Attention new customers: The first bill for every new account will reflect a water miscellaneous charge. This is a water
service fee for obtaining a beginning meter read and establishing billing and accounting records. Accounts are billed
monthly. Bills not paid by the due date as shown on the bill are considered late. When accounts are turned off for
nonpayment, a reconnection service charge will be due as well as any applicable charges. If an unpaid previous balance
appears on the bill, the unpaid amount is NOT extended to the current month's due date.
If a special trip is made to the customer's premises (re-reads, meter tests, meter shut off, data loggers, etc) a trip charge
will be applied to the monthly billing.
Name:
Service Address:
Mailing Address:
Email Address:
Connection Date:
Phone Number:
To guarantee the payment of any and all indebtedness for water , sewer and stormwater fees which may be or become due to Utilities by said
customer. Customer agrees that such deposit or any part thereof may be applied by the Department at any time in satisfaction of said
guarantee. The Department agrees to refund to the customer that portion of the deposit applying to the services discontinued, less any amounts
due to the Department. This Deposit shall not preclude the Department from discontinuing for nonpayment and all services covered by this
deposit regardless of the sufficiency of said deposit to cover such indebtedness for such services.
1. I hereby request and authorize Fort Myers Beach Utilities to supply water/sewer service to the above described property until receipt
of formal notice from me requesting discontinuance of such water/sewer service.
2. I agree to promptly pay for said water/sewer service at the rates established by Town Council/Lee County Utilities Division.
3. I hereby agree to abide by the rules and regulations applicable to said water/sewer service.
4. I agree by signing up for this account that I am responsible for the monthly stormwater fee.
Signature:
Date:
Driver's License #:
________________________________________________________________________________________________________
Account Number: Deposit Amount:
Please email completed form to :
NEWACCOUNTS@FMBGOV.COM
City:
State:
Zip:
Please utilize our online service at eonlinebill.com/ftmyers to pay your bill and set up paperless billing
Office use only
