Fillable CITY OF FALLON PROPERTY OWNER AGREEMENT FOR AUTOMATIC (City of Fallon)

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CITY OF FALLON PROPERTY OWNER AGREEMENT FOR AUTOMATIC (City of Fallon)

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The CITY OF FALLON PROPERTY OWNER AGREEMENT FOR AUTOMATIC (City of Fallon) form is 2 pages long and contains:

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File type: PDF

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Please fill out & sign the following form digitally, or print and fill out. Then, submit it with one of the following methods:
1. Scan and email to: clerksoffice@fallonnevada.gov
2. Fax to the City of Fallon: 775-423-8874
3. Print and bring into the City of Fallon Clerk's Office.
CITY OF FALLON
PROPERTY OWNER AGREEMENT FOR
AUTOMATIC CONTINUATION OF UTILITY SERVICES
Name of Property Owner: ______________________________________________________________
Mailing Address:
Property Owner’s Designated Agent or Property Management Company:
If applicable
Property Manager’s Name: Phone No. ________________
Property Manager’s Address:
This Agreement authorizes the City of Fallon (“City”) to bill for utilities for the below listed property of
properties (collectively “Property”) in accordance with the terms and conditions applicable to the City’s
utility customers by and automatic continuation of utility services to the Property. The Property subject
to this Agreement is:
Utility Service Address(es): ** ____________________________________________________________
____________________________________________________________
____________________________________________________________
**Additional addresses covered by the Agreement are attached hereto as Exhibit “A”.
The Agreement is governed by the following terms and conditions agreed to by the parties.
1. The utility accounts applicable to the Property above listed shall automatically revert to the
Property Owner’s name when a tenant’s utility accounts for said Property are terminated.
Each time services are established in the Property Owner’s name the applicable service
charges will be applied to the account and a deposit may be required. Said accounts are the
City’s municipal electric, water, sewer, water treatment and sanitation utility system.
Street City State Zip Code
If applicable
Street City State Zip Code
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2. The Property Owner agrees to be responsible for payment of all City utility services
(electricity, water, sewer and sanitation) when the accounts are placed in the Property
Owner’s name (whether or not the Property Owner is aware that the account has been
changed to the Property Owner’s named) until such time as a tenant thereafter reapplies for
utility services or the Property Owner requests, in writing, utility services to the Property be
turned off.
3. It is the obligation of the Property Owner (or his or her tenant) to notify the City of any
changes in occupancy which may pertain to timely and proper payment of utility bills. All
notices required by the Property Owner to the City and any other changes in this Agreement
requested by the Property Owner including, but not limited to, changes in the applicable
residences and mailing addresses must be in writing. It is the Property Owner’s
responsibility to notify the City if there is a change of ownership of the Property.
4. The Agreement does not prevent the City from discontinuing utility services for nonpayment
of bills or noncompliance with the City’s utility service rules and regulations.
5. The Property Owner agrees to hold the City harmless for any claim or injury to any person or
property that might be sustained as a result of termination of service.
6. This agreement may be canceled by the City or Property Owner at any time with a 10 day
written notification. The Property Owner will remain liable for all costs incurred in the
provision of services until proper notice is received by the City.
7. This Agreement shall by cancelled if any of the City utility accounts become delinquent for
nonpayment while in the Property Owner’s name.
I have read and fully understand the terms and conditions governing this Agreement. I attest that I am
the legal record owner (or authorized agent thereof) of the real property subject to this Agreement.
As evidence thereof, I have affixed my signature.
Property Owner or Authorized Agent’s signature: ____________________________________________
Date signed: ____________________________________________
City of Fallon representative’s signature: ___________________________________________________
Date signed: ____________________________________________
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CITY OF FALLON PROPERTY OWNER AGREEMENT FOR AUTOMATIC (City of Fallon)

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Completed 1 February 2021

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