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APPLICATION FOR UTILITY SERVICE

FOR OFFICE USE ONLY

Account # Closing Date/Beginning Lease Date:

(Documentation Required)

Meter Size Dwelling Units Acct. Set-up Fee:

Deposit:

Service fees:

Total Amount:

Location

Services:

Water, Sewer & Trash

Water & Sewer

Water Only

Trash Only

WO#

Service Request (check one):

Applicant: Property Owner

Tenant

STOP TRANSFER

Management Company

In consideration for receiving water, sewer and/or trash service from the City of Savannah, Georgia, at the above location, I hereby acknowledge responsibility for payment of service billings. Accounts are billed on a bi-monthly basis and payment by the indicated due date is required to prevent interruption of service. I am responsible for water/sewer and/or trash service until the account is closed. In consideration for having water service initiated/restored at the above address, I agree to ensure that all water service facilities (sink and tub faucets/inside and outside, toilets, etc.) are turned off; or that someone will be on the property to check for leakages. We recommend that you turn off your private cut off valve, if applicable. Once the application is processed; it may take up to 2 working days to restore water service. I have read and agree to the terms and conditions. I further understand that applications will not be processed without appropriate identification, documentation, and payment.

Signature: Date:

Name:

(Last, First, MI OR Business Name)

C/O or Person of Contact:

Social Security Number (last 4 digits)/Tax ID:

*Previous Address: Date to Disconnect:

(If transferring service to new location or canceling current service.) Service Address: City, State, Zip code

Mailing-forwarding Address: City, State, Zip code

(If different than Service Address)

Telephone Number: Alternate Phone Number:

Email Address:

By providing my email address, I agree to receive electronic communications from the City of Savannah. Please note: All applicants requesting new or transferred services will be charged a non-refundable $30 Account Set-up Fee.

Completed Applications & Supporting Documents Can Be Emailed to: adwqai@r.postjobfree.com Mailing Address: P.O. Box 1968, Savannah, GA 31402-1968 Public Office: 305 Fahm St, Savannah, GA 31401 Ph: 912-***-****

Terms & Conditions

Account Set-up Fee: A non-refundable fee of $30 will be charged to each new utility account upon establishment. This fee is charged for rented locations and owner- occupied locations. The fee is also required when an account holder transfers existing utility services to a new location.

Deposit: City of Savannah may require a deposit on some new accounts, including commercial accounts, depending on the service location meter size/type. Deposits range from $100.00-$1,000.00. When service is terminated, the deposit on the account will be applied towards any outstanding balance. If there is no balance due or a credit remains, a refund check will be mailed to the forwarding address provided after the final billing has occurred. Billing Cycle: Bills are issued on a bi-monthly basis. The billing date is determined by your location within our service area. Due dates are not adjustable.

Payment Terms: Payments are due within 20 days of the bill date. Failure to receive a bill does not exempt penalties or disconnection for non-payment. We are not responsible for late remittances made through the mail service.

Late Penalty: A late penalty of $5.00 or 10% (whichever is greater) will be added to your current bill amount, if bill is not paid by 5:00 p.m. on the 10th day following the due date.

Administrative Processing Fee: Any account not paid in full within 17 days of the original due date will be charged a $50.00 administrative processing fee.

Disconnect Policy: All accounts billed an administrative processing fee will be subject to service disconnection. Service will be reconnected after the delinquent balance and fees are paid in full.

Returned Payments: Returned payments will be charged a $30.00 or 5% (whichever is greater) fee. Unpaid

returned payments will be subject to disconnection. Checks will no longer be accepted on accounts having three returned payments. Payments will be required in the form of cash, money order, or debit/credit cards. Terminate Service: Only an accountholder listed on an account can terminate service. Verification of personal identifying information will be required. Service will be disconnected the next working day or at a later specified date, excluding weekends and holidays.

A final reading will be taken on requested termination date and a final bill or deposit refund check will be mailed to the forwarding address provided.

Reinstated Service: Accounts with outstanding balances will be required to pay the entire balance before new service can be established; along with any deposits required and/or service fees.

Tampering Policy: In the event a meter or service

equipment has been tampered with or unauthorized

usage has occurred, service will be disconnected

immediately. A Tampering Fee ranging from $100 to $300 will be due before service can be restored.

Additional Fees/Service Fee:

Broken Padlock/Curb-cock Lock $25.00

Locking Meter/Broken Padlock $60.00

Plugging Meter $75.00

Meter Removal/Change-out $100.00

Water Leaks Policy: If a water leak is found on the customer’s side of the meter, it is the customer’s responsibility to have the leak repaired immediately. The City of Savannah has the right to turn the water off until the customer can have the leak repaired. Water should be turned off when not is use until repair is complete. A leak adjustment may be granted after evidence and

confirmation of repairs are made.

Payment Options:

• Online:

www.savannahga.gov/utilitypay

• ACH Bank Draft

• Mail to address listed on bill

• Office Drop Box 24/7 (do not use for delinquent

payments)

• In-person at our office during regular business hours For more information on User Rates and Billing Schedules please visit our website: www.savannahga.gov/utilities Mailing Address: P.O. Box 1968, Savannah, GA 31402-1968 Public Office: 305 Fahm St, Savannah, GA 31401

Ph: 912-***-****

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