Loading...
WS-28C Commercial New Meter Application - 2023-12-07DOMESTIC WATER SERVICE REQUEST – COMMERCIAL/NEW METER *Indicates required information to process your request Location to Begin Water Service: *Service Address : *City:Zip Code: *Assessor Parcel No: Billing Account Information: Owner Developer Contractor Tenant *Name: *Mailing Address: *City :Zip Code: *Doing Buisiness As:Type of Business: *Phone Number: *Email Address:Business Hours: Fax Number: E-mail Address: Please create a 4 to 8 character (letters and numbers) passcode for identification purposes. This passcode will be required to allow you to process certain transactions over the telephone. PASSCODE: Property Owners are responsible for payment of water bills. Owners may authorize tenants to receive and pay the bill; however, responsibility for the account remains with the Property Owner. By signing this document, I certify I am the legal landowner or designee of the property identified as the service address above, all information is true and correct, and I acknowledge and agree to all terms on the back of this form. I assume all responsibility for any bills costs, loss, damage, or fees associated with water service regardless of user or use. Upon termination of the tenant’s account, the account will automatically revert to the owner’s name. I understand all bills are due and payable within 25 days of billing, and a 1 ½% interest charge will be assessed against all delinquent bills. At time of meter install monthly water and sewer service fees will commence. *Initial Property Owner with Commercial Rental Property: Do you authorize the tenant to receive copies of the bill? Yes No If yes, Tenant information section (above) must be completed. *Date Signed: _______________*Signature: ______________________________________________ Tenant/Designee Signature:______________________________________ Date Signed: _______________ COACHELLA VALLEY WATER DISTRICT, 75-515 Hovley Lane East, Palm Desert CA 92211 (760) 391-9600 FAX (760) 568-1789 developmentservices@cvwd.org WS 28 C - Rev. 10/12 *TYPE OF SERVICE:Domestic Irrigation Fire Protection Sewer Fax Number: *Emergency Contact Name: *Work Phone Number: *Cell Phone Number: *E-Mail Address: Suite No.: Customer Contact Information: CVWD USE ONLY: Account Number: TERMS AND CONDITIONS Coachella Valley Water District (CVWD) owns, operates, and maintains the portion of the water service line from the water main to the outlet of the hydrant or gate valve on the downstream side of the meter, check valve or backflow prevention device (Service Connection). The Customer is responsible for the remaining portion of the service line to the commercial unit being served (Customer Service Line). The Customer Service Line includes separate domestic water and fire sprinkler systems. Property Owners are responsible for payment of water bills. Owners may authorize tenants to receive and pay the bill; however, responsibility for the account remains with the Property Owner. By signing this document, I acknowledge and agree to adhere to and abide by all of CVWD’s Regulations (Regulations). Customer acknowledges that CVWD will provide a single Service Connection to Customer’s property identified in this application (Property). In the event CVWD discontinues water service to the Property for any reason set forth in CVWD’s Regulations, including, but not limited to, failure to make payment when due, CVWD may, in accordance with the Regulations, discontinue water service to the Property. If CVWD discontinues water service to the Property, there is no water service for the fire sprinkler system. Customer assumes all risk of loss and damage to the Property, including the residential unit located on the Property or injury to persons arising out of the termination of such water service and hereby waives all claims in respect thereof against CVWD, including losses arising from or in connection with the loss of fire sprinkler protection. In addition to the foregoing, Customer assumes all risk of loss or damage to personal and real property due to backflow from the fire sprinkler system portion of the Customer Service Line into the domestic portion of the Customer Service Line for any reason whatsoever, including without limitation, any water quality exceedances. Customer shall assume the defense of, indemnify and hold harmless CVWD from and against all actions, causes of action, damages, demands, liabilities, costs (including, but not limited to reasonable attorneys’ fees), claims, losses and expenses of every type and description (collectively, Costs) to which it may be subjected or put, by reason of, or resulting from: (A) the design, construction, testing (including inspection to ensure that such system is operational), operation, maintenance, repair and replacement of the fire sprinkler system located on the Property; (B) the performance of or failure to perform of the fire sprinkler system located on the Property during Customer’s ownership of the Property; (C) backflow from the fire sprinkler system portion of the Customer Service Line into the domestic portion of the Customer Service Line for any reason whatsoever, including without limitation, any water quality exceedances during Customer’s ownership of the Property; and (D) any death, injury, property damage, accident or casualty caused or claimed to be caused by the discontinuance of water service to the Property for any reason set forth in CVWD’s Regulations, including, but not limited to, failure to make payment when due, including any Costs arising from or in connection with the loss of the use of the fire sprinkler system on the Property during Customer’s ownership of the Property. CVWD shall make all decisions with respect to its representation in any legal proceeding concerning this section. Customer hereby waives all claims and demands against CVWD for any such Costs. Customer acknowledges that CVWD shall have no obligation nor responsibility with respect to the design, construction, testing (including inspection to ensure that such system is operational), operation, maintenance, repair or replacement of the fire sprinkler system on Customer’s Property which shall be Customer’s responsibility and Customer shall bear all risk of loss or damage thereto and/or thereby, by whatever cause inflicted which shall be Customer’s responsibility.