WATER SERVICE COMMERCIAL APPLICATION

APPLICATION FOR WATER SERVICE COMMERCIAL

MUNICIPAL AUTHORITY OF WASHINGTON TOWNSHIP

**Please contact the office to complete the application/service process.

This Credit Deposit Application for Commercial Water Service is subject to the Rules and Regulations established by the Municipal Authority of Washington Township. A deposit will be required based on meter size. Please call the office to discuss.

The deposit is refundable after a period of three years if payments have been satisfactory and there is no balance due on the account, or it may be applied to your “Final Bill” when vacating the premises. Refunds are optional and discretionary with the Authority after review of payment records in accordance with the general rules.

By signing this application, you agree to protect the meter from freezing or rough usage, and that you will be responsible for all charges incurred at this address.

Bills are issued monthly and are determined by meter registration and size. Bills are mailed the first week of the month and due the last Tuesday of the month, after which a 5% penalty is assessed. If the balance remains unpaid after 10 additional days, a delinquent notice will be sent with a water shut-off date if the account remains unpaid. You will be billed for any charges connected with collecting unpaid bills, including a $25 posting fee if your property is posted for shut-off. If a check is returned for insufficient funds, a $45.00 fee will be added to the account. If water is shut off for a delinquent account, a $ 50.00 fee will be added to the account.

If service is to be discontinued at this service location, the Authority is to be notified and arrangements made for the proper termination of service within 5 days. Failure to notify the Authority will necessitate additional charges on this account. $1.00/month capital improvement fee is added to every cusotmer’s bill

Please Check One:

Owner Landlord Tenant

Name

Service Location

# In Household

Address where bills are to sent

HOME Phone#

Work Phone#

Cell Phone#

(If tenant is checked above, list name of landlord, address and telephone number.)

Service will NOT BE STARTED if landlord information is not completed prior to the scheduled turn on date or if there is a balance due on the account.

Landlord Name

Landlord Address

Landlord Phone#

NAME OF FORMER TENANT IF KNOWN

Account number if known

Driver license number

State License issued

I Accept

I hereby acknowledge that the above information is correct and that I agree to use the sewer according to the Rules and Regulations of the Authority, and to pay for sewer service at the above service location.

TYPE YOUR NAME HERE

date

HOw are you paying your security deposit?

ANY OTHER INFO you would like to tell us?

IMPORTANT: When you click the SEND button below, you will be taken to our secure payment page. If you want to pay online, choose the SECURITY DEPOSIT drop-down and follow the instructions for payment.

PLEASE BE SURE TO INCLUDE YOUR ACCOUNT NUMBER OR SERVICE ADDRESS IN THE REFERENCE FIELD WHEN PROCESSING YOUR PAYMENT.

** BE AWARE OF PROCESSING FEE– YOU WILL BE ABLE TO SEE THE FEE BEFORE ALLOWING PAYMENT TO PROCESS — As of October 1, 2016 the convenience fee is 2.65%. The minimum fee is $3.00.

***DO NOT USE ANY DASHES, SLASHES OR PERIODS IN THE EXPIRATION DATE, CARD NUMBER OR PHONE NUMBER– IT WILL NOT ACCEPT IF YOU DO.

E-Check is also a payment option–this service is a flat $1.50 service fee — please be aware—E-checks are not resubmitted– should the funds not be available the first time it is presented– it will not be reprocessed and you will incur a NSF charge from both MuniciPay and the Authority.

If you prefer to pay via check or money order, you can drop a check or money order off at our office or mail to:
Municipal Authority of Washington Township
1390 Fayette Ave
Belle Vernon PA 15012