Water Service Certification Form

Water Service Certification Form

Recitals

WHEREAS, Client Name: (the "Client") is the owner or authorized agent of the property requiring water service certification; and

WHEREAS, Provider Name: (the "Provider") is engaged in the provision, testing, inspection, or installation of water supply systems and is duly authorized to certify water service; and

WHEREAS, the parties desire to document the scope of services, certifications and payment terms related to the water service described below, and to set forth certain contractual terms governing the certification provided herein;

NOW, THEREFORE, in consideration of the mutual covenants contained in this Water Service Certification Form, the parties agree as follows:

Certification Details

Meter Number:     Service Activation Date:

Scope of Work

Payment Terms

Late Payment Fee:     Preferred Payment Method:

Term and Termination

Term Commencement Date:     Term Expiration Date (if applicable):

Termination for Cause: Either party may terminate this certification upon material breach by the other party if such breach is not cured within days after written notice specifying the breach.

Certification and Compliance

The Provider hereby certifies that, to the best of its knowledge after performing the services identified in the Scope of Work, the water service described above:

Meets applicable potable water quality and supply standards and is suitable for its intended use unless otherwise noted in the Attachments.

Has been inspected and tested as described in the Scope of Work, with results recorded in the Certification Reference or Attachments.

No cross-connections or backflow conditions were observed at the time of certification except as described in Attachments.

The Provider's certification is limited to the conditions observed and tests performed on the date(s) indicated and does not constitute a warranty beyond the scope expressly set forth in this form.

Confidentiality

Each party agrees to hold in confidence all information designated in writing as confidential or that should reasonably be understood to be confidential given its nature (collectively, "Confidential Information"). Confidential Information does not include information that is publicly known, rightfully received from a third party without restriction, or independently developed without use of Confidential Information. The receiving party shall use Confidential Information solely to perform its obligations under this form and shall take reasonable measures to protect such information from unauthorized disclosure. These confidentiality obligations shall survive termination or expiration of this certification for a period of three (3) years.

Liability; Limitation

Provider's liability for claims arising out of this certification, whether in contract, tort (including negligence), or otherwise, shall be limited to direct damages and shall not exceed the fees paid to Provider under this form for the services giving rise to the claim. In no event shall Provider be liable for incidental, consequential, special or punitive damages. Nothing in this limitation shall exclude liability for gross negligence or willful misconduct.

Governing Law

This certification and any dispute arising out of or related to it shall be governed by the laws of the State of without regard to conflict of laws principles.

Entire Agreement

This Water Service Certification Form, together with any Attachments and written amendments signed by both parties, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior negotiations, proposals and agreements, whether written or oral. Any modification must be in writing and signed by authorized representatives of both parties.

Acknowledgments

By signing below, the parties acknowledge that they have read and understood this Water Service Certification Form, have authority to enter into it, and agree to be bound by its terms.

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