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2. 

3. City of Kingsford

   The Progressive City

5. Start Service Agreement for Utility Billing

7. Property Owner Information
9. Name*
10. Email Address*
12. Address*
14. City*
15. State*
16. Zip Code*
18. Phone Number*
20. Requested Start Date*
    Requested Start Date
22. IS THIS A RENTAL UNIT?*

    1. Yes
    2. No
24. TENANT Name*
25. Email Address*
27. Address*
29. City*
30. State*
31. Zip Code*
33. Phone Number*
35. Invoice Delivery Method*

    1. Regular Mail
    2. Email Delivery
37. Landlord/Tenant Agreement
    1. Parties agree and acknowledge that if water service is terminated for non-payment or otherwise, water service will not be reinstated until all charges associated with reinstating the service are paid in full. 
    2. Tenant agrees and understands that the City will require a $150.00 security deposit, prior to placing service in the Tenant's Name. Receipt #_____________ Date Rec'd:_____________ [Cash/Check/CC] (circle one)
    3. Parties agree and acknowledge that the City, if notified by either the Landlord or Tenant in writing that the Tenant is no longer responsible for payment of the utility services, the billing will be placed in owner's name. The written notice must include the requested date of termination, both the reading from the water meter and the outside remote, forwarding address of tenant and the signature of the requesting party. 
    4. Parties agree and acknowledge that per Section 40-40(b) of Kingsford Code or Ordinances, any utility charges imposed by or pursuant to this article or by subsequent resolution of the City which remain unpaid and are not fully covered by deposits will be applied to the tax bill for the real property upon which the service was rendered and become a lien on the property. 
39. Property Owner Signature

41. The undersigned have ready and understand the conditions of this application. 

43. Tenant Signature
45. City of Kingsford

    305 S. Carpenter Avenue

    PH: (906)774-3526

    Fax: (906)774-7093

    City of Kingsford's Website

47. This institution is an Equal Opportunity Provider and Employer

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48. Print Only

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