permit Utility access to retrieve the meter within 48 hours or pay additional rental and retrieval charges.

Confidentiality

Each party shall treat as confidential all non-public business information disclosed in connection with this Agreement and shall not disclose such information except to employees, contractors, or advisors who have a need to know and who are bound by confidentiality obligations. Confidential information does not include information that is or becomes publicly available through no breach of this Agreement, or that was independently developed or lawfully obtained from a third party.

Governing Law; Entire Agreement

This Agreement shall be governed by and construed in accordance with the laws of the state or jurisdiction in which the Utility operates. This Agreement, including any attachments and written fee schedules incorporated herein, constitutes the entire agreement between the parties with respect to hydrant meter service and supersedes all prior negotiations and understandings, whether written or oral.

Acknowledgement and Certification

Applicant certifies that the information provided in this application is true and accurate, that Applicant is authorized to request service at the stated location, and that Applicant accepts responsibility for compliance with the terms and conditions set forth herein. Applicant acknowledges receipt of and agrees to the Utility's hydrant meter policies and fee schedule as applied to this request.

Sign Now