Fillable City of Glenwood Springs Electric & Water Service (City of Glenwood Springs)

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City of Glenwood Springs Electric & Water Service (City of Glenwood Springs)

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The City of Glenwood Springs Electric & Water Service (City of Glenwood Springs) form is 1 page long and contains:

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Country of origin: US
File type: PDF

U.S.A. forms for City of Glenwood Springs

BROWSE CITY OF GLENWOOD SPRINGS (CO) FORMS

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OFFICEUSEONLY
Number
Amount
Deposit Date / /
Name on ID
DL#
City of Glenwood Springs
Electric & Water Service Application
ServiceConnectDate___________/___________/____________
DateofApplication___________/____________/_____________

RENT OWN
PleaseCheckOne

Ap
plicant’sName
Service
Address
Mailing
Address
City State
Zip
E‐mail
Address
Cell# Work#
 _______________

SSN(lastfour#)orCitySalesTax/ Biz License#

IunderstandthatelectricenergywillbeprovidedinaccordancewiththemostcurrentrulesandregulationsoftheCityofGlenwoodSpringsElectricandWaterSystem.
The rulesandregulationsareavailableforreviewat
theofficeoftheutilityboardortheCityClerk’soffice.IherebyagreetopaypromptlyfortheserviceforwhichI
ambilledandfurtheragreethatmyservicemaybeterminatedafternoticeoffailuretomakesuchtimely
payments. Ialsounderstandthatservicemaybe
disconnected,andthatImaybeliabletocriminalproceedingsfortamperingwiththemetermeasuringmyserviceorfortheftofelectricenergyorwater. Additionally,I
understandthatI willberequiredtopayareconnectfeeandpossibleadditionalutilitydepositsbeforeserviceisreconnectedandthatonreferralofmyaccountfor
collection,Iwillbeliableforpaymentofallreasonablecosts,includingcourtcostsandattorneyfees.
Sign
ature Date /
/_______________
101 We
st 8th Street, Glenwood Springs, CO 81601 * 970-384-6455 * www.cogs.us
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City of Glenwood Springs Electric & Water Service (City of Glenwood Springs)

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Completed 23 January 2021

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