APPLICATION FOR UTILITIES AT RICHLAND MUNICIPAL UTILITIES
PO BOX 798, 204 E WASHINGTON, RICHLAND, MO 65556 573-765-3532
______OR ______
DATE SERVICE TO BEGINPERSONAL BUSINESSACCOUNT NUMBER
PRIMARY APPLICANT:
______
LAST FIRSTMSERVICE ADDRESS
______
DRIVER’S LICENSE NUMBERSTATEMAILING ADDRESS (IF DIFFERENT)
______
SOCIAL SECURITY NUMBERDATE OF BIRTHBUSINESS NAME IF BUSINESS ACCOUNT
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PLACE OF EMPLOYMENT / PH #PH ONE # CELL PHONE #
CO-APPLICANT:SERVICE REQUESTED DEPOSIT
______NATURAL GAS ____ $ 150.00
LASTFIRSTMELECTRIC ____ 75.00
ALL ELECTRIC ____ 150.00 WATER ____ 50.00
______SEWER ____ 25.00
DRIVER’S LICENSE NUMBERSTATEYARD LIGHT ____ -0-
TRASH ____ -0-
______OTHER______
SOCIAL SECURITY NUMBERDATE OF BIRTH
TOTAL DEPOSIT$ ______
______
PLACE OF EMPLOYMENT / PH #
DEPOSIT RECEIPT # ______
NAME OF OTHER ADULTS LIVING AT THIS ADDRESS:CASH______CHK #______
______HAVE YOU OR ANYONE ELSE HAD UTILITIES
WITH RICHLAND BEFORE? ______
YES NO
______WHEN? ______
UNDERWHAT NAME?
______
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PERSONAL REFERENCE:
______
NAMEADDRESSPH #
DO YOU ______OR ______THIS PROPERTY ?OWNER’S NAME IF RENTING: ______ OWN RENT
ADDRESS: ______
THE UNDERSIGNED, JOINTLY AND INDIVIDUALLY, IS APPLYING FOR UTILITIES FROM RICHLAND MUNICIPAL UTILITIES UPON THE TERMS AND CONDITIONS SHOWN ON THIS APPLICATION ( INCLUDING INFORMATION FOLLOWING SIGNATURE LINE ) IT IS ALSO CERTIFIED THAT THE TERMS AND CONDITIONS STATED ARE UNDERSTOOD.THE ABOVE STATEMENTS ARE TRUE TO THE BEST OF MY KNOWLEDGE AND I UNDERSTAND THAT THIS APPLICATION WILL BE VERIFIED AND A CREDIT CHECK MAY BE RUN ON MY CREDIT STATUS.
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APPLICANT’S SIGNATUREDATE
______
CO APPLICANT’S SIGNATUREDATE
READ CAREFULLY !!!
BELOW ARE ADDITIONAL TERMS AND CONDITIONS AGREED TO WHEN APPLYING FOR UTILTY SERVICE FROM RICHLAND MUNICIPAL UTILITIES:
Will pay the service deposit as requiredand maintain a “good standing” with RMU by paying the bill on or before the due date. In the event that “good standing” with RMU is not maintained, said RMU can review the deposit and establish a new one based on current policies.
If any person who will be living at this location owes RMU from a previous service and the amount is not paid within a time stated by RMU, this application will be revoked and service disconnected. Any debt due to RMU will be paid before application for service is completed. If connection is completed and prior debt is discovered, the debt will be paid immediately or it will be added to the account subjecting the account to RMU’s normal disconnect cycle.
In the event a joint membership is dissolved by divorce, separation, or death, the deposit is applied to the existing account and a new application and deposit must be completed by the person remaining at the service location. Any remaining deposit will be forwarded to the applicant or the original account.
By making application for utility services, the applicant agrees to pay for any and all such services, whether such services are rendered solely to such person or to other persons found on the premises, and whether such costs are incurred solely by applicant or jointly with others found on the premises. Said occupant, user or person purchasing or receiving such services, or any owner of such premises, shall be jointly and severally liable to pay for such services. In the event of non-payment for utility services, the City shall have the right to sue occupant, user or person purchasing or receiving utilities, or any owner of premises, in an civil action in a Court of law to receive and collect any sums due for such services, to include an award for reasonable attorney fees and their costs incurred in such suit.
By signing the written application for services, such person signing said application for services, to the extent permissible by law, expressly grants to the City an easement authorizing ingress and egress upon affected premises for the limited and strict purpose of installation, maintenance, repair, removal, location or relocation, of any such public utility or public works facilities, equipment or property, and to take any other reasonable actions which are necessary to ensure the effective and safe operation of such public utility or public works services.
If this application is approved and utility services are provided by RMU, I agree that the terms and conditions contained on this Application and Service Agreement, the terms and provisions of Section 700.060 of the Richland City Code and of any other applicable city ordinances concerning utility services, which are incorporated herein by reference, shall be binding upon me and I agree to comply with any and all such terms, conditions and provisions, I further agree that this Application and Service Agreement and any such ordinances shall all become part of the contract and agreement for utility service between RMU and myself.
If this application is approved and utility services are provided by Richland Municipal Utilities, I agree that the terms and conditions contained on this Application and Service Agreement, the terms and provisions of Section 700.060 of the Richland City Code and of any other applicable city ordinances concerning utility services, which are incorporated herein by reference, shall be binding upon me and I agree to comply with any and all such terms, conditions and provisions. I further agree that this Application and Service Agreement and any such ordinances shall all become part of the contract and agreement for utility service between Richland Municipal Utilities and myself.
Iacknowledge receipt of a copy of Section 700.060 of the Richland City Code and further acknowledgement that utility services provided pursuant to this Application and Service Agreement are conditioned upon my compliance with the provisions of Section 700.060.
By making this Application and agreeing to the terms and provisions of the Service Agreement, I acknowledge that the government of the City of Richland is deemed to be situated in Pulaski County, Missouri, and that for the purpose of any legal action to collect and sums not paid for utility services provided, or for the enforcement of any of the terms of his Service Agreement, I agree that venue shall be proper in the Circuit court of Pulaski County, Missouri, and I hereby consent that any such legal action or court action may be brought in the Circuit Court of Pulaski County, Missouri, regardless of where I may reside in the future.
By making this Application and Agreeing to the terms and provisions of the Service Agreement, I agree and expressly grant to the City the right, privilege and authority to trim trees, overhanging branches, hedges, shrubs, or other obstructions which might endanger of interfere with the safe construction, operation and maintenance of electric poles, wires, conductors, cross-arms, transformers, or other electrical fixtures, devices or apparatus, or and other utility or public works equipment, fixtures, devices or apparatus necessary for the continued safe delivery and receipt of utility services. I further acknowledge and agree that, if it is determined by the City that such entry upon the premises or property is necessary to inspect, maintain or repairs such utility fixtures, devices or apparatus, such as to ensure the continued safe delivery of utility services and the continued safe operation of the utility system, and I refuse to permit such entry, my refusal shall constitute good and sufficient reason for the City to terminate service until such time that the continued safe operation can be ensured. I agree that my grant of permission to enter upon the premises or property shall not create any obligation upon the City to take any action beyond that already required by applicable local, state and federal law or regulation, nor shall it be deemed to create any right or power of the City to exercise dominion or control over any land, property or premises, nor shall it be deemed to create any liability of the City of any kind whatsoever, including, without limitation, any liability of the City for the exercise or failure to take any act I may permit or authorize.
I understand and agree to the additional terms and conditions shown above as being part of my application for utilities:
______INITIALS
SECTION 700.060 : APPLICATION FOR SERVICES, JOINT AND SEVERAL LIABILITY FOR CHARGES, CITY’S RIGHT TO MAINTAIN AND REPAIR
- Application Process: Requirements to Obtain and Maintain Utility Service.
Any person desiring to purchase, establish or receive, at a specified location and premises, any public utility or public works services from the City, whether they be for sewer, water, electricity, gas, or any other such similar services now or hereafter offered to be provided for a charge by the City, shall make written application for such services to the City Utility Billing Clerk on a printed form provided for such purpose. In addition to any other applicable city ordinance, state or federal law, rule or regulation, the process for making application for utility services, the approval of such application, and the delivery and termination of such services shall also be subject to the following rules:
1.Such person, or applicant or customer, shall make and sign the application in the true name of the customer desiring utility service and the use of a fictitious name shall constitute good and sufficient reason for the City to deny the application or to terminate service upon discovery.
2.In the event the applicant is a business entity, including, without limitation, a corporation, partnership, limited liability company, or sole proprietorship whether or not the sole proprietorship is utilizing a registered fictitious name, the City shall be permitted to require the application to be submitted by, and the payment of the charge for services to be rendered guaranteed by, an individual in the name of said individual. The refusal of an applicant to make such submission and to provide such guarantee shall constitute good and sufficient reason for the City to deny the application for service.
3.For purposes of this Section “person” or “applicant” or “customer” shall mean any individual or entity, or both, making application for and/or receiving utility services pursuant to this Section and other applicable city ordinances.
4.For purposes of this Section “services” or “utility services” or “public works services” shall include, without limitation, any and all public utility or public works services delivered, furnished or provided by the City, whether they be for sewer, water, electricity, gas, or any other such similar services now or hereafter offered by the city to be provided or furnished for a charge, the provision of which is subject to the application and approval process set forth in this Section.
5.Any change in the actual identity of the customer receiving services at a specific location and premises shall require the submission of a new application for services to ensure the continued delivery of services. In such event, the failure to make a new application for services shall constitute good and sufficient reason for the City to terminate services.
6.No utility services of any kind shall be delivered or furnished by the City unless and until a written application is completed by the applicant for such services and such application is approved by the City.
7.No such application shall be approved if it is determined by the City that the application is not complete or otherwise is not in compliance with this Section.
8.Upon approval of the application, the applicant agrees to comply with any and all applicable ordinances of the City and with the terms and conditions contained within this Section and which are set forth on the face of the written application, which shall become the contract and agreement for the provision of utility services between the City and the applicant.
9.No utility services of any kind shall be delivered or furnished by the City if it is determined by the City that the delivery of such service would not be in compliance with any applicable technical codes or other provisions of this Section, other applicable City ordinances, state or federal laws, rules or regulations.
10.Violation of or non-compliance with any provision of this Section, other applicable City ordinances, state or federal laws, rules or regulations, regarding utility services, by the customer, shall constitute good and sufficient reason for the City to terminate utility services to the customer.
11.By making such application such person agrees to pay for any and all such services, whether such services are rendered solely to such person or to other persons found on the premises, and whether such costs are incurred solely by such person, or jointly with others found on the premises. Said occupant, user or person purchasing or receiving such services, or any owner of such premises, shall be jointly and severally liable to pay for such services rendered to and on the premises. Any occupant and user of any premises, or any owner or such services, now receiving any and all public utility or public works services from the City, shall be jointly and severally liable to pay for such services rendered to and on the premises. The failure to pay the charges for the services provided or furnished by the City shall constitute good and sufficient reason for the City to terminate such services. In addition, in the event of nonpayment for such services, the City shall be entitled to sue said occupant, user or person purchasing or receiving such services, or any owner of such premises, in a civil action in a Court of law of competent jurisdiction, to receive and collect any sums due for such services, to include an award for reasonable attorney fees and their costs incurred in such suit. By making such application, such person specifically agrees that, for the purposes of any such legal action, venue shall be proper in the Circuit court of Pulaski County, Missouri, and any such legal action shall be brought in the Circuit Court of Pulaski County, Missouri.
12.As a condition to receiving or continuing to receive utility services, the applicant and customer shall agree to comply with any and all ordinances, rules and regulations of the City regarding the City’s right to ingress and egress and to enter upon the property of the applicant and customer to maintain the utility equipment and system and to ensure the continued safe operation of such equipment and system. ______INITIALS
BCity’s Right to Ingress and Egress to Maintain Safe Operation of System:
As a condition of receiving any public utility or public works services from the city, whether they be for sewer, water, electricity, gas, or any other such similar services now or hereafter offered by the city to be provided or furnished for a charge, the City shall have the right of ingress and egress, and to enter upon the premises and property receiving suchservices, upon all due and reasonable notice to such person receiving services, except in the event of emergency, for the strict and limited purpose of the installation, maintenance, repair, removal, location or relocation, of any such public utility or public works facilities, equipment or property, and to take any other reasonable actions which are necessary to ensure the effective and safe operation of such public utility or public works services. To the extent reasonably possible, and to the extent permissible by law, any person purchasing or receiving such services if not the owner of the premises, or the owner of such premises, shall, upon the request of the City, grant an easement to the City authorizing such ingress or egress for the limited and strict purpose of the installation, maintenance, repair, removal, location or relocation, of any such public utility or public works facilities, equipment or property, and to take any other reasonable actions which are necessary to ensure the effective and safe operation of such public utility or public works services. By signing the written application for services, such person signing said application for services, to the extent permissible by law, expressly grants to the City an easement authorizing ingress and egress upon and the right and privilege to enter the affected premises for the limited and strict purpose of the installation, maintenance, repair, removal, location or relocation, of any such public utility or public works facilities, equipment or property, and to take any other reasonable actions which are necessary to ensure the effective and safe operation of such public utility or public works services. Upon making application for services and/or receiving such services, the customer agrees and expressly grants to the City the right, privilege and authority to trim trees, overhanging branches, hedges, shrubs or other obstructions which might endanger or interfere with the safe construction, operation and maintenance of electric poles, wires, conductors, cross-arms, transformers, or other electrical fixtures, devices or apparatus, or any other utility or public works equipment, fixtures, devices or apparatus necessary for the continued safe delivery and receipt of utility services. If it is determined by the City that such entry upon the premises or property of a customer is necessary to inspect, maintain or repair such utility fixtures, devices or apparatus, such as to ensure the continued safe delivery of utility services and the continued safe operation of the utility system, the customer’s refusal to permit such entry of objection to or contest of such entry shall constitute good and sufficient reason for the City to terminate service until such time that the continued safe operation can be ensured. Nothing contained within this Section shall create any obligation upon the City to take any action beyond that already required by applicable local, state and federal law or regulation. Nothing contained within this Section shall be deemed to create any right or power of the City to exercise dominion or control over any land, property, or premises. Nothing contained within this Section shall be deemed to create any liability of the City of any kind whatsoever, including, without limitation any liability of the City for the exercise or failure to exercise any act authorized by this Section.