Service Application and Agreement Sample Contracts
CORBET WATER SUPPLY CORPORATION SERVICE APPLICATION AND AGREEMENTService Application and Agreement • September 19th, 2024
The following information is required by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application of to discriminate against you in any way. However, if you choose not to furnish it, we are required to not the race/ national origin of individual applicants on the basis of visual observation or surname.
CROOKED CREEK WATER SUPPLY SERVICE APPLICATION AND AGREEMENTService Application and Agreement • February 17th, 2022
The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname.
SERVICE APPLICATION AND AGREEMENTService Application and Agreement • November 30th, 2023
The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname.
SERVICE APPLICATION AND AGREEMENTService Application and Agreement • November 30th, 2023
The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname.
CULLEOKA WATER SUPPLY CORPORATION SERVICE APPLICATION AND AGREEMENT + CITY SEWERService Application and Agreement • February 23rd, 2024
The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname.
SERVICE APPLICATION AND AGREEMENTService Application and Agreement • August 20th, 2020
The District shall sell and deliver water and/or wastewater service to the Applicant and the Applicant shall purchase, receive, and/or reserve service from the District in accordance with the Service Policies of the District, as amended from time to time by the Board of Directors of the District. Upon compliance with said Policies, including payment of a deposit, the Applicant shall become eligible to receive service.
SERVICE APPLICATION AND AGREEMENTService Application and Agreement • February 29th, 2024
The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname.
Wylie Northeast SUDService Application and Agreement • October 6th, 2016
SERVICE APPLICATION AND AGREEMENT + CITY SEWERService Application and Agreement • January 12th, 2022
The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname.
WIMBERLEY WATER SUPPLY CORPORATIONService Application and Agreement • July 20th, 2022
The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname.
SERVICE APPLICATION AND AGREEMENTService Application and Agreement • November 1st, 2023
The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname. □ White, Not of Hispanic Origin □ Black, Not of Hispanic Origin □ American Indian or Alaskan Native □ Hispanic □□ Asian or Pacific Islander □ Other(Specify) □ Male□ Female
MEDINA WATER SUPPLY CORPORATION SERVICE APPLICATION AND AGREEMENTService Application and Agreement • July 30th, 2024
The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname. Ethnicity: not Hispanic or Latino Race: White Hispanic or Latino Black or African American American Indian/Alaska NativeGender: Male Asian Female Native Hawaiian or Other Pacific Islander
SERVICE APPLICATION AND AGREEMENTService Application and Agreement • July 2nd, 2021
❑ New Construction, no prior water/sewer services at this location. Please include Membership Fee in the amount of $402.50 (payable to Windermere Oaks Water Supply Corporation) with this application. In addition, if not previously paid, each Applicant shall be required to achieve parity with existing Members by contributing capital in an amount of $4,600.00 (Equity Buy-In Fee) assessed once per lot/tap. Applicant will also pay Installation Fee for water service of $862.50 and the Installation Fee for wastewater service of $862.50. A customer service Inspection fee of
10393 U.S. HWY 87 WService Application and Agreement • April 16th, 2021
KINGSLAND WATER SUPPLY CORPORATIONService Application and Agreement • May 20th, 2022
SERVICE APPLICATION AND AGREEMENTService Application and Agreement • September 4th, 2024
The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname.
SERVICE APPLICATION AND AGREEMENTService Application and Agreement • March 24th, 2022
Service Application and AgreementService Application and Agreement • May 7th, 2025
The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname.
Wylie Northeast SUDService Application and Agreement • October 18th, 2019
SERVICE APPLICATION AND AGREEMENTService Application and Agreement • June 9th, 2022
Form: FCWS001 CORPORATION USE ONLY Date Approved: Rate Code: Meter Install Date: Work Order Number: Account Number: Service Inspection Date: FLO COMMUNITY WATER SUPPLY CORPORATION SERVICE APPLICATION AND AGREEMENT Please Print: DATE APPLICANT’S NAME...Service Application and Agreement • July 8th, 2022
Contact #1 ( ) - (circle one) Cell Home Work [ ] I agree to accept text messages Contact #2 ( ) - (circle one) Cell Home Work [ ] I agree to accept text messages
Account #: Membership: Service Application: Proof of Ownership: Bell CAD Prop ID: Easement: Meter Serial #:Service Application and Agreement • May 20th, 2021
Account #: Membership: Service Application: Proof of Ownership: Bell CAD Prop ID: Easement: Meter Serial #:Service Application and Agreement • January 26th, 2022
WATER SUPPLY CORPORATION SERVICE APPLICATION AND AGREEMENTService Application and Agreement • October 23rd, 2024
Service Application and AgreementService Application and Agreement • January 31st, 2024
The following information is requested by the Federal Government in order to monitor compliance with Federal Laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/origin of individual applicants on the basis of visual observation or surname.
SERVICE APPLICATION AND AGREEMENTService Application and Agreement • December 27th, 2020
Walston Springs Water Supply Corporation, a corporation organized under the laws of the State of Texas (hereinafter called the
MANVILLE WATER SUPPLY CORPORATIONService Application and Agreement • October 31st, 2016
MANVILLE WATER SUPPLY CORPORATIONService Application and Agreement • June 10th, 2020
Service Application and AgreementService Application and Agreement • August 15th, 2022
The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname.
CRESCENT HEIGHTS WATER SUPPLY CORPORATION SERVICE APPLICATION AND AGREEMENTService Application and Agreement • February 27th, 2015
The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname.
SERVICE APPLICATION AND AGREEMENTService Application and Agreement • November 12th, 2024
The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname.
CULLEOKA WATER SUPPLY CORPORATION SERVICE APPLICATION AND AGREEMENTService Application and Agreement • September 22nd, 2022
The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname.
CORBET WATER SUPPLY CORPORATION SERVICE APPLICATION AND AGREEMENTService Application and Agreement • July 29th, 2020
The following information is required by the Federal Government in order to monitor compliance with Federal laws prohibiting
SERVICE APPLICATION AND AGREEMENT + CITY SEWERService Application and Agreement • June 21st, 2022
The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname.
SERVICE APPLICATION AND AGREEMENTService Application and Agreement • July 9th, 2019
The following information is requested by the Federal Government in order to monitor compliance with Federal laws prohibiting discrimination against applicants seeking to participate in this program. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race national origin of individual applicants on the basis of visual observation or surname.