Utility Meter Installation Form

UTILITY METER INSTALLATION FORM

Service Provider Name:     Provider Contact:

Customer Name:     Customer Contact:

Service Address:

RECITALS

WHEREAS, Service Provider is duly qualified and experienced in installing, testing, and commissioning utility meters and related equipment in accordance with applicable codes and industry standards; and

WHEREAS, Customer owns or controls the premises identified above and desires installation of a utility meter described in this Form, and Service Provider is willing to perform such installation under the terms set forth herein; and

WHEREAS, the parties desire to set forth the Scope of Work, Payment Terms, responsibilities for permits and inspections, and other terms applicable to the installation.

SCOPE OF WORK

Description of services to be provided (installation, connection, testing, removal of existing meter where applicable, and final commissioning). Provide specific locations, access points, required civil work, and any materials to be supplied.

INSTALLATION DETAILS

Electric    Gas    Water    Other:

Requested Start Date:     Estimated Completion Date:

Permit Required: Yes    No     Permit Number (if available):

PAYMENT TERMS

Total Installation Fee: $     Deposit Amount: $

Late Payment Charge:     Payment Address for Invoices:

TERM AND TERMINATION

Term Commencement Date:     Term Expiration Date:

Either party may terminate for material breach if the breach is not cured within days after written notice. Termination for convenience by Customer requires days written notice and payment for work performed to date.

CONFIDENTIALITY

All technical, commercial, and site-specific information exchanged in connection with this installation that is identified as confidential or that a reasonable person would understand to be confidential shall be kept confidential and used only for performance of this Agreement. Neither party shall disclose such information except to its employees, contractors or regulators on a need-to-know basis and who are bound to maintain confidentiality.

Customer acknowledges that meter data may be subject to separate privacy or regulatory requirements and agrees to comply with applicable obligations regarding access and disclosure.

By checking this box, the signing party acknowledges and accepts the Confidentiality provisions above.

WARRANTY & ACCEPTANCE

Service Provider warrants materials and workmanship for a period of from date of commissioning. Warranty excludes damage from third-party interference, force majeure, or improper use by Customer.

GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the state of without regard to conflict-of-law principles.

ENTIRE AGREEMENT

This Form, together with any attachments, scopes of work, and approved change orders executed by both parties, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior agreements, understandings, negotiations and discussions, whether oral or written.

AUTHORIZATIONS & CERTIFICATIONS

Customer certifies that they are the owner or authorized agent for the premises and authorize Service Provider to enter the premises as necessary to perform the installation. Customer further confirms that required site access, utilities, and approvals will be provided in accordance with the schedule.

Customer Authorization: Authorized

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