Owner Service Agreement Form

You will need information from the Fees & Deposits page to fill out the 'Service Deposit' section of the Customer Service form.
I/we (if married, both names must be provided)
 
 
(hereinafter, the “OWNER”), desire to be a OWNER of the Jefferson Water and Sewer District (hereinafter, the “DISTRICT”) and directly receive the bills for utility service charges for the following service address:
 
 
under this Owner Service Agreement (hereinafter, “OSA”).
 
 
 
For good and valuable consideration, including the right to obtain or continue to receive services from the DISTRICT, the OWNER agrees to the following:
 
1. LIABILITY FOR PAYMENT: OWNER agrees to pay the DISTRICT for utility service charges, and any other applicable DISTRICT fees and/or penalties, for the above service address during their tenancy at such address. OWNER is responsible for all applicable tap fees, usage charges, deposits and any other applicable DISTRICT fees or charges for the above listed property. If any such fees or charges are unpaid, the DISTRICT may, at its sole discretion, terminate DISTRICT services to the property and certify delinquent charges to the County Auditor, resulting in a lien upon the property. The DISTRICT may also impose penalties or pursue any other remedy permitted by law. While the DISTRICT may, in its sole discretion, as a courtesy, and at the request of the OWNER, directly bill a tenant of said property for usage charges, the owner shall ultimately be responsible for any uncollected DISTRICT fees or charges and if such delinquent fees or charges remain unpaid, may be certified to the County Auditor, resulting in a lien upon the property.
 
2. BILLING: The rates and charges are prepared and billed monthly in accordance with DISTRICT Regulations. Bills and notices relating to the conduct of the business of the DISTRICT will be mailed to the OWNER at the service address indicated above (or mailing address, if provided below) unless the District is informed of a new mailing address by submission of a new OSA, or unless a DISTRICT change of address form has been completed and returned in a timely manner to the DISTRICT business office. The DISTRICT shall not otherwise be responsible for delivery of any bill or notice.
 
3. SERVICE DEPOSIT: In accordance with DISTRICT Rules and Regulations, a service deposit fee is required for a new OWNER account, or for an existing OWNER account where such OWNER has filed for bankruptcy, been disconnected from the DISTRICT system or had delinquent DISTRICT charges certified to the County Auditor for collection since establishing an account. Any OWNER may apply for relief from such deposit requirement if they qualify for a hardship variance under the DISTRICT Rules and Regulations. The service deposit will be held by the DISTRICT and applied to any outstanding balance due the DISTRICT at the time OWNER account is voluntarily or involuntarily terminated. Where no balance is due, such deposit will be refunded to the OWNER in accordance with DISTRICT Rules and Regulations for refunds. If there is a TSA for the Service Address indicated above, the service deposit will be collected from the Tenant.
 
 
4. INSPECTION BY DISTRICT: OWNER agrees to be subject to inspection of DISTRICT property at the service address listed above in accordance with DISTRICT Regulations.
 
5. ACCOUNT CHANGE: OWNER agrees to provide DISTRICT with reasonable notice within 2 weeks that they are moving from the Service Address or any other change to the ownership of the Service Address.
 
6. RULES AND REGULATIONS: OWNER further agrees to adhere to all DISTRICT Rules and Regulations, and agree, in particular, to be liable for all water and sewer fees and charges incurred for the above listed premises, whether the accounts for such premises are carried in the OWNER name or in the name of tenants or other persons.
 
By completing the form below, OWNER understands and agrees to all of the foregoing.
 
 
 
 
 
 
 
 
 
 
 
 
  
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Important

 
Your information will be submitted securely to our Customer Service Administration and kept on file. To complete the agreement process, we will require your signature, a copy of a valid driver’s license or state ID along with your deposit. [Deposit amounts will vary depending on the services rendered. Please refer to ‘Fees & Deposit’ Part III located on Page 7 to determine the deposit amount or contact our office for assistance].
 

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